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

Our mission is to provide affordable and accessible medical care for everyone in the community. We understand that medical bills can be overwhelming, and that’s why we offer Crowd Share, a cost-sharing solution that replaces traditional insurance premiums. We want to make sure that every member of the community can gain access to high-quality healthcare without breaking the bank.

We want to make it clear that Gathercare does not benefit from withholding or rejecting claims. Our Sharing Deposit pool is not connected to our profit margin, and we do not inspect your case for microscopic holes to use as a basis for rejection. The Sharing Deposit pool is kept away in the trustee’s account and is your money, as well as other Carers like you. We use this pool to cover your hospitalization cost and we claim the amount from the pool.

Every case we Crowd Share impacts the Sharing Deposit pool and affects the amount of monthly Crowd Share that every Carer has to bear. We strive to keep this amount reasonable and affordable for everyone.

However, some cases do get rejected. Our panel of experts from eMas reviews every incoming case for suitability for Crowd Share to avoid unnecessary burden to the community. Their task is to scrutinize every case and ensure that it meets the necessary criteria for Crowd Share.

On 16/8/2021, one Carer requested admission due to a 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 for Crowd Share. It was unfortunate for the Carer that the 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 Carer was treated as an outpatient, and the pustule went into complete remission after a couple of weeks of medication.

At Gathercare, we want you to benefit from our program while upholding fairness for everyone in the community. We encourage you to consult our panel of medical experts in eMas (03-4041 3627) before proceeding if you’re unsure about your diagnosis. Our goal is to provide affordable and accessible healthcare for everyone in the community, and we appreciate your trust in us.