Just reminder, to everyone else.. What the above poster has mentioned here, and what mr Ramjade has also said, are hearsay and no basis. I will say even the hospital staff is also hearsay because they also don't know how the process really works in an insurance company
The conversation in the last few post seems to imply the person working at certain insurance companies or certain companies, will happily decline claims.
It's abit like the auntie talk in a restaurant, saying the worker very stingy with food, dont want to give me more tea or more soup. Honestly, if the worker is not the owner, the worker just dont give a damn. they do enough not to get scolded by boss, and they do enough to please the customer, so they would have follow the SOP set by their boss. they really not in there to save money for their boss by giving less tea or soup to the customer.
Now using this analogy and apply to a corporate setting, the employees dont go to office thinking how many claims i want to decline so the company earns more profit. the employee is there, show up, analyse claims, dont get scolded by boss, do work according to SOP, clock out and go home. To decline claim, later the hospital call, the customer call, the agent call, so much work to handle.
I dont work in claims, i just apply normal logic. We all have to remember these are normal employees. i am just a normal employee too. i dont go into office thinking how i can strategise for my employer increase profit by 30% to hit RM100mil RM200mil profit or whatever.
Yes, one can argue, what i have said also hearsay and no basis. but hey... i lay out good analogy at least..? and my past contribution should count for some credibility right?
Good night, happy new year
Yes, and I refuted OP based on true experience and I made it clear 2nd point is based on hearsay, it is included as a suggestion on why some cases are delayed/rejected.
Tbh, some posters here made it sound like insurance is a money game scam where early birds reap the benefit and those that don't exit the game bears the loss. If insurance is so unreliable, why even bother getting it ?