Have you tried making a complain to Bank Negara Malaysia?

Mind letting us know the reason of declination?

As a ex-GE staff, in order to decline a claim, we have to open a physical file and write down our justification and proof. Usually the whole file consist of 10+ pages for a single case and it's not an easy process to decline a claim. Last but not least, for every declination >RM5,000, we will need to present and get the approval from our Chief Operating Officer which is very tedious because he is our top management and that's the reason we don't decline case without solid proof. Whereas approving a claim is so much easier.

I think it would be fair for both Insurer and Insured if you explain the whole situation in detail especially for the mass market. If you need help in fighting for your claim, do let me know your policy number, I'm sure I will be able to help you if your case is genuine.

Hope your appeal will be accepted.

Please do update and hope all is well for you.

When u are better, please do give us more details

God Bless

Firstly very sorry to hear of your diagnosis, hope that you will get well soon. I believe you have rather a strong case here because a cyst in 2001 may not be related to cancer in 2014. Furthermore, your policy was bought way back in 1994 when the cyst was non existent then.

Suggest to write to Financial Mediation Bureau which is stated in the decline letter sent to you.

They are rather unbiased. Good luck.

Okay, that makes things much clearer.

Normally for say such disease like Cancer, getting t within 1-year of Purchase of an Insurance Policy will trigger many investigations by the Company as to whether you really knew that you were sick or was already a pre-condition, meaning it was really existing and you may or may not have known about it.

Since GE has already honored the previous policy in 1994, my personal opinion is that its going to be tough for you to fight for GE to honour based on the new policy.

You will really need some sort of supporting letters from your current doctor that in May 2013, when you bought the upgraded policy, you were not aware of the condition or your condition was non-existent.

Try to talk to your current doctor and see if they are willing to help you draft somethings along those lines.

Nay you have a speedy recovery

Few points to question... All these could be due to laziness of agent as well

1) when you say upgrade, i assume you actually mean a new policy. Always in insurance form they will ask about medical check up and results, if any. Now this has not been disclosed to insurance company. So, even if you were not aware of your condition, you did fail disclose about those medical check up.

2) and you mention doctors giving advice? You mean those check ups or what? Abit confused. If those medical check up is company related, got nothing to do with GE?

Sorry for your illness... Hope you gain a full recovery soon.

Best wishes for a speedy recovery TS!

I do not have any vested interest on the outcome of the claim either way, but with your permission, I would like to share my 2 rupiah opinion.

The summary of it is that I do not think the claim on the 2013 policy would be successful.

Insurance is a contract- nothing more, nothing less. So let's have a quick look at the components of a contract. There is the buyer/proposer, the seller/acceptor and consideration which is something of value, in this case the monetary insurance premium that the client would be paying.

One of the main difference of a insurance contract compared to other contracts, is that it is a contract of uberrimae fidei in latin which means utmost good faith. So the client is supposed to declare their health in full, to the best of their knowledge in good faith to the insurance company. The insurance companies then decide should they want to accept this proposed insurance, decline or impose any special condition to it.

By not declaring the medical condition (cyst) even though knowing about it and with doctor's acknowledgement of its existence is a breach of contract of utmost good faith. Whether or not it is a top-up policy with the same policy number or an entirely new policy is not relevant because the condition existed prior to the policy being entered in 2013 (pre-existing condition). The exception here is that companies may at certain times make an explicit waiver for health requirements declaration for certain periods or certain products (i.e. senior citizen life coverage that do not require medical check up).

The next question that may arise is that the cyst was on the right breast, whereas the cancer was on the left breast. So in tandem with the non-declaration of a pre-existing condition, we now look at whether this is a material fact. A material fact is defined as one that would make an underwriter make a different decision. Some definitions go as far as to term it 'prudent underwriter'.

If the client had disclosed the existence of the cyst when taking up the policy in 2013, would the underwriter decline the case? Would the underwriter request for a medical check up at their panel clinic? Would they impose a loading term? Would they exclude breast coverage?

We wouldn't know, but the choice of declaration is not within the scope of the client nor the agent to determine. The client is supposed to declare and let the underwriter make the decision. In that case, even if case was mistakenly approved, the burden of proof and claim then rests with the insurer and not with the client as is the case now.

The small silver lining is that the insurer would need to refund the premiums paid since 2013. You may still opt to write in to appeal based on compassionate grounds but the chances wouldn't be very high.

Once again, i wish you good health and a speedy recovery and i'm sorry i could not give you a brighter reply to your claim.

Find an honest agent. Although that’s not easy to come by. Insurance companies abide by the contract and usually not out there to cheat customer's money. You must understand insurance companies also can't have customer lying to get money from insurance companies. After all, we hope the money paid by insurance companies, really go out to deserving individuals.

The irony is TOP agent doesn’t mean the best. It means this agent brought in a lot of sales. After all, their priority is closing sales. The bigger the better. The faster, the better. A proper agent would have sat down asked the customer each question in the proposal form, ensure the customer understand the questions in it and made sure everything that needs to be disclosed was indeed disclosed so that we don’t have this non-disclosure problem.

And please don’t cancel any insurance without thinking through.

In Malaysia, all insurance companies is like this, giving them money for them to enjoy is right, claiming from them are wrong.
So I never buy insurance anymore, as the policies are not protecting my interest.