# Insurance claim denied



## Linuxpro

I injured my shoulder. Being unaware that ii had dislocated it, I went to a clinic. The doctor gave me some pain killers so I could travel to Taipei for a week. My arm was numb.

I returned in great pain. My girlfriend took me to the emergency room. I was told I had dislocated it, but it has reseated. The pain was caused by the nerve bing pulled, or something like that.

AIA stalled me until now. I had to cancel my follow on appointments for lack of approval from them. I received word Monday that my claim was denied because I did not go to the emergency room within 24 hours.

I have almost no sensation in my left hand, but it is usable.

What rights do I have?

No I was not injured on the job. The injury was due to sports. There is no fault due to anyone.


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## simonsays

go to CASE, and I am pretty miffed why you are getting this kind of treatment .. 

for me- well, my own insurance, Prudential, nor our company insurance, IHP (tokyo Marine) never rejected any .. ) so was it for my former employer's insurer - Asia Medical/Raffles Medical


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## Linuxpro

ecureilx said:


> go to CASE, and I am pretty miffed why you are getting this kind of treatment ..


 What is "CASE"?

In the USA I would just go bust up their office. My chance of being prosecuted are pretty small, so I would not worry myself about consequences. Eventually they would just give up and pay my claim.


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## civicblade

There is virtually no consumer/customer protection in Singapore before the recent "Lemon Law" and I do not think the lemon law covers insurance policy. Singapore is super pro business and AIA is a big business in Singapore. 

Go to CASE and they will advise you to bring the case to Small Claims Tribunal in the subordinate courts.


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## civicblade

Read the fine prints first. Your policy may not include sports related injuries.


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## Linuxpro

civicblade said:


> There is virtually no consumer/customer protection in Singapore before the recent "Lemon Law" and I do not think the lemon law covers insurance policy. Singapore is super pro business and AIA is a big business in Singapore.
> 
> Go to CASE and they will advise you to bring the case to Small Claims Tribunal in the subordinate courts.


I see. Now that I think about it I would rather not get the government involved. In my experience business use this sort of thinking:

"If I am ordered to pay a customer a refund, or say $1000, then I set a precedence, and will end up paying hundreds of customers. It is cheaper to pay out $10,000 in bribes to the courts to make sure I never pay a customer anything."

They take that approach in the USA. That is why so many people are willing to take matters into their own hands.

While it would be nice to get my money up front, I figured out the "loopholes" in the system. I can get my money back in the long run.


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## Linuxpro

And yes it is emotionally very difficult for me to "stand down". Back in the USA I would have most certainly have taken this matter in my own hands months ago. I have to adapt to life in Asia even if that means giving up one thing that is uniquely American, and that is the willingness to break the law, and flight back even if the enemy makes me so small like a speck of ink on a huge paper. From what I have read and heard from my colleagues, people just "bend over and take it" here.


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## toothdr

Erm Linuxpro been reading your problems. Ecureilx told you a simple solution to complain to CASE. Don't understand your government conspiracy theories etc but I'm sure if you thrashed an office up in the US you would get arrested. Sorry to hear your in pain have you tried any anti-inflammatories like Voltarol (Sodium Diclofenac) for pain relief???
Anyway just trying to help


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## Linuxpro

toothdr said:


> Erm Linuxpro been reading your problems. Ecureilx told you a simple solution to complain to CASE. Don't understand your government conspiracy theories etc but I'm sure if you thrashed an office up in the US you would get arrested. Sorry to hear your in pain have you tried any anti-inflammatories like Voltarol (Sodium Diclofenac) for pain relief???
> Anyway just trying to help


Thanks man

The insurance covers the traditional Chinese doctor, so I will continue with it. I have regained sensation in my hand, and have little pain. 

We have a free legal advice service at work. I will inquire about CASE.

Actually law enforcement in places like Arizona is not what you see on TV. What would they charge me with? Vandalism? They would look bad picking on a "Gulf War Veteran" for such a petty crime, against a company who nobody likes. It is not worth their time because no jury will convict. They will not gain anything. The city wants to bust people for one reason.... Fines are revenue. So long as nobody is injured, and no weapons are involved, they will not even show up for hours. Such a "crime" is pretty common, and never makes the news.


