I would like to know the proper channel to follow when complaining about the insurance company that does not want to pay the promised benefits while claiming.
In my case the was is a portion in the brochure that say the we shall claim the following with no extra cost being cow worth P5,000. P3,000 worth of grocery and P5,000 for tombstone. This same brochure is still being advertised as we speak. Upon claiming we received only money for burial and the three benefits we were told we will receive only one item. They said the policy holder was suppose to pay P3 extra to qualify and therefore we won’t receive any. We requested for the policy documents and we were told it was verbal since they were dealing with group and members of the said group are largely illiterate to understand any obligation from the insurance company. Kindly advise me of which step to take if advisable to do so since the insurance company always say they will come back to us but are taking forever now. My fear is the same brochure is being given to people as they sell their products.
This is unacceptable. I wonder if this insurance company know how many rules they’ve broken?
To begin with they’ve misrepresented their product by not explaining that the policyholder needed to pay extra for the benefits they were offered. Section 13 (1) (a) of the Consumer Protection Regulations forbids a supplier from selling a product that “does not match any sample or description given to the consumer”. Section 13 (1) (e) says they must offer products and services “as advertised or represented”. Section 17 (1) (g) outlaws exploiting a consumer’s “illiteracy or inability to understand the language of an agreement”. I could go on.
I think you need to speak to NBFIRA as soon as possible and get their advice. They have the power and the willingness to use it.
Where’s my medical aid?
Hello Richard. Please help me with my medical aid. In January 2019 they closed my account even though my payments were up to date. I only noticed this when I was trying to do my payments end of January. Apparently the account was closed around September 2018 without my knowledge. I've been sending them emails asking them to tell me how long was my account closed up until Jan 2019 and haven't got anything yet. They only managed to reactive it in March 2019 and they have been deducting my monthly payments directly from my account since March. I haven't balanced the December and January fees yet (the one they refused to take back in January after they closed my account for no reason and without letting me know). Last week I received a message that my account has been suspended due to non payment of December and January fees. I send them an email (sent it to 5 people who are aware of my case) but haven't got any response from any of them. Today I received another message that my account has been terminated.
We all make mistakes. None of us are perfect because we’re human, not robots.
However, I’m a little less tolerant of organisations that make mistakes. Yes, they’ll happen occasionally but why do they happen repeatedly and why do they sometimes become so complicated? Why also, when mistakes happen, don’t they get fixed as soon as possible?
Your medical aid company had several opportunities to look into your situation and fix it. There’s really no excuse for taking so long to fix your problem.
The good news is that I contacted senior managers at your medical aid company and they promised to intervene and do their best to sort things out, unlike their more junior staff.
UPDATE: The senior managers got back to me, saying that they contacted the customer, apologized and have agreed a payment plan that allows him to catch up and get back to normal. Finally!
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