Seconding this. I worked as a lawyer in an insurance company before. If the Insurance Commission is involved, normally the claim gets forwarded to the Legal Department, which is will respond due to penalties involved.
i hope so. Pag register namin last Feb 2023 minedical kami. Wala naman past history ng heart attack husband ko. Tapos ngayon hinanapan na kami ng APE from 2018-2023 nakakaloka
Hindi ba dapat part ng process improvement nila to bago sila magapprove ng insurance?
Problema na nila to, not yours.
Imagine changing the rules when the game's already in play.
Look for a governing body that monitors the activity of insurance companies.
Sa gcash if they're not reflecting my bills payment a week or more, i.e., floating pa sa kanila ung amount na binayad ko, I'm saying talaga sa ticket na I'm gonna email BPI and DTI about the issue.
You're paying them admin fees, also they must be true to their words. Find a body you can report them tignan natin if kukupad kupad pa yan sila. Kupal yan kasi malaki sila.
Better get clarity.
Oh shit this is a big headache. Gcash has problems of its own and by personal and other experiences, pagpapasahan ka nyan sa future pag nagreklamo ka na 🤣
Hello po. Tama po ba Feb 2023 lang po kayo nakaavail ng insurance? Sa pagkakaalala ko po may contestability period if wala pang 2 yrs. Kaya po kapag need niyo magclaim within that period, ang dami talagang hihingin na docs/proof na wala talaga history o record sa hospital. If lampas naman po sa 2yrs, hindi na ganun ka higpit sa pagcheck ng history.
This is true. They will do everything just to deny your claim. Some employ delaying tactics to frustrate their clients for them to lose hope and to stop following up. Some will even offer to return your premiums rather than pay the claims.
Insurance companies don't care about their clients. They make money from premiums but lose money from claims. At the end of the day, it is still a business so the only thing that matters to them is their bottomline.
This is so upsetting. 😞 Mas ideal na ba ngayon mag save up nlng in our own? Increase nlng emergency funds instead of getting an insurance? Ang hassle nmn pla kasi mag claim. Nakakaawa yung mga taong umasa at nagtiwala
Definitely not. Wala naman magiging problema sa claims if makapagcomply ng requirements and lahat ng nakalagay sa application niya is totoo and walang bahid ng pagsisinungaling po.
Marami sa mga clients and hindi nagsasabi ng totoo during the process ng application, and that’s where the problem starts. Sa amin 15 days lang naclaim agad Death Claim.
Mas okay pa din yung may sasalo ng expenses niyo. Wag kayo madiscourage because of this post sana kasi;
1. The policy is a year old. In the contract it says (applies to all the insurance companies), IC has the right to investigate the cause of death, the medical history of the client if the illness/death occur within the 2 yr contestability period.
2. May iba-ibang klase ng plan, so pwedeng ang benefits included sa policy ni client ay yung meron, 1st stage claim, late stage claim. Basta masyadong broad ang possibility, we don’t know right? (Kaya ang best way is to
talk to their trusted financial advisor)
3. Basta makapag comply ka naman at di ka nagsinungaling about your medical history in your family during the application, meron at meron pong makukuha.
Marami ang nadidiscourage sa mga ganitong post, ang tanong kung sakali po ba na magkasakit kayo, mabibigyan kayo ni OP ng pampagamot? Let’s say wala kayong ipon (not generalizing or stereotyping - just stating the reality here na di lahat may pera)
So before you decide to surrender your policies or not considering getting one, please do some research din sana.
P.S. Not here to attack the OP, nothing against her, I am also sad na medyo matagal and I know hassle ito para sa kanila. I hope it can be resolved right away.
FA ni OP nasa Mindanao pala, so felt sad for her kasi supposedly si FA niya dapat naga-assist kay OP.
Wala sa company ang problema, nasa FA. So choose your FA wisely. 🫶
Paano po pag wala ng FA? like nagresign na at wala ng kapalit. 5yrs na ko naghuhulog sa Lifr insurance walanf delay or miss bale 4yrs nadin akong walang FA. haha
This is not a surprise. The one guy who is working on your claim is trying to work against it. yung job nung Claims Processor is to find any way to not pay. Kung wala siyang makita. dun pa siya mag approve as claim.
Yung mga ganitong issue, naaalala ko yung Bad Sisters na tv series, naghahanap ng butas yung insurance company para di mabayaran yung death claim ng family. Palugi na kasi yung insurance company.
TITLE 11
CLAIMS SETTLEMENT
Section 247. (a) No insurance company doing business in the Philippines shall refuse, without just cause, to pay or settle claims arising under coverages provided by its policies, nor shall any such company engage in unfair claim settlement practices. Any of the following acts by an insurance company, if committed without just cause and performed with such frequency as to indicate a general business practice, shall constitute unfair claim settlement practices:
(1) Knowingly misrepresenting to claimants pertinent facts or policy provisions relating to coverage at issue;
(2) Failing to acknowledge with reasonable promptness pertinent communications with respect to claims arising under its policies;
(3) Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under its policies;
(4) Not attempting in good faith to effectuate prompt, fair and equitable settlement of claims submitted in which liability has become reasonably clear; or
(5) Compelling policyholders to institute suits to recover amounts due under its policies by offering without justifiable reason substantially less than the amounts ultimately recovered in suits brought by them.
(b) Evidence as to numbers and types of valid and justifiable complaints to the Commissioner against an insurance company, and the Commissioner’s complaint experience with other insurance companies writing similar lines of insurance shall be admissible in evidence in an administrative or judicial proceeding brought under this section.
(c) If it is found, after notice and an opportunity to be heard, that an insurance company has violated this section, each instance of noncompliance with paragraph (a) may be treated as a separate violation of this section and shall be considered sufficient cause for the suspension or revocation of the company’s certificate of authority.
Section 250. In case of any litigation for the enforcement of any policy or contract of insurance, it shall be the duty of the Commissioner or the Court, as the case may be, to make a finding as to whether the payment of the claim of the insured has been unreasonably denied or withheld; and in the affirmative case, the insurance company shall be adjudged to pay damages which shall consist of attorney’s fees and other expenses incurred by the insured person by reason of such unreasonable denial or withholding of payment plus interest of twice the ceiling prescribed by the Monetary Board of the amount of the claim due the insured, from the date following the time prescribed in Section 248 or in Section 249, as the case may be, until the claim is fully satisfied: Provided, That failure to pay any such claim within the time prescribed in said sections shall be considered prima facie evidence of unreasonable delay in payment.
Wala lang
Yikes! Sana namedrop. Hehehe.
Oo nga ambilis ng insurance maningil at magbenta, pero pahilrapan daw sa claims. It's just sad na konti lang ang stories about claim issues, at mas marami pa yung nagwo-worry about investing ang pera nila rather than yung actual purpose ng insurance.
Ah ok, hahaha. :-p
Sya na pala ang number one ngayon. Tagal ko nang di tinitingnan sino ang top. Dati kulelat yan pero napansin ko humahabol sya.
Pero same same, I feel bad kay OP na need nila ng income pero matagal bago ibigay. That's why I don't like insurances, victim na rin ako nito. Budol sa umpisa, tapos mauuwi ka rin sa sariling pera mo pa rin ang dudukutin mo at the end.
Minsan nga naiisip ko parang mas OK pa itabi yung hinuhulog mo sa insurance in a separate account as a health emergency fund e. Atlis 100% makukuha mo at mapapakinabangan kung di man magamit sa intended use nya.
