Pacific Cross Health Insurance PLC Pacific Cross HealthPacific CrossPacific Cross Health ThailandPacific Cross ThailandPacific Cross Health Insurance Denied a valid health insurance claim and then tried to pay me to go away Bangkok Bngkok

I hold health insurance with Pacific Cross Health Insurance Thailand. Over the past number of months, there have been no problems with small claims (usually under $75), however the first time that I made a more sizable claim, around $700, they immediately escalated the matter to the CEO, falsely asserted that I suffered from a pre-exisiting condition, accused me of failing to declare this condition, offered to pay only about $150, amended my policy to exclude the health condition they claim I sufer from, and refused to directly address any of my arguments. When I didn't go away, they suggested that I accept a cancellation of my policy minus all claims paid to date.

This started a few weeks ago. I had been sufering from tremendous fatigue and exhaustion, the kind where you sleep 8 hours, wake up and feel like you can't get out of bed. I did my research and went to speak with an Endocrinologist. In Thailand, you can book specialists direclty. There is no need to be referred by a GP. The Endocrinologist agreed that testing for the male hormone panel was a good idea. This test measures levels of many, many different hormones, one of them being Testosterone. My insurance from Pacific Cross Health Insurance Thailand covers outpatient visits and covers such lab tests. The cost was around $700. When I submitted the claim to Pacific Cross Health Insurance Thailand, they immediatley escalated the matter to the CEO who offered me around $150 and lectured me regarding the fact that insurance companies are not here to cover pre-existing conditions. (I don't disagree with him).

His argument that I suffered from a pre-exisiting condition related to my hormones stem from my admittance to him that 4 years ago at an anti-aging clinic where I was visiting in an effort to optimize my health and slow down the aging process, my Testosterone levels were found to be sub-optimal. Now this is not an emergency. The Testosterone levels could though have been a little higher and I was advised that if I wished I could supplement with Testosterone a few times a month and see the result. In no way was it absolutely necessary. Indeed sub-optimal Testosterone levels can be the temporary result of stress, lack of sleep, insufficnet food intake, and even certain medications. I decided to try it for some time, did gain some muscle during that time, and then stopped any and all supplementation at least 3 years ago. (The tests that I got a few weeks ago showed me in perfect health despite zero supplemntation in 3 years).

Despite the medical fact that sub-optimal levels of Testosterone can be the result of many mundane day to day life experiences and does not automatically indicate a disorder or disease in any way, Pacific Cross Health Insurance Thailand decided that I had a pre-existing hormonal condition that I failed to disclose when I applied. This decision was made by a doctor who never examined me, who does not reside in Thailand, who is not available to answer any questions and who is on the payroll of Pacific Cross Health Insurance Thailand.

When I pushed the CEO of Pacific Cross Health Insurance Thailand to address the obvious, that Testosterone levels drop in NORMAL men all the time for all kinds of reasons (even being around young children) and that doctors everywhere will agree that this does not mean that the man suffers from a ' hormonal condition', he refused to address my point and simply repeated over and over again that I had a pre-existing conditon and they would not pay more than $150.

When it became clear to Pacific Cross Health Insurance Thailand that I wasn't going to walk away without a fight, they tried to get rid of me by suggesting that I accept them cancelling my policy with a full refund minus the claims paid out to date.

The case is with the relevant government bodies now. I hope that this serves as a warning to others. Pacific Cross Health Insurance Thailand cannot be trusted. They may be a scam or a fraud or they may just increase profits by denying claims whenever they think they can get away with it and paying claims where there is no way out. I don't know. From what I saw, I can say for sure that where there is any room at all to manuever to avoid paying a cliam in full, they will do just that. With the claim fought directly by a doctor on the payroll of Pacific Cross Health Insurance Thailand and the CEO himself, there is nowhere to turn for the policy holder. When I called their offices in Bangkok, every person I spoke with said that only the CEO could help. What kind of insurance company leaves all power over a $700 claim to the CEO? Is this the kind of insurance company you want to trust with your health, especially in Thailand?

If you want health insurance in Thailand that will actually be there for you when you get sick, I do not recommend Pacific Cross Health Insurance Thailand.