https://www.thestar.com.my/news/nation/2021...surance-company


From the star today, what do you guys think? Honestly it makes me furious! One anxiety attack has no relation to cancer, can they do this?:

KUALA LUMPUR: The High Court here has recorded a consent judgment between a 42-year-old cancer patient and an insurance company in a RM2.5mil lawsuit she filed against the latter.

In the judgment recorded before Judicial Commissioner Liza Chan Sow Keng here on Monday (March 29), businesswoman Tan Siew Wei and Great Eastern Life Assurance (Malaysia) Bhd achieved a full and final settlement in one of the two insurance policies she is claiming for.

In the settlement, a sum of RM500,000 was to be paid by the defendant to Tan as a full and final settlement of all the claims and demands which Tan has against the defendant, in respect to the particular policy.

Tan, who was diagnosed with Stage 4 cervical cancer in 2019, had sued the company for rejecting her critical illness insurance claims on allegations that she had broken the policy clause with a non-disclosure on her mental state, where she was diagnosed with an anxiety attack in February, 2017.


She is suing the company to claim for RM500,000, which is the basic sum assured from the first life insurance policy, and another RM2mil, the basic sum assured from her second life insurance policy.

The court ordered for the settlement sum to be paid before April 1 and did not make any order as to costs.

Neither party would have any further claim against the other after the settlement is completed. The policy shall be terminated with all the benefits and rights provided under the policy to cease.

Tan's lawyer Ng Kian Nam said hearing for the RM2mil policy continues on April 14.

In the statement of claim filed on Aug 12, last year, Tan said she bought the first policy in 2015 from Great Eastern with a half a million basic sum assured and a monthly premium of RM600 payable for 20 years.

In 2018, she signed up for a second policy with a RM2mil basic sum assured and a monthly premium of RM1,666.70 payable for 61 years.

Before entering into the agreement on both policies, Tan said she had truthfully filled in her information in the forms and made full disclosures in line with the Financial Services Act on her health, including declaring that she did not have depression or anxiety at all material times.

On Dec 27,2018, the plaintiff said she gave birth to her fourth child at a private hospital in Cheras and the next year, she was diagnosed with cancer.

She subsequently made insurance claims on critical illness from the defendant, as well as other insurance companies where she had bought life insurance policies.

Tan claimed that all of the companies have compensated her, but Great Eastern had repudiated both her policies and returned her monthly premiums on grounds that she had made a non-disclosure, had a psychology consultation and had been diagnosed with anxiety attack.

In Great Eastern's statement of defence, the defendant said it had assessed and processed the plaintiff's insurance claims and found that the plaintiff did not have the right to the basic sum assured under the policies.

It claimed the plaintiff had a psychological consultation history on April 17,2014.

It further claimed the plaintiff was diagnosed with anxiety attack and was prescribed Xanax on Feb 13,2017.

The defendant claimed that Tan had consulted with another doctor on Feb 16,2017, and complained about an infection in her body.

"The defendant found that the plaintiff had the illness and is aware of the illness as early as February, 2014.

"She, however, failed to disclose the diagnosis, treatment or the illness in her forms," it added.

Great Eastern said it had rejected the plaintiff's claims through its letters dated June 18,2019 and returned her premiums via direct credit.

"Therefore, the defendant's rejection of liability on the plaintiff's claim was valid, lawful and justifiable," it said.

Lawyers Wong Hok Mun and Chris Lim appeared for the defendant in the proceeding.

This post has been edited by adey64: Mar 31 2021, 12:14 AM

Plenty insurance do this only the rich can fight back while the poor waiting to die je

So then.. get insurance is pointless? From GE? lol?

This gonna be gud, let GE suffer humiliation and improve their unreasonable claims process. This looks stupid and the regulators need to look into this.

That is why never trust insurance. plain stupid. Only enrich agent and the company only. Where got protect rakyat one.

Malaysia universal health is the best . GH RM1.

Our otais from insurance talk pls share ur two sen...must be alot of tea to spill 😀

the "news" from this thread had already been posted in LYN existing thread at 8am yesterday....

Prudential vs Great Eastern: My Experience, Not all insurance companies are the same
https://forum.lowyat.net/topic/4833082/+100#entry100459538

can read or post there for added info?

achieved a full and final settlement in one of the two insurance policies she is claiming for.....
why she did not get settlement for the 2nd policy at the same time??
why hearing continue on April 14?
will she get to win the 2nd one too??

