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 Pelanggan kecewa AIA Insurance menipu

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WaCKy-Angel
post Jul 24 2024, 09:02 AM

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QUOTE(WaterBuffalo @ Jul 24 2024, 06:11 AM)
I read the entire update on X. It was wise of them to kick up a fuss and viral this case out to garner attention. There are plenty of people out there who will blindly accept what insurer say and just fork out from their own pocket even though it’s the insurer’s role.
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Mind to share why insurer reject?

Seems like bone fracture or something. Did the insured play dangerous sports or something?
WaCKy-Angel
post Jul 24 2024, 09:05 AM

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QUOTE(kons @ Jul 24 2024, 08:54 AM)
my company give.

unli outpatient.
1m for hospitalization..
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Wow 1mil is very high. U C level?
WaCKy-Angel
post Jul 24 2024, 09:09 AM

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QUOTE(alexandersuk @ Jul 24 2024, 01:24 AM)
Ayam no Dr but 19K "can be outpatient" sounds strange.

Not possible to charge 19K without surgery. I wonder what procedure was done
WaCKy-Angel
post Jul 24 2024, 09:09 AM

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QUOTE(kons @ Jul 24 2024, 09:06 AM)
everyone here the same..

gwai lo company
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Cool
WaCKy-Angel
post Jul 24 2024, 09:27 AM

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QUOTE(sexysarah1992 @ Jul 24 2024, 09:14 AM)
What they mean is he didnt have to masuk hospital and simply spend 19k when it was just a small case. Just go to clinic can settle RM200
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Not possible. Simple warding even 10 days wont costs 19K.
The most expensive thing (excluded surgery) is MRI imaging but if bone fracture should just need x-ray that is not expensive.

QUOTE(WaterBuffalo @ Jul 24 2024, 09:18 AM)
The insurer claimed that it was an issue on the hospital side whereby the hospital’s reporting was inconsistent.
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Very normal. This is where agent comes in play. A good agent will help u to deal between hospital and insurer.
Bad one will MIA.
WaCKy-Angel
post Jul 24 2024, 09:30 AM

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QUOTE(sexysarah1992 @ Jul 24 2024, 09:26 AM)
U still dont get my point. The customer didnt even need to admit to hospital in the first place. Minor case just go to clinic. The issue now is their type of people love to abuse medical card. Even simple cough and cold cases they are going hospital just so they can admit and get MC for few days.

Their whole purpose of their life is not to work but to just sail thru life peacefully. Thats why they love taking MC
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Lel i doubt u are Dr, but neither am i.
However i dont think if insurer say can do outpatient RM200 and hospital will dare dare charge until 19K
Something is very wrong in this case.
WaCKy-Angel
post Jul 24 2024, 09:48 AM

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QUOTE(submergedx @ Jul 24 2024, 09:30 AM)
Obviously hospital surcharging when they know you're medical card holder.

This is another case that government need to step in and require transparent charging standard for private hospital.

why canteen eat rice need price display but hospital no need?
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Still not possible to surcharge until 19K without a surgery.

QUOTE(WaterBuffalo @ Jul 24 2024, 09:31 AM)
Read the full thread on X. The agent stepped in to help but can’t do much. When it was viraled out, only then someone from AIA called her to apologize and promised to deal with the hospital side to get it resolved.
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Agent not trying hard enough.

QUOTE(sexysarah1992 @ Jul 24 2024, 09:41 AM)
When i was warded for 4 days 3 nights at a private hospital , my bill came up to 5500. So i dont see how a 10 day stay cannot reach 19k

Hospital fees are very expensive . U go see MRI costs how much.
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Deswai i said something is very wrong if without surgery it is impossible cost 19K.
So dont blame the insured. Insured is most probably innocent.

Hospitals usually roughly knows what can be claimed and what not, even GL approved it does not mean hospital can simply do any diagnostics or try to max the limit.
They do worry patient wont pay if insurer reject.

