Welcome Guest ( Log In | Register )

Outline · [ Standard ] · Linear+

 Insurance Talk V7!, Your one stop Insurance Discussion

views
     
victorian
post Dec 10 2025, 06:02 PM

Look at all my stars!!!
*******
Senior Member
5,627 posts

Joined: Apr 2011
From: Kuala Lumpur



QUOTE(Ramjade @ Dec 10 2025, 05:27 PM)
Up to you to think if I want to twist stuff. This is just my interpretation of job description which reconfirm my belief that insurance company does not have your interest even if you buy stuff from them. On paper,  they are supposed to pay you but when time comes they try every trick to not pay out.

So the only way to win the game is play by their rules so that you give them no way to deny you claims when you want to claim. They want you to wait for 2y before use insurance. Sure. I will wait 3 years. They want me to declare, I declare je.

I learn from a blogger in Singapore do not depend on insurance when you need it. Always depends on yourself. You yourself do not have any terms and conditions. When you can have 6 figure passive income, no need for insurance. Cut yourself free. Maybe because I learnt that better to self insure Vs be at mercy of insurance companies.
*
It's not wrong to not buy insurance ya know.

Self-insurance is also a type of risk mitigating action, when you consciously save up a portion of the money for rainy days.

Then you have no one to blame except yourself.
MUM
post Dec 10 2025, 06:04 PM

10k Club
********
All Stars
14,932 posts

Joined: Mar 2015

QUOTE(JIUHWEI @ Dec 10 2025, 05:47 PM)
Yes, he can appoint and authorize someone to act on his behalf, via writing.
Otherwise, PDPA will block the person everywhere.

My point for Ramu to detail a chronology of events together with the relevant documents is to assist the claims officer to sekaligus understand the whole story and put two and two together.
The claims officer process hundreds of claims every day. There is no time for them to sit around and piece things together for one customer.
So usually we will do such work. It doesn't take long at all.
How difficult is it to arrange documents in chronological order?
*
I think, the insurance company are requesting for more documentation to do chronological events "WITH" supporting documents.
Ramu should just "assist" them to get those documentation for them to build up and support the claim case file.
Ex. When he said he had done blood tests when getting the GDL, ...then they just want the blood test reports to see what were tested and the result of all the items tested. To see if there are any issues which the insured did not disclose.


Attached thumbnail(s)
Attached Image
Wedchar2912
post Dec 10 2025, 06:24 PM

Look at all my stars!!
*******
Senior Member
3,665 posts

Joined: Apr 2019
Honestly, it’s quite a sight to watch. A huge firm hides behind layers of paperwork, process and bureaucracy; most of which they designed themselves, to slowly suffocate a claim instead of settling it. Less about finding the truth, more about exhaustion by compliance. After all, forms must be respected; people, optional. devil.gif

Then again, at some point, it’s hard to even feel sorry anymore. He should have known better how this game works. HBP? Obviously that magically links to everything, including cancer, right? brows.gif doh.gif

But hey, the well-oiled profit machine must keep running. So many mouths to feed, especially agents. And full disclosure, I'm not pretending to be holy here. I do invest a sizable amount in insurance companies too... just not the ones operating in Malaysia. Time to look at rebalancing. drool.gif

This post has been edited by Wedchar2912: Dec 10 2025, 06:24 PM
Wedchar2912
post Dec 10 2025, 06:31 PM

Look at all my stars!!
*******
Senior Member
3,665 posts

Joined: Apr 2019
QUOTE(MUM @ Dec 10 2025, 06:04 PM)
I think, the insurance company are requesting for more documentation to do chronological events "WITH" supporting documents.
Ramu should just "assist" them to get those documentation for them to build up and support the claim case file.
Ex. When he said he had done blood tests when getting the GDL, ...then they just want the blood test reports to see what were tested and the result of all the items tested. To see if there are any issues which the insured did not disclose.
*
I just read the pic you attached.

Don't know what to say... want to pity the chap also I don't know to. At end, easier to just ignore.


Imagine this...

