What are you trying to claim? From two insurance company for the same amount or the difference? Say if the bill is Rm 30k, and your company only allow you to claim Rm20k. Are you trying to claim from the second insurer another Rm30k or Rm10k?

Use common sense

If u buy RM100K and RM150K medical limit

Of course u would claim from B if u got a claim of RM120K for example

1. for medical bill i know... we can only claim by using original documents , let say the my single medical card policy is enough to support the medical cost but
what if the medical cost need to take some claim amount from my 2nd medical card policy? how do we get 2 original copies to the two different insurer?



2. i was referring to original death/TPD .... let say i have few life policies from different companies and i wanna to claim all of it at the same time. The death
certificate/ medical reports (TPD) must be in certified true copy by the lawyer firm right? so it can be certified up to how many copies we want right?

This post has been edited by mcfeemo: Jul 13 2013, 11:26 AM

1)Medical bill is only claimable with original documents. The reason due to it is to avoid fraud(double claimant of hospital fees).

However, From Great Eastern(I'm not sure the term&condition from other company) that it's claimable from the second card if the first card is out of limit.

Well, how does it works?
When ones hospitalize for RM120,000. He is having a card with Zurich annual limit RM50,000 and Great Eastern limit RM100,000. He able to claim the first RM50,000 using Zurich medical card cashless. But, he has to prepare RM70,000 cash to pay the hospital first then only it's reimburseable by Great Eastern.

Well, why don't I use Great Eastern card first then I pay RM20,00 cash and get back RM20,000 by reimbursement from Zurich?
I'm not sure either other companies allow claim from second card. If you have claimed RM100,000 from Great Eastern but the RM20,000 is not claimable from Zurich then it's too bad.

You said insurance company only accept original medical bill?
For the above case, you or your agent have to submit Great Eastern the bill certified true copy bill by Zurich.

In Great Eastern, other company co-insurance or deductible is also claimable in Great Eastern.
Refer to the attached file page 2 for your reference with example and scenario.

2)Yes, death certificate is claimable with certified true copy by Commissioner of Oath. for all the insurance companies.

I have been in this industry for long, I'm a Great Eastern scholar and also previously work in Great Eastern as Management Trainee staff, I have been designated from Claim/Agency/Customer service/Health care services/Actuarial/Product marketing within a year. I know the processes and procedure very well.

However, I'm now a full time agent from Great Eastern, do pm me if you are interested in getting a new policy or have doubt in insurance's procedure.

This post has been edited by ExpZero: Jul 13 2013, 01:43 PM


Attached File(s)
 SmartMedic_PWU_20130617.final.pdf ( 243.33k ) Number of downloads: 27

Not really. I'm not sure about other medical cards. But with Prudential medical card... no worries.

I was admitted to GMC Penang in 2010 for surgery. Below are the documents I submitted to Prudential (reimbursement method):
1. Summary of Claims (letter) from other insurance company stating which is claimable and which is non-claimable (scanned copy -- as I do not have original copy)
2. Certified true copy of medical bills by GMC Penang.
3. Photostat copy of medical report (hospital said they cannot certified true copy for medical report)

I got my cheque 2 weeks after submissions
The only thing which is not claimable is RM10 of registration fee


I have another new medical card which is Great Eastern (SM200). But I'm a bit worry about this card.
My friend admitted to GMC Penang 2 years ago using his GE medical card (SM200) due to food poisoning, he has to bear the injection (to relief the pain) cost (RM100 - RM200). Not all medical expenses are claimable.
Another friend of mine was admitted to GMC Penang (for 2 days) using standalone GE medical card due to complication after stung by bees. GE does not allow doctor to use any medical equipment for my friend's case.


I believe not all insurance companies are same. So it is better for you to clarify with your insurer.

Hi ExpZero,

Thanks for sharing "SmartMedic_PWU_20130617.final.pdf".
Glad to know GE has revamped the medical plans. The best thing is new benefits also apply to old policy holder without any charges.

Hope to see further improvement.
Please keep us updated. Thank you

E.g medical bills and 36CI claims..
My colleague fainted during office working hour and we sent him to hospital and Dr/Specialist performed angioplasty
test and found that he have 3x blocked/clogged/hardening artery. Operation Bills includes inserting a catheter (thin tube) into
vessels and passing a device (tiny balloon) through the tube to open the artery costed him total RM80K ..
He submitted medical report expenses using medical card from 2nd medical card insurance(company B).
Medical Report and Medical Bill = 1x original bill.. Now, he want to claim 36 Critical Illness from insurance company A but do not have genuine medical report and medical bill

Conclusion:-
Medical Report (Original/Genuine) = 1 .. Medical Bill = 1 (RM80k)
Medical Card (Company B for the past 3 years ) with higher limits= got the medical report during claim submission.


