There was a letter in the Straits Times that the insurance company rejected a permanent disability claim from an insured person who was paralyzed from the waist down. The insurer claimed that his person could do sedentary work and does not qualify for a claim.
I checked the definition of the cover from the CPF website and found the following:
This Dependent Protection Insurance scheme provides CPF members and their families with some money to tide them over the initial years should the insured members become physically/mentally incapacitated or die.
The website further states: The member becomes physically/mentally incapacitated and can no longer work as certified by a doctor. The scheme does not provide any further guidance to the doctor how to certify that the member "can no longer work".
The DPIS scheme has been in existence for more than 30 years. It is unsatisfactory that there is no clearer definition about what incapacity meant. There must be many actual cases in the past that could be used to provide guidance on how to deal with some specific cases.
I checked the definition of the cover from the CPF website and found the following:
This Dependent Protection Insurance scheme provides CPF members and their families with some money to tide them over the initial years should the insured members become physically/mentally incapacitated or die.
The website further states: The member becomes physically/mentally incapacitated and can no longer work as certified by a doctor. The scheme does not provide any further guidance to the doctor how to certify that the member "can no longer work".
The DPIS scheme has been in existence for more than 30 years. It is unsatisfactory that there is no clearer definition about what incapacity meant. There must be many actual cases in the past that could be used to provide guidance on how to deal with some specific cases.
Just a thought.
ReplyDeleteDid Mr. Tan come across such a case when he was CEO of NTUC Income?
If he is still CEO, what action would he take towards this unfortunate policyholder, when even CPF itself is ambiguous about what precisely is the term "incapacity"?
Guess Mr. Tan still have to conform to industry norms.
Apparently, the fault lies with CPF, and insurers seize upon it to escape payment.
Guess CPF knows, but pretends not to know, turning a blind eye, to pass responsibility to industry to settle.
Cool, but ruthless.
the problem is that there is no such thing as "can no longer work" as long as one's brain is still functioning.
ReplyDeleteA doctor would be sore afraid to say any person "can no longer work" unless the person's brain is not functioning. A paralysed person could still work from a wheelchair. Computer technology can allow a fully paralysed person to write a book. So technically, how is a doctor going to say anyone can no longer work.
Therefore the insurance condition clause "can no longer work" is heavily biased in favour of the insurer. Doctors dont dare to decalre for sure a person can no longer work!! And as long as a person can earn $10 a day even selling tissues, he is considered able to work, never mind paralysis or half vegetable!!!
This is grossly unfair practice of the insurance companies. I am very very disappointed that the very famous insurance company which claims to be made different, can take such a heartless stance and wouldnt payout a cent to someone who is paralysed waist down.
I am further disappointed and appalled that the relevant regulatory and political authorities are keeping completely silent.
rex
Insurance companies nowadays are full of shit. They do not work within the ethics of life protection anymore, thus have turn into very selfish organizations.
ReplyDelete