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 Complaint About AIA insurance

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bbjslee
post May 21 2008, 06:00 PM

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QUOTE(Jean72 @ May 21 2008, 05:16 PM)
I am staying in Ipoh. Yes, I am great I am happy with this agent. And ING is not a bad insurance company. Perhaps you can check up their medical card
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http://thestar.com.my/news/story.asp?file=...1586&sec=nation

ING was previously involved in some controversy over their medical card. Please check with your agent for newest update.


Added on May 21, 2008, 6:07 pm
QUOTE(sily22 @ May 21 2008, 04:45 PM)
Thanks for the concern. I think the most important thing is having a GOOD insurance AGENT.

The problem here is why other insurance company can cover and mine cant. i paid my insurance monthly and it is still active. The reason the decline this claim is they say it fall under the category of pregnancy and maternity. This is nonsense.
I read the policy. I agree with the requirement pay up-front when admitted to hospital, that is the reason why we ask AIA to issue Guarantee Letter so that You dont need to pay up-front. Even if pay up-front first also they will issue ghe GL. The point here is that they decline this claim. After I make complaint then only they twist the word say they want me to pay the whole surgery first in cash then only claim later. But they cant assure me it is claimable or not. The doc very sure this surgery is claimable only ask me to proceed with it. He has many years experience with it. This is a very common and minor surgery according to him.

We really need to Beware with all the INSURANCE company. They are very good at beating around the bush.
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- Please check back your policy documents and find out what's the exclusion.
- Problems usually arises due to 2 reasons.
a) Not informed properly by agents
b) Didn't read through the policy thoroughly

As an agent (I'm not from AIA), I can't tell you 1 - 100 things that is excluded & all the details, but they are all written in the policy.
Normally insurance company provides refund if you cancel the policy within certain period of in-forcement (w/o any claim that is).


This post has been edited by bbjslee: May 21 2008, 06:07 PM
bbjslee
post May 28 2008, 12:36 AM

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QUOTE(cute_boboi @ May 27 2008, 09:25 PM)
Something I have posted before, but just to inform everyone.

Most of you will not encounter this, but for surgery/anesthetic/ICU/etc. there is fine print the cost is spread over x years, normally 3 yrs. Not sure about the latest T&C now. Maybe those in AIA/ING/Prudential/etc. can check it out and post it here.

e.g. I take my friends' policy which is from AIA also several years ago. Company bought from AIA coverage 200k for surgery/etc. We are not talking PA/death/etc. Our PA are 500k each, death is 500k each. Don't ask which field I'm in which requires so high coverage.  wink.gif Latest I know, they are covered at 1M each.

He involved in accident, and the bill for surgery/etc. alone goes somewhere >75k. Yes, it is a big bad accident. 75k does not include PA claim yet.

Anyway, the full time AIA agent also don't know about this fine print, until we informed him about the accident and he checks on the finer details to help us to claim. Then only he found out and inform us that the claim can only be claim over 3 yrs, i.e. max 66k/year. Anything above that must fork out from own pocket money, which is >10k

After claim 66.667k, there is remaining 133.333k for that coverage to claim in future. But the point here is, max 66k/yr for 200k coverage over 3 yrs.
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Is that due to Max. Annual Claim amount?
For GE, there's an Max. Annual Claim and Max. Lifetime claim.
bbjslee
post Jun 17 2008, 06:25 PM

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QUOTE(sily22 @ Jun 17 2008, 02:33 PM)
Finally after 2-3 weeks, I got the reply from AIA. I am more displease than ever. I dont get the answer I want. This is the 2nd complaint. I wonder. Do i need to proceed for the 3rd complain again.
Basically, what they say is still the same thing. Still beating around the bush. According to them, that this medical card is just serve as an identification and its a value added- service. No guarantee in issueing the Guarantee Letter. If GL is not issue doesnt mean cannot claim but have to pay first then the only they will review to pay me back or not.
The reject my request of full refund and ask my agent to assist me.
What happen is my Agent called me and scold me for making this complaint. I am not complaining him. He sound so rude as I owe him and cause him trouble for this.

Do I deserve this? Nothing I can do now. What else I can do? Should I make 3rd complain? I wish to reply the letter to AIA but they dont have any fax or email for me reply. If I have to reply, I have to go thru bank negara again.

I cant change agent. I have to stick with this agent and AIA dont want to issue me an assurance letter to protect me if in the future I will admitted again to the hospital for the same surgery.