In 2018, she signed up for a second policy......
in 2019 she filed for cancer claim....
will that period fall under "contestability period"??

for as per this
https://ringgitplus.com/en/blog/insurance/3...%20your%20risks.

"During the Contestability Period is the period (usually of two years) during which the insurer is not obligated to pay a claim because of misrepresentations of material facts given to your underwriter when determining your risks.

Once these two years have gone and passed, your policy will then enter the Incontestability Period, where claims can be given even though there have been some misrepresentations of material facts."

The first policy which was bought in 2015 would falls under "Incontestability period"

This post has been edited by MUM: Mar 31 2021, 01:56 AM

implausible act from GE, bad for their reputation.
Anyhow, GE loss other insurance companies gain.

pihak insurance sial,
bayar je,
bukan duit lu,
tu duit pelanggan lu,
boikot insurance ge,

Insurance are basically to suck from the poor to the rich hence it is basically useless when it come to claims

Better off putting your money liquid investments like gold or ETFs as your insurance fund in case of emergency

Why bother making others rich while you suffer humiliation when you submit claims it will reject up to certain amounts

In chronological order...
Feb 2014 - Aware of her psychological illness
Apr 2014 - had a psychological consultation history
--- 2015 - Bought 1st GE policy - without declaring that she did not have depression or anxiety at all material times
Feb 2017 - diagnosed with anxiety attack and was prescribed Xanax
Feb 2017 - consulted with another doctor + infection in body
--- 2018 - Bought 2nd GE policy - without declaring that she did not have depression or anxiety at all material times

In summary, GE's defense


I guess the matter is non-disclosure rather than the critical illness payout being the problem.

The case is not totally "won" yet as quote:


Next hearing 14th Apr

Then again, I'd like to bring up important notices when applying for insurance that people always miss out / trust what the agent say too much.

you get illness and try to claim insurance.
insurance company refute your claim.
you have to go court to fight while at the same time fighting your illness.
all these stress and hardship is what you get after pay them for all over the years while their ceo and directors jolly at Maldives or Hawaii.

it is very sad to know consumer rights in malaysia is still very lacking in all sectors.

big companies know that many cannot afford to fight them in court because they have lots of money and you dont.

Not the rights but education and awareness how does insurance work

Malaysians are mostly suckers and over invested insurance thinking that money will fall from sky when’s the fact when bad thing so insurance will limit the damage by paying as low as possible while throwing out higher claims so that they can pay their shareholders dividend so instead

true also.....

you are right insurance agent can promise you the sun and moon but the policy will say otherwise....

Insurance is a great safety net.

But people should remember:

1) it's only a safety net, not a lifeboat
2) too insurance agents out there oversell their policies, consumer must research and read, and don't 100% rely on insurance when facing money trouble

30% to 40% of your insurance premium goes to your agent to buy bmw.

this 30~40% of the premium will applies for how many years?
only 1 or 2 years or until maturity of the plan?

Not 30-40, in Singapore it's 40-50% for first year. It's called FYC (first year commission). Then it drops over time to mid-high single digit over time. (Go to agent office you will see a scoreboard with how much FYC agents earn in that particular month or year). This kind of system is purposely created to encourage agents to keeping looking for new business revenues for the insurance company.

Profits for ILPs are slighter higher than traditional life. So if you know how to invest, try not to subscribe to ILPs.

This only applied to life insurance, which is highly profitable for agents and companies. PA insurance on the other hand only low single digit range of commission over the tenure the policy. So agents have greater incentive to sell life insurance over others. Medical insurance is a lose-money business. Basically the insurance companies are using profits from life insurance business to cover their loses in medical insurance.

The BMW thing is very true. I did a short intern at AIA SG once and their kick-off event grand prize is mercedez with COE fully paid. As an AIA insured, that's very heartbreaking to see. Would rather have the premium paid used to donate to the unfortunate rather than paying for a luxurious car, more so in Singapore.

This post has been edited by TOS: Mar 31 2021, 12:49 PM

https://blog.moneysmart.sg/life-insurance/e...-your-policies/

Can refer to the above guide. Though it is in Sg, it should be around the same in Msia