KUALA LUMPUR, Feb 20 — A stage four tongue cancer patient, whose medical insurance claims were rejected, has received a full refund of premiums from his insurer after it voided his policy.
Ramu Krishnan Sinnamuthry said his insurer, Allianz Life Insurance Malaysia Berhad, denied several of his medical claims, before subsequently cancelling his policy and returning all premiums he had paid since 2023.
He paid RM469 monthly from April 26, 2023, which later increased to RM505 a month from April 26, 2025. In total, he paid roughly RM15,000 in premiums over two years.
Full premium refunds after a policy is voided are not typically automatic under standard life and medical insurance contracts.
Ramu held an Allianz UltimateLink investment-linked life policy with a HealthInsured (Plan 300) medical rider issued in April 2023. The policy contract states that if coverage is voided due to misrepresentation or non-disclosure of material facts, the insurer “may not” refund premiums paid.
In other words, based on this policy wording, a full premium refund is not automatic and would generally be considered unusual under standard contract terms.
Refund provisions in the contract are generally tied instead to early cancellation during the free-look period or to surrender values based on accumulated account units, rather than reimbursement of all premiums paid.
Ramu previously filed three separate claims related to his cancer diagnosis and treatment totalling RM25,647. The claims comprised a CT scan admission costing RM5,442.95 submitted on July 28, 2025; a first biopsy confirming cancer at RM4,001.70 submitted on August 20, 2025; and a second biopsy to identify the primary tumour site costing RM16,202.35 submitted on September 4, 2025. All procedures were carried out at ParkCity Medical Centre.
Following the policy’s cancellation, Ramu has continued treatment without insurance coverage. He now pays between RM10,000 and RM15,000 out of pocket every two weeks for immunotherapy at an oncology centre in Bangsar South, in addition to oral chemotherapy taken twice daily, amounting to as much as RM360,000 a year.
Ramu described the refund as unsatisfactory and escalated the matter to the Financial Market Ombudsman Service (FMOS), an independent dispute resolution body established under Bank Negara Malaysia (BNM) to handle complaints between consumers and financial service providers.
“I am OK, improving little by little,” Ramu told CodeBlue in a recent message, adding that he has submitted the required documents to FMOS and is awaiting a response.
While his appeal with FMOS remains under review, Ramu said he is willing to share his experience with other policyholders facing insurance claim disputes, particularly those seeking refunds or considering formal complaints.
“If there is anyone who is in my situation due to the insurance claims, I am willing to give them a helping hand on how to go about either getting the refund or bringing it up to FMOS,” he said, adding that he does not intend to charge for the assistance.
Ramu first spoke to CodeBlue last year about delays in his insurance claims while undergoing stage four tongue cancer treatment.
Finance Minister Anwar Ibrahim, in a written Dewan Rakyat reply on January 22, said health insurance disputes accounted for just 3.4 per cent, or 112 complaints, of the 3,253 cases received by FMOS in 2025. About three-quarters of these were resolved through mediation or adjudication.
CodeBlue previously reported persistent delays and claim denials in health insurance, while Bayan Baru MP Sim Tze Tzin said many policyholders do not know they can seek formal dispute resolution.