I feel very disappointed. Now i know why many people say insurance cheat people because we dont have good agent to explain PROPERLY. They suppose to help us but they didnt and ignore us.

Where is the justice??? Do you think you all really can TRUST YOUR LIFE WITH AIA as what AIA slogan is?
I really feel AIA make me "going around in circles" to discourage me from making futher complaints.
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Though I'm not an AIA agent, I'm sorry that this incident has made you lost your trust on Insurance.
This is what I would do:
- Lodge a report with AIA about your agent
- Request to change the agent.

The other way, find out how much you can get if you surrender your policy. Sometimes short time suffering is better than long term suffering.
Get another medical card (standalone or rider) from another Insurance Company. And while you're apply for new Insurance Policy (medical card) DO NOT surrender your AIA policy 1st, because there is waiting period... etc. And furthermore there maybe exclusion and possibility being rejected due to your previous surgery.

If you don't mind, let us know what surgery was that, to you it could be a major surgery, but to other insurance company it could be a minor surgery which will not affect you from getting new insurance. Also, let us know roughly how old you are. Below 35? 35-40?... etc. There are a number of Insurance Agents here in the forum, with some basic info, we would be able to give you better advice and recommendation.
bbjslee
post Jun 18 2008, 01:46 AM

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QUOTE(sily22 @ Jun 17 2008, 10:39 PM)
This is the feedback i got from AIA. I do wish to change the agent but I cant because this policy has more than 6 years already. I have to stick with it unless he quit. Sound sad isnt it?
My intention at the first place was complain about AIA because they teach their agent what to say and they use their agent to protect themself by blaming the fault to the agent.

Surrender my policy? That is really a big lost.

The surgery I go thru is call "LAPAROSCOPY OVARIAN DRILLING" is this treatment cover? According to Doctor yes but according to AIA, NO!!! Base on that face they say they cant issue me the GL and they issue me the NON-GL and advise me not to file-in the claim but i can still try to file in where they wont stop me from doing so. What nonsense is this? to make the simple term that I understand mean THIS SURGERY is not covered and cant be claim. They dont want to admit that. I am using the exact same situation now asking them, will the issue me the GL? will they pay me back if i pay first, they just go round and round say u can try but no guarantee. What is that mean??? I really dont understand.

I am only 30 years old and this is the first time using medical card for the surgery and face so much difficulties. How will I still have confident with insurance, with AIA?
They deny and dont want to let me talk to the boss, the person incharge, they dont want to give me confident. Some how i feel that i am being bully by them because they know that you need them more than they need you!


Added on June 17, 2008, 10:50 pmI wish my story, my bad experience with AIA can share with Everyone. Let everyone beware with their own insurance, especially AIA.
I am going to create a blog and post all the experience, the conversation i had with AIA, the complain letter, that I got to share with EVERYONE. Let everyone know. Let the news be spread since nothing else I can do to further proceed with the complaint. I see no point making the 3rd complaint because i will get back the same answer and some how i feel that Bank negara are not helpful enough too. I have already file the complaint to bank negara, to NCCC ( national Consumer Complaint Center), post the story to MyFM station, i even try Jabatan perdagangan dan Hal ehwal pengguna and yet all i got is "nothing".

Can anyone tell me what else I can do? I am very "sakit hati" with what I had experience. I really wish to let the whole world know my experience.
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From what you've stated, AIA did not directly say cannot claim. The people you spoke to in AIA they are not sure if it is claimable or not. But there's a point I find it weird, which is "advise me not to file-in the claim" this is very weird indeed. Normally, under situation where they are unsure claimable or not, they'll ask you to pay first and "please" file in the claim later.

30 years old is consider young, you can still purchase a medical card at a relatively cheap premium. But due to your past surgery, there could be some complication. Insurance company might ask for your medical report, extra premium or exclusion clause attached. Go and see some insurance agent from GE/Pru/ING... etc. Get medical card from them, submit the proposal form. Then make a choice from there, while you're doing that do not surrender your AIA policy first.

Another thing is I see no reason why because due to "6 years" you cannot change agent. I'm not sure about other Insurance company's law, but in GE, you can change but with the consent of your current agent.

Some personal advice regarding Medical Card.
- Get at least 2 medical card if you can afford it. All the medical card has it's limit, some are in annual limit/treatment limit/lifetime limit. In most cases, one medical card's limit is not enough to last you a lifetime. Unless you're very lucky.
- Lots of insurance agent I know, have 2 or 3 medical cards. Some get from different insurance companies. Why? Silly22's example is a perfect reason. Put the eggs in different baskets. Surgery A can claim from Company G, but not from Company P, Surgery B can claim from Company P but not Company G... etc.