Dear Mum, i know you are healthy now and not suffering from cancer stage 4 at least.
But we would like to do a full audit... please provide full details of all your medical condition from 2017 to 2023, all doctor visits, a report from all the doctors and each visit...
If you fail to do so, all future medical claims will be invalidated.

ps: at least I am being kind and ask all these paperwork while you are still healthy. Finally, thank you for paying your insurance fees all this while. Much appreciated.


not sick also will vomit lar after reading rite?... confused.gif

This post has been edited by Wedchar2912: Dec 10 2025, 06:33 PM
MUM
post Dec 10 2025, 06:41 PM

10k Club
********
All Stars
14,932 posts

Joined: Mar 2015

QUOTE(Wedchar2912 @ Dec 10 2025, 06:31 PM)
I just read the pic you attached.

Don't know what to say... want to pity the chap also I don't know to. At end, easier to just ignore.
Imagine this...

Dear Mum, i know you are healthy now and not suffering from cancer stage 4 at least.
But we would like to do a full audit... please provide full details of all your medical condition from 2017 to 2023, all doctor visits, a report from all the doctors and each visit...
If you fail to do so, all future medical claims will be invalidated.

ps: at least I am being kind and ask all these paperwork while you are still healthy. Finally, thank you for paying your insurance fees all this while. Much appreciated.
not sick also will vomit lar after reading rite?...  :confused:
*
I think, they won't want to spend any resources on me, to give them any documentation as they need to spend resources to process it and other possible legal entanglement that may arise.
I dont claim they dont care.....
If only when I claim within x or xx yrs, then they will ask.
I think if the policy had been in place for xx yrs, they will not ask unless or maybe when they suspect it is congenital cases.

Wedchar2912
post Dec 10 2025, 06:46 PM

Look at all my stars!!
*******
Senior Member
3,665 posts

Joined: Apr 2019
QUOTE(MUM @ Dec 10 2025, 06:41 PM)
I think, they won't want to spend any resources on me, to give them any documentation as they need to spend resources to process it and other possible legal entanglement that may arise.
I dont claim they dont care.....
If only when I claim within x or xx yrs, then they will ask.
I think if the policy had been in place for xx yrs, they will not ask unless or maybe when they suspect it is congenital cases.
*
yeah... this could be the reason everyone says don't ever use your new medical card for at least 2 to 3 years...

now the new advice is to buy medical insurance when very young... allow the insurance firm to earn free premium for 10 years by not claiming anything for 10 years... innocent.gif
MUM
post Dec 10 2025, 06:53 PM

10k Club
********
All Stars
14,932 posts

Joined: Mar 2015

QUOTE(Wedchar2912 @ Dec 10 2025, 06:46 PM)
yeah... this could be the reason everyone says don't ever use your new medical card for at least 2 to 3 years... 

now the new advice is to buy medical insurance when very young... allow the insurance firm to earn free premium for 10 years by not claiming anything for 10 years...  innocent.gif
*
Ha ha ha, ..sort of like some suggested younsters to get a credit card, use and pay annual fees and some personal loan with interest and pay on time, ...just to build a good credit score track record for better chances of getting a loan later in life.
victorian
post Dec 11 2025, 09:01 AM

Look at all my stars!!!
*******
Senior Member
5,627 posts

Joined: Apr 2011
From: Kuala Lumpur



QUOTE(Wedchar2912 @ Dec 10 2025, 06:31 PM)
I just read the pic you attached.

Don't know what to say... want to pity the chap also I don't know to. At end, easier to just ignore.
Imagine this...

Dear Mum, i know you are healthy now and not suffering from cancer stage 4 at least.
But we would like to do a full audit... please provide full details of all your medical condition from 2017 to 2023, all doctor visits, a report from all the doctors and each visit...
If you fail to do so, all future medical claims will be invalidated.

ps: at least I am being kind and ask all these paperwork while you are still healthy. Finally, thank you for paying your insurance fees all this while. Much appreciated.
not sick also will vomit lar after reading rite?...  :confused:
*
Insurance company are running a business, they are not your “family members” per se and does not have obligation to pity you.

Now if you are already with them for 10+ years, of course the trust will be there, making the claims easier. But if you just joined for 2 years, there is bound to be some scrutiny, whether this meet newly joined fella is in to take advantage of his situation etc. Not until the extend you cannot claim, but you have to cooperate if they request for more information.


