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Wednesday, November 17, 2004

My Heart - Insurance

They call them Insurance Salesman. Years ago when I first graduated they came in numbers to me asking me to buy Insurance Policies with them, mostly for Life Insurance. In those days they could afford to give you meals while they talked about the benefits of Insurance and they tried to sell you them to the maximum coverage. Of course then we were lowly salaried so we could not buy much cover I bought a few, which of course as I got older I converted them for cash.

In my younger years I used to work for oragnisations which used to cover me for all sorts of risks, life, accident, hospitalisation mostly. And I never thought the importance of having any insurance coverage other than those I bought and later converted to cash. I thought it would be a waste of money; why not spend the money somewhere else or why not enjoy the hard earned money that you have. Or later why not put the money into ASB or similar.

But time passes, and you get older and you retire. When that happens then that big umbrella is taken away from you. And if you are sick or hospitalised then you have to use whatever resources you have to overcome your hospitalisation damages. And these are not cheap.

For my heart bypass surgery, I was admitted into the Gleneagle Intan Mediacl Centre in KL by using a Hospitalisation Insurance card from an Insurance Co. - Global something, a Chinese Malaysian Bank insurance. And I suppose the Hospital must have checked with the Insurance Co. that it was a valid Insurance card and so admitted me with only an entrance fees for RM 800.00 to be paid. And I informed my Insurance Agent about it. There was no protest from my Insurance Agent. And the Co. faxed the Insurance form which I signed before being admitted. And things went smoothly and I was operated upon a day later.

And then the surprise came. When I was transferred to Room 564, a few days after being in the ICU, the Insurance Agent came and he must have asked my Doctors to fill in all the Insurance forms. And my wife later got a call from the Insurance Co. that they wanted me to pay for all my hospitalisation fees. Well well, what happened to my Insurance? I did not understand. And by the afternoon the Hospital Accountant (or was he just the Cashier? Loh?) came over asking for a deposit of RM 20,000.00 with the final bill to be paid later in whatever form before being discharged. And he was quite rude about it. The Hospital had been very nice to me but that Accountant (Cashier?) guy was very demanding, and in that Room then was only my son and I. I was lying horizontal (quite helpless) and he was standing there very authoritatively. What a mess I thought. When my wife came later that afternoon we told our Insurance Agent about and he was of no help. Not that we have no money to pay for my surgery and the hospitalisation fees but I felt a bit insulted by the Hospital Accountant (Cashier?) and the man on the phone from the Insurance Co. who phoned about the invalidity (?) of my Insurance coverage. I thought I have been paying my insurance premium very religiously every year.

Now this Insurance Co. that I am insured with was selected by me a few years back when I first retired from a Co. I used to work for. I had Sihat Malaysia originally but when I tried to claim from them when my wife was admitted into a private Hospital in Ampang KL that year I was refused. They said that I have not been their client for over 1 year. Fair enough I thought. And while walking in the lobby of that Hospital I was approached by this Insurance Salesman who was promoting the Global something Insurance, (he had a desk there then) telling me how good his Insurance is and how superior it is compared to Sihat Malaysia. I got influenced by his sweet talk and I signed, for me, for my wife, and my 2 children. My premium was quite heavy so was for my wife but for my children they were quite cheap. Later my children were not interested anymore in the Insurance so left the insurance to be covered for my wife and I. And I stopped being insured by Sihat Malaysia.

Of course when I think seriously about hospitalisation, why not be admitted into a Government Hospital when you are ill. Easily said than done. Anyone have tried that? If you are a retired and pensioned off Civil (Government) Servant probably you have a better treatment but for a retiree like me, I am just a person with an IC no.

In July this year I was taken ill and I admitted myself into a private Hospital in Ampang. I called the Insurance Co., got admitted into the Hospital by using the Insurance card. But later the Insurance Co, asked me to pay in full and claim from them later. Luckily I was only there for a couple of days so it was not that expensive. Now how do I claim?. The Insurance Co. instructed me to call on my Insurance Agent and make my claim through him. I got his old card and tried to call him. I failed - he either have left the Co. or he had changed his phone no. I called the Insurance Co. asking for this guy, and I was told to quote his Agent No. My God, how was I know?. After a few desperate calls, and calling names (tried to very civil at first) on the phone - all heated up - and saying that I must have been cheated, a nice sing song voice at the other end told me to leave a message and she would try to get the message to the Insurance Agent. I was getting somewhere after roughing up a few people. And the Insurance Agent called me up a few days later, and I recorded his hp no. on my handphone so that I may call on him again.

Unfortunately, about 1 week later I was again admitted into a Hospital but this time in Kuantan, this time for a suspected heart attack which I did not know about then. I was hospitalised for about 10 days, and again I used the Insurance card to get admitted. And the Insurance Co. agreed. But a few days later they turned on me by saying that I should pay first and claim later. I thought, there we go again. But I had no choice really.

I managed to meet my Insurance Agent in KL after I got out of the Hospital in Kuantan. I gave him my claims, signed a few forms and he said that there should be no be any problem with my claims. He would however need to give the claim form to the Doctor in charge of me at the Ampang Hospital for endorsement. I agreed. A few days later when I called him he said I should check with the Doctor whether the Doctor had endorsed the claim form, and I did. I found that the form had been endorsed and I told my Insurance Agent to collect it from the Doctor’s office at the Hospital. Until today I am still awaiting the answer on whether my claims have been approved or not.

The claims for my hospitalisation in Kuantan, I gave it to the Insurance Agent when I was in bed recovering from my heart surgery in Room 564. I am waiting as well. Now that I have paid fully for all my hospitalisation fees for the heart surgery, I am still to claim for what I have paid. I bet the Insurance Co. will find excuses of not paying me all my claims. Just my evil thoughts, but I suppose I am right.

What I wish to share here is that the conditions of hospitalisation Insurance or whatever Insurance that one takes on any coverage must be well understood. Insurance Salesman can easily cheat you, their sweet talk can influence you and you get trapped into paying heavy premium without reaping the benefits. And when you need them they will shy away from you, giving all sorts of excuses, and even telling you that they have no authority to approve your claim or that some small prints in the Insurance Certificate do not allow you to claim for that and for this. And the other people in that Insurance Co. are just faceless voices at the end of your phone lines. What to do? Have I been conned?.

To shout back, e-mail: mylias@tm.net.my


To Shout Back

1 Comments:

Blogger Waris Tok Naga said...

Bro MyLias,

I am going to forward this url to mcoba on the same thread. I hope it's ok with you.

My first job was as an Insurance Broker and we did the first GPA for PDRM via their koperasi. That was also the time when we arranged for all kinds of insurance for the "start-up" for Syarikat Gula Padang Terap -- marine, All Risk etc

peace,
Zin Dahari aka Waris Tok Naga

4:53 PM  

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