Kisah benar ini saya ambil dari FB kawan saya. Untuk elak dari kesalahan etika Takaful Ejen, saya akan sembunyikan nama pengendali Insurans/Takaful ini. Cerita ini bukan untuk bencikan Insurans/Takaful, tetapi untuk pedoman bakal pencarum dan pencarum Insurans/Takaful untuk TAHU DAN FAHAM apa yang TERTULIS DI POLISI. Dan juga untuk diri sendiri, sebagai Insurans/Takaful ejen tak boleh janjikan bulan dan bintang pada klien. TAK SEMUA BENEFITS PIHAK INSURANS/TAKAFUL COVER. Akan ada PENGECUALIAN.
This message serves more as an advisory than anything else. As most of my closer friends are probably aware, my dad is currently fighting a losing battle against stage four pancreatic cancer. The cancer has become life limiting and we are looking at anything from a couple of weeks to (hopefully) two months.
The cancer was first misdiagnosed by CGH to be late stage three gallbladder cancer, which is just as aggressive. We then decided to seek a second opinion with Dr Tan Yew Oo from Singapore Oncology Consultants(SOC) who subsequently referred us to a Hepatobiliary Specialist, Dr Tay Khoon Hean at Gleneagles, for 1, further investigation of the cancer, and 2, to explore the possibility of doing a Whipple's Procedure. After further investigation, my dad was confirmed to be suffering from Pancreatic Cancer.
Before any of the procedures were started, my dad checked with his insurance agent to see if he could do a claim for the procedure. Our agent committed that everything would be claimable up to 600k a year. For those in the business, you would know this translates to high premiums. However, when my dad tried to claim for the charges incurred, he found out he was unable to do so as he had previously signed an exclusion for his hepatobiliary system. This system includes many major organs such as your liver, gallbladder, biliary duct, so on so forth. We then found out that the exclusion was because my dad suffers from Hepatitis B, which concerns more of the liver than anything. The medical bill he had to foot came out to about S$85k and insurance company X refused to pay a single cent, even though their agent made a mistake by telling us that we would be able to claim fully. We have appealed repeatedly and this letter is the latest outcome. We also found out from my dad that all he was told when signing the exclusion was that he would be excluded coverage from all Hepatitis B treatments, without being made to fully understand this medical jargon that he was unknowingly not being covered for.
This episode has left my family, or whatever soon to be left of my family, wondering how can insurance companies issue policies such as this and still be allowed to operate and collect money from us blatantly. Clearly the responsibility of understanding the contract now falls to us, the consumers, and Insurance Company X simply has to get us to sign on the dotted line, shake legs, and start collecting free money. Also, why were we not even paid a single cent even though we showed them evidence that their agent committed to us? Is this the current spirit of salesmanship? Regardless, my family and I are truly disappointed by the whole event and might be cancelling all our remaining policies with Insurance Company X, least we be let down by their "professionalism" again.
So at the end of this rant, three lessons to takeaway.
1. You might be insured but not necessarily protected.
2. Do your check-ups religiously. (My dad is only 60 btw)
3. Check your existing policies for exclusions and your parents' as well. They might not know what they have been told to sign.
My critically ill dad got fucked over by Insurance Company X. Total medical damage S$85k, total claims awarded, S$0.00. Happened because he was told to sign an exclusion that wasn't explained clearly. Agent say can claim before he started treatment, in the end cannot claim.
*26/08/15* To all who readily offered support and encouragement, my family and I would like to thank you from the bottom of our hearts. My dad is currently undergoing palliative care and we just want to make it our current priority that he goes in peace and not in pain. To add on, this post was intended to increase awareness, not spread hate, and I hope this has helped in some little way.
PS:// Saya suka item no 3. Check your existing policies for exclusions and your parents' as well. They might not know what they have been told to sign. Saya ada beberapa klien yg jatuh no 3 yg mana existing policies ada exclusions.