Is Insurance Plan a Scam? Woman Claims AIA Refuses to Cover RM19,000 Medical Bill After 4 Years of Payments

Source: The Vocket

Many people understand the importance of having a personal insurance plan to cover future medical costs. However, stories of policyholders failing to claim medical expenses according to their policies are increasing.

Acha Natasha’s Frustration

Recently, Acha Natasha expressed her disappointment on Facebook. She claimed that a well-known insurance company, which she had been paying for nearly five years, refused to cover her medical expenses.

It Started with an Accident

The trouble began when Acha’s husband fell from the first floor. They rushed to KPJ Kajang hospital for treatment. Acha had been paying into her insurance policy for almost five years, and this was their first claim. The hospital issued a Guarantee Letter (GL) that was approved by the insurance company.

Additional Health Issues

At the hospital, doctors found other issues like a fractured bone and high blood pressure. Acha received three GLs, all approved. The total medical cost reached RM19,424.37.

Deposit Payment and Rejection

Before being discharged, Acha paid a RM400 deposit, fearing the insurance might not cover the costs. Later, the last GL was rejected three times because the insurance company claimed the treatment could be done as an outpatient.

No Response from Insurance Company

Acha and her agent gathered the necessary documents and resubmitted the application. Unfortunately, they received no response. The hospital sent a demand letter from a lawyer, but the insurance company remained silent.

Accusations of Fraud

Acha was frustrated and accused the insurance company of being fraudulent for refusing to pay her medical expenses, despite her long-term payments. She also questioned why previously approved GLs were later canceled.

Hope for Resolution

In a recent update, a representative from the insurance company contacted Acha, promising to investigate the case within 10 days. The hospital, on the other hand, threatened legal action if the bill was not paid.

Acha hopes this issue will be resolved quickly as she is now burdened with a massive debt due to the insurance company’s refusal to take responsibility.