PRUDENTIAL MAKING EXCUSES NOT TO PAY OUT MY MOTHER'S INSURANCE CLAIMS

Recently, my mother had the misfortune of meeting an accident and has been on
a wheelchair for the past 6 months. She had the good benefits of buying many
policies to protect her family against such incidents but was aghast to
receive Prudential's rejection of disability.

These are what my mother and us have been going through but yet Prudential
deem it not serious enough to be considered disability, may I ask what is
disability to the insurance companies?

1) After a fall, my family doctor and medical specialist have written reports
that the fall was unexpected and my mother had “slight concussion” to the
brain.

2) Numbness in her arms and legs forced her to be wheelchair-bound for the
past 6 months.

3) Her daily life revolves around family member helping her to cloth, feed,
move around.

4) She have been enduring painful cramps in arms and legs and unable to live
a normal life.

5) She have been doing therapy twice a week since hospital discharge, and the
results are not ideal, but Prudential does not accept this results.

6) Her doctors have written reports based on forms provided by Prudential,
but yet Prudential officers stated that those reports are not what they want.
Would Prudential clarify on what reports to provide, and what standards
should we adhere since their own forms are not suitable for their claim
officers?

7) Her specialists are unable to provide treatment to full recovery and have
suggested that she uses a wheelchair for her daily movement, does that count
as disability?

8) She had bought many add-on riders to have peace of mind, yet she cannot
claim on such a big event on my life. What is the purpose of insurance?

9) How can we trust insurance agents when they are trained in sales, but not
trained in the terms of the insurance?

10) Prudential has informed us that their agents are not trained in claim
procedures, then who can we turn to after we paid premiums and improved
Prudential's sales?

11) My family is unable to seek help from Prudential's agent because he is
not trained in claims issues, and their claim department refuses to accept
medical reports following their standard forms. My family has no idea who to
seek help.

12) The claim rejection is not transparent and Prudential said it is unable
to provide us other details citing “confidentiality”.Is this fair to
customers that is now no longer valuable but a liability to Prudential?

13) We bought a policy with many riders to protect ourselves, when we meet
the claim events and Prudential raised the threshold of paying out, should my
family accept it as bad luck on our side?

14) I was requested to submit a mandatory financial status report on my
income for the past years, is this fair that they do not ask this when we are
buying a policy but then make it mandatory when we need a claim?

15) We had purchased additional provisional disability benefit but Prudential
reject as doctors were unable to diagnose her medical problem. Does this
rejection means all her riders and main policy can be considered as useless
since nothing is payable?

16) My mother is disabled, forced to use a wheelchair, the medical reports by
professionals are overwhelming in favour that the disability resulted from
the concussion by the accidental fall, yet Prudential can reject it because
causes of the medical condition is not certain. Using the insurer's own
terms, are we consumers protected?

It is frightening that Prudential can reject my mother's claims because the
doctors are unable to diagnose and treat her. I have no idea that they based
their insurance on a perfect world where every medical condition and every
medical treatment is confirmed and guaranteed in black and white in some
medical, or should I say, insurance text book.

As everyone needs insurance, it frightens me that the insurer can use their
own terms and conditions to reject a claim because a medical condition is not
certain despite the victim being wheelchair bounded. What are our rights as
consumers?

It is really frightening that insurance agents keep telling us how important
it is to buy insurance, but when we really need to pay our medical bills,
they do their utmost best NOT to pay out.

Tiredgirl
A.S.S. Contributor