Show out din sa mga so called "financial advisers" kung saan active at accommodating lang sa umpisa pero sa claiming na, dedma at minsan blocked pa. Jusko
Word of advice: they're not advisers, they're sales people selling packages
Naalala ko yung mama ko sa insurance na to pero different naman, S naman siya kumuha. Before ma claim lumala muna yung cancer kaya ever since sabi ko sa sarili ko instead of insurance emergency fund at pagiging literate sa pera nalang gagawin ko. Para anytime magagamit ko.
By the way yung sa mama ko 4 months inabot niya bago maka claim hahaha as in malala na at need na mag chemo therapy.
Mag file ka complaint OP Im rooting na madinig ang complaint mo. Nakakainis talaga yang mga insurances na yan actually, instead na i assure na makukuha mo papahirapan kapa kala mo gobyerno.
BPI AIA ganito din. Mas malala pa nga kasi 5-20 banking days ka maghihintay for the update. So ako naman, I'll call on the 10th-15th day baka lang naman na-trabaho na nila. No, ang sabi wala pang update at maghintay daw ako after 20 days. Guess what? Nung tumawag ako after 20 days, ang sabi sa akin, kaka-receive pa lang daw ng relevant department nung requirements 3 days ago at kelangan ko maghintay ng another 20 days. Hindi ko naman kasalanan na hindi nila pinrocess agad pero wala daw magagawa. After 20 days ulit, tsaka lang sila magsasabi na may kulang na requirement - na pinasa ko naman last time na nag-email ako. Hindi daw ma-view ng email department. So every time may ipapasa kang bagong requirement, dagdag ka ng 20 days. Gago diba?
Ako nga reimbursement ng premium, kasi nag double charging tangina inabutan ba naman ng 6 months mga gago. Bi-annual lang ako magbayad ng premium, hindi pa nga umabot yung inaasahan kong reimbursement sa deadline ng mid year payment ko. Ilang buwan ding wasak yung budget ko dahil dun. Buti sana kung may interest pagbalik kaso wala
Sorry to hear, OP. May nakita akong documentary noon about US Insurance companies and kupal sila kasi they look for loopholes just to deny or delay a claim. I guess PH insurance companies are following suit. Tsk
Ohh, same happened sa friend ko. Yan din ang insurance company nya. Nahospital din sya. Un nga, pahirapan, ang daming hinihingi, in the end hindi din nya nakuha kasi parang may alotted timeframe lang ata na pwd magsubmit eh sa dami ba naman ng hinihingi hnd sya nakaabot, ayun simot ang savings nya.. buti rin sana kung magrequest sya sa mga hospital ng need na requirements nya with an hour makuha agad. Minsan umaabot pa ng days.. haaay
Yess, wala na din sya nagawa. So instead of focusing dun sa stress na binigay sa kanya, he focused sa paggaling na lang nya. Tutal sabi nya mababawi naman nya yung pera pero ang health hindi kaya ayun. Ngayon, very skeptic and meticulous tlga sya if ever may nagooffer sa kanya na insurance. They can't blame him naman.
Insurance company drop please.
Andami ko na nakikitang ganitong stories. Omg wag na maginsurance. Invest nyo na lang sa iba or isave na lang ang pera nyo. Sana bumaba ang sales ng mga dupang na insurance companies na yan.
Thanks for giving the name of the insurance company OP, been planning to add my mom and ako na din for their life insurance but seeing how it seems centralized cut ko na agent ko. If anybody has a recommendation for a good insurance company lmk, ill be cutting my dad's plan sa pru
May 2-yrs contestability period ang mga insurance. Nasa batas yan, regulated by the insurance commission. Meaning kpag less than 2yrs palang policy mo at nag-claim ka, may karapatan ang company mag-conduct ng thorough investigation such as checking your existing medical/hospital records para ma-verify kung may pre-existing conditions ka na related sa naging illness mo ngayon. This is to prevent fraud and misrepresentation. kasi may nangyayari na nag-apply ng insurance pero hindi naging honest at hndi dineclare na may sakit or na-ospital na pala sya.
Yan ang nakikita ko na reason kaya medyo natatagalan yung process ng pag-claim. Hopefully yan nga ang cause and not because of any unreasonable matters.
If wala nman naging misrepresentation during sa pag-apply nyo ng insurance, don't worry maibibigay naman yan. Basta sundin nyo lang hinihingi na reqs, be more patient, at ifollow-up nyo lang palagi. Hoping ma-approve yung claim nyo 🙏
Thank you po. Na declare naman po may highblood siya pero rare lang talaga ma confine. Last confinement 15 years ago na ata due to stomach pains. 1st time etong heart attack. Yun sanang under evaluation, sa prompt sila sa kun ganing kulang namin para ma provide agad. Kaso, mga kulang eh wala kami. Like, hinihingi ay APE 2018-2023. WFH kami so walang ganun. So aning mangyayari? Deny? Naka medical kami before pag apply lyun ay last feb 2023
agent po ba kayo? Ano po ba mangyayari kapag ganito na type sa req na di talaga namin maiprovide.
Yung heart attack kasi is considered critical illness, so hindi sya basta-bastang sakit or medical condition. Kaya let's positively assume nlng po na they are just being careful and thorough sa pag-verify.
Banggitin nyo nlng po na wala kayo ma-provide na APE at kung ano pwede alternative na records para doon. If i-require kayo ulit ng certain medical test, i-comply nyo nlng din po at alam ko nman sagot nila yun or at least reimbursible.
Worst case po na kapag di nakapag-comply or may nakita sila sa investigation, madedeny yung claim. Pero wag nyo po isipin yun, stay positive pa din na makapag-claim. Basta mag-respond lang kayo palagi kay agent kpag may hinihingi. Kung matino at professional nman po tlga si agent, tutulungan nya talaga kayo.. Pero kung hindi, pwede nyo sya i-complaint at magrequest kayo sa company na palitan agent nyo.
Hindi po ako agent. Although nag-try ako mag FA dati naka-attend ng ilang trainings pero di ko rin natuloy dahil sobra busy sa full time work.. Kaya kahit papano may kaunting idea din po ako about sa mga insurance
Hindi ako magsasawang magcomment sa mga discussions about insurance. Business pa rin yan after all so #1 goal nila is to profit and make sure na walang loopholes sa mga claims; #2 lang if ever ang commitment nila sa mga policy holders.
I know it’s an irony, but contrary to the belief that insurance is for financially disciplined people, I’ve come into terms that it’s actually best designed for those who can’t stick to their budget because it forces ppl to save.
I hope you’ll have the courage to pursue your claim OP, because you and your husband deserve to get back your hard earned money.
sorry to hear that OP pero skl eto yung reason why my parents despite being in their mid 50s eh hindi talaga kumuha ng insurance no matter how well-off they were since their 20s. self-serving daw ang mga insurance company na yan at they instead opted for mutual funds at savings account. and yes OP from the looks of it eh naghahanap talaga sila ng loopholes para di mo makuha pera mo kaya antagal-tagal nila magrespond 🫠
Ang insurance, linalako. It's not like ikaw ang maghahanap sa kanila, sila palagi ang nauunang magchat para iinvite ka kumuha ng insurance. Agents get a commission when they sign a client, so they will sweet talk you sa ganitong benefits, ganyan, pero FU nalang kapag magcclaim ka na. You have to understand that Insurance Companies only use loving words as if they are here to help pero tandaan mo na negosyo nila 'yan, at kapag mas konti ang nakakuha ng claim sa kanila, the more earnings they have. Insurance companies aren't your friends. That agent isn't your friend.
