If you haven’t experienced it, good on you! But those who have had their insurance claims rejected, know exactly how painful it is to have your claims turned down by your insurer! And the processes that follow suit? Urgh don’t even mention it.
But fine, you got your claims rejected. You want to know what actions you can take. So here are some of the actions you should take.
Here’s what you can do should your insurance claims get rejected:
1. Find out why your claim has been denied!
Your insurance company should have given you an official letter or statement detailing the reasons as to why your claim has been denied. Understand those reasons. Check against your insurance policy to make sure that they are not mistaken.
If you have an agent, make sure that he or she explains it to you clearly. Sometimes if it is a small claim, especially with motor insurance, the relationship the agent has with the insurer and his or her negotiating skills may come in handy. Ask if he or she can help.
If you do not have an agent, and should you require further explanation regarding the denial, your best option would be to go directly to the insurance branch and speak to someone from the claims department.
2. Can you appeal?
After checking all the facts and going through your policy more than just once, you may feel that you have been wrongly denied! You can try to appeal or dispute the decision given by the insurer.
Your claims may have been denied over minor issues such as insufficient documents. This should be solved easily enough and you should consider yourself lucky. Understand the requirements well and offer all that is requested. Get your agent to go through the documents to ensure no mistakes made this time around.
On the other hand, if it is not a simple matter such as missing documents, you may want submit an official complaint to your insurer’s complaint unit or internal dispute resolution department. Write in and send along all supporting documents. Make sure that you have make copies of all documents handed in. And wait patiently.
3. Seek help from relevant parties
So you’ve seeked the help of your agent and your insurer’s claims department. Filed a complaint with the complaint department and still not getting the desired outcome? All the time knowing (or feeling) that you have been unfairly treated? What you can do next is to take this matter up with the relevant parties:
PIAM – Persatuan Insurans Am Malaysia (General Insurance Association of Malaysia) if it is a general insurance/ takaful am related claims.. Such as a motor insurance claim due to theft or accident.
Bank Negara Malaysia – Bank Negara Malaysia via its BNMLINK and BNMTELELINK channels, offer dispute resolution services to tthe public in regard to all banking as well as insurance related matters.
Ombudsman Financial Services – is a non-profit organisation under Bank Negara that offers complaint and dispute resolution services between the public and its members that among others, consist of local banks, financial institutions, insurance companies as well as takaful operators.
When you file for your complaint/ dispute with any of the agencies above, please make sure to have understood clearly their requirement. For instance, PIAM and Ombudsman Financial Services require that the complaint be made within 6 months from the date you receive a letter rejecting your claim from the insurer.
For contact information, refer at the end of this article.
4. Take the matter to court
If your complaint/ dispute is still unsuccessful after all the complaints done, you can still take it to court. This is perhaps the last resort. You can engage a lawyer. But before resorting to this, please make sure you have a real solid case as this may end up being a long and difficult ride. If you are sure that this is the action you’d like to take, please make sure that your lawyer has the experience in such a case and has good reference.
Find below contact details of relevant agencies that offer complaint/ dispute resolution services:
Persatuan Insurans Am Malaysia/General Insurance Association of Malaysia
Level 3, Wisma PIAM
150 Jalan Tun Sambanthan
50470 Kuala Lumpur
Tel: (03) 2274 7395/9
Fax: (03) 2274 5910
Email: pic@piam.org.my
Bank Negara Malaysia – BNMTELELINK
(For complaints through fax, mail/post and emails)
Bank Negara Malaysia
P.O. Box 10922
50929 Kuala Lumpur
Tel : 1-300-88-5465 (1-300-88-LINK)
(Calling from overseas: 603-2174-1717)
Fax: 603-2174-1515
E-mel: bnmtelelink@bnm.gov.my
SMS : 15888
Operating hours: 9.00 pagi – 5.00 petang (Isnin – Jumaat)
Bank Negara Malaysia – BNMLINK
(For walk in customers)
Tingkat Bawah, Blok D
Jalan Dato’ Onn
50480 Kuala Lumpur
Operating hours: 9.00 pagi – 5.00 petang (Isnin – Jumaat)
Ombudsman Perkhidmatan Kewangan
Walk in at:
Tingkat 14, Blok Utama
Menara Takaful Malaysia
No. 4, Jalan Sultan Sulaiman
50000 Kuala Lumpur.
Or mail your official letter of complaint to:
Unit Pengurusan Aduan
Ombudsman Perkhidmatan Kewangan (664393P)
(dahulu dikenali sebagai Biro Pengantaraan Kewangan)
Tingkat 14, Blok Utama
Menara Takaful Malaysia
No. 4, Jalan Sultan Sulaiman
50000 Kuala Lumpur.
Click >here< to file your complaint online.