medical claim denied after letter of guarantee given

Last August I had a baby by c.section at a lovely private hospital on Hong Kong Island as my insurance company provided the hospital with a letter of guaranteed payment based on a letter written by my obstetrician stating why this procedure was medically necessary. Now, all these months later they are denying liability and say that it was not medically necessary after all (using the same letter from my doctor) and that we have to pay over $100,000 in hospital bills!!!!

Has this happened to anyone else? What can I do now?

Dispute it with your insurance company. By the way was this private insurance or, say, through a company medical plan? If you bought the medical coverage through an insurance agent get him/her to help you. If it's under a company medical you can get your HR involved.


Also, ask the insurance company who you can get in touch with if you don't agree with their decision. I think they have to tell you who you can go to. Can't remember if it includes the Ombudsman, but you can definitely lodge a complaint with the Insurance Claims Complaints Bureau http://www.iccb.org.hk/


However, take it up with your insurance company first. If you're not satisfied with their response then take it up with the ICCB.


Good luck!