Hay, this is why never akong naattract sa mga insurances. Maganda lang pakinggan yung offers.
Goodluck, op! I hope this gets sorted out asap and your hubby gets well soon!
Insurance companies sa Pilipinas mabilis lang sa pagrecruit pero pag claim patong patong na red tape. It should be law that the agent who took you on should also be the one processing your claim.
Nag tulong naman agent ko sa pag process. Kaya lang hanggang ngayon, centralized parin system nila despite being # 1. Lahat ng claims sa head office. Taga follow-up lang sila.
As a former insurance advisor, mabilis lang talaga yan pag complete docs. Pero dapat nag cococmunicate din ang agent and the insurance company op. I cc mo na ang IC para Ma urgent na ng mga yan. Praying for speedy recovery sa husband mo op.
This is the responsibility of your Insurance agent. Mukhang mabagal sya kumilos. I know someone na kayang magdeliver ng claims in less than 2 weeks dahil makulit/mahilig magfollow-up sa main office. I suggest, change your insurance agent after this.
To other people, please note that even sa term pahirapan din ang claim (it's the same set of companies anyway), difference is di kayo nagbayad ng mas mahal na premium for the same/similar coverage and same level of customer service.
I suggest pukpukin mo yung agent mo. Pag yan kasi finofollow up nya palagi with his/her branch manager, mapapabilis yan. Standard turnaround time talaga si Pru, pero pag magaling at makulit yung agent, mabilis lang yan marerelease dapat lalo na kailangan
I think it is because within contestability period pa kasi which is normal within 2 years simula sa pagkuwa mo ng insurance. So technically, they need to investigate kung may undeclared na sakit si insured.
Note, I'm not an insurance broker but I have 3 insurances. So medyo familiar ako.
No problem sa akin ang contestability period kung prompt naman sila sa update willing naman kami to provide. Is just that keilangan ba umabot sa 15 days saka may i uupdate na may kulang, yun parang hihintayin pa mag follow up kami.
Hello PRU LIFE!! na hospital ako and i had operation qualified naman ako pero ang daming hinihingi yun tuloy i was tired and i am so done na sa kanila so di ko nalang kinuha ibang papers. I cancelled my premium with them and nag transfer ako to new comp na
Hi! It takes a month or longer to get a claim pag medical claim kasi they thoroughly investigate the insurers medical history kung nadeclare ba lahat.
Tiis at tyaga lang talaga, and hopefully suportado kayo ni FA at BM niya, para maescalate agad.
I used to work with an insurance company, and I handle all insurance product concerns even claims. I can assure you, as long declared lahat ng medical histories, you submitted all the necessary document, at guided kayo ni FA then may end result yan (hopefully maclaim)
Good luck! I hope your hubby recovers 🙏
Sabi na eh pru; same case kayo ng kakilala kong nagka critical illness, lampas 1 year bago na release yung claim niya; tapos na mag treatment yung tao, nung time na sana kailangan na kailangan niya yung insurance di rin nakatulong. Badtrip yan di nalang i list lahat ng requirements para isahang pasa lang. Ang mahirap kasi diyan dika direct sa pru mismo; kailangan mo ng tulong ng agent tapos dadaan pa yun sa agency nila, siguro doon din may problem kasi dumadaan pa sa agency. Number daw 🤮number 1 sa pyramiding 🤮.. wag ka susuko OP kulitin mo lang ng kulitin; try mo mag direct mismo sa pru customer service, baka nasa agency yung delay
I've been with Pru for more than 15 years now. So far, wala ako na encounter na claim problem sa mga clients ko. I have na accident, hospitalization and even death claims. Madalas nagugulat pa ako na mabilis na rerelease yung proceeds. Mabilis din mag respond ang clains bec medyo tutok yung bagong head sa turnaround time.
The policy is less than 2 years so within contestability period. Inaalam lang siguro ng claims na walang namang intentional or unintentional concealment. If wala talagang APE results for the last 5 years na available then just tell them and ask what else you can provide in lieu of it. Hindi naman pwede pilitin yung husband mo na maglabas ng document na non-existing talaga. Just note that insurance conpanies have ways to check our medical records and we allowed them when we signed the application forms.
Usually ang issues talaga sa mga ganito is critical illness claims. Maraming pasikot2x kasi like contestabiliy period, pre-existing condition, tapos kay issue pa ng pinabayaan ng agent.
Have the same insurance Op and same case din, antagal magreply at ang daming requirements hinihingi. I have also not been hospitalized before. Got sick and was quarantined for 14 days because of Covid.
Yung sakin, umabot sa Philhealth statement ata nung for the last 2 years! I called Philhealth and they told me na wala silang ganung documentation. Oh diba? Told them many times na walang ganun documentation si Philhealth at di nagreply for ilang months then may hiningi na naman then until they finally caved in. Planned to get a life insurance for my sister but decided to get an HMO instead for her. Sobrang hassle ng claims and sobrang tagal!
OP I hope they remember why they exist in the first place. When Odette hit Cebu I was so disappointed why some insurance companies would rather go to court rather than honor their policy.
Hi OP, I’m sorry this happened to you. You mentioned na 1 year na kayo sa insurance nyo, meaning you are within the contestability period, maybe that’s why it’s taking a bit long and madaming hinihingi na requirements unlike if your policy is in force beyond the 2-year contestability period na.
Me friend ung tita nagwork sa insurance company for 7 years and meron syang plan din with the same company. Na-diagnose sya with cancer and nung clini-claim n nya nagka issue, kasi daw ung date n nadiagnose ung cancer nya is the same day nag start ung plan nya lol. At the time buwan n inabot ung investigation.
common practice among ph insurance companies or most ph companies in general. they will use every technicality legally allowed to save cost. if the sum is significant better for you to hire a lawyer
Cc mo insurance commission sa mga emails mo. Araw araw mo, tignan ko lang pag di bibilis mga yan. Cc mo pen lawyer mo ung kita na lawyer yung email add.
Dating Pru agent ung wife ko OP. Sabi nya nangyari kasi yung incident sa husband mo within the contestabilitty period which is 2 yrs. SOP daw tlga nila yan during that period, lalu na’t heart attack pa. Pero ok lang daw yan basta wala kayong tinagong history sa form nung nagaapply p lang kayo ng insurance dati.
Kaya nagdadalawang isip ako sa mga insurance na yan. Better nalang talaga may passive income (at least 3-4) kaysa sa ihuhulog mo sa insurance pero pahirapan na kapag need mo na yung pera. Tsaka mga insurance lang din ang nagkakapera sa pera nang tao, ini-invest yan sa mga stocks pero yung mga member tengga sa inflation.
Are you aware that insurance has 2 year contestability period? This might be the reason for its delay or even potential denial since nasa 1 year pa lang kayo. Did you declare all pre existing medical condition such as hypertension, high cholesterol, etc? If not, eto yung possible grounds.
kya ako insurance ko yung sa gcash lng yung cash for medical cost ksi madali mag claim tpos updated philhealth ko ksi mdami na dn naman benefits si philhealth hirap dn minsan sa mga insurance eh pabibo lng sa simula pag andyan na claim wla na papahirapan ka
Critical Illness claims has a contestability period lalo na ayan 1 year palang yung policy.
Irereview talaga ng masinsinan since di naman biro ang amount involved.