This post has been edited by WaCKy-Angel: Jul 24 2024, 09:48 AM
WaCKy-Angel
post Jul 24 2024, 10:05 AM

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QUOTE(Aaron212 @ Jul 24 2024, 09:53 AM)
masuk OT just do scopy checking already 8k at SJMC

not doing any srgery or cut anything

just scopy which is a diagnostic

private hosp all crazy mia
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Bro scope is already considered small surgery. Need to go operation theater and anesthesia and this alone costs alot!

Since the patient fall down i guess only need X-ray that is cheap. Even CT also not expensive.
MRI should not be applicable.

So how to get 19K if without surgery?
WaCKy-Angel
post Jul 24 2024, 10:08 AM

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QUOTE(sexysarah1992 @ Jul 24 2024, 10:01 AM)
U dont get my point. When a patient comes to hospital, the hospital will always always assume its a serious case in the first place. They will do every single scan possible to rule out anything that complicate stuff. Hey, u are claiming insurance ma, no harm doing every scan.

Padahal, after all the scan is done, turns out there isint much injury to the patient. So the dr will ask the patient to be warded in hospital for a number of days for observation. All these adds up. 19k is nothing nowadays.
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No, hospital wont dare simply do every scan.


WaCKy-Angel
post Jul 24 2024, 10:09 AM

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QUOTE(Aaron212 @ Jul 24 2024, 10:08 AM)
mana ada

scopy is not surgery

masuk OT caz patient asleep wont feel pain

can be done without OT also

just private hosp give u tido so u no pain but wallet pain

anytime mask private hosp they use best diagnostic

might not be appropiate n overkill for the said incident but its private hosp
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Masuk OT consider surgery laaaaaaaaaaaaaaaaaa

Who tell u scope can do without going OT ler?
WaCKy-Angel
post Jul 24 2024, 10:11 AM

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QUOTE(RT8081 @ Jul 24 2024, 10:09 AM)
yeah, this is why i never liked AIA. For my case when i kena surgery, allianz promptly settle all mine including getting my deposit back, while my agent deal with the hospital to get doc's final report.

this doc report is very important, anyway claim went through and all is well
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Wait till u try GE lel.
WaCKy-Angel
post Jul 24 2024, 10:21 AM

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QUOTE(Clowninja @ Jul 24 2024, 10:10 AM)
>7 pages

well, i be brief, i'm an avid AIA customer more than 10 years already. All medical claims are covered by insurance with only one condition,

>You have to be admitted to hospital no matter how many days aka, sleep on hospital bed and we will cover you

Proof : recent case : scoliosis.

that is all, ciao
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Mind to share how is scoliosis pain? And how u get it?
How is the procedure to get admitted? Ayam afraid go hospital after Dr check cant do anything and cant claim.....


I had back injury carrying heavy stuffs.

Didnt go to hospital just go clinic get painkiller jab. After that its very easily get hurt again and go clinic jab again.
Went chiropractor but its very expensive and cant claim so end up no go.
Been 4 years already...


QUOTE(Aaron212 @ Jul 24 2024, 10:12 AM)
u funny man

masuk OT not equals to surgery

heard of dental paeds specialist bring kid into OT tido asleep just to do fillings and metal crowns?

tat aint surgery

but its for kids who are uncopperative or OKU kids
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Crowning not consider surgery kah?
Haiya lazy argue lah

QUOTE(etan26 @ Jul 24 2024, 10:14 AM)
My GE agent good service, my daughter medical settled with no issue at Columbia Hosp.
Make sure you get a good insurance agent.
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Agent was fine...its GE rejecting claim and i had to threaten report to BNM only they approve.
WaCKy-Angel
post Jul 24 2024, 10:48 AM

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QUOTE(Aaron212 @ Jul 24 2024, 10:35 AM)
crown is not surgery

can be done directly chairside

no surgery involve also got need to enter OT

OT doesnt mean die die surgery
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https://www.altimadental.com/5-common-types...dental-surgery/

Idk sounds like considered surgery to me.
Ok lah lazy to argue already...


