SIVA PRAKASH VS XXXX INSURANCE
CASE FACTS
1. ‘A’ (deceased) was involved in a road accident and admitted to hospital ‘J’ in 2015.
2. He had a follow-up treatment in hospital ‘K’ after a month.
3. Both hospitals gave a positive remark upon his discharge and follow-up.
CASE FACTS
1. ‘A’ (deceased) was involved in a road accident and admitted to hospital ‘J’ in 2015.
2. He had a follow-up treatment in hospital ‘K’ after a month.
3. Both hospitals gave a positive remark upon his discharge and follow-up.
4. In 2016, ‘A’ bought three insurance policies with XXXX insurance. The policy will be known as P1, P2 & P3.
5. He declared all information required to the best of his knowledge. There is no question about an accident in the proposal form. Policy accepted and premium collected.
5. He declared all information required to the best of his knowledge. There is no question about an accident in the proposal form. Policy accepted and premium collected.
6. In 2019, ‘A’ bought another large sum insurance policy. The same proposal form was filled with similar answers. The policy will be known as P4. Policy accepted and premium collected.
7. At the time, ‘A’ was doing multiple jobs. The agent picked one of the jobs for employment and put his total income as income into the proposal form.
8. In 2020, ‘A’ died due to a road accident.
8. In 2020, ‘A’ died due to a road accident.
9. In 2020, upon receipt of the death claim, XXXX insurance admitted liability and paid the policies P3 taken in 2016. Also, XXXX insurance admitted liability for P1 & P2 in writing.
10. Later, in 2021 XXXX insurance rejected the P4 claim under the pretext there was a non-disclosure issue. Also, rejected P1 & P2 on the same ground without re-calling the initial liability admission.
11. The non-disclosure questions pertain to infirmity and salary.
11. The non-disclosure questions pertain to infirmity and salary.
12. ‘A’ never had any infirmity and declared his salary rightfully.
13. As I was not happy with the response from XXXX, I pursued taking the XXXX insurance to court. I did it under the executor's capacity.
13. As I was not happy with the response from XXXX, I pursued taking the XXXX insurance to court. I did it under the executor's capacity.
14. As soon as the case entered the court, XXXX insurance claimed the policy was rejected due to non-disclosure and fraud.
15. The fraud issue was an apparent afterthought.
15. The fraud issue was an apparent afterthought.
16. XXXX insurance claimed that the policy taken in 2019 was a fraud. Bear in mind the beneficiaries for all four policies are his kids.
17. The policies were signed in front of XXXX's insurance agent.
17. The policies were signed in front of XXXX's insurance agent.
In a nutshell:
XXXX insurance rejected the insurance death claim by giving the following reason:
- ‘A’ had infirmity and failed to disclose. (XXXX did not produce any conclusive evidence to support this)
XXXX insurance rejected the insurance death claim by giving the following reason:
- ‘A’ had infirmity and failed to disclose. (XXXX did not produce any conclusive evidence to support this)
- ‘A’ did not disclose his actual salary. (XXXX did not produce any conclusive evidence to support this)
- ‘A’ did not sign policy P4. (XXXX did not produce any conclusive evidence to support this)
- ‘A’ did not sign policy P4. (XXXX did not produce any conclusive evidence to support this)
Siva Prakash produced a hospital report confirming ‘A’ was healthy and never had any infirmity.
Siva Prakash confirmed ‘A’ had multiple sources of income through various witnesses.
Siva Prakash confirmed ‘A’ had multiple sources of income through various witnesses.
Siva Prakash confirmed that XXXX’s agent witnessed the signature of the policy. Again, all the beneficiaries of the policy are his kids. (This leaves no room for possible fault play)
The police report confirmed the cause of death of the accident due to the rider's negligence.
The police report confirmed the cause of death of the accident due to the rider's negligence.
Now, the trial is ongoing. I hope the truth will prevail.
The Ministry of Finance (MOF) through Bank Negara Malaysia (BNM) should endure this case as a lesson to protect the Rakyat from these greedy insurance companies. I demand the MOF to act on the following:
The Ministry of Finance (MOF) through Bank Negara Malaysia (BNM) should endure this case as a lesson to protect the Rakyat from these greedy insurance companies. I demand the MOF to act on the following:
A. It is a general practice for most, if not all, insurance companies to announce the number of policies matured and paid, medical claims and death claims awarded and paid to the insurers.
In the spirit of transparency, I urge the MOF to make it compulsory for all insurance companies in Malaysia to declare a breakdown of total number of various claims rejected on an annual basis.
-Encourage transparency instead of a lopsided sales gimmick-
-Encourage transparency instead of a lopsided sales gimmick-
B. Currently, there is a non-contestable clause for policies that is more than two years under the insurance act.
MOF should take indispensable steps and amend the insurance act to introduce a non-contestable clause for accident death claims. (No one can predict an accident, that's the reason it is called an accident!)
-Protect the vulnerable-
-Protect the vulnerable-
I will solicit to collect support from wider Malaysian upon the court’s final verdict.
This is not the first incident, I am sure that this won't be the last. MOF must ensure to cross all the T’s and dot all the I’s.
Together we stand for ‘Rakyat’!
This is not the first incident, I am sure that this won't be the last. MOF must ensure to cross all the T’s and dot all the I’s.
Together we stand for ‘Rakyat’!
Please share and retweet for a better reach!
#insurancescam
#protectlife
#lifematter
#rakyatlawanpenipu
#MOFhelpRakyat
#insurancescam
#protectlife
#lifematter
#rakyatlawanpenipu
#MOFhelpRakyat
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