Hospital Admission Cashless Claim

Below are the bills for a 3 day stay in a hospital for typhoid fever: pangastritis (commonly called stomach flu or stomach bug).

Two important points to note here are:-

1) Except for admission (administration) fee, ID hand-band, and laundry, everything else was paid in full

2) A more important observation to make is that the patient is only eligible for a RM200/- R & B.  If you note the first bill, you’ll see that she stayed in a single bedder for 1 night costing RM221.31 which would have caused her to be penalized and she would have to pay 20% of the total bill (about RM800/-)

This was caused because of miscommunication! Upon admission, my client was wrongly advised by the hospital admission, that they had referred to the Insurer and she had to pay 20% of the total bill. So she decided that it was alright to upgrade to a single bedder.

The next day, when I visited her, I was surprised to get this information and I queried the hospital & Insurer. After my feedback, and my client knowing that the co-payment applied only for room-upgrade, she moved into a 2 bedder room. And the Insurer was generous enough to understand the miscommunication and even absorbed the excess in room charges, about RM22/-

Times like this are what prove to be the moment of truth. It is for this type of situations that Insurance Consultants are actually paid. 

Some people are very conscious of  brand name. They believe that famous is best and good. Personally I have come across some famous organizations that work strictly to rule…. follow the system at the cost of speed and flexibility

Others may claim that they may be able to walk into an insurance company and get a policy at a “cheaper rate”. Imagine the above situation where you would really  have to know the terms & conditions of the policy or else you would have lost RM800/-  . Also very possibly, if not in a coma, you would probably be in great pain or very sick and not in a position really think well.

Rama Krishnan

RKC Agency

012-320 8475

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