I got a medical card with Allianz (umsir200) but it comes with an exception- Ovarian Cyst (that's what they wrote in the policy). So earlier this year, I tried to use the card for uterine fibroid operations, but it was rejected. Lucky I got company insurance to cover for the operation.

Now I got a bit worry. If they don't cover Ovarian Cyst, does that mean they don't cover uterine fibroids? Because for me, ovary is different organ from uterus although they are part of reproductive system. Does that mean my whole reproductive system won't be cover by the medical card? What happen if the worst thing happens and I got cancer in one of those organs (ovary, uterus, cervix). Does that mean they won't cover it too?

Talked with customer service before I submit I give the card details to the hospital, and you know la their answer- they couldn't give an actual answer and just advise to submit the application to them. I wish they could properly listed down the exception in the policy rather than just give me two words like that.

Yea, that's why I tried to request for GL to cover the operation. Got to admit I was disappointed when it got rejected.




I think I'll do that. And if they inform me that ovarian cyst = uterine fibroid in their definition, then I need to request an updated policy that excludes ALL the conditions, don't simply put Ovarian Cyst in my policy and reject my request for something that's not related to it after all.

Will consider changing insurance if the premium is cheaper or something, since I got two pre-existing conditions now if I want to swap insurance.

They didn't. I didn't receive any rejection letter or email. Just got a call from hospital to say my GL request was rejected, and do you have another insurance that we can use to cover the operation? So I gave them my company's insurance details instead. The rejection letter was probably sent to the hospital? Maybe.

Thanks for your advice. Really appreciate it. I just wish they could be clearer, if they don't cover the whole reproductive system just said so in the first place la. Now I wonder if they going to send me an updated policy that exempted both ovary-related and uterus-related conditions. Can they do that? Changing the exemption while I'm still covered under them? Which is different from the one that I signed up for? hmmm...

Thanks.

The Insurance co cannot simply impose a new exclusion if you have not made a claims against them.

However they can change or impose any new terms & conditions if you have made a claim and it is a yearly renewal policy.


Haven't claim anything from them because of the rejected GL request. I'm hoping if there is a new TnC, they should send me a copy and highlights the changes.

Question is, where is your agent ? shouldn't you be asking for his/her assistance ?

He did follow up, received mssg from him on the rejection and an apology about it. But I feel he also was subjected to the Claim Dept's final decision. I have no idea what else he can do. He thinks it was rejected because the diagnosis might be related to my pre-existing condition.

So far no reply yet from them, but I just want to settle this confusion for future peace of mind.

Thank you so much for your advice.

Edit: Smy quote doesn't seems to work

This post has been edited by River: Jun 21 2019, 11:32 AM

So... I've sent them an email about this, and more than a month later (after two follow-up emails), I've finally got a reply.



First: I've sent them the first email on 19th June, so I have no idea why they mentioned my email is dated 17 July (unless you know, they try to tweak their response time's reporting, which I'm pretty sure is a breach or something).

Second: My assumption is correct. It looks like they exclude all the reproductive system rather than exclude one condition only. Almost everything 'could be related' (their words, not mine) to menorrhagia (heavy bleeding) - Uterine fibroids can cause it (in my case), cervical cancer can cause it, heck, even kidney disease can cause it.

Third: Myoma is the scientific name for Uterine Fibroids, which wasn't excluded in the policy. I wonder why they put it in my reply.

I'm requesting a full list of diagnosis that was excluded from my policy, due to this 'could-be-related' things. I doubt they'll able to give it to me. This reply definitely doesn't give me a peace of mind that I hope for.