- 1. Online transaction: Claimant alleged he didn’t received the OTP or SMS alert on the alleged online purchase.
- 2. Online transaction: "Phishing" case involving fake webpage.
- 3. Online transaction: Online scam on purchase of hand phone for RM1.00
- 4. Unauthorized Retail Transaction Involving Stolen Credit Card: Credit Cards in wallet left unattended at public place.
- 5. Unauthorized Retail Transaction Involving Stolen Credit Card: Credit card accidentally left at supermarket.
- 6. Compromised Credit Card: Dispute involving 12 unauthorized retail transactions – Card was not lost or stolen.
- 7. Compromised Credit Card: Stolen credit cards - 12 unauthorised transactions – Claimant alleged Bank did not sent any verification calls to him.
- 8. Charges Debited into the Credit Card Account
Cash Deposit Machine(CDM)
- 1. SMS/Phone Scam: Unauthorized remittance via internet banking to an oversea account.
ATM Cash Dispensation
- 1. Non Dispensation of Cash: CCTV Not Strategically Positioned.
- 1. Delay in notifying the Insurer: Vehicle stolen – Late notification of Theft claim for more than 4 weeks.
- 2. Delay in notifying the Insurer: Vehicle stolen - Insurer notified 4 months after incident.
- 3. Delay in notifying the Insurer: Vehicle stolen – Delay of 23 days in notifying the loss to the Insurer.
- 4. Delay in Lodging Police Report: Vehicle stolen – Police report lodged 9 days after the incident.
- 5. Exclusion: Owner lent his motorcar to a friend - failed to return the car - Met with an accident - Own Damage Claim rejected as motorcar allegedly used for Criminal Activity.
- 6. Exclusion: Motorcycle stolen – Rider was not in possession of a valid driving license.
- 7. Application of Average Clause: Vehicle underinsured - Application ‘Average clause’ policy in determining the cost of repair.
- 8. Failure to take reasonable precaution: Vehicle left unattended with engine running.
- 9. Failure to take reasonable precaution: Vehicle left unattended – Key in ignition switch – engine running.
- 10. Total Lost: ‘Total Loss’ Claim vs Insurer Cost of Repair
- 11. Tampered Chassis Number
- 12. Non –disclosure: Whether there was any non-disclosure by Insured in the absence of specific questions in the Proposal Form – whether there was a breach of para 5, Schedule 9 of the Financial Services Act 2013 by Insurer.
Life &General/ Family
- 1. Non-Disclosure: Critical Illness Benefit claim due to Breast Cancer – Failure to disclose history of ultrasound examination of the abdomen and pelvis and bilateral mammogram in the Proposal Form.
- 2. Non-Disclosure: Death claim due to lung cancer – Undisclosed medical history of Hepatitis B in the Proposal Form.
- 3. Non-Disclosure: Death claim due to Subarachnoid Haemorrhage – Failure to disclose medical history of Hyperlipidaemia in the Proposal Form.
- 4. Non-Disclosure: Failure to disclose medical history of Syphilis 40 years ago in the Proposal Form.
- 5. Non-Disclosure: Failure to disclose medical history of skin rashes/allergic reaction in Proposal Form.
- 6. Total and Permanent Disability Claim: TPD claim due to Parkinson disease rejected by Insurer.
- 7. Total and Permanent Disability Claim: TPD claim due to Leg Amputation declined by Insurer.
- 8. Total and Permanent Disability Claim: TPD claim due to Eye related illness was refused by Insurer.
- 9. Delay in Notifying the Insurer: Claimant met with an accident - Claim filed not within stipulated time frame.
- 10. Personal Accidental: Death claim– Whether the cause of death was accidental or due to illness
- 11. Exclusion Cause: Driving without a valid driving license Whether it falls within the meaning of "illegal activities".
- 12. Exclusion Cause: Riding a motorcycle with an Expired License of more than 10 years.
- 13. Exclusion Cause:Preventive Medication: Is It Medically Necessary?
- 14. Exclusion Cause:Whether Riding with an Expired Licence is a Violation of the Law
- 15. Pre-Existing: Death benefit claim – dispute on pre-existing illness of Hypertension prior to Certificate inception - failure to support contention with medical evidence.
- 16. Investigatory Purposes: HSI claim due to ‘No Recurrent Brain AVM’ – Declined by Insurer as admissions solely for investigation purpose and not Medically Necessary with no treatment rendered.
- 17. Terms and Conditions: Participant underwent CT coronary angiogram - Treatment administered as an outpatient - Insurer declined claim as treatment does not comply which the certificate Coverage with requires admission.
- 1. Marine Cargo: Inland Transit Claim - Damage to cargo during unloading process from the conveyance.
- 2. Travel Insurance: Schedule flight missed – Unable to arrive on time to airport as train services were due to heavy snow – Declined by Insurers as circumstances of claim was beyond scope of policy coverage.
- 3. Burglary: Robbery at Outlet – Participant unable to comply to the new terms and condition of the Certificate as it was only made available to Participants after the loss had occurred.