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 Insurance Talk V6!, Everything about Insurance

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dragonlady P
post Jan 27 2021, 01:12 AM

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QUOTE(wykoh2 @ Jan 22 2021, 04:15 AM)
Hi, anyone can update on the private hospitalise for covid patient? I saw my AIA agent friend update that only AIA accept private hospitalise for covid patient?
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What AIA is doing is merely a marketing gimmick. Inside your policy it will state hospitalisation benefits. For example if you go to government you get for example rm60/day allowance. Or if you go to private hosp you get rm200 allowance. Now they just turn it around and say you get covid coverage. It’s a pay and claim basis coverage and SUBJECT to “reasonable and customary charges”. So if your bill is rm40k for instance but what is considered reasonable and subject to customary charges is only rm2k for example. So the other rm38k come out from own pocket la.

Always know what your financial rights are. Have an awareness of the timebombs in your policy.
dragonlady P
post Jan 29 2021, 02:24 PM

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QUOTE(ckdenion @ Jan 27 2021, 09:05 PM)
hi wykoh2, yeap basically they will cover expenses if admitted to private hospital due to COVID. reason being is because their medical cards do not have this exclusion clause that excludes "communicable disease that requires quarantine by law"

COVID-19 falls under this exclusion. so without this exclusion clause, there is no right AIA can reject the claim due to exclusion. but there are a few TnC applies.
- from what I know, you cannot just simply want to seek treatment for COVID from private hospital. you need to go to government hospital and if government hospital refers you to private hospital, then only this treatment can be submitted for claims.
- there is no cashless claim facility for admission due to COVID-19. in another words, you must pay all the bills incurred then only submit it to insurance company to claim (subject to Reasonable and Customary Charges). for example certain items wont be cover like doctors PPE suit, face mask face shield and etc...
hi dragonlady, I wont say that AIA is doing marketing gimmick. more like agents are the one who use this point to do marketing. AIA has to cover because of the reason above i stated to wykoh2
hi taiping... not to say catch... more to TnC. can refer to my reply above.
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Isn't this just hospitalisation benefit at the end of the day? So if the government refer you to private hospital because of COVID then only you can claim this hospitalisation allowance for up to rm6k max 30 days which is the rm200/day allowance. It is a product that has existed before covid but now it's being sold as to cover ur covid expenses. I du lan a bit cos that day the agent hard sell to me like crazy but when i ask him if i suffer from complications end of the day capping limit only 6k right. then he cannot answer. so yeah..

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