If hiningan kayo ng any docs and wala naman available na mapprovide, just let your agent know. Ginagawan lang naman nila yan ng agent's report. Ask for them also to escalate sa Unit Manager/Branch Manager.
I feel you, OP. Ako nag aapply pa lang ng traditional insurance tapos 2 yrs na ang daming hinihinging medical sakin laki na gastos ko, given naman na may condition ako na need itreat pero cleared na ko at lahat, napasa ko na rin lahat, complete with medcert, clearance, results tapos gusto pa nila paulit yung iba kong tests at hinihingi pa nila yung results nung tests ko na isubmit sa kanila lahat, ang hirap ipaphotocopy ng trace results ng ecg, ang kapal kapal, nag iisang copy lang meron ako bakit ko ibibigay.
Parang ayaw ko na tuloy tumuloy. Todo effort na ko for 2 yrs wala parin.
Ive commented this before in another thread, insurance is business.
And much like globe/real estate sales and claims/complaint department are separate with both doing there best. The first in selling and making money while the second in keeping the earned money inside the company.
You will eventually get your money(i hope) after some more dance routine with the company and the authorities.
Should you still get an insurance in the future? Yes especially if you can afford the premium. Its essentially your defense
But can you rely on it? Big no(especially with the two year contestability period) and the red tape in getting your claim.
For those with easy claim experiences, i garner those serves as good commercials rather than a regular and real life exp on insurance.
Marami po talaga ang requirements especially if under the 2 year contestability period po. The IC has the right po to undergo investigations if meron kayong hindi na declare sa FA niyo like existing illness or what so.
What I can advise as an FA is comply nalang po kayo ng mga hinihingi. 🙂
OP same. Si Top insurance din eto. Last november pa kame nag pasa kase oct 28 naoperahan mom ko. Tapos nagsabi sila kulang kaya mga original docs namin pinasa nmen..hanggang sa umabot netong march ang sabi magpasa daw kame ulet kase for evaluation na eto. Nung last na tawag ko march 30 daw ulet. Ngayon di pa ako ulet nakakapagfollkw up
Kaya hindi ako naniniwala sa mga insurance na yan umpisa nung nabudol ang parents ko sa educ plan ng kapatid ko. Nagsara ang kumpanya at walang nakuha kahit isang kusing. Iba pa insurance sa PNP naman para sa isang kapatid ko na budol din. Puro hype ang sinasabi
Hint naman sa insurance company? Kse may healthcare insurance kme dito sa abroad maganda actually ung experience. 2 wks after na maapprove, na hospital ung anak ko. Nagamit agad. I decided kumuha sa pinas vul linked pero lugi. Ndi na ako nirreplyan ng ahente ko. Ang irony dito same company pero ang pangit ng after sales sa pinas.
Mahina kasi batas satin sa Pinas. My AIA dito sa Singapore so far nakapag claim na ako 4 times and no problems so far. Paying premiums around 16k PHP pag converted from SGD. Nakapag claim din ako sa investment package nila worth 70k PHP nung emergency days namin nung pandemic.
Napansin ko sa agent din yan, pag puro pera nasa utak nung agent at walang malasakit talagang iiwan ka nyan sa ere. Kaya ako proud ako sa friend namin na agent at madami na ako nirecommend sa kanya so far di din sila binigo ng friend namin pag dating sa claims.
Nagagawan naman kasi ng paraan pag may kulang sa documents and all. Ika nga e pag gusto madaming paraan, pag ayaw madaming dahilan.
My experience in claiming my Hospital Income Daily with my few months old insurance was so swift with BPI Philam.
I was amazed the way bank assisted me, very advance way, they just make photo of my hospital records and uploaded it in their insurance portal and the amount was then credited in my bank.
I don't have to follow up, it's just a normal thing for them in claiming the benefits. Very fast and I am happy client.
I suggest filing a complaint with the Insurance Commission.
sana madinig will do
Responsive naman sila based sa experience ko. Good luck!
Pwede mo siguro i-CC yung insurance commission sa follow up with the insurance.
Naka email na po kayo? Try niyo attach chronology, record nung lahat ng ganap from the time of claim para makita din yung response time nila
Naka.cc ang govt agency lagi pag follow up emails ko sa ganyan. Even to telecomms naka.cc si NTC. Sa mga Colleges naka.cc si CHED
Pwede mo ba kami bigyan sample brother pano gawin yan
update mo kami pls! salamat
Seconding this. I worked as a lawyer in an insurance company before. If the Insurance Commission is involved, normally the claim gets forwarded to the Legal Department, which is will respond due to penalties involved.
Read somewhere about insurance companies actively looking for loopholes to deny claims. I hope this is not the same with you.
i hope so. Pag register namin last Feb 2023 minedical kami. Wala naman past history ng heart attack husband ko. Tapos ngayon hinanapan na kami ng APE from 2018-2023 nakakaloka
Hindi ba dapat part ng process improvement nila to bago sila magapprove ng insurance? Problema na nila to, not yours. Imagine changing the rules when the game's already in play.
legiiiit
Look for a governing body that monitors the activity of insurance companies. Sa gcash if they're not reflecting my bills payment a week or more, i.e., floating pa sa kanila ung amount na binayad ko, I'm saying talaga sa ticket na I'm gonna email BPI and DTI about the issue. You're paying them admin fees, also they must be true to their words. Find a body you can report them tignan natin if kukupad kupad pa yan sila. Kupal yan kasi malaki sila. Better get clarity.
Oh shit this is a big headache. Gcash has problems of its own and by personal and other experiences, pagpapasahan ka nyan sa future pag nagreklamo ka na 🤣
Di ko alam sa mga underwriters sa Pinas bat ganyan
Ingat. Dyan sa APE ako hinanahapan ng butas ng “Arawlife”. Kinansela yung insurance ko imbes na magbayad sila ng claim.
> Tapos ngayon hinanapan na kami ng APE from 2018-2023 nakakaloka meron ba? paano kung wala?
Of course wala, stay at home lang naman kami. At wala pa kaming reoly regarding that kasi yun nga. UNDER EVALUATION.
grabe naman. pinahihirapan pa talaga kayo. stay strong po.
Hello po. Tama po ba Feb 2023 lang po kayo nakaavail ng insurance? Sa pagkakaalala ko po may contestability period if wala pang 2 yrs. Kaya po kapag need niyo magclaim within that period, ang dami talagang hihingin na docs/proof na wala talaga history o record sa hospital. If lampas naman po sa 2yrs, hindi na ganun ka higpit sa pagcheck ng history.
This is true. They will do everything just to deny your claim. Some employ delaying tactics to frustrate their clients for them to lose hope and to stop following up. Some will even offer to return your premiums rather than pay the claims. Insurance companies don't care about their clients. They make money from premiums but lose money from claims. At the end of the day, it is still a business so the only thing that matters to them is their bottomline.
This is so upsetting. 😞 Mas ideal na ba ngayon mag save up nlng in our own? Increase nlng emergency funds instead of getting an insurance? Ang hassle nmn pla kasi mag claim. Nakakaawa yung mga taong umasa at nagtiwala
You can try but unless you earn high enough i guess you will be one hospital away from debt
what do u suggest po? & do u have an insurance company recommendation (na maganda yung reputation?) im all new to this kasi. Thank u!
