Insurance Company Forfeits Approval & Causes Man to Fork Out RM19K For His Medical Bill

X user @arfdy12 shared a story posted by a woman named Acha on Facebook. She said that she unfortunately had to share the story of what happened to her husband several months ago with AIA Malaysia, one of the leading insurance companies in the country. She said that she was exhausted from following up with AIA, and her insurance agent had also helped them because the answer that they received month after month was that there was no update. It was worse when she called their Customer Service line because there was no answer for their case.

Acha’s husband fell from the first floor in March 2024 and was brought to the KPJ Kajang Specialist Hospital for follow-up treatment. She added that he had made payments for medical insurance to AIA for almost five years, and this was the first time he wanted to use it.

When they arrived at the hospital, the Guarantee Letter (GL), which had been requested from the hospital, had already been approved, so her husband had been warded.

When he was warded, the hospital requested three GLs from AIA, and all had been approved. He was warded for seven days, and when he was discharged, hospital staff said that her husband had to place an RM400 deposit in case there was anything not covered by the insurance company. However, the hospital informed them later on that the final GLs had all been declined by AIA, and the insurance company had asked the hospital to amend the report. She said, “The hospital had already carried out everything that AIA had asked for three times, but everything was still REJECTED.”

The excuse they gave was that “the treatment could have been done as an outpatient,” but the woman said that it was an accident and needed medical attention from a doctor. The couple then sought advice from their agent, who was fortunately willing to help. Together with the agent, they headed to the hospital for a discussion and to collect all the necessary documents to be submitted to AIA.

Acha wrote, “I’ve called and emailed, but because I’m busy with work, I haven’t had time to visit the AIA headquarters. The problem is that AIA is such a big company with numerous sales agents, but everything becomes LOUSY when it comes to claims. All their answers are the same when I call their Customer Service.”

She said she was even more frustrated when the hospital sent a demand letter from the lawyer to claim the bill, but there was still no news from AIA. She finished by saying, “Did AIA cheat us because everyone knows that if there is an accident, an insurance company must cover the cost of the treatment. Otherwise, why would people take the trouble to pay every month, but something like this happens when there is an accident?” She ended by saying, “Seriously, this is a SCAM.”

In another update, Acha said that her husband had finally received a reply for the first time on this issue, and they asked for ten days to investigate.