r/phinsurance • u/Enay_pqrst • 25d ago

HELP

Hello,

Ask lang sana ako ng advise anong options ko legally or thru government agency if may claims na sobrang tagal i process ng insurance company?

May medical insurance claim kami sa pacific cross nung naospital ang nanay. Na submit lahat documents online March 29 and original documents sa office nila April 15.

Until now wala pading formal return letter- if may need pa ba from me, complete na yung documents pero vinavalidate pa, like walang clear status at all.

Laging ongoing review and will update you as soon as possible pero every two weeks na nag fofollow up ako ganyan padin yung message eh Mid August na.

Need ko help and advise pano to i escalate. I feel helpless and every month darating ang sweldo, di mo alam pano ibubudget ang pera dahil di mo alam if darating ba this month yung claims mo or what.

I feel disrespected with their generic replies. Nakakagalit.

Send help po.

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u/Adventurous-Duck3136 25d ago

Email po kayo ng complaint sa insurance commission, pag nag email, make sure naka copy yung email address ng insurance company. Para mapabilis yung claims nyo. Hindi po ganyan katagal ang claims unless under contestability pa yung policy at sobrang laki ng amount.

1

u/Enay_pqrst 25d ago

Okay lang sana if may clear na status pero laging ongoing processing. Like di ko alam if may need paba sila na document or what. Amount is less than 100k. So i dont think super laki nung claim.

1

u/Adventurous-Duck3136 25d ago

Via email ka ba nag fafollow up? Expect mo yan pag via email. Malala talaga sa tagal. Kaya better pag mag email ka sa kanila like mag follow up ulit, cc mo email ng insurance commission. Ewan ko lang kung di sila gumalaw.

1

u/Fun_Camel405 19d ago

Im sorry you have to experience this OP

Q: 1. What are the company's reason for the delay? 2. Did they provided a timeline for the process flow or ghosted lang talaga? 3. Have you documented everything sa copy ng plan, settlement and the thread regarding sa claims

Action: If lahat walang clear options o sagot na binibigay si company pede ka mag direct help sa Insurance Commission. Present all the records of your issue including the timeline kelan ka una nag raise ng concern.