Case study
New Policy RM 60k Claim Approval for Acute Heart Condition
By Woode Woo, Agency Manager
👤 Client profile
• Age: 45 years old
• Policy commencement: 8 months
• Policy commencement: 8 months
📉 The Challenge
• The client, only 8 months into his new policy, experienced sudden acute chest pain and was rushed to the hospital.
• Diagnosis revealed that his main artery was 90% blocked.
• The medical bill came to RM 60,823.80.
• The complication:
Most insurers in Malaysia withhold cashless admission for new policies under 2 years (disputable period).
The insurer required proof that the client did not already have a blockage when he purchased the policy.
• Diagnosis revealed that his main artery was 90% blocked.
• The medical bill came to RM 60,823.80.
• The complication:
Most insurers in Malaysia withhold cashless admission for new policies under 2 years (disputable period).
The insurer required proof that the client did not already have a blockage when he purchased the policy.
💡 The Solution
• Our team acted quickly to advocate for the client:
• Collected and compiled all medical reports, test results, and doctor statements.
• Expedited communication with the insurance company’s claims department.
• Referenced the policy’s 120-day waiting period, highlighting that the client was already beyond that period.
• Assisted in proving there was no pre-existing blockage at the time of purchase.
• Collected and compiled all medical reports, test results, and doctor statements.
• Expedited communication with the insurance company’s claims department.
• Referenced the policy’s 120-day waiting period, highlighting that the client was already beyond that period.
• Assisted in proving there was no pre-existing blockage at the time of purchase.
🎯 Key Benefits of the Change
• Claims expertise matters: Without guidance, the client may have faced delays or rejection.
• FINNO advocates for clients: We don’t just sell policies — we stand by our clients when they need us most.
• Trust in protection: Even in complex cases, FINNO ensures policies deliver on their promises.
• FINNO advocates for clients: We don’t just sell policies — we stand by our clients when they need us most.
• Trust in protection: Even in complex cases, FINNO ensures policies deliver on their promises.
✅ Outcome
• After 2 months of investigation, the insurer approved the claim.
• The client received full reimbursement of RM 60,823.80.
• Most importantly, the client avoided a major financial setback and regained confidence in his coverage.
• The client received full reimbursement of RM 60,823.80.
• Most importantly, the client avoided a major financial setback and regained confidence in his coverage.