I am having several conversations with ex pats about the major health insurance companies being quick to accept huge premiums only to refuse any sort of claim - seems like a total scam.
Am I the only one tolerating this? Probably better to put the premium money in a savings account. Over the past 5 years I have had repeated battles with insurance companies here in Phnom Penh - not just on medical matters.
Their default position is to refuse every claim unless you have the time and patience and energy and connections to fight them. Always a lovely feeling when the claim money finally hits your account after they have put you through hoops to get it. I once attended an appeal meeting with one of their lawyers who had 12 other people in the meeting room.

Your post seems a little short on details. You mentioned an existing condition, were you fully open and honest about this when you applied for the insurance?

From my experience they are wary of any pre-existing condition before you joined them. And even if you didn't, the onus seems to be on you to provide evidence from your medical records to prove that or else they will seek your authority to search your medical records and contact your doctors etc. Otherwise they won't pay.

The only times I think payment is relatively simple is when you've already been contributing a long time or else you have an accident

Self insure , health insurance is a business not a charity, the premiums go up as you get older then eventually they won't insure you and years of premiums will be down the drain.
It's a gamble with the odds in thier favor.

Some excellent and wise responses - thank you. Yes I have disclosed full medical records at the outset to be totally honest and transparent. Bottom line is that the insurance companies employ legal medical underwriters and have little regulation. Judge and jury. However, the legal qualifications of these people are weak when faced with a world class commercial KC - that is your best bet. Go in hard and fair and leverage your claim with the assistance of friends in high places. It's a marathon not a sprint.

if you are an american veteran of the military you get insurance mostly as a gift
i got medical and social security pay i dont even need

A commercial KC? How much were you claiming to warrant instructing one of those big guns?

Furthermore, what insurance company(s) are we talking about? You mentioned local ones, are there any Cambodia insurance companies? I don't mean brokers, there are plenty of them.

Expatenglish wrote: ↑Mon Dec 12, 2022 7:24 am I am having several conversations with ex pats about the major health insurance companies being quick to accept huge premiums only to refuse any sort of claim - seems like a total scam.
Am I the only one tolerating this? Probably better to put the premium money in a savings account. Over the past 5 years I have had repeated battles with insurance companies here in Phnom Penh - not just on medical matters.
Their default position is to refuse every claim unless you have the time and patience and energy and connections to fight them. Always a lovely feeling when the claim money finally hits your account after they have put you through hoops to get it. I once attended an appeal meeting with one of their lawyers who had 12 other people in the meeting room.

Insurance scam. The premise of the movie City of Ghosts.

Yes there ARE Cambodian insurance companies but since I'm in litigation with one and the case is ongoing I'm not at liberty to name names. My KC would not be amused. And yes - it is a substantial sum. Smart cookies these KCs. Donkeys years ago I was a litigant acting in person in a Civil matter and up against a QC who was acting for the other party. Said QC was a young lady of shall we say ample proportions. Wouldn't have passed the Virgin Atlantic flight crew selection criteria. On enquiring of said lady the correct form of address for a lady QC we established it was Miss. In front of His Honor the presiding Circuit Judge she complained that I had written "bollocks" over her paper settlement offer. As I was paying her fees I advised her that she should lay off the minced pies at Christmas. She knew that she couldn't sue me in a Court for my comments under oath. After the hearing we were both back on the same train from Brighton County Court to Victoria. I was in First Class sipping a Gin and Tonic. Said QC was in second class eating a cheese and pickle sandwich with the 1000 GBP fee I had paid her. Nice work if you can get it. QED

Doc67 wrote: ↑Tue Dec 13, 2022 10:30 am A commercial KC? How much were you claiming to warrant instructing one of those big guns?

Furthermore, what insurance company(s) are we talking about? You mentioned local ones, are there any Cambodia insurance companies? I don't mean brokers, there are plenty of them.

Forte is a proper insurance company...