Silly22, this is what I would try to do:
1. Complain about your agent gao gao at AIA. Try to change to another agent
2. Shop for medical cards from other Insurance Company. But beware... cheap things are not necessary good.
3. Since you can't cancel AIA medical card, once you completed step 2, you would have 3 medical cards!
4. If you really hated AIA and does not want anything to do with the company, surrender your policy once the surrender value almost matches or more than the total premium you paid. For Traditional plan, it is usually somewhere between 15 - 20 yrs.
5. Now you would ask what to do with AIA medical card for another 10 yrs? My strategy is use your company's medical card 1st, once exhausted or not enough to cover, then use AIA, then only use your new Insurance Policy's medical card. Do take note that usually medical card has 120 days of waiting period.

This post has been edited by bbjslee: Jun 18 2008, 02:07 AM
bbjslee
post Jun 18 2008, 06:13 PM

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QUOTE(cd928 @ Jun 18 2008, 04:22 PM)
i feel sorry for what u have been going through with aia insurance.im also coverd by aia since 2001 and never claim before (thank goodness im healthy as ever).
your bad experience i shall take note/aware of if something similar happen to me in the future, lucky i have company insurance also (ING).Last 2 years i go to clinic the doc said i have something like fungus under my armpit have to follow-up SJMC then i call ING they say not cover because its under facial treatmen sweat.gif  when i told the doc what happen she was shock "armpit under facial treatmen??"
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Maybe they thought you're waxing your armpit hair icon_idea.gif


Added on June 18, 2008, 6:17 pm
QUOTE(joycecross @ Jun 18 2008, 04:44 PM)
hey... i feel sorry for what you are going thru.....

i really understand as it's quite rough emotional roller coaster...

I am oso very worried about AIA insurance now...especially reading thru the threads...

I wish I know the rule of the thumb, go for those that doesn't split in details like advised by one isurance agent here.

anyway, all the best.. hopefully u hear good news
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It is very important to get a good servicing agent, especially those who are willing to go an extra mile.

Some of the cases I heard of:
- Agent negotiate with hospital to amend the invoice (not the amount) but to lump sum some charges. So that can claim more.
- Agent go to hospital on Chinese New Year eve to visit client who had accident that day. And help with claims.
- Agent who pick up customer's call in 3 am and give advice on claims.


This post has been edited by bbjslee: Jun 18 2008, 06:17 PM
bbjslee
post Jun 20 2008, 08:44 PM

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QUOTE(hamster9 @ Jun 20 2008, 08:34 PM)
Congrats... ur claim is sucessful  rclxm9.gif  I'll be passing you the cheque once it's ready, probably next week.  nod.gif 

I dun need the commission to earn a living since I have fixed salary already. I treat the commission an additional money to spend (probably for shopping or so tongue.gif)

I slap 9 them if cannot claim  vmad.gif  In the medical card pamphlet there write can claim laparoscopy. Later I scan it and post it up here. But also note the exclusions, must have nothing to do with treating infertility, pregnancy or beauty.  They just scared if they say can claim but then actually cannot, lagi they die right? So might as well, save their @$$ and say cannot claim coz this job is not theirs, supposed to be the agent job to know what can be claimed or not. Plus Customer Service are not in Medical line, how should they know what is laparoscopy?

Anyway you already have me, just ring me if there's anything  icon_rolleyes.gif
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rclxm9.gif rclxms.gif
Good Work!!
bbjslee
post Nov 13 2008, 12:39 PM

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QUOTE(tiing2020 @ Nov 13 2008, 11:02 AM)
hello evrybody,i am new here, i just bought my insurance from AIA 8 months ago. this insurance is together with the medical card. Currently, i go and check at medical centre and found that there is a thyroid. i need to go there 1 month one. now all the bills i need to pay from my pocket money. The medical centre ppl like not so happy when i ask how to claim. i ask them how to claim, but they talk other thing to me. thet medical is AIA panel also but no such claim form.
anyone can help me??????
the claim form got 2 part, 1 part is personal detail, another part must be fill up by the doctor right?
i ask the doctor, the doctor said not she fill up, need to pass to admin. now i really no idea what to do.
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Ask your Insurance Agent to help you. He/She should be the facilitator between you and the claim departments.
Just insured 8 months then have thyroid.... not easy to claim. It'll be lengthy process, be prepared.

 

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