Cerita say AIA argue can be treated as pesakit luar, and no need hospitalization

Doctors argue need hospitalization

if they wan to play, they can dispute almost anything under the sun

why this med and not that med?
why surgery when can use other techniques?
etc etc

end up those paying for insurance suffer more than they shud

TBH, i agree that insurance is kinda scam

we take insurance to help us in the future, but what for if got additional clause (Exclude pre-existing condition).. then no point dy taking insurance liao

lagi2 now their premium getting more expensive from paying 180, now became 270 (sudah 3-4x update price)

last time, my father got admitted at oversea hospital, already take travel insurance but because he got pre-existing condition, insurance die2 rejected the claim despite the diagnosis not entirely related to his case.

they are not even trying to help the client or anything, just straight declined the claim.

best policy for eternal coverage - don't get into any major accident or chronic health issue

for we know this......not referring to the insurance co - this is a given

the Medical fraternity - this one.....once you kena sangkut - make sure fat wallet, pray insurance will take care, company cover, or some form of safety net .........for when they come, they'll come with guns blazing to drain you dry

stay safe

The normal practice is private hospital will do as many unnecessary diagnostics as possible like MRI, CT Scan, Dexa Scan, X-Ray, etc. I guess any doctor that can extract the most money from insurance will get more bonus.

On the insurance side, any person that is able to minimize outflow of money will get special bonus.

Got doctor in private hospital that reject patients who will claim from insurance and only entertain patience that will pay with own money

u dont get the point ?

ktard pandai baca but tak pandai memahami ka

They sendiri said KPJ amended the report because found out the BP of the patient not normal

Nope. It’s normal to ask such questions as I have worked in claims before and if the clients give good justification, there are no problems approving such claims. Normally, it’s due to non-disclosure as reasons why such claims are queried or the doctor report say something else.

A lot of claims reject stories are not happening to themselves and most are people listening to others tell their stories. A lot of time, people leave out some details when they tell their stories and at the end they will come to conclusion that insurance are scams.

Like I say before, based on my experience, I approved tons of claims every day and most claims got no issues at all but there are always one or two which I will ask for more justification and usually those claims will be rejected at the end by my supervisor. Of course the clients will then appeal and if they can provide proper justifications, it will be approved at the end.

Nevertheless, that was years ago and I work in claims for just a year only.

3 GL required, meaning even hosp knew the forthcoming so need to see all 3 pre and post medical reports and not only 1 as posted in post #1

This post has been edited by jojolicia: Jul 24 2024, 08:21 AM

ada beli PA? jatuh dari tgk 1, I think can claim PA also

how many ppl can fork out 19k in malaysia, 1.9k also very hard

This post has been edited by anakkk: Jul 24 2024, 08:16 AM

park for future reference

That’s why I say disclosure are important. If you don’t disclose when you buy, it will always be a problem when you claim. Insurance companies have doctors as consultants and they know whenever someone did not disclose properly. This problem is usually due to agents who oversell their products and a lot of time they don’t tell the full story about policies. Ask yourself. How many of you really go and read your insurance policy especially the exclusion part?

I agree on the BOLD part.

Whatever it is, the moment got pre-existing conditions, straight up going to decline (Unless can prove otherwise).. hence whats for paying insurance again?
if can't cover 100% for pre-existing, why not co-payment then?

after few incident of insurance not able to cover this and that, we started to go through the policies again.

tbh, one must have a insurance company stock in his investment portfolio.

KPJ is worst when it comes to charges.

meanwhile micare happily pay for company employee je..

should just get micare...

Yours how much they cover? Mine 50k for hospitalisation and 6k for outpatients

my company give.

unli outpatient.
1m for hospitalization..

RM 19 K is not much? What is our currency in Rupiah?

How about looking at it this way?



If a company that big with that much money cannot even pay RM 19 K, then who do you think is the B40 here? So in 2024 we support scammers now? I did not get the memo.