AIG DEFIES Poppi act AND DELAYS TO PAY

I have been an AIG Hospital Plan client for more than 10 years. This policy is a hospital cash plan that pays a fixed daily benefit from day one of hospital admission. It is not a medical aid and does not pay based on diagnosis, treatment outcome or medical condition severity.

I was recently admitted to hospital by my GP due to a heart-related condition. During my stay, a hernia was also discovered. After discharge, I submitted my hospital cash plan claim together with the hospital account clearly showing my admission and discharge dates.

Due to AIG changing their claims system, I first struggled to obtain the correct process and forms. I eventually uploaded all required documents through the new online portal nearly 3 weeks ago.

After hearing absolutely nothing further, I contacted AIG today to complain about the delay and was advised that Loretta King is now handling my claim.

I then queried why nobody had contacted me regarding any outstanding information. Ms King responded by saying, “Oh, I just emailed it.” Had I not personally called today to follow up, how much longer would I have been left waiting without any communication?

I fully understand and accept reasonable verification requests such as:

* Copy of ID * Proof of bank account

However, I am extremely concerned and confused by AIG now demanding:

* Copies of all blood test results * Radiology reports * Oncology reports * Full medical findings * A motivation letter from the cardiologist explaining why I was admitted to hospital

Why are these documents necessary for a hospital cash plan that simply pays a daily amount based on hospital admission?

My hospital account already clearly confirms:

* Date of admission * Date of discharge * Length of hospital stay

Surely that is what determines the payout under this type of policy.

This is not a medical aid claim requiring treatment authorisation or investigation into diagnoses. It is a fixed hospital benefit policy.

My blood test results, oncology records, scans, specialist reports and private medical findings have absolutely nothing to do with confirming whether I was admitted to hospital for the number of days reflected on the hospital account.

What concerns me even more is that I previously had a completely separate cancer policy with AIG. In 2016, after I was diagnosed with breast cancer and underwent a double mastectomy, that cancer policy paid out and was then cancelled by AIG.

At the time, I specifically questioned what would happen if I ever developed another form of cancer in future, and I was simply told that once the policy paid out, the cover ended permanently. I complained about this situation at the time and never even received proper feedback.

I therefore find it deeply concerning that oncology reports are now suddenly being requested on an unrelated hospital cash plan claim.

Why is oncology information being requested when:

* I was admitted for a heart-related condition; * A hernia was discovered during admission; and * This policy only pays a daily hospital benefit?

I believe these requests are excessive, invasive and unrelated to the actual benefit being claimed. I am also concerned about the unnecessary processing of highly sensitive personal medical information and whether this aligns with the principles of the POPIA Act.

After faithfully paying premiums for over a decade, I am extremely disappointed by:

* Excessive delays * Poor communication * Constant changes to the claims process * Lack of transparency * Last-minute requests for additional documents * Demands for highly confidential medical records unrelated to a hospital cash plan payout

I would appreciate a proper explanation from AIG as to why all these deeply private medical records are necessary to process a simple hospital cash plan claim based on confirmed admission and discharge dates.