19/04/2024
COMPLICATED CLAIMS ISSUE
Today i assisted an Existing AIA client to figure out her issue on unsolved claim that happen September last year. Client contacted me on Tuesday thru WhatApps and explain all the sequences regarding her own journey to submit her claim.
She was struggling for months going back and forth with AIA by calling customer service line and thru AIA+ app.
After listening to her stories and investigate the Claim History, there's 3 Main issues.
1. Guarantee Letter (GL) Rejected upon emergency admission.
Client visited Emergency Room Pantai Hospital on 23rd September 2023 Morning after felt pain and discomfort on lower stomach area. After diagnosis, ER Doctor suspected the case will be Chronic diseases. With servicing agent advice to just proceed, client agreed to submit GL for further examination and Treatment. After some time, client's GL were rejected and the case goes to "Pay & Claim" because client's policy is still in Contestable Period.
(Contestable Period - Insurance Company have rights to launch investigate any Critical Ilness admission for the First 2 Year of Client's Policy). Majority of people misunderstand this as "Rejected" instead of "Pay & Claim during investigation".
After the GL rejected news, client felt uneasy with current agent advice and decided to discharge and gone for Government Hospital due to treatment cost.
2. Uncomplete Bill & Receipt
After been neglected by current servicing agent, client decided to submit the claims by herself despite not knowing the process. AIA Customer Service done a massive effort to guide her. However, there's thing that client did not understand and thus making her felt more stress.
3. Wrong claim form and category
Client's servicing agent did provide assistance and did the first claim. However, after I thoroughly check it was wrong claim form and category submitted. Thus make the claim rejected and case close.
SOLUTION PROVIDED:
Tracked back all the document submitted by client’s agent, and review all correspondence letter by AIA. And examine client’s contract policy.
- Confirming that AIA already close the investigation on client and can claim/admission.
- Collect Full Itemised Bill & Patient’s Report from Pantai Hospital.
- Divide & Organised 2 different type of claims with designated form. One from ER admission from Pantai Hospital, and other from Treatment operation on Government Hospital.
- Personally submitted all the documents for claims directly at HQ to expatiate the case.
Also due to completion of investigation on Client’s Disease chronology, client’s eligible for all benefit thus I did recommend her transfer to Pantai Hospital from Government Hospital to utilized the Privilege of having AIA Medical Card.
RESULTS:
The claims have been re-open and now in progress. Client felt relief as few problem for months have been lifted and propose to appoint me as her new Servicing Agent.
Antara Perkhidmatan Insurance & Takaful yang says sediakan secara *PERCUMA* adalah;
- Quatation
- Penerangan Manfaat Plan
- Review Policy yang sudah ada
- Knowledge
- Situasi Semasa
Semua boleh, Semua Percuma
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Insurance & Takaful 📚✍️ Khidmat Professional, Consistent & Terperinci 𝙄𝙨𝙩𝙞𝙢𝙚𝙬𝙖 𝙐𝙣𝙩𝙪𝙠 𝘼𝙣𝙙𝙖:
✅ Policy Review (Percuma)
✅ Perlindungan Pendapatan
✅ Hibah / TPD
✅ Medical Card
✅ Tabung Pendidikan Anak / Education Fund
✅ Pengurusan Kekayaan / Wealth Management
✅ Penjagaan Pekerja / Employee Retention (Business Owner)
✅ MLTT / MLTA (Rumah)
✅ Personal Accident Insurance & Takaful
🔵 Kenapa Pilih Saya?
- Agent Rasmi berdaftar dan dikawal selia AIA Berhad/ AIA Public Takaful
- Teliti dan Jujur
- Consistent & Pantas
- 24/7 Bersedia Berkhidmat
- Servis Yang Mesra
- Berpengalaman menghadapi “Bebanan” Sakit Kritikal (Ahli Keluarga Sendiri)
🔴 Kenapa Pilih AIA?
- No. 1 Syarikat Insurans & Takaful
- Rekod Jumlah Bayaran Pampasan TERTINGGI di Pasaran lebih 6 tahun berturut-turut
- Mudah & Pantas Proses Claim
- Fast Lane Customer Service di Hospital
- Mempunyai Hospital Platinum dan diberi layanan VVIP
- Fund Management yang Cemerlang (BlackRock)
- Beri Rewards lebih kepada anda untuk amalkan Gaya Hidup Sihat (AIA VITALITY)
𝙁𝙤𝙡𝙡𝙤𝙬 saya 𝙙𝙞 𝙢𝙚𝙙𝙞𝙖 𝙨𝙤𝙨𝙞𝙖𝙡 👇
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