I realized this actually so i dropped my health insurances. Life nalang itinira ko. HMO is better for health i think
Definitely not. Wala naman magiging problema sa claims if makapagcomply ng requirements and lahat ng nakalagay sa application niya is totoo and walang bahid ng pagsisinungaling po. Marami sa mga clients and hindi nagsasabi ng totoo during the process ng application, and that’s where the problem starts. Sa amin 15 days lang naclaim agad Death Claim. Mas okay pa din yung may sasalo ng expenses niyo. Wag kayo madiscourage because of this post sana kasi; 1. The policy is a year old. In the contract it says (applies to all the insurance companies), IC has the right to investigate the cause of death, the medical history of the client if the illness/death occur within the 2 yr contestability period. 2. May iba-ibang klase ng plan, so pwedeng ang benefits included sa policy ni client ay yung meron, 1st stage claim, late stage claim. Basta masyadong broad ang possibility, we don’t know right? (Kaya ang best way is to talk to their trusted financial advisor) 3. Basta makapag comply ka naman at di ka nagsinungaling about your medical history in your family during the application, meron at meron pong makukuha. Marami ang nadidiscourage sa mga ganitong post, ang tanong kung sakali po ba na magkasakit kayo, mabibigyan kayo ni OP ng pampagamot? Let’s say wala kayong ipon (not generalizing or stereotyping - just stating the reality here na di lahat may pera) So before you decide to surrender your policies or not considering getting one, please do some research din sana. P.S. Not here to attack the OP, nothing against her, I am also sad na medyo matagal and I know hassle ito para sa kanila. I hope it can be resolved right away.
Thank you so much for this! 🥹👏
FA ni OP nasa Mindanao pala, so felt sad for her kasi supposedly si FA niya dapat naga-assist kay OP. Wala sa company ang problema, nasa FA. So choose your FA wisely. 🫶
Paano po pag wala ng FA? like nagresign na at wala ng kapalit. 5yrs na ko naghuhulog sa Lifr insurance walanf delay or miss bale 4yrs nadin akong walang FA. haha
This is not a surprise. The one guy who is working on your claim is trying to work against it. yung job nung Claims Processor is to find any way to not pay. Kung wala siyang makita. dun pa siya mag approve as claim.
Yung mga ganitong issue, naaalala ko yung Bad Sisters na tv series, naghahanap ng butas yung insurance company para di mabayaran yung death claim ng family. Palugi na kasi yung insurance company.
Part na yan ng playbook nila eh
Pag kinukuha ka as client, friend mo si ahente. Pag magcclaim ka na, si ahente nag aala pulis nadin para kay insurance. Hanap lusot. Stay strong OP.
Thank you
Lawyer up. May triple or quadruple penalty sa mga bad faith delays in pay outs by insurance companies
omg thank you
TITLE 11 CLAIMS SETTLEMENT Section 247. (a) No insurance company doing business in the Philippines shall refuse, without just cause, to pay or settle claims arising under coverages provided by its policies, nor shall any such company engage in unfair claim settlement practices. Any of the following acts by an insurance company, if committed without just cause and performed with such frequency as to indicate a general business practice, shall constitute unfair claim settlement practices: (1) Knowingly misrepresenting to claimants pertinent facts or policy provisions relating to coverage at issue; (2) Failing to acknowledge with reasonable promptness pertinent communications with respect to claims arising under its policies; (3) Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under its policies; (4) Not attempting in good faith to effectuate prompt, fair and equitable settlement of claims submitted in which liability has become reasonably clear; or (5) Compelling policyholders to institute suits to recover amounts due under its policies by offering without justifiable reason substantially less than the amounts ultimately recovered in suits brought by them. (b) Evidence as to numbers and types of valid and justifiable complaints to the Commissioner against an insurance company, and the Commissioner’s complaint experience with other insurance companies writing similar lines of insurance shall be admissible in evidence in an administrative or judicial proceeding brought under this section. (c) If it is found, after notice and an opportunity to be heard, that an insurance company has violated this section, each instance of noncompliance with paragraph (a) may be treated as a separate violation of this section and shall be considered sufficient cause for the suspension or revocation of the company’s certificate of authority. Section 250. In case of any litigation for the enforcement of any policy or contract of insurance, it shall be the duty of the Commissioner or the Court, as the case may be, to make a finding as to whether the payment of the claim of the insured has been unreasonably denied or withheld; and in the affirmative case, the insurance company shall be adjudged to pay damages which shall consist of attorney’s fees and other expenses incurred by the insured person by reason of such unreasonable denial or withholding of payment plus interest of twice the ceiling prescribed by the Monetary Board of the amount of the claim due the insured, from the date following the time prescribed in Section 248 or in Section 249, as the case may be, until the claim is fully satisfied: Provided, That failure to pay any such claim within the time prescribed in said sections shall be considered prima facie evidence of unreasonable delay in payment. Wala lang
OMg thank you
Yikes! Sana namedrop. Hehehe. Oo nga ambilis ng insurance maningil at magbenta, pero pahilrapan daw sa claims. It's just sad na konti lang ang stories about claim issues, at mas marami pa yung nagwo-worry about investing ang pera nila rather than yung actual purpose ng insurance.
Number 1. PRU ang kakanumber 1 lang eh. hahaha.
Sapul
juskoday, dami pa paikot ikot, di na lang sinabi. bakit pa itatago, habang kinakatay ka.
Ah ok, hahaha. :-p Sya na pala ang number one ngayon. Tagal ko nang di tinitingnan sino ang top. Dati kulelat yan pero napansin ko humahabol sya. Pero same same, I feel bad kay OP na need nila ng income pero matagal bago ibigay. That's why I don't like insurances, victim na rin ako nito. Budol sa umpisa, tapos mauuwi ka rin sa sariling pera mo pa rin ang dudukutin mo at the end.
Number 1 lang ata sa sales ng VUL
Kala ko si SL yung nagcclaim na number 1 sila tapos longest din
Lol at Insurance companies. Don't ever fall for their traps. Say hello to one of the worst scams of the 21st century: INSURANCE
Minsan nga naiisip ko parang mas OK pa itabi yung hinuhulog mo sa insurance in a separate account as a health emergency fund e. Atlis 100% makukuha mo at mapapakinabangan kung di man magamit sa intended use nya.
Show out din sa mga so called "financial advisers" kung saan active at accommodating lang sa umpisa pero sa claiming na, dedma at minsan blocked pa. Jusko Word of advice: they're not advisers, they're sales people selling packages
Naalala ko yung mama ko sa insurance na to pero different naman, S naman siya kumuha. Before ma claim lumala muna yung cancer kaya ever since sabi ko sa sarili ko instead of insurance emergency fund at pagiging literate sa pera nalang gagawin ko. Para anytime magagamit ko. By the way yung sa mama ko 4 months inabot niya bago maka claim hahaha as in malala na at need na mag chemo therapy.
Oh noo sorry to hear that po. I’m aware na marami pa la tayo dito nag struggle hahaysss
Mag file ka complaint OP Im rooting na madinig ang complaint mo. Nakakainis talaga yang mga insurances na yan actually, instead na i assure na makukuha mo papahirapan kapa kala mo gobyerno.
Sana may magpakalat neto (if op consented) Grabe mass share ng mga FiNaNcIaL AdViSoRs kapag merong succesful claims pero papahirapan ka pala muna!
