Hello All

Would like to see if anyone has experience on Hospitalisation claims via insurance?

Company hospitalisation max is rm50k
Personal hospitalisation is way moreeee

Current situation:

Have been seeing specialist and doctor using company AIA, most probably will need to go for operation. If the cost of operation exceed rm50k that covers by company AIA, is it possible for me to utilise my personal insurance coverage (GE) to pay for the remaining cost?

I know is do-able, but GE insurance agent advise to self-pay the remaining cost then submit claim to GE.

Is there a way for exmaple for me to request GL via GE so that automatically GE will covers whatever remaining cost from the operation?

We all know, paying from own pocket first and claim, might take long to get money back from insurance company

as far as i know your personal insurance if to cover exceeding bill is by pay and claim reimbursement basis

What is your own annual and lifetime limit claim ?

claim company first then not cover then only can start claim your own one

What operation?

Your agent is correct. Pay for remaining excess and send for reimbursement is the correct way.

Different policy, different insurance have different coverage, and different assessment. You cannot expect other insurer to 100% cover all the remaining excess.

Don't even think about splitting the hospital bill because it will complicate things - some thing in the bill will raises some questions, some inconsistencies because the billing people did a sloppy job that will further delay your final GL.

Alternatively, why not just request GL under your personal insurance?

Side question.

If my personal insurance has co-payment say RM500 or say 10% of total bill of 50k so will be 5K.
Can i claim that amount RM500 or 5K from my company insurance?

I think can. Tats why some working adults choose a high deductible medical for their personal coverage as being employed will pay for the deductible.

yes, it's better to get one GL only. If you get 2 GL, both insurance company will try to push the bill to each other for the "first payment" so that they can cover the remaining only, ends up will delay the whole process. I've seen this happen before, very complicated.

Personally, I'll opt for the hassle free, straight away use the personal insurance coverage. Use the correct coverage for the needful amount.

Stop worrying about what if in future. This is the purpose of the insurance. Else you will create so much issue out of nothing. It is not worth your time to worry about it.

Technically, I don't think there's anything in the policy wording saying against doing this, so I think it should be okay.

You do have to provide all the complete documents tho.

Yes of course. This is relatively easy. You get a GL for your personal insurance and then pay-and-claim the rm5k deductible from your corporate cover. It's also much easier on the wallet as you only need to bear the deductible amount.

In TS case, why not go for his personal insurance since the estimated expenses going to exceed rm50k? Seems rather silly.

But how to get the documents? Coz usually if GL usually during discharge just provide discharge summary and bill summary.
Insurer sure wants other documents.

not only summary, you can always request medical/lab report from the doctor. With those things it is good enough

Go to billing counter. Request for full itemized bill, all medical report and all lab reports. Say for insurance claim purpose. They should have it in pdf. Have them emailed.