QUOTE(Clowninja @ Jul 24 2024, 10:38 AM)
>carrying heavy stuffs
well mate, that is how i was diagnosed and the cause of it. To make it simple, i worked as dealing with heavy stuffs, day in night out, physical exhaustion for 4 years. I quitted, worked at forklift factory next, got lower back pain not because of heavy stuff, but flexing my body to reach to certain point, putting my body at my limit (also i quitted after my case and worked at IT deskjob from now on).

The pain, i would say bearable but at one point you cant handle for one day and you just need a day off lay down on bed throughout the day. And so i thought, why not i just claim MC with backpain? So i did, but my doctor suggested me to go check xray with his letter permission, so i went, prayers and thoughts it can go on 2 ways

1 - there's nothing concerning about my backpain and i just pulled a trollface
2 - there's actually a backpain and i must be diagnosed with MRI in case of scoliosis

Lord and behold i got the latter, the followup was i went to private hospital that was recommended by my parents. Procedures :
1 - Counter check in, say you got this and that, show proof (my xray result)
2 - Show insurance medical card (i find this to be essential to have one)
3 - To what my parents said, said by our insurance agent, AIA covers all medical bills if you admitted to hospital (stay in the hospital at least 1 night)

After that, you just have to wait for them to contact AIA, get approval and then wait for vacant room for your admission. Everything else were just doctor followups until you get discharged, all paid by insurance.
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I did went for X-ray required by Chiropractor but after checking no mention of scoliosis.
After many chiro sessions the Dr says its the muscles holding the spine injured and not strong anymore.

Maybe i will go hospital for checking. Atleast can claim company insurance for outpatient specialist if cant claim medical card.
WaCKy-Angel
post Jul 24 2024, 10:54 AM

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QUOTE(cursetheroad01 @ Jul 24 2024, 10:53 AM)
Kekwa malaysians
Rather throw money at insurance companies that is known to fuck over the patients and the healthcare system instead of throw money at the already established public healthcare system.

Already know how public healthcare dont get enough resources to work properly, yet still dont want to ask for increase in annual healthcare budget.
Bila servis teruk due to that lack of resources in the first place (siapa la yang kedekut sangat?), sibuk nak surprised pikachu salahkan staff nurse, salahkan doktor.

Tak payah nak solely blame KKM and SPA for mismanagement. Rakyat pun sama bodo.
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Donasi ke certain country more important.

#sugarpointisreal
WaCKy-Angel
post Jul 24 2024, 11:04 AM

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QUOTE(Clowninja @ Jul 24 2024, 10:57 AM)
no, why would i go to chiropractic? Even the case of insurance scam like AIA here, at least this can be dealt with higher ups and laws.

but chiropractic? You are dealing with a person with no guaranteed it can work on you or not, you paid for it, cash with no refunds.

as of right now, after 2 years of my deskjob, i can still go to private hospital right now, get admitted for 1 night, and say i want to do physiotherapy, show my medical card, all of this will be claimed.
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Why physio need to admit though? Unless u cant move?

U did that 2 years? What Dr wrote reason for admission?
WaCKy-Angel
post Jul 24 2024, 11:04 AM

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QUOTE(Boomwick @ Jul 24 2024, 11:01 AM)
Ct scan 2 to 2.5k+
Cta (angio) 3 to 3.5k

Mri 1200 to 1400
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Wait MRI cheaper than CT meh?

Angio quite cheap where?
WaCKy-Angel
post Jul 24 2024, 11:50 AM

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QUOTE(Aaron212 @ Jul 24 2024, 11:12 AM)
im a registered dentist here in MY

it is not a surgery

and dont quote source from self made blog/website

aiyo itu pon mau ajar
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Clinic where? Got discounts for ktards?

 

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