Thursday, September 17, 2015

Danger of upgrading a health insurance plan

Dear Mr. Tan

My family is currently in a dispute with an insurance company with regards to a health shield upgrade.

·        My mom is elderly, cannot read and speak very limited English.
·        She was on the health shield plan C for several years, and successfully did an upgrade to plan A in Feb 2014.
·        She has been diagnosed with colon cancer and has been treated in a private hospital since Apr 2015
·        The insurance company will not honor the upgrade to Plan A as there was no disclosure of my mum’s diabetes during the upgrade.  

My mom’s proficiency in the English language is limited. When filling up the upgrade documents and questionnaires, the agent did not go through the questionnaire in detail with my mum. My mum was not aware about what she was signing. her at all.

The insurance agent failed in his duty to help the policyholder to make a full disclosure of her medical condition for upgrading the plan. The insurance company was also negligent. Surely, they should know that an elderly person will have some medical condition. They should not rely on the questionnaire, especially as it was signed by the agent (who has a conflict of interest).

I have been approached on similar cases in the past - i.e. rejection of claim under an upgraded shield plan. I advise elderly people to stay with their current plan and avoid all types of upgrading. I downgraded to Medishield Basic myself, and will stick with it.


Anonymous said...

Lodge a complaint to MAS.Don't wait .

Anonymous said...

Often it is conflict of interest that makes the insurance agents to avoid fact finding. Their interest is closing the case.
MAS should haul up these agents. Obviously they are not fit and proper.

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