I am very frustrated and angry with Great Eastern Insurance Company.     

A month ago, I brought my mother for treatment to Sime Darby Medical Center, as my mother was experiencing PR bleeding (bleeding when she goes to toilet) and stomach pain for 3 days continuously. The doctor has stated the illness as "Colitis", and has urged my mother to be admitted and undergo endoscope and other necessary treatments ASAP.

But, to my shock, Great Eastern has declined the admission Guarantee Letter (GL) . When I called their customer service asking for the reason, they were giving many reasons such as my mother is a new customer (11 months old), no sufficient information,  they suspect this might a pre-existing illness and many more. After numerous phone calls, I was still not able to understand on what basis or exclusion term they have declined the guarantee letter. They are just guessing that it could be this or that or this, and based on that, they are declining me my benefits. When I asked them to justify and validate their speculation, they said they will need to investigate and that will take approx 2 to 3 months. How could a patient wait for 3 months? Are they out of their mind?

The next day I brought my mother to Selayang Gvt Hopt for treatment.

Then, I have submitted an formal written complaint to the insurance company, and they responded, giving me the same biased reasons, which I am not willing to accept. I feel cheated by this company and I have lost my trust in this company. They are giving many invalid reasons to deny GL for a genuine case. I have asked to terminate my mother's policy, and full refund of the premiums that I paid, but they resisted on that.
I am thinking of taking legal action against this company, if its posibble. Hence, I would like to get advice if the case can be fought in court, and what are the chances of winning.

Please help. I feel that this company is cheating me.  Despite my mother being a medical insurance holder, I still had to bring her to government hosp where the waiting list for treatment is longer. They are taking my money, but not giving me what I deserve.They are not being fair. I want justice. Please advice.

Thank you.

where is ExpZero

he sell great eastern u can ask him

https://forum.lowyat.net/index.php?showtopi...&#entry66189024

ExpZero Summoning.... pls help?

bro, if let say someone change/upgrade their medical card plan after 1 year, GE will still decline the GL for investigation purpose?

Hi Exp Zero,

Thank you for your reply. Really appreciate it.

But why the SOP is not being made aware to the client? It is never mentioned in the policy or by the agent that cases within 1 year time will require stupid 2 to 3 months investigation. Why it is never mentioned to the client? It is not even in GE policy. If they have mentioned that, I have made a better decision not taking this stupid insurance that do investigation for 2 to 3 months. This is a medical necessity and waiting for 3 months is really not rational at all.

And why I need to pay first when I'm having the medical card? I should be enjoying the GL benefit, unless there is a valid reason like for example my mother case falls into any of the exclusions. That I really can accept.

But now there any giving excuses like they are no sure, and there is not enough information. What in supposed to do if there is not enough information? I have forwarded all the documents given by the doctor. So now GE except clients to do research and find out information regarding the illness before admission to the hospital. What the hell? When they are selling, none of this were mentioned either by the agent or in the policy.

Really, based on my experience, GE is being unethical and biased. They don't really care about their client. Their so called SOP sucks, and client is not even made aware of that. Please don't choose GE, if you want your life really assured.

I really want to terminate my mom's and my policy with the company. Just tat I want my money back,  but the stupid company dowaan to give back my money. I mean I never have claimed nything from them, so it is fair enough for me to get me back my money, but this the company said can't give. Blood suckers. Wants people money, but not giving them wat they deserve.

Truely agree. I also piss off with GE agent. If there is any reputable insurance company that allow customer to purchase insurance via online, i'm very very much interested and terminate my lousy insurance policy!

Example is fundsupermart to allow customer to buy unit trust via online and bypass unit trust agent!

End of the day, Great Eastern is lousy insurance company. What do you expect from Singaporean company? They all just want to take your premium but not pay when you claim. So many people I know complain about the same thing with Great Eastern.

I think last time even their staff also complained and had street protest and demonstrations outside their HQ in Jalan Ampang? Any company where the staff have picket demos and complaints can't be good. MAS last time also the same and look at it now.

better wait for the investigation result.

if the result is not in ur favor then only terminate

I have never believe in any part of the insurance selling which basically say that a medical card will get you admitted into a private hospital.

The most tangible entrance fees for admission that a private hospital look to is credit-card or cold hard cash. Insurance medical card really is second rated.

Besides, I heard that it is common practice that private hospital bump up the charges when they deal with insurance claim vs a cash paying customer. This could also draw down the insurance claim limit faster than necessary.

