KUALA LUMPUR, Feb 20
A stage 4 tongue cancer patient, whose medical insurance claims were denied, has received a complete refund of his premium following the cancellation of his policy by the insurance company.
Ram Krishnan Sinnamtri reported that Allianz Life Insurance Malaysia Berhad rejected some of his medical claims before subsequently voiding his policy and reimbursing all premiums he had paid since 2023.
He was paying RM469 monthly starting from April 26, 2023, which later increased to RM505 per month from April 26, 2025. Over two years, he contributed around RM15,000 in premiums.
Typically, life and health insurance policies do not grant a full premium refund automatically if a policy lapses.
Mr. Lam held an Allianz UltimateLink investment-linked life insurance policy that included a medical rider issued in April 2023. The terms of the insurance contract mention that a refund of premiums may not occur if the coverage is voided due to misrepresentation or non-disclosure of essential information.
This implies that a full premium refund is not standard and would usually be viewed as an exception under normal conditions.
Refund clauses generally relate to early terminations during a designated free look period or to surrender values based on cumulative account units, rather than offering a complete premium repayment.
Previously, Mr. Lam had submitted three claims totaling RM25,647 for his cancer diagnosis and treatment, which included a CT scan hospitalization fee of RM5,442.95 submitted on July 28, 2025, and two biopsy claims within the following months that together cost over RM20,000. All medical procedures were conducted at Park City Medical Center.
After canceling the insurance policy, Lam continued his treatment without coverage, spending between RM10,000 and RM15,000 every two weeks out-of-pocket for chemotherapy and immunotherapy, which adds up to approximately RM360,000 annually.
Lam expressed that the refund was inadequate and has escalated the issue to the Financial Markets Ombudsman Service (FMOS), an independent body established to resolve disputes between consumers and financial service providers.
“I’m fine, I’m getting better little by little,” Lam noted, adding that he has submitted all necessary documents to FMOS and is now waiting for their response.
While his appeal is under review, Lam is willing to share his experiences with other policyholders who may face similar claim disputes, particularly those seeking refunds or contemplating formal complaints.
“If anyone finds themselves in the same situation as I am with an insurance claim, I’d be glad to support them, whether that’s getting a refund or pursuing their case with FMOS,” he remarked, clarifying that he has no plans to request assistance.
Last year, Ram discussed the delays in insurance claims during his treatment for stage 4 tongue cancer.
In a recent statement, Finance Minister Anwar Ibrahim mentioned in response to the Dewan Rakyat that among the 3,253 cases reported to FMOS in 2025, only 3.4 percent, equating to 112 cases, were related to health insurance disputes. About three-quarters of these issues were resolved through mediation or court.
It has been highlighted that delays and denials in health insurance claims persist, with MP Sim Tse Tsing noting that many policyholders remain unaware of their rights to pursue formal dispute resolution.
