Tan Kin Lian's Blog: One-sided stories and half truths

Wednesday, December 22, 2010

One-sided stories and half truths

A financial adviser wrote to me to complain that my postings on rejection of private Shield claims are negative and one sided, and that it did not contain details of the reasons for the rejection.

I am not able to post the details as the claimant usually does not wish to be identified. In some cases, the claims are still under appeal, and they do not wish to damage their chances. They do not wish their friends or family to know of their difficulty.

On the contrary, I know of many instances where the insurance agents tell one side stories, exaggerations and half truths to get consumers to buy life insurance or private Shield insurance that are a waste of money. These are told verbally to the consumers, without any written record. The agents are more likely to be the people who are responsible for one-sided stories.

Here are the half truth stories.

Tan Kin Lian

2 comments:

Wilfred said...: Hi Mr. Tan,

Every month I have clients claiming private-shield. There has been no case of rejection due pre-existing exclusion except for one case in which the exclusion was explicitly written in black and white from the onset as the life assured was already facing pre-existing illness at the time of purchase.

Overall my shield claims experience has been good and all my clients are happy with it.; December 22, 2010 8:45 AM
Spur said...: In recent years, insurers standard practise is to check with the hospitals and even polyclinics for your whole medical history whenever you make a claim. Your personal & intimate medical records are not as confidential as you think --- in S'pore insurers are fully entitled to get a copy of them, and insurers utilise a SOP set-of-rules devised by their panel of doctors/specialists to ascertain whether there is any possibility of pre-existing conditions that resulted in your current claim. This SOP is of course very strict to minimise claim costs to the insurers.

Insurers also cross-check with other insurance companies, in case you had declared some medical problem previously when applying for other insurance, or you claimed some medical previously. This is useful to catch those where there is no formal or easily obtainable records. Eg. You went direct overseas treatment or you only go to those 1-man-shop TCM etc.

As medical records systems are getting more integrated and widespread in S'pore, it is harder to "escape" the investigation of insurers. Consumers must therefore declare every medical condition truthfully, even those minor but persistent ones like frequent backaches, or skin rashes or frequent runny nose in the morning etc.

Of course got those heng-suay cases like somebody got minor hypertension (pre-hypertension) but polyclinic doctor did not convey a serious outlook on it and maybe brushed it aside, but still recorded in the patient record. When insurers see the medical records, they will by-default deny all those issues linked to hypertension e.g. heart disease, heart attack, stroke, vascular dementia, kidney problems, eye diseases/blindness, osteoporosis in women etc. All these excluded becoz you have hypertension.

On the flip side, I know of couple of cases where people actually had some minor pre-existing but becoz they never sought treatment for those, and they already on the Shield plan for at least 8+ years, so they got away with it when they finally claim medical treatment for those problems.; December 22, 2010 10:59 AM