Insurance advises

[jphasia]

In case someone has good advise:

I have been with Aetna Thailand since 1999 for health insurance. It started as Bupa Blue croos Thailand that time, then became Aetna Thailand and recently this year became Allianz Thailand.

I have been on Premium IPD 5MTHB coverage since 1999, renewed the policy every year without any issues.

During the period as Bupa, I was based in Bangkok and so was renewing directly in Bupa office in Bangkok.

Later, I moved to Phuket and I was requested by Aetna to go through a broker in Phuket for anything. I couldn't understand really why because Aetna had also an office in Phuket.

My sister moved about 20 years ago to Thailand and I advise her to get an health insurance as well. She followed my advice and opt for the same insurance and plan as me.

The years passed with any issues about insurance, renewing the policies on time every year.

Since the last 4 years, my sister having financial difficulties, I have paying her premium myself for her to the broker. As the renewal are the same date for both of us, I am proceeding a global bank transfer for both of us to the broker. No issues. After the payment, the renewed policies been delivered by the broker later. Until this year!

The renewal for both policies are in April and got the notification for renewal by the broker in March. At the meantime, I got a notification directly from the insurance that Allianz took over Aetna but everything will remain unchanged. So I proceeded the bank transfer for both policies in March as usual. Of course keeping the necessary payment evidences.

It happened that in the beginning of the year, I had some health issues and was advised by the hospital (Bangkok Phuket hospital) to proceed some costly test (MRI...). After confirmation from the insurance that will cover (in Marsh) to both directly the hospital and me, i had an appointment scheduled for end of April for these tests.

When I showed up for this appointment, the hospital informed that the insurance won't cover these tests as I didn't renew my policy. I trier then to contact the broker but he was not reachable. After multiple calls to the insurance directly, they finally confirmed that they will cover the agreed test and advised me to go directly to Allianz Phuket office to collect my renewed policy.

I got my policy and asked the one from my sister but they told it was not ready yet. I found it weird as the renewal are the same date and the payment was done at the same time for both policies.

Time passed and as of today, my sister still didn't get her policy. Asking Allianz, she has not evidence that she is still covered. She has been advise by Allianz to fill a complain at the police station as there seems to be a lawsuit against the broker who of course disapeared.

My main concern, apart that if she has any heath issue at the moment, she is not cover but what will happen if she want to continue with Allianz later? Will they just accept to renew her policy or consider as new client and might not accept her due to health conditions and age (57)?

[Celsius]

39 minutes ago, jphasia said:

renewed the policy every year without any issues.

 

So as is the case with most insurers here everything was nice and great as long as they were collecting payments?

[jphasia]

23 minutes ago, Celsius said:

 

So as is the case with most insurers here everything was nice and great as long as they were collecting payments?

Correct

[richard_smith237]

You have proof that you paid the broker.

You have proof that you used the broker recommended to you by the Insurance company.

 

The way I see this is that the insurance company is responsible for their mistake in approving a fraudulent broker and should be honouring your transaction.

 

Sheryl has good information 'for all things medical' and will be able to point you in the direction of the insurance ombudsman where you can lodge a complaint. 

 

The issue of course is that you need continued insurance cover for your sister that includes the pre-existing condition and you need confirmation of this now, I'd be very forceful with the insurance company and push to speak to someone higher up.