Dear Mr Tan,
My family members have been insured under X Shield for several years. Last year, we decided to upgrade the plan and add rider to enhance our coverage. All documents were submitted on the same day. Later we received policy contract, we were told that our daughter's plan will only commence in 1 Feb 08.
On 30 Dec 07, my daughter was admitted to hospital for investigation. After several tests, we were told that medical attention need to be administered immediately. In early Jan 08, we submitted a claim on X.
To our greatest surprise, X had just refunded our daughter's rider premium and resend us a new policy contract putting her coverage back to the initial coverage saying the upgrade and rider has been decline due to "pre-existing condition". Can X approve upgrade and then later decline it, is it fair for policyholder in our case?
If X has approved the upgrade previously, a contract has existed. It does not matter that the upgrade will commence later. To my knowledge (and I am not a legal expert), it is not correct for X to cancel the upgrade and refund the premium.
I think that X can cancel the policy if there is a pre-existing condition that is material to the upgrade, but it must be known previously to the insured. I am not sure about their grounds on this matter.
You can raise this matter with X. If they do not give you a satisfactory explanation, you can file a complaint with FiDREC,
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