A consumer took a private Shield policy. His claim for medical treatment was rejected due to "non-disclosure" of medical condition. However, he did honestly declare all that he knew. There were conditions that were not explained to him by the doctor, but was not used to reject the medical claim. One condition was diabetes mellitus.
When he went for a health checkup in the polyclinic, he was not told that his diabetes had reached a serious stage that require medical treatment. In fact, he was not placed on medication. His non-disclosure of this condition was used to reject a subsequent claim for a condition that is not related to his condition. I am now helping the consumer to gather evidence that he was not concealing any information.
But it is quite stressful for him to be saddled with a hospital bill of $7,000 that was not paid. If this was not covered, he would have gone for treatment in B2 ward and pay a much lower bill. Sometimes, the existence of an expensive medical insurance policy creates more problem to the consumer.
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09/12 - 09/19
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- Non-disclosure of existing medical condition
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