TS, in your case, you could always pay first for the private hospital, and claim back later. If you have beyond reasonable doubt that it is not an existing pre-condition, GE cannot deny you your claim down the road. You could always decide on cancelling the insurance AFTER the claim if GE did not serve your needs and expectation.

Great eastern medical card is "As charged" or "As charged subject to reasonable medical fee" ?

How to find the price of the medical cost for the GE as charged price list?

Some Insurance Companies have Bancassurance Partnerships with Banks, meaning u can buy selected Insurance Products at Banks, and sometimes, the products are priced lower compared to Agent products

Great Eastern - partners OCBC
Prudential - partners Stan Chart and UOB
AIA - Partners Public Bank (due to former agreement with ING)
Tokio Marine - Partners RHB Bank
Sun Life - Partners CIMB

Bank owned Insurance Compaies

Etiqa - Maybank
HLA - Hong Leong
AmLife - AmBank
AXA Afin - Affin Bank

I am having similar situation recently. In the midst of appealing now.
GE declined my claim with reasons which is not acceptable.

In short:
--> the time they approach, anything CAN CAN CAN.
--> the time we need claim, they will decline with all kind of funny funny reasons to leceh us.

         

I am a strong believer of having sufficient or rather more than sufficient insurance in one's life and this coverage should move upwards or downwards accordingly to the changes in one's life and earning capability. Somehow, I do agree with the caliber and integrity of most insurance agents in Malaysia sucks big time as I personally witness how a young lady who just joined the industry keep insisting me to get my investment link policy way beyond what I can afford and after which, I realized she did that because she is trying to hit some target set.

Nonetheless, like all industries, there are the bad rotten apples, at the same time, there are the good and honest one. I am glad I have found one. Trust me when I said I am a good reader of insurance agents as I have seen far too many. From my days in London to Singapore to now Malaysia. First time in my life my insurance agent advise me against buying 3 policies from her in one go as she find that the financial impact on me will be great and advise me accordingly which one to go for first and subsequently slowly up the ante.

After reading 4-5 pages of this thread I happened to come to a conclusion which I guess not many will agree as well. Insurance company is just another business entity operating for the sake of profit generating, well even the hair saloon you cut your hair is operating for money. One day when you realised your hair style done by the hair saloon is not as good, will you ask for  your money return and go around telling everyone that the hair saloon cheated your money etc? My guess is no and why is that so? The business model is almost identical, Hair saloon is making money out of you by providing a service to you and hair stylists are like agents bridging the market gap between you and the hair saloon. There are good hair stylist and there are bad one, so when you happened to find one good one. Please stick to him/her and frankly speaking, it is of no fault from the company point of view.

At the same time, I find insurance knowledge from majority Malaysians is severely lacking (applies to agents as well) Many have no idea when to make known their medical condition to the insurance company and when things happened, they start calling for the head of the insurance companies. Hey com'on, if you were to buy a used car and after taking the car out of the dealership, immediately the engine dies off. Would you blame the dealer for not telling you the existing problem with the car? Or would you take full responsibility and pay for repair on your own? Metaphors are all around us just that due to the lack of sufficient insurance coverage knowledge, many are led by the nose of their "trusty" insurance agents and omit declaring or under declare their existing or known condition which eventually haunted them.

I read all policies given to me before I sign the acknowledgement slip. I declared all medical conditions regardless how mild or insignificant it is (even my agent commented how detail I am). I even have a full discussion with the panel doctor when I go for my check up. When I need to make a claim, I always call my agent up and get her to advise me on what to say and what to do when I see the doctor. I noticed many times people tends to downplay their condition in front of doctor which eventually caused the medical report issued by the doctor to completely downplay your condition as well. This eventually become your problem when you want to process a claim.

Currently I holding 3 policies and each is around 30% above my expected payout because I like to be sure that my family is well taken care of if something bad happened to me. So far, I feel GE has been quite professional in dealing with my case as even for my generic skin condition - eczema, they requested previous medical report from my GP in Singapore.

If anyone stated that they do not need any insurance policy, I really do hope you earn much much more than the rest of us and yet have much much less commitment than the rest of us. Oh ya, please at least ensure your car is insured, why? Because if you accidentally bumped into mine, I will like to claim from your car insurer. At least that is protection I expect to have as a fellow road user. Protection for your family remains your personal call. I pray for good health and great life to you if you decided not to be insured.