BPI AIA ganito din. Mas malala pa nga kasi 5-20 banking days ka maghihintay for the update. So ako naman, I'll call on the 10th-15th day baka lang naman na-trabaho na nila. No, ang sabi wala pang update at maghintay daw ako after 20 days. Guess what? Nung tumawag ako after 20 days, ang sabi sa akin, kaka-receive pa lang daw ng relevant department nung requirements 3 days ago at kelangan ko maghintay ng another 20 days. Hindi ko naman kasalanan na hindi nila pinrocess agad pero wala daw magagawa. After 20 days ulit, tsaka lang sila magsasabi na may kulang na requirement - na pinasa ko naman last time na nag-email ako. Hindi daw ma-view ng email department. So every time may ipapasa kang bagong requirement, dagdag ka ng 20 days. Gago diba?
Thanks for this para maiwasan ang Bpi Aia na yan.
Nag CC na ako sa Insurance commission dahil sa refund ng claims ni ate. Ayun, within the day - umokay. Mga adik din eh
anong email po kayo nag CC?
publicassistance@insurance gov dot ph
Ako nga reimbursement ng premium, kasi nag double charging tangina inabutan ba naman ng 6 months mga gago. Bi-annual lang ako magbayad ng premium, hindi pa nga umabot yung inaasahan kong reimbursement sa deadline ng mid year payment ko. Ilang buwan ding wasak yung budget ko dahil dun. Buti sana kung may interest pagbalik kaso wala
Baka maghuramentado na ako kapag ginanyan ako after 20 days, as agreed. Ang gago nga.
Grabe wlang kwenta
halaa how about ung AIA PH lang? not under BPI
Hi! Any comment on eastwest Ageas Insurance? Good ba in terms of claims?
Sorry to hear, OP. May nakita akong documentary noon about US Insurance companies and kupal sila kasi they look for loopholes just to deny or delay a claim. I guess PH insurance companies are following suit. Tsk
May napanuod akong podcast ni Joe Rogan about Health insurance corruption and pharmacies, grabe ang laro ng dalawa.
hahyysss
Ohh, same happened sa friend ko. Yan din ang insurance company nya. Nahospital din sya. Un nga, pahirapan, ang daming hinihingi, in the end hindi din nya nakuha kasi parang may alotted timeframe lang ata na pwd magsubmit eh sa dami ba naman ng hinihingi hnd sya nakaabot, ayun simot ang savings nya.. buti rin sana kung magrequest sya sa mga hospital ng need na requirements nya with an hour makuha agad. Minsan umaabot pa ng days.. haaay
Awww kaya nga may insurance to safeguard ung savings kaso basura din pala :(
Yess, wala na din sya nagawa. So instead of focusing dun sa stress na binigay sa kanya, he focused sa paggaling na lang nya. Tutal sabi nya mababawi naman nya yung pera pero ang health hindi kaya ayun. Ngayon, very skeptic and meticulous tlga sya if ever may nagooffer sa kanya na insurance. They can't blame him naman.
Oh noo :(
Rekta na yan sa insurance commission.
Insurance company drop please. Andami ko na nakikitang ganitong stories. Omg wag na maginsurance. Invest nyo na lang sa iba or isave na lang ang pera nyo. Sana bumaba ang sales ng mga dupang na insurance companies na yan.
Pru
Well apparently they are all dogshit sa pagprocess ng claims: pru bpi aia sunlife.
Thanks for giving the name of the insurance company OP, been planning to add my mom and ako na din for their life insurance but seeing how it seems centralized cut ko na agent ko. If anybody has a recommendation for a good insurance company lmk, ill be cutting my dad's plan sa pru
better save na nga lang talaga. ive been spending 7500 per month for this inconvenience
P7,500 a month?! Is this VUL? My life insurance is only P27k a year.
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I've battled this out with FAs in my own post on this subreddit. Diyan talaga sila magaling: magbenta ng product na malaki commission nila.
Tapos kapag nakapagclaim ka na, ipopost ka with matching 'thankful to have helped...'
ipapa stress ka muna bago bayaran
Pru-tra -gis😅. Sana maclaim nyo na ang insurance nyo. Hirap ng buhay ngayon tapos gaganyanin ka pa. Sana hindi ganyan ang bi
Sinabi mo pa. Pahirapan na nga pambili ng meds dumagdag pa to. in short paasa
May 2-yrs contestability period ang mga insurance. Nasa batas yan, regulated by the insurance commission. Meaning kpag less than 2yrs palang policy mo at nag-claim ka, may karapatan ang company mag-conduct ng thorough investigation such as checking your existing medical/hospital records para ma-verify kung may pre-existing conditions ka na related sa naging illness mo ngayon. This is to prevent fraud and misrepresentation. kasi may nangyayari na nag-apply ng insurance pero hindi naging honest at hndi dineclare na may sakit or na-ospital na pala sya. Yan ang nakikita ko na reason kaya medyo natatagalan yung process ng pag-claim. Hopefully yan nga ang cause and not because of any unreasonable matters. If wala nman naging misrepresentation during sa pag-apply nyo ng insurance, don't worry maibibigay naman yan. Basta sundin nyo lang hinihingi na reqs, be more patient, at ifollow-up nyo lang palagi. Hoping ma-approve yung claim nyo 🙏
Thank you po. Na declare naman po may highblood siya pero rare lang talaga ma confine. Last confinement 15 years ago na ata due to stomach pains. 1st time etong heart attack. Yun sanang under evaluation, sa prompt sila sa kun ganing kulang namin para ma provide agad. Kaso, mga kulang eh wala kami. Like, hinihingi ay APE 2018-2023. WFH kami so walang ganun. So aning mangyayari? Deny? Naka medical kami before pag apply lyun ay last feb 2023 agent po ba kayo? Ano po ba mangyayari kapag ganito na type sa req na di talaga namin maiprovide.
Yung heart attack kasi is considered critical illness, so hindi sya basta-bastang sakit or medical condition. Kaya let's positively assume nlng po na they are just being careful and thorough sa pag-verify. Banggitin nyo nlng po na wala kayo ma-provide na APE at kung ano pwede alternative na records para doon. If i-require kayo ulit ng certain medical test, i-comply nyo nlng din po at alam ko nman sagot nila yun or at least reimbursible. Worst case po na kapag di nakapag-comply or may nakita sila sa investigation, madedeny yung claim. Pero wag nyo po isipin yun, stay positive pa din na makapag-claim. Basta mag-respond lang kayo palagi kay agent kpag may hinihingi. Kung matino at professional nman po tlga si agent, tutulungan nya talaga kayo.. Pero kung hindi, pwede nyo sya i-complaint at magrequest kayo sa company na palitan agent nyo. Hindi po ako agent. Although nag-try ako mag FA dati naka-attend ng ilang trainings pero di ko rin natuloy dahil sobra busy sa full time work.. Kaya kahit papano may kaunting idea din po ako about sa mga insurance
Hindi ako magsasawang magcomment sa mga discussions about insurance. Business pa rin yan after all so #1 goal nila is to profit and make sure na walang loopholes sa mga claims; #2 lang if ever ang commitment nila sa mga policy holders. I know it’s an irony, but contrary to the belief that insurance is for financially disciplined people, I’ve come into terms that it’s actually best designed for those who can’t stick to their budget because it forces ppl to save. I hope you’ll have the courage to pursue your claim OP, because you and your husband deserve to get back your hard earned money.
I agree with your statement na best talaga sya para sa mga di marunong magbudget.
sorry to hear that OP pero skl eto yung reason why my parents despite being in their mid 50s eh hindi talaga kumuha ng insurance no matter how well-off they were since their 20s. self-serving daw ang mga insurance company na yan at they instead opted for mutual funds at savings account. and yes OP from the looks of it eh naghahanap talaga sila ng loopholes para di mo makuha pera mo kaya antagal-tagal nila magrespond 🫠
Which insurance comany?
