14 January 2013
Editor, Forum Page
Straits Times
I have received several requests for assistance from elderly consumers
who had upgraded from the basic Medishield cover to an integrated
Shield policy offered by an insurance company and have their
subsequent claims rejected.
The main reason for rejection is the alleged non-disclosure of
pre-existing illnesses at the time of upgrading. In many cases, the
medical record came from the polyclinic that were treating the
consumer. The consumer might not aware about the medical
condition as they did not understand what the doctor had told them.
Some of these treatment had happened many years earlier.
Many consumers were not aware of this risk of non-disclosure, as they were
not properly explained of this requirement by the insurance agent.
They were also told that the private Shield policy provide better
coverage. This is not true in the case of an elderly patient who was willing to be
treated in a subsidized B2 and C class ward. The Private Shield plan require them
to pay a significantly higher premium without getting any tangible benefit. Instead,
they have to suffer the trauma of getting their claim rejected.
I suggest that it should be the duty of the insurance company to
check for existing medical conditions at the time of accepting the
upgrading, rather than at the time of a claim. They can ask the
consumer to declare the doctor that they have been seeing regularly.
Even if the insurance company had to reject the claim under the
upgraded cover, they should at least assist the consumer to make a
claim under Medishield, instead of leaving the consumer in the lurch.
Tan Kin Lian
President
Financial Services Consumer Association