Whole Life c/w TPD, 36 CI, Saving/Investment, PA and Medical Card (Insurance Company A for the past 15yrs) = cannot claim 36CI ( rm100k), as original medical report has submitted to Company B as above. Note:- Medical Card for this company A got lower limit(as 6-in-1 package)
compared to high medical card limits of company B.

During emergency case like above, will you want to claim 1) Medical Card/Bill Cost or 2) 36 Critical Illness ?? For average/poor ppls.
Good Thoughts..

This post has been edited by netmask8: Jul 13 2013, 11:44 PM

Is doctor willing to fill up 2 set of forms? One for Company A. Another set of form for Company Z?

Sorry, it's quite hard for me to understand your statement.
yes, with payment.

For the medical card portion, you can only claim up to maximum of the bill, in this case Rm80k. Since it has been taken care off by the 1st insurer, you cannot claim the medical portion from 2nd insurer to get Rm160k.

As for the CI, you can get the hospital help to fill up the CI report, which you can get from the insurer if the agent is no longer around. The hospital is also able to provide certify true copy of the bill and report but your friend will need to pay for the report.

It is best to bring the policy document to the insurance company and to understand which part of CI can be claimed, if the agent is no longer with your friend.

Hmmmmm very complicated situation

Get hospital to fill up the CI report is not the same with copy of the bill and report ?

Need original medical bill and medical report to claim 36CI from insurance company B ..
The original medical bill and medical report is already submitted to claim medical card expenses from insurance company A.
He checked with the insurance company B agent, he is no longer in insurance field, BUT his upper line/insurance mgr is
be the new servicing agent for him and want ORIGINAL bill/medical report.. This upper line/insurance mgr is got 18 yrs experiences..

As for the case of Prudential, the attending Doctor will help to fill up a report for CI claim. This form is provided by Prudential and is to be submitted with the policy document along with the certified true copies of the medical report.

Take note the report MUST tally with the insurer definition for CI. So its best to discuss with the Doctor

Certified copy is sufficient. BTW, which insurance company is the B insurance? Perhaps agents here are able to guide you in more specific.

This post has been edited by roystevenung: Jul 14 2013, 09:48 AM

It is my colleagues whom happen recovered thru artery surgery and now, he go through all the insurance plans he bought..

He will call up his insurance agent or the claim dept and seek proper/right documents.. BUT, the medical
bill (original/genuine) = 1 .. have been submitted..Let him clarify from insurance company on the documents on
claiming 36CI .. If not sure, callup insurance agent or claim dept for right informations.Don't make own assumption/conclusion.
A phone call may be useful in clearing all the doubts/mess ..

-Double Post-

This post has been edited by netmask8: Jul 14 2013, 03:24 PM

Yes, don't make any assumptions. There is a procedure to follow when it comes to claims and each insurance company have their own procedures. I'd advise to deal thru email, at least there is a black and white communication.

But like I said, the doctors report MUST TALLY with the insurer's definition of Critical Illness. The only way to determine this is to get an agent's or help over the counter, if he/she is uncertain of which CI to claim from.

How would anyone know beforehand which medical card to use when admitted to hospital? In common sense, human will choose medical card with highest annual credit limits as nobody know how much will it cost.

2nd is why having 2 medical card? I would choose to have a 450k annual credit limits for my medical card to avoid all those troubles. Of course everyone want that but it's too expensive. I would say yes if you buy with investment link or saving plan. I bought a standalone and I have no problems of the discussed issue above. It only cause me rm112 per month. 3 yrs back i was paying rm300 per month with room and board rate = rm150. As I noticed it is not even enough to cover basic sharing room rate at hospital. I switched to pacific insurance medical card with my room and board rate at rm 350 much higher than my previous 1 and i only pay rm112 per month. I have saved 188 monthly and i put in to investment and it's more than what i saved in insurance link fund and the most best part is i can withdrawn anytime without any interest compare with insurance company. Be wise all of you.

any agent servicing KL area ? please pm me. thanks !

No offence bro, a good friend of mine is doing Pacific, it's cheap but please read the T&C.