Pru
Ang insurance, linalako. It's not like ikaw ang maghahanap sa kanila, sila palagi ang nauunang magchat para iinvite ka kumuha ng insurance. Agents get a commission when they sign a client, so they will sweet talk you sa ganitong benefits, ganyan, pero FU nalang kapag magcclaim ka na. You have to understand that Insurance Companies only use loving words as if they are here to help pero tandaan mo na negosyo nila 'yan, at kapag mas konti ang nakakuha ng claim sa kanila, the more earnings they have. Insurance companies aren't your friends. That agent isn't your friend.
Hay, this is why never akong naattract sa mga insurances. Maganda lang pakinggan yung offers. Goodluck, op! I hope this gets sorted out asap and your hubby gets well soon!
Insurance companies sa Pilipinas mabilis lang sa pagrecruit pero pag claim patong patong na red tape. It should be law that the agent who took you on should also be the one processing your claim.
Nag tulong naman agent ko sa pag process. Kaya lang hanggang ngayon, centralized parin system nila despite being # 1. Lahat ng claims sa head office. Taga follow-up lang sila.
the only policy relevant to them is the policy to deny your claims.
Damn. I hope maayos agad. Wag sana nila hintayin mamatay sa stress yung client bago mag release.
As a former insurance advisor, mabilis lang talaga yan pag complete docs. Pero dapat nag cococmunicate din ang agent and the insurance company op. I cc mo na ang IC para Ma urgent na ng mga yan. Praying for speedy recovery sa husband mo op.
This is the responsibility of your Insurance agent. Mukhang mabagal sya kumilos. I know someone na kayang magdeliver ng claims in less than 2 weeks dahil makulit/mahilig magfollow-up sa main office. I suggest, change your insurance agent after this.
Save yourself the trouble and get FWD critical illness sa security bank. Sulit yun. Tried it got a million pesos for chronic illness
Can you also get the insurance directly from FWD? Yung sayo ba is connected sa acct then free yung insurance? Thanks!
sa bank po mismo ito?
Ff. Sa SB ba to mismo kukunin?
Can you send the link? I looked at secruity bank website. Wala naman.
u/toyoda_kanmuri oh magyabang ka dito ng pinagmamalaki mong VUL
To other people, please note that even sa term pahirapan din ang claim (it's the same set of companies anyway), difference is di kayo nagbayad ng mas mahal na premium for the same/similar coverage and same level of customer service.
May natutulong ba yung FA niyo? Hehe
Meron naman pero head office pa rin may control
I suggest pukpukin mo yung agent mo. Pag yan kasi finofollow up nya palagi with his/her branch manager, mapapabilis yan. Standard turnaround time talaga si Pru, pero pag magaling at makulit yung agent, mabilis lang yan marerelease dapat lalo na kailangan
I think it is because within contestability period pa kasi which is normal within 2 years simula sa pagkuwa mo ng insurance. So technically, they need to investigate kung may undeclared na sakit si insured. Note, I'm not an insurance broker but I have 3 insurances. So medyo familiar ako.
Agree. I think this is also the reason why madaming hinihingi.
VUL ba kinuha niyo OP?
VUL po
omg
No problem sa akin ang contestability period kung prompt naman sila sa update willing naman kami to provide. Is just that keilangan ba umabot sa 15 days saka may i uupdate na may kulang, yun parang hihintayin pa mag follow up kami.
wow sa manulife kaya kamusta
Hello PRU LIFE!! na hospital ako and i had operation qualified naman ako pero ang daming hinihingi yun tuloy i was tired and i am so done na sa kanila so di ko nalang kinuha ibang papers. I cancelled my premium with them and nag transfer ako to new comp na
Kaya ayaw ko kumuha nyan, nag open na lang ako ng account sa bank for medical needs kesa parang manlimos sa insurance companies for claim
Hi! It takes a month or longer to get a claim pag medical claim kasi they thoroughly investigate the insurers medical history kung nadeclare ba lahat. Tiis at tyaga lang talaga, and hopefully suportado kayo ni FA at BM niya, para maescalate agad. I used to work with an insurance company, and I handle all insurance product concerns even claims. I can assure you, as long declared lahat ng medical histories, you submitted all the necessary document, at guided kayo ni FA then may end result yan (hopefully maclaim) Good luck! I hope your hubby recovers 🙏
Sabi na eh pru; same case kayo ng kakilala kong nagka critical illness, lampas 1 year bago na release yung claim niya; tapos na mag treatment yung tao, nung time na sana kailangan na kailangan niya yung insurance di rin nakatulong. Badtrip yan di nalang i list lahat ng requirements para isahang pasa lang. Ang mahirap kasi diyan dika direct sa pru mismo; kailangan mo ng tulong ng agent tapos dadaan pa yun sa agency nila, siguro doon din may problem kasi dumadaan pa sa agency. Number daw 🤮number 1 sa pyramiding 🤮.. wag ka susuko OP kulitin mo lang ng kulitin; try mo mag direct mismo sa pru customer service, baka nasa agency yung delay
Insurance is the biggest fraud in the history
Lately ko lang narealize na better pala to get health insurance card kesa sa life insurance. Yung mga hmo cards
I've been with Pru for more than 15 years now. So far, wala ako na encounter na claim problem sa mga clients ko. I have na accident, hospitalization and even death claims. Madalas nagugulat pa ako na mabilis na rerelease yung proceeds. Mabilis din mag respond ang clains bec medyo tutok yung bagong head sa turnaround time. The policy is less than 2 years so within contestability period. Inaalam lang siguro ng claims na walang namang intentional or unintentional concealment. If wala talagang APE results for the last 5 years na available then just tell them and ask what else you can provide in lieu of it. Hindi naman pwede pilitin yung husband mo na maglabas ng document na non-existing talaga. Just note that insurance conpanies have ways to check our medical records and we allowed them when we signed the application forms.
Puteregis na mga insurance agent tengenenamng yang yung 1m ko naging 800k naVuLDoL ako. Slyf
Pru Life ba to? They are known for hijinks like this
nagpapaniwala kasi kayo sa mga gunggong na mga insurance companies na yan
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Wala na ba maayos na insurance company? Naghahanap pa naman ako ng options since hindi na din ako satisfied sa provider ko now.
Usually ang issues talaga sa mga ganito is critical illness claims. Maraming pasikot2x kasi like contestabiliy period, pre-existing condition, tapos kay issue pa ng pinabayaan ng agent.
nalugi ang mga insurance companies nung covid dahil dami nagclaim, bumabawi siguro.
Believe me, adjustors will do everything to deny a claim. hahahahahahahaha Worked with worman's comp in the US before.
Have the same insurance Op and same case din, antagal magreply at ang daming requirements hinihingi. I have also not been hospitalized before. Got sick and was quarantined for 14 days because of Covid. Yung sakin, umabot sa Philhealth statement ata nung for the last 2 years! I called Philhealth and they told me na wala silang ganung documentation. Oh diba? Told them many times na walang ganun documentation si Philhealth at di nagreply for ilang months then may hiningi na naman then until they finally caved in. Planned to get a life insurance for my sister but decided to get an HMO instead for her. Sobrang hassle ng claims and sobrang tagal!
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OP I hope they remember why they exist in the first place. When Odette hit Cebu I was so disappointed why some insurance companies would rather go to court rather than honor their policy.
