Apr 1 2016, 03:27 PM
QUOTE(kathi24 @ Feb 7 2014, 04:41 PM)
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.
but btw kathi, if the case was genuine. u have all rights to sue the insurance company and high chances to win. but finding the right lawyer is the hard part. 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.
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