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Dispute with AIA

  1. #11

    Join Date
    Apr 2017
    Posts
    20

    Also, them threatening to sue your employer shouldn't be a cause of concern for you. The HR would be more than aware of how to deal with such cases. The HR though should be aware of how the policy works i.e. if the total payout includes the prenatal check amounts then it would not be straight forward. The AIA policy when we joined the firm was pretty clear on how the maternity cover works and what are included.

    shri likes this.

  2. #12

    Join Date
    Jan 2008
    Posts
    10,551

    i have medical, dental and vision (each at 80%) coverage through my company (which is in fact an insurance company), they cover US$5000 of the birth of my kids, there is no coverage for pre natal coverage and check ups during pregnancy which we covered ourselves , probably, best to ask your insurance company to forward the copy of your certificate of insurance and look at the small prints for the actual coverage of the policy to see if you are covered or not, once you can see in black and white, then you can complain to your insurance company, BUT if the policy don't state coverage for pre natal coverage and check ups, then it was your presumption that this aspect was covered.


  3. #13

    Join Date
    Oct 2014
    Posts
    1,753
    Quote Originally Posted by Tcresident011
    The AIA policy when we joined the firm was pretty clear on how the maternity cover works and what are included.
    As was mine and it didn't require us to call or email them to find out what was covered. It was all laid out very clearly. @Plus did your HR not provide you with a policy document outlining the coverage in detail?

  4. #14

    Join Date
    Feb 2009
    Location
    Hong Kong
    Posts
    1,583
    Quote Originally Posted by Plus
    The whole thing makes no sense as far as why would AIA choose to guarantee a certain payment to the hospital beyond what they say I’m eligible for and then take the responsibility on themselves to collect.
    This doesn't make sense. Can you find out if this is how they usually work? Usually with co-pay I'd expect to pay my share on the spot?

  5. #15

    Join Date
    Apr 2017
    Posts
    20

    Co-pay doesn't work for Maternity cover as you would do for a GP visits ..with my experience with AIA, the amount they usually cover is indicated upfront and that amount covers all pre natal, delivery and ante natal doctor visits. Say for example if the total amount covered is $100 k and you have already used 25k for prenatal visits and scans, you will be eligible for hospital claim upto $75k. That toooincludes limits on how much the hospital can claim for various procedures.

    shri likes this.

  6. #16

    Join Date
    Oct 2014
    Posts
    1,753

    Another thing about AIA is that the newborn isn't covered until 14 days after birth or something like that. So charges related to the care of the baby are not under the maternity limit.


  7. #17

    Join Date
    May 2006
    Posts
    416

    Unless your policy document was very unclear, I think you're going to have a hard time with this one. As many others have pointed out, the policy document usually states what the coverage is.

    You can try filing a complaint with AIA and the IA, but it is quite likely the Terms and Conditions will say that the policy document is the official record.

    https://www.ia.org.hk/en/aboutus/lodge_a_complaint.html


  8. #18

    Join Date
    May 2008
    Location
    DB
    Posts
    3,377

    @Plus Please check your private messages as I sent you one and it hasn't been answered. A friend of mine is with AIA and will help connect you with someone there regarding the hotline call you had. Please reply to my private message to share the relevant information.

    rani likes this.

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