Q: I am a medical doctor working for a clinic. I have been working with around 13 to 18 insurers and always feel frustrated as some claims get rejected by some insurers while others accept them. It is very difficult to understand which insurer is covering what. Certain policies are clear but most of them are confusing. How can we cope with such situations? A: Your experience is quite understandable. But the entire blame cannot be shifted to the insurance company. In the over-all insurance sector, there is a lack of well-qualified and trained personnel. Some insurance claims handlers may not be well conversant with the conditions of the policy. The policies are also drafted in such a way that gives some scope for confusion. The recent drafting of policies by CCHI has provided some sort of uniformity to the standard coverage. But it also has certain grey areas, which are being interpreted differently. I will suggest you to put the diagnosis and prognosis clearly on your prescription slip. This will help the doctors processing your claims to relate the prescription with the drugs, tests and other procedures and reduce the number of rejections. You can always re-submit the rejected claims with your comments and explanation. If you feel that the claims are rejected unjustifiably then you have a right to lodge a complaint and even stop dealing with the concerned insurance companies. Q: We have been insuring all our properties under Property All Risks policy for almost over a decade. We have around 30 laptops, which are also covered under this policy. Recently one of our laptops was stolen from our office. When we lodged a claim with the insurer, we were surprised to see that our deductible was SR5,000 for each and every claim. The cost of our stolen laptop was SR3,000. We suggested them to reduce the deductible but the insurer is not willing to reduce the deductible. How to address this issue? A: If we compare the cost of laptop a decade ago, the rates have reduced tremendously. May be you would have got at least 50 percent of the claim amount had it been lost a decade earlier. But now the values have come below the deductible amount. Moreover the laptops are mobile devices and are carried by the person. Hence I would suggest you to take a separate policy for your laptops and other similar devices. This policy may be called a Personal Possessions All Risks policy. The deductible is usually SR100 to SR250 and there are two type of coverages: one within Saudi Arabia and the other worldwide. Depending upon the usage you may select the coverage. You may need to pay at least 5-10 times more than your current rate. * Shujaath Ahmed Khan, an M.B.A., General Manager, Creative Associates is also a consultant and an expert in Insurance, Investments and Real Estate. He can be contacted at [email protected], website-www.creativeassociates.blogspot.com. __
