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My Insurance Nightmare – How my broken hand was trampled on

By JS Lua

Most of us buy insurance for a peace of mind. For me, my travel insurance claim with ACE insurance was an additional nightmare that I have to handle upon my return from my trip.

An unfortunate fall that happened in 10 seconds, required me to spend more than 3 hours on the phone with the ACE claims officers, with most time spent being put on hold. After almost 2 months I’ve submitted my claim, I am $1000 poorer from medical bills, and is still being forwarded to “Upper Management”.

While in the US, I fell and broke my hand the night before my return flight to Singapore. I was unable to seek medical attention as it was late, and my flight back to Singapore was early morning. Hence I purchased a temporary cast from a pharmacy, and returned to Singapore to seek treatment. Upon touchdown, I went to a GP, and was referred to a hand specialist because of the severity of my injuries. I incurred an initial cost of $650 my injury. Two days later, I submitted my claims online to ACE on 23 May 2014, and submitted my hardcopy receipts on 27 May 2014.

That was the easy part. Suffering from the fall, taking the 20-hour flight back in a cast, was the easiest part of the injury. Claiming from ACE, was emotionally more painful than my physical fall.

Two weeks later, my insurance agent called ACE for an update. He had advised me that it typically takes 1 week, and at most 1 month for claims to be processed.

ACE officers state that this claim is not claimable as I had not initially sought treatment overseas. I appealed that it was not practical for me to miss my flight to seek medical treatment in a foreign land. Furthermore, it will definitely cost more than $650 if I was to rebook a flight and seek treatment in the US.

ACE agreed to submit to “Higher management” for appeal, and first promised to reply within the week during mid-June.  5 calls later, over 5 weeks, “next week” and “Higher management” have been repeated countless times. They have repeatedly made unfulfilled promises that they will reply within 24 hours, or the next week.

ACE agents have reneged on their promises. ACE delayed and waffled on this case for 40 days and counting. When I called, I was met with long waiting times, cold staff and unhelpful motherhood statements. They also claimed that they do not have the telephone numbers of their “Upper Management”.

Conveniently, “Upper Management” has become the bogeyman for them to throw all excuses of delays and “approvals”.

In the Insurance policy, under Section 4 - Overseas Medical Expenses, the clause protects the insurance company by including stipulating that ACE can request the patient to return to Singapore. I imagine this is to avoid expensive medical costs overseas.

However in this case, I have delayed my pain and rushed for my flight to return home as this will save time and medical fees. Logically, I have actually helped to save medical costs for ACE insurance. I have acted in the spirit of the policy clause. Yet now, they are biting me for the technicality of this clause.

Turns out even getting back my own property from them is difficult. “I’ll email you later”, “Give us one week”, “I’ll tell ‘Upper Management”, “It is in the mailing room”. All these platitudes, I can repeat the script of an ACE officer just after seeking one claim from them. Till now, I am still waiting for that promised email.

Now that they have finally returned my receipts after a long battle, I can finally move on to try to claim from other sources.

I have noticed a disturbing trend in the Insurance industry: repeated delaying, waffling and bouncing customers to “upper management”. Due to the extensive red tape and difficulty in reaching the claim approvers in these companies, consumers may eventually just give up their claims. I beseech the regulatory authorities to note these potentially misleading and irresponsible acts on the part of insurers. Perhaps, a service level agreement can be reached, where Insurers state that they must reply within a certain period. This will ensure accountability, and reduce the tendency for claims to be lost in a hierarchy.

For me, the claim process from ACE had been nothing short of a nightmare. With a broken hand, jetlagged, and medical bills to handle, waiting to speak to a robotic and unhelpful claims officer was just salt to my wounds.

Perhaps, profit-driven insurers can structure a new kind of secondary insurance products to protect consumers from incidents when their initial insurer refuses to honour the consumers’ claims. However, I highly doubt Insurers will offer such secondary insurance. For they know that the underwriting risk of the primary insurer reneging on promises is too high.

ACE Insurance replied to TOC's queries on this issue and Mr Mack, Country President of ACE Insurance wrote,

We apologise for the delay and inconvenience that the contributor experienced with regards to her claims submission. ACE is committed to improving our claims processes and we would like to thank the contributor for bringing our service lapses to our attention. We have taken measures and will continue to do so, to improve our service quality.

The contributor sought to claim for medical expenses arising from her treatment in Singapore after an accident overseas. She had not received treatment overseas which is a pre-condition stated in the policy wording for a claim for post-journey medical expenses. We will be contacting the contributor to resolve the situation.

A SMS was sent to the customer that her claim has been approved about 5 days after TOC contacted them about this story. ACE Insurance has since paid up all claims to JS Lua as of 9th July.