Gathercare Rejected My claim? Here's What you Should know - GatherCare

Gathercare Rejected My claim? Here’s What you Should know

Sometimes we say no

We can’t stress this enough. Gathercare as a private entity does NOT gain any monetary advantage by withholding or rejecting claims. Your unclaimed “premium” does not turn into our profits hence we don’t inspect every microscopic holes in your case to use as a basis to reject your claims.

The concept of Sharing Deposit replaces the aforementioned premium we are used to in the insurance industry. The Sharing Deposit is untethered to our profit margin and is kept away in the trustee’s account. We cover your hospitalization cost by claiming the amount from this Sharing Deposit pool. This pool is your money, and other Sharers like you.

Lets Review How Sharing Deposit Works

Every case we Crowd Share will impact the Sharing Deposit pool and is reflected in the amount of monthly Crowd Share that every Sharer has to bear every month. Every normal person would want this amount to be reasonably low.

With that said, some cases do get rejected. But not before it’s being scrutinized by our panel of experts from eMas to avoid unnecessary burden to the community. It’s their task to screen every incoming case for suitability for Crowd Share.

True Story

On 16/8/2021 one Sharer requested for admission due to the diagnosis of sebaceous cyst/pustule in his neck, which was superficial at a glance. eMas confirmed that the case should require no admission and was unfit Crowd Share.

It was unfortunate for him that his case was rejected but it was for the greater good of the community. Everyone was saved from sharing up to RM3k to RM4k needlessly. The Sharer was treated as outpatient and his pustule gone into complete remission after a couple of weeks of medication.

The Take Away

While we want you benefit from this program, we must also uphold fairness for everyone else in the community. Please consult our panel of medical experts in eMas (03-4041 3627) before proceeding if you’re unsure about your diagnosis.

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