QUOTE(MUM @ Dec 10 2025, 06:41 PM)
I think, they won't want to spend any resources on me, to give them any documentation as they need to spend resources to process it and other possible legal entanglement that may arise.
I dont claim they dont care.....
If only when I claim within x or xx yrs, then they will ask.
I think if the policy had been in place for xx yrs, they will not ask unless or maybe when they suspect it is congenital cases.
*
You can still claim within 2 years, but they will scrutinise your claim more. Hence, if it’s really not urgent, try to postpone as late as possible to avoid the scrutiny.

If a policy has been active for 10 + years, chances are the condition developed when you are still insured, hence less chance it is Pre existing
JIUHWEI
post Dec 11 2025, 09:38 AM

Regular
******
Senior Member
1,334 posts

Joined: Nov 2008
QUOTE(MUM @ Dec 10 2025, 06:41 PM)
I think, they won't want to spend any resources on me, to give them any documentation as they need to spend resources to process it and other possible legal entanglement that may arise.
I dont claim they dont care.....
If only when I claim within x or xx yrs, then they will ask.
I think if the policy had been in place for xx yrs, they will not ask unless or maybe when they suspect it is congenital cases.
*
Only congenital conditions detected before the age of 17 and below are excluded.
GalaxyV
post Dec 11 2025, 09:50 AM

Enthusiast
*****
Junior Member
788 posts

Joined: Apr 2018
Looking for self service plan. Any recommendation?

My case: https://forum.lowyat.net/index.php?showtopic=5548741&hl=

This post has been edited by GalaxyV: Dec 11 2025, 09:51 AM
MUM
post Dec 11 2025, 10:50 AM

10k Club
********
All Stars
14,932 posts

Joined: Mar 2015

QUOTE(GalaxyV @ Dec 11 2025, 09:50 AM)
Looking for self service plan. Any recommendation?

My case: https://forum.lowyat.net/index.php?showtopic=5548741&hl=
*
I think, just think, ..
If you hv self service plan, that means "self service" ....no insurance provided human assistance?

If that is true and legally binding, ...then prepare in advance who to assist you in running around getting those required documentations requested by the insurance company when they process your claim submission.
That person whom you had predetermined need to know what, how and where to get and you maybe must also need "authorises that person in advance......just in case you are bedridden and too weak to communicates.

Read back the last few recent pages, to get a brief idea of "possible" difficulty after submitting a claim even with a human agent friend assisting.
GalaxyV
post Dec 11 2025, 10:59 AM

Enthusiast
*****
Junior Member
788 posts

Joined: Apr 2018
QUOTE(MUM @ Dec 11 2025, 10:50 AM)
I think, just think, ..
If you hv self service plan, that means "self service" ....no insurance provided human assistance?

If that is true and legally binding, ...then prepare in advance who to assist you in running around getting those required documentations requested by the insurance company when they process your claim submission.
That person whom you had predetermined need to know what, how and where to get and you maybe must also need "authorises that person in advance......just in case you are bedridden and too weak to communicates.

Read back the last few recent pages, to get a brief idea of "possible"  difficulty after submitting a claim even with a human agent friend assisting.
*
so insurance like those said, a scam?
MUM
post Dec 11 2025, 11:01 AM

10k Club
********
All Stars
14,932 posts

Joined: Mar 2015

QUOTE(GalaxyV @ Dec 11 2025, 10:59 AM)
so insurance like those said, a scam?
*
If you think and strongly believed that you had been scammed by them, ..
You can always contact FMOS and BNM for resolutions
Wedchar2912
post Dec 11 2025, 11:43 AM

Look at all my stars!!
*******
Senior Member
3,665 posts

Joined: Apr 2019
hahaha.... of course... after paying obediently and not claim anything for 10 years, sure lah good relationships....

trying to claim within 2 years is bad relationship... lol. like what everyone been saying, better wait 3 years... or best still, 10 years. Else regret also cannot cry... console.gif

hence I also agree with you. Its all biz.. a well oiled biz... luckily I invested a decent amount in insurance firms overseas. Its time to look inwards towards those in Malaysia... brows.gif








QUOTE(victorian @ Dec 11 2025, 09:01 AM)
Insurance company are running a business, they are not your “family members” per se and does not have obligation to pity you.

