The purpose of insurance is to pay claims, especially for legitimate claims. It is not to make excessive profit for the insurance company. In some countries, it is illegal for an insurance company to reject a claim for unjustified reasons. If they wish to cite "non-disclosure", they need to have reasonable grounds. As the situation seem to be quite bad in Singapore, it is best for consumers to avoid changing insurers or to avoid upgrading of Shield plans.
The behavior of the insurance company is bad in another respect. Even if they are entitled to reject the claim, it is still their duty to pay the Medishield portion of the claim, as this cover is supposed to continue from one insurer to another, and from one plan to another. By rejecting the claim, the insurance company is failing in its duty to treat its customer fairly.
If you are caught in this situation, and your claim is unfairly rejected, you have the following options:
- Lodge a complaint to FIDREC (www.fisca.sg) for your claim to be mediated or adjudicated
- Write a letter to the newspaper to complain about the unfair rejection
You can read several stories about unfair rejection of Shield claims in my website. Go to www.tankinlian.com/ask.aspx and search for 'Rejection" or "Shield".
Tan Kin Lian