Policyholders of the Pan American International Insurance Corporation are upset with the company.
Calls, and a letter to The Nation, tell of Pan American questioning the reports of local medical practitioners; paying sickness instead of injury benefits, which is less money, and claim delays because of questions from the regional claims centre in Trinidad and Tobago.
Part of the unsigned letter, states . . . “When one calls or visits their office, there is absolutely no one there who can give any input or guidance as far as your queries are concerned. The usual response is ‘we are awaiting correspondence from Trinidad. All claims and payments go to Trinidad to be processed and the decisions to pay or not to pay are made there.’ ”
General manager of the company, Keith King, said all claims had to be honoured.
“The conditions of each policy are governed by the contract. The company cannot arbitrarily alter the terms of the contract. We must abide by the terms as set out. There are instances when we ask a claimant to satisfy us that the length of time being claimed is justified and, in some instances, some clients are uncooperative in this regard, but if any of our clients have a problem with us, they have recourse in that they can go to the Financial Services Commission.
“However, no insurance company deliberately sets about to deny a claim, but there must be proof in keeping with the terms of the contract,” he said.
King confirmed their regional claims department is in Trinidad and cases were referred there. He said any claim required the appropriate documentation such as a claimant statement and reports from a physician, but in some cases he said the information provided was either too vague or inaccurate, which then required the department to request clarification, which in turn added to the length of time it took to provide settlement.
King said he was unaware of any issues with customer service.
“We train our staff to understand that good customer service is our hallmark and where a member of staff does not deliver, there are penalties,” he said. (CA)
