Wednesday, November 21, 2012

Wrong classification of hospital claim

The policyholder was shocked that the private Shield plan paid out only $150 from a hospital bill of $6,200 in a subsidized B2 ward. This was due to a wrong classification of a large item called consumables, and the insurer did not notice it. Fortunately, a friend helped the patient to get a larger payout

1 comment:

Jeremy Ow said...

This is the problem with insurance companies that upsell their medical shield plan. They will try to sell private shield plans as much as possible giving the reason that it allows the insured to get the best treatment in private hospitals, and even if one does not seek treatments in private hospitals, he can also go to public hospitals and still make claims on the treatments.

The focus is only on the benefits of a private shield plan and not approaching the whole insurance based on the financial background and real needs of the insured. Not all people can afford the high premiums for a private shield plan and not all people seek treatments in private hospitals. If that is the case, why do we need public hospitals anyway when everyone is going to private hospitals?

For this eldery case, it is unnecessary to have a private shield plan as it does not make sense for her to buy a private shield plan at higher premium cost and yet do not make use of the plan to seek treatment in private hospitals. This is contradictory to what she has bought. Why buy a private shield plan when one does not intend to seek treatments in private hospitals?

If one really needs a private shield plan looking at treatments in private hospitals, by all means buy one that is suitable and one will intend to use it in future. If not, why keep paying high premiums year after year just only to use public hospitals most of the time to make claims for one's medical treatments? It does not make sense at all!

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