JASMINE LIM asked 3 years ago
Need some general advice on insurance agents.
We’ve met really good agents and some are so-so. The good ones have many years of experience in claim and because of these experience, they’re able to provide advice and appeal for your claim. The so-so ones probably just help you process your claim and pass on the claim denied message to you.
Having a good insurance coverage is more important than having a good agent but if an agent only passes message saying claim denied and cannot contribute much in the claim appeal process it defeats the purpose of having a good medical card.
We’ve even heard stories that the agent is not willing to fight for certain cases because it affects their team’s KPI etc. which is absurd.
From CFLieu website, if a claim is unfairly rejected we can go to PIAM Information Centre and Ombudsman for Financial Services (OFS) but having a good agent will reduce the chances / likelihood to go through such channel.
Allianz’s medical card is very attractive but we do not have someone we know being an Allianz agent.
- Is having a good insurance agent important?
- Are we able to purchase Allianz insurance from you? If yes, who will be the agent, CFLieu himself?
ERIKA Staff answered 3 years ago
Hi Jasmine
Pertaining to medical card and medical claims - when application process is done properly and correctly, the need for appeal for any claims is almost non-existent, except for things that fall within gray areas (rare). We focus a lot of this - the way we walk thru application process with clients is longer and more thorough than most tied insurance agents - but it's for a good reason.
Because when we are able to foresee the probable issues that can arise as a result of a 'rushed' application process - it is never good to be reactive, but instead be proactive so we take measures to prevent a future claim issue by doing the right things/process from the beginning.
For example, most of the 'appeal' process we do is during the application stage (NOT during claim) if we feel insurer impose unfavourable non-converage clause on our clients. Of course, our judgement & advice on this is only part of it, the other part is how supportive is your attending doctors in providing the relevant document to support your appeal during the application stage.
So whether the appeal is successful or not, you will know very clearly (and would have consented to ) what's excluded from your coverage from the beginning.
Therefore, zero surprises when you submit medical claims in the future.
Years of experience is just one of the factor because common sense and critical thinking of the servicing agent also important dealing with such cases. Example, a 50y old baker with 30y experience can insist making cheese cakes manually but in today's age, a 30y with 5 years experience possessing higher common sense/critical thinking can turn the process of making cheese cakes more efficient, consistent quality and with higher output by automating it using machines.
That being said, it is highly recommend you visit a panel hospital with any medical card because that means zero need for any manual claim process as panel hospital provides cashless admission - bills are settled by insurer directly to the hospital.
Other than that, any pre/post admission outpatient claims can be settled within 2-3 working days, faster than any form filling by agents, as most insurers have their respective mobile app for customer to submit claims via the app - uploading receipts scan, entering some details and then insurer pay you online directly to your registered bank account.
Yes, you can think of our insurance license as broker-license by BNM - it will always be CF Lieu but of course, supported by a team of associates, like here in AskCF.
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