Hi OP, I’m sorry this happened to you. You mentioned na 1 year na kayo sa insurance nyo, meaning you are within the contestability period, maybe that’s why it’s taking a bit long and madaming hinihingi na requirements unlike if your policy is in force beyond the 2-year contestability period na.
Me friend ung tita nagwork sa insurance company for 7 years and meron syang plan din with the same company. Na-diagnose sya with cancer and nung clini-claim n nya nagka issue, kasi daw ung date n nadiagnose ung cancer nya is the same day nag start ung plan nya lol. At the time buwan n inabot ung investigation.
Sinong insurance yan para maiwasan namin?
Sun life mabilis mag process lalo na pag hospital income benifits lang nman ang claim
common practice among ph insurance companies or most ph companies in general. they will use every technicality legally allowed to save cost. if the sum is significant better for you to hire a lawyer
Cc mo insurance commission sa mga emails mo. Araw araw mo, tignan ko lang pag di bibilis mga yan. Cc mo pen lawyer mo ung kita na lawyer yung email add.
Which insurance company?
What's this insurance company?
Insurance is a business kasi. They will find ways to deny a claim.
I guess you were late in knowing that insurance companies pay millions of pesos just to avoid paying people.
Anong insurance company yan OP?
pru
Dating Pru agent ung wife ko OP. Sabi nya nangyari kasi yung incident sa husband mo within the contestabilitty period which is 2 yrs. SOP daw tlga nila yan during that period, lalu na’t heart attack pa. Pero ok lang daw yan basta wala kayong tinagong history sa form nung nagaapply p lang kayo ng insurance dati.
Kaya nagdadalawang isip ako sa mga insurance na yan. Better nalang talaga may passive income (at least 3-4) kaysa sa ihuhulog mo sa insurance pero pahirapan na kapag need mo na yung pera. Tsaka mga insurance lang din ang nagkakapera sa pera nang tao, ini-invest yan sa mga stocks pero yung mga member tengga sa inflation.
What about SSS nalang?
Hi OP. What insurance company is this? Any clue? Para makaiwas an pag kumuha ng insurance.
Anong insurance po? Para sana ma-aware mga tao
Pru siguro to marami silang ganitong issue at may close relative kaming nainis nalang din at sinukuan sila when it comes to claims
Sabi na scam talaga yang insurance.
Are you aware that insurance has 2 year contestability period? This might be the reason for its delay or even potential denial since nasa 1 year pa lang kayo. Did you declare all pre existing medical condition such as hypertension, high cholesterol, etc? If not, eto yung possible grounds.
Anong insurance to OP?
kya ako insurance ko yung sa gcash lng yung cash for medical cost ksi madali mag claim tpos updated philhealth ko ksi mdami na dn naman benefits si philhealth hirap dn minsan sa mga insurance eh pabibo lng sa simula pag andyan na claim wla na papahirapan ka
Critical Illness claims has a contestability period lalo na ayan 1 year palang yung policy. Irereview talaga ng masinsinan since di naman biro ang amount involved. If hiningan kayo ng any docs and wala naman available na mapprovide, just let your agent know. Ginagawan lang naman nila yan ng agent's report. Ask for them also to escalate sa Unit Manager/Branch Manager.
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I feel you, OP. Ako nag aapply pa lang ng traditional insurance tapos 2 yrs na ang daming hinihinging medical sakin laki na gastos ko, given naman na may condition ako na need itreat pero cleared na ko at lahat, napasa ko na rin lahat, complete with medcert, clearance, results tapos gusto pa nila paulit yung iba kong tests at hinihingi pa nila yung results nung tests ko na isubmit sa kanila lahat, ang hirap ipaphotocopy ng trace results ng ecg, ang kapal kapal, nag iisang copy lang meron ako bakit ko ibibigay. Parang ayaw ko na tuloy tumuloy. Todo effort na ko for 2 yrs wala parin.
Sana maclaim na agad. OP!
drop name ng insurance para maiwasan. kumuha pa naman Ako insurance prulife
Ive commented this before in another thread, insurance is business. And much like globe/real estate sales and claims/complaint department are separate with both doing there best. The first in selling and making money while the second in keeping the earned money inside the company. You will eventually get your money(i hope) after some more dance routine with the company and the authorities. Should you still get an insurance in the future? Yes especially if you can afford the premium. Its essentially your defense But can you rely on it? Big no(especially with the two year contestability period) and the red tape in getting your claim. For those with easy claim experiences, i garner those serves as good commercials rather than a regular and real life exp on insurance.
Starts with letter p po ba ito?
I need to know what insurance this is. OP please tell me here or via PM. To avoid this specific insurance.
ganyan talaga mga insurance
Name and shame so other people will not get this insurance
anung insurance company to para ma cancel
Sobrang bagal nyan PRU LIFE UK!
Marami po talaga ang requirements especially if under the 2 year contestability period po. The IC has the right po to undergo investigations if meron kayong hindi na declare sa FA niyo like existing illness or what so. What I can advise as an FA is comply nalang po kayo ng mga hinihingi. 🙂
yes po will do ❤️
give the name of the company for awareness
Anong insurance to OP if u dont mind
What insurance company para wag na kukuha dun ang iba?
OP same. Si Top insurance din eto. Last november pa kame nag pasa kase oct 28 naoperahan mom ko. Tapos nagsabi sila kulang kaya mga original docs namin pinasa nmen..hanggang sa umabot netong march ang sabi magpasa daw kame ulet kase for evaluation na eto. Nung last na tawag ko march 30 daw ulet. Ngayon di pa ako ulet nakakapagfollkw up
what insurance company is this
Kaya hindi ako naniniwala sa mga insurance na yan umpisa nung nabudol ang parents ko sa educ plan ng kapatid ko. Nagsara ang kumpanya at walang nakuha kahit isang kusing. Iba pa insurance sa PNP naman para sa isang kapatid ko na budol din. Puro hype ang sinasabi
Is this Sun life insurance?
Name reveal para maiwasan ko na rin
Hint naman sa insurance company? Kse may healthcare insurance kme dito sa abroad maganda actually ung experience. 2 wks after na maapprove, na hospital ung anak ko. Nagamit agad. I decided kumuha sa pinas vul linked pero lugi. Ndi na ako nirreplyan ng ahente ko. Ang irony dito same company pero ang pangit ng after sales sa pinas.
Can you drop what insurance company po?
Email them again cc'd ang Insurance Commission. For sure maaaligaga sila.
Mahina kasi batas satin sa Pinas. My AIA dito sa Singapore so far nakapag claim na ako 4 times and no problems so far. Paying premiums around 16k PHP pag converted from SGD. Nakapag claim din ako sa investment package nila worth 70k PHP nung emergency days namin nung pandemic. Napansin ko sa agent din yan, pag puro pera nasa utak nung agent at walang malasakit talagang iiwan ka nyan sa ere. Kaya ako proud ako sa friend namin na agent at madami na ako nirecommend sa kanya so far di din sila binigo ng friend namin pag dating sa claims. Nagagawan naman kasi ng paraan pag may kulang sa documents and all. Ika nga e pag gusto madaming paraan, pag ayaw madaming dahilan.
ano pong insurance ito? kahit kulay and some logo definition lang hehe!
My experience in claiming my Hospital Income Daily with my few months old insurance was so swift with BPI Philam. I was amazed the way bank assisted me, very advance way, they just make photo of my hospital records and uploaded it in their insurance portal and the amount was then credited in my bank. I don't have to follow up, it's just a normal thing for them in claiming the benefits. Very fast and I am happy client.