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## Linuxpro

I talked to my colleagues about this. I have changed my mind. I am going to fight. I write a tactful (unfriendly, but not threatening) letter to AIA this morning. I will go to CASE, and I will make a lot of noise about this.

I informed them that I have told my story to my colleges. My colleagues know they have no choice but to go to the emergency room on the first hint of an injury, or they may not be covered for failure to get medical attention within 24 hours. I guess AIA will be seeing a lot of claims that they would not have been seeing if they were running an honest operation. How stupid of them to force the client to somehow "know" that he or she will require major medical attention within 24 hours of an injury. What if I hit my head? I might not be aware of a concussion, or a brain hemorrage for days. So should I run to the emergency room immediately for a boo-boo on my head?

No it is not about the money. It is about the fact that they stepped on my toes, and they will continue to do it to my colleagues. 

Years ago, Motorola gave up and paid me just so I would stop harassing them. 

I have some resources outside Singapore to launch a cyber attack against them if needed.


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## jam1

You are one tough man. I have to salute you for that.

Did you approach your financial advisor or "insurance agent" for advise? 



Linuxpro said:


> I injured my shoulder. Being unaware that ii had dislocated it, I went to a clinic. The doctor gave me some pain killers so I could travel to Taipei for a week. My arm was numb.
> 
> I returned in great pain. My girlfriend took me to the emergency room. I was told I had dislocated it, but it has reseated. The pain was caused by the nerve bing pulled, or something like that.
> 
> AIA stalled me until now. I had to cancel my follow on appointments for lack of approval from them. I received word Monday that my claim was denied because I did not go to the emergency room within 24 hours.
> 
> I have almost no sensation in my left hand, but it is usable.
> 
> What rights do I have?
> 
> No I was not injured on the job. The injury was due to sports. There is no fault due to anyone.


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## Linuxpro

jam1 said:


> You are one tough man. I have to salute you for that.
> 
> Did you approach your financial advisor or "insurance agent" for advise?


The HR department will not back me on this, or even respond to inquiries. It seems Singaporeans fear confrontation.

I will not stand down until I get paid or someone can show me a legitimate reason for my claim being denied. "Failure to seek treatment within 24 hours" is not a legitimate reason. I do not care if it cost me 10,000 to collect the few thousand dollars. When I was a kid my drunken father beat the crap out of me almost every day. Today nobody gets away with stepping on my toes.


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## Linuxpro

I have been going around blasting AIA everywhere. Several people have made reference to the Asian desire to "save face". I keep receiving two points of view:

1. They will refuse to pay in order to avoid showing weakness.
2. They will give in to keep the respect of a Westerner.

I am not sure witch of the above is true. Will they be embarrassed by the fact that I am calling attention to their fraudulent activity?

Will the press take an interest in my problem?


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## toothdr

Are you John Rambo in disguise ;-) 

Just kidding Linux how's the pain more importantly?


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## Linuxpro

toothdr said:


> Just kidding Linux how's the pain more importantly?


Feeling much better.

Also I may have the issue resolved.


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## simonsays

Linuxpro said:


> I have some resources outside Singapore to launch a cyber attack against them if needed.


You are a scary person .. hope the powers-be aren't monitoring this thread ..


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## Linuxpro

ecureilx said:


> You are a scary person .. hope the powers-be aren't monitoring this thread ..


The issue is closed now, no need for the inconvenience.


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## jam1

Linuxpro said:


> Feeling much better.
> 
> Also I may have the issue resolved.


That is good to know. Do you mind sharing with us how was the matter resolved?

Did you do any follow up with a specialist? Do not take shoulder injuries lightly. I fell from a mountain-biking trip 8-9 years ago and had an injured shoulder. Although the doctor then said it was a minor muscle injury and a bruised bone ( I cannot remember the exact term), that muscle still ache in cold weathers


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## Linuxpro

jam1 said:


> That is good to know. Do you mind sharing with us how was the matter resolved?
> 
> Did you do any follow up with a specialist? Do not take shoulder injuries lightly. I fell from a mountain-biking trip 8-9 years ago and had an injured shoulder. Although the doctor then said it was a minor muscle injury and a bruised bone ( I cannot remember the exact term), that muscle still ache in cold weathers


i talked really "sweet" until I got some $&@ overdue sympathy. 

Maybe the gave in from my nagging.


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