MANILA - Medical insurance has grown in popularity in recent years as more people start to take better note of their health and how it affects finances. And while there are many individuals who have had no issues dealing with their respective insurance companies when paying for their premiums or their claims, there are also people whose dreams of having a financial safety net when a health crisis strikes becomes a nightmare instead.

For media practitioner Robbie Pangilinan, this nightmare became a reality when the insurance company he currently has a policy plan with cancelled without notifying him. He survived 2 strokes only a few years apart and with the change in lifestyle, he also opted to expand his coverage, getting a Family Plan from well-known healthcare provider Maxicare.

“I got the plan so that my family members can also avail of the product. Aside from me, my son Louis Pangilinan is also one of the beneficiaries. I occasionally have memory lapses due to my stroke so I set up a quarterly payment scheme so that there would be less tracking of monthly bills to look into,” he shared.

However, issues arose early this year when Maxicare informed Robbie that he was behind on his payments, a claim he refuted, sending screenshots of the last 3 payments he made which are meant to cover the last 2 quarters. Robbie admitted that he was slightly delayed, having paid the January due date only in March. However, Maxicare said that due to the lapse of the policy payment, Robbie is required to pay for the 3rd month in advance and set the due date on March 16, just over a week after the original payment was settled.

However, Robbie claimed that since he has caught up with his payment, the next payment date should still be on April, a position that his account officer, Dino Godoy supported. Despite this, Maxicare terminated the policy without informing Robbie. This was due to the underwriters rejecting the reinstatement of his account, resulting in the cancellation. These developments prompted Robbie and his wife to request for the reimbursement of their payment as they March payment was rendered moot due to the cancellation of the policy without their knowledge.

However, talks with Maxicare have been difficult and over the span of several months, the issue has yet to be resolved. Maxicare noted that a refund was unlikely because under the company’s records, Robbie was confined in a hospital last January 18. However, Robbie refuted this claim and said that his last confinement was on Oct. 28 to Nov. 1, 2019. Several requests were made, including documents regarding his confinement spanning the said dates and the proof of the last payment for 2019. For Robbie, it was a stretch that a company as large as Maxicare is unable to verify pertinent information or data of its clients, more so involving records of its client's payments.

“I know that 11,000 seems to be a small amount for some, but this is still money that I earned though my own sweat and blood. I just want my money back and for Maxicare to explain to me why it had to be so difficult for me to do so,” Robbie said.

Tracking payments made would have been easier had Maxicare issued official receipts acknowledging the payments made. However, Robbie said that they never received any official receipts from the company whenever they would pay for their premiums. Maxicare has yet to respond to the family’s request for the reimbursement despite several follow-ups from both the family and the account officer handing Robbie’s insurance policy plan.- Elishah Pangilinan