It is a common practice when anything happen to us that we think is eligible for insurance compensation, the first thing we do is calling our insurance agent. A good servicing agent will assist you with all the documents. They will meet the doctor, fill up your form, get your document certified and submit it to insurer. Superb level of service isn’t it? All you have to do is only to sign a few forms of claimant. However, please appreciate what your insurance agent do for you. That’s a lot of job to be done. Signing the paper is only 1% of the total picture.
After a few weeks, the insurer payment check will arrive in your mailbox. It is also possible that the agent will personally deliver the payment to you if you authorize it. However,the hardest thing to do for the agent is to inform you when your insurance claim is rejected! What can you do if the claim is declined?
1. Discuss with your insurance agent
Sit down with your agent and clarify the reason why the claim is rejected. Insurance company will issue a letter regarding the reason of rejection. Insurer will point to the certain clauses in your policy that define the claim term. If you agent is still new in the business, get help from his immediate officer who is already in the industry for a longer time.
2. Clarify the situation with the Claim Department of Insurance Company
You can also go straight to the claim department to clarify the matter. Make sure you get a thorough explanation from the insurer’s staff. Ask whether you can appeal or provide other supporting documents to be eligible for the claim.
3. Financial Mediation Bureau (FMB)
The Financial Mediation Bureau (FMB) is an independent body set up to help settle disputes between you and your financial services providers who are its members..The FMB provides you with free, fast, convenient and efficient avenue to refer your disputes for resolution as an alternative to the courts. These disputes may be Banking/Financial related as well as Insurance and Takaful related .
The insurer may reject the claims on technical grounds. But if you think it is unfair to you, you can always seek FREE help from Financial Mediation Bureau. Here is the contact information:
The FMB can be contacted
at the following address :
The Financial Mediation
Bureau
Level 25
Dataran Kewangan Darul Takaful
No. 4, Jalan Sultan Sulaiman
50000 Kuala Lumpur.
| Telephone : | 03-22722811 |
email at enquiry@ fmb.org.my or Write your equiries online
4. Get a lawyer
If FMB can’t help you, you can still pay a lawyer. Who knows about law better than a lawyer?
5. Get help from Media
I wouldn’t suggest you to ask your local reporter to get you on front page because of claim rejection. The insurance company won’t pay you either! Just use your brain to think. If they pay you after you show your protest publicly, this means the insurer is encouraging others to do the same when their claim is rejected. Don’t be a fool. They will let you shout. After a few years, people will forget about the story. There must be a strong valid reason why your claim is denied. You won’t end up being a celebrity either.
More information about insurance:
When Should We Review Our Life Insurance Coverage?
What Happen to your Life Insurance Without Nomination?
Great Eastern MediCare 100: Protected up to hundred years old
How to Read Great Eastern Investment-linked Policy Statement
How to Avoid Investment-linked Policy Lapse
How Much Critical Illness Insurance Cover do you Need?
Definition of 36 Critical Illnesses or Dread Diseases in Insurance Policy
Why you should first buy Investment-linked Insurance Policy
ROI of insurance
6 replies to "5 Things You Can Do if Your Insurance Claim is Rejected"
Hi Mr KC Lau,
Im Raj, Seeking your valueable advice for the current sitution that i faced now. i’ve just buy an apartment direct from developer for RM480k at penang. ive got the full loan from the bank(maybank) and i got an call from etiqa go for medical check up (35yrs MRTA plan). prior this medical check up i,ve signed my loan offered and snp from developer. after a month…actually today i receive a email from banker saying that my mRTa had been declined and reason due to my glucose level is high 7.5. i was told by banker tht as long u have personal insurance than no issue. loan should be okay.
now my worry is
1. my personal insurance is quite old which i think RM20k if anything happens to me. which definitly not gonna help
2. can i take additional insurance such as MLTA? if i plan to take would it also cause the same roadblock due to the etiqa rejection(will it reflect in any system tht this personal had been declined due to high glucose level?)
kindly help to advice based on my scenario above. any recommendation?
Really appricated your help on this.
Thanks in advance.
Hi Raj,
1. You should also try apply for insurance since this is a major worry for you. RM20k life insurance is not enough as you stated.
2. When you apply for new insurance, they will ask whether you got rejected before. In this case, you have to be honest to tell the reason of decline.
3. Ask some experienced agents who can seek advice from their underwriters or upline on how to increase your chances of getting insurance application approval.
In short, you can lead a healthy lifestyle now onwards, get a better health report, and apply again.
Thanks alot for the valuable advice. will survey around to get the better coverage. Thanks again ya
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