Non Payment of Covid Insurance

[Jarboy]

Hi,

 

I got Covid in Thailand January of this year.

 

I made a claim on my insurance policy with Tune Insurance Company and on 15th June received an email from them that said "Please be informed that your medical claim has been approved."

 

But since then nothing. No response to my many emails and emails to them from the Agent (LUMA Health) that I bought the insurance through.   

 

Any suggestions as to what I might do?

[scubascuba3]

Could try the Consumer Protection Board, if claim is a decent size use a lawyer.

 

https://www.ocpb.go.th/index.php?filename=index

[Jarboy]

27 minutes ago, scubascuba3 said:

Could try the Consumer Protection Board, if claim is a decent size use a lawyer.

 

https://www.ocpb.go.th/index.php?filename=index

Thank you for your reply - it's not a big claim - only 26,000 Baht

[Etaoin Shrdlu]

The best place to seek to resolve insurance issues or disputes is the Office of the Insurance Commissioner.

 

https://www.oic.or.th/en/consumer

 

The OIC is quite consumer-friendly and also has the ability to issue fines or revoke insurance broker and insurer licenses. Make an appointment and bring a Thai speaker. You'll get a fair hearing. Ask your broker about helping you with your complaint.

[Gottfrid]

58 minutes ago, Jarboy said:

Thank you for your reply - it's not a big claim - only 26,000 Baht

That´s big enough to not want to lose when you paid for an insurance. ???? You have got good advices from two posters here. Just get on with it. As they already approved, they should not get away with it. Good Luck!

[EricTh]

1 hour ago, Jarboy said:

Thank you for your reply - it's not a big claim - only 26,000 Baht

 

What proof did you provide that you were infected with Covid?

 

[Jarboy]

14 minutes ago, EricTh said:

 

What proof did you provide that you were infected with Covid?

 

I had to provide them with this information.  All sent via mail from UK to Bangkok
 

Copy of Insurance Policy.
Copy of Passport.

Proof of travel stating the date of entry into Thailand, such as the passport page with the date of entry stamped or Travel itinerary from Airline.

Doctor/ Physician's report describing significant symptoms, diagnosis and result of treatment.

All Treatment history from the admission date in hospital to the discharge date from the hospital.

All Original receipt with description of medical expenses or summary statement of medical expenses and receipt.

I'll follow up on the paths suggested above.  Thanks for your help and advice.

[Fairynuff]

12 hours ago, Jarboy said:

Thank you for your reply - it's not a big claim - only 26,000 Baht

Big enough to fight for what’s rightfully yours

[Fairynuff]

A Thai friend had 3 separate insurances, 2 of which were taken over by the government when they went bust. The agency is giving people the run around repeatedly asking for the same documents, more signatures and so on. They’re hoping people will just give up despite having already being told payment under process.

[Aussieroaming]

Yeah, too many claimants caused some insurance companies to bail. It didn't help that some Thais were trying to get infected in order to get a windfall payment. 

[Troy Tempest]

I had to make a claim against Tune/Luma Healthcare when I ended up in ICU for a suspected heart attack!

 

I had to pay the hospital up front and then submit the claim.

 

It was for 36,000 Thb.

 

It took me nearly 6 months to get it, but in the end they paid (less many deductions)!

 

The hospital in question was Bangkok Hospital in Chaweng, Koh Samui.

 

They told me that was normal for Tune Insurance claims and that I was lucky to get any payout!

 

Many do not!