A lawyer has taken an insurance company to task for allegedly classifying her as having cancer, contradicting the medical report issued by the physicians treating her.
Lim Zi Hwei was admitted to a private hospital in Kuala Lumpur on Dec 4 last year, and was discharged five days later. The final diagnosis on her medical report stated that she had a “pituitary tumour and metabolic syndrome”.
A pituitary tumour is an abnormal growth in the pituitary gland. Most pituitary tumours are benign (not cancerous).
“On Dec 27, 2022, I received a notification from AIA that the Final Guarantee Letter (FGL) was ready. I read through the FGL and was shocked to discover that I was classified under ‘C751 – Malignant neoplasm of pituitary gland’,” said Lim, who has been an AIA Malaysia policyholder since 2010.
A malignant neoplasm is a cancerous tumour.
“I immediately went to Prince Court Medical Centre to view the claim form submitted by the treating doctors. I read through the forms and report, and none of the treating doctors had diagnosed me with malignant neoplasm.”
Lim said she went to AIA Malaysia’s headquarters in Jalan Ampang, Kuala Lumpur, on the same day.
“I told the customer service personnel about the diagnosis in the FGL, and she told me that she would clarify it with the claims department.
“I waited for 40 minutes, and when she returned from the claims department, she informed me that the diagnosis (in the FGL) was based on the medical report.
“As I had a copy of the medical report, I showed it to her and asked her to point out to the doctors’ diagnosis of me having malignant neoplasm.
“She could not, and then told me that she was instructed to inform me to call the Guarantee Letter Department for clarification.”
Lim found it odd that she had to call the department for clarification when she was already in the building, and that the customer service representative could have just gotten someone from the department to meet her.
“When I told her that, the customer service representative left her station and returned some 15 to 20 minutes later. She told me that I should ignore the word ‘malignant’, as based on the medical report, the classification was the closest they could find in their system to describe what I had.
“I told her that this was unacceptable, and wanted to record the conversation, but I was stopped by another personnel who requested me to delete the recording. I refused, and the lady who attended to me said she was not going to answer any more questions and asked that I leave.
“This diagnosis, which will now be in my personal records, will be damaging to me, as it can be accessed by other insurance companies. I will not be able to get new insurance coverage in the future since I have allegedly been diagnosed with ‘cancer’ by AIA.”
Lim lodged a police report at the Travers police station in Brickfields, Kuala Lumpur, later in the evening.
On Jan 16, 2023, Lim received an email from AIA Malaysia that read: “We have found that the claims assessor had inadvertently selected the incorrect ICD (International Classification of Disease) for illness coding under the Diagnosis Section, ie. C751 – Malignant neoplasm of pituitary gland”.
“However, under the Additional Notes Section of the same FGL, the claims assessor had manually elaborated on the final diagnosis, as verified by the endocrinologist.”
Lim fears that many other policyholders, who fail to read the contents of their FGL, will also be classified or diagnosed incorrectly by their insurance companies, affecting their coverage in the future.
“I want AIA to provide me, in black and white, evidence that they have changed the FGL based on the medical report issued by the hospital, and that my name is clear of cancer in its system,” Lim added.
Twentytwo13 has reached out to AIA Malaysia for comments.