Now if you are already with them for 10+ years, of course the trust will be there, making the claims easier. But if you just joined for 2 years, there is bound to be some scrutiny, whether this meet newly joined fella is in to take advantage of his situation etc. Not until the extend you cannot claim, but you have to cooperate if they request for more information.
You can still claim within 2 years, but they will scrutinise your claim more. Hence, if it’s really not urgent, try to postpone as late as possible to avoid the scrutiny.

If a policy has been active for 10 + years, chances are the condition developed when you are still insured, hence less chance it is Pre existing
*
brandonkl
post Dec 11 2025, 12:00 PM

-
*****
Junior Member
997 posts

Joined: May 2013
From: Kuala Lumpur


There's a Prudential plan, Pruvalue Med with Booster that have RM18 million coverage.

Isn't that a lot even for most serious critical illness?
cooldog_777
post Dec 11 2025, 12:11 PM

Getting Started
**
Junior Member
65 posts

Joined: Apr 2022


don't know where you guys learn the 2 or 3 years rule.
Amazing.. I have been in this industry for so long, first time hear this.
if you really need medical attention, u can claim immediately.
Except those pre-existing illness which have waiting period.
Tell u guys, insurance is not scam. Can claim or not, actually depends a lot on the doctors report. doctor kena pandai pandai cerita sikit.

victorian
post Dec 11 2025, 12:28 PM

Look at all my stars!!!
*******
Senior Member
5,627 posts

Joined: Apr 2011
From: Kuala Lumpur



QUOTE(cooldog_777 @ Dec 11 2025, 12:11 PM)
don't know where you guys learn the 2 or 3 years rule.
Amazing.. I have been in this industry for so long, first time hear this.
if you really need medical attention, u can claim immediately.
Except those pre-existing illness which have waiting period.
Tell u guys, insurance is not scam. Can claim or not, actually depends a lot on the doctors report. doctor kena pandai pandai cerita sikit.
*
No written rule on this but its common sense that the shorter the policy duration, there will be more effort from the claim officer to investigate your claim, especially for conditions/surgeries that are optional and can be hidden during policy underwriting.
MUM
post Dec 11 2025, 12:39 PM

10k Club
********
All Stars
14,932 posts

Joined: Mar 2015

QUOTE(brandonkl @ Dec 11 2025, 12:00 PM)
There's a Prudential plan, Pruvalue Med with Booster that have RM18 million coverage.

Isn't that a lot even for most serious critical illness?
*
If one is now 25 yrs old at 75 yrs old (50 yrs later) 18 mil may seems not so much,....but the premium to be paying to sustain it may be too much for retiree at 65-85 yrs old without large passive income
victorian
post Dec 11 2025, 12:53 PM

Look at all my stars!!!
*******
Senior Member
5,627 posts

Joined: Apr 2011
From: Kuala Lumpur



QUOTE(brandonkl @ Dec 11 2025, 12:00 PM)
There's a Prudential plan, Pruvalue Med with Booster that have RM18 million coverage.

Isn't that a lot even for most serious critical illness?
*
That's why they are not afraid to offer this rider, because the base is 8 mil which is already a lot to begin with.

It sounds good on paper but chances are you are not going to utilize it.
Ramjade
post Dec 11 2025, 01:26 PM

20k VIP Club
*********
All Stars
24,388 posts

Joined: Feb 2011


QUOTE(cooldog_777 @ Dec 11 2025, 12:11 PM)
don't know where you guys learn the 2 or 3 years rule.
Amazing.. I have been in this industry for so long, first time hear this.
if you really need medical attention, u can claim immediately.
Except those pre-existing illness which have waiting period.
Tell u guys, insurance is not scam. Can claim or not, actually depends a lot on the doctors report. doctor kena pandai pandai cerita sikit.
*
There is a 2y waiting period for most of the disease. Anything else other than the disease or accidents are fully covered. If you have high blood pressure, diabetes, heart attack, stroke, cancer, gastric you pay and claim first if less than 2 years cause the insurance company want to investigate to see if you cheated them of money. If you are clear, then insurance company will honour the payment.

But after 2y they won't investigate unless you commited some fraud. So admission all approved.

Now the question who can come out with say RM50k on the spot?

This post has been edited by Ramjade: Dec 11 2025, 01:34 PM

389 Pages « < 385 386 387 388 389 >Top
 

Change to:
| Lo-Fi Version
0.0187sec    0.61    6 queries    GZIP Disabled
Time is now: 15th December 2025 - 12:06 PM