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Protect consumers against rejected claims caused by alleged non disclosures
12 Jan 2020 (20 views)

I have seen many cases of consumers being denied legitimate claims due to alleged non disclosures. I ask the regulator to study this matter and get insurers to adopt a code of practice that is fair to consumers.

This is how many of these cases happened. 

The consumer was approached by an insurance agent who advised the consumer to switch to a better integrated plan. The agent explained that the consumer will get better coverage and the premium can be paid from Medisave savings, so the consumer does not need to pay any cash outlay for the upgrading. 

Most consumers are convinced by the advantages and agreed to convert to the recommended plan. The agent helped them to complete the application for the upgrading.

As the consumer is likely to be somewhat old, the consumer is likely to have some medical condition. The agent are likely to tell the consumer that these are ordinary conditions and do not need to be declared. If the condition is declared, the application is likely to be delayed. 

In some cases, the consumer may not be aware of the medical condition, as he or she is not undergoing any continuing treatment. 

If the consumer makes a claim after the conversion, the insurer is likely to check with the hospital on the past medical conditions. The hospital may submit a report about a past medical condition that the consumer has not declared. The insurer is likely to reject the claim due to non-disclosure. 

I have seen, in some cases, rejected claims for frivolous reasons. 

I suggest that the code of ethics to be observed by insurers should be:

a) Insist on a medical examination for an applicant who is older than 40 years
b) Carry out the check with the hospital on any past medical condition at the time of application and not at the time of a claim.

If the insurer does not carry out the medical examination or the check, the insurer should be disallowed from rejecting a claim due to non-disclosure of past medical conditions.

Tan Kin Lian


Protect consumers against rejected claims caused by alleged non disclosures
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I have seen many cases of consumers being denied legitimate claims due to alleged non disclosures. I ask the regulator to study this matter and get insurers to adopt a code of practice that is fair to consumers.

This is how many of these cases happened. 

The consumer was approached by an insurance agent who advised the consumer to switch to a better integrated plan. The agent explained that the consumer will get better coverage and the premium can be paid from Medisave savings, so the consumer does not need to pay any cash outlay for the upgrading. 

Most consumers are convinced by the advantages and agreed to convert to the recommended plan. The agent helped them to complete the application for the upgrading.

As the consumer is likely to be somewhat old, the consumer is likely to have some medical condition. The agent are likely to tell the consumer that these are ordinary conditions and do not need to be declared. If the condition is declared, the application is likely to be delayed. 

In some cases, the consumer may not be aware of the medical condition, as he or she is not undergoing any continuing treatment. 

If the consumer makes a claim after the conversion, the insurer is likely to check with the hospital on the past medical conditions. The hospital may submit a report about a past medical condition that the consumer has not declared. The insurer is likely to reject the claim due to non-disclosure. 

I have seen, in some cases, rejected claims for frivolous reasons. 

I suggest that the code of ethics to be observed by insurers should be:

a) Insist on a medical examination for an applicant who is older than 40 years
b) Carry out the check with the hospital on any past medical condition at the time of application and not at the time of a claim.

If the insurer does not carry out the medical examination or the check, the insurer should be disallowed from rejecting a claim due to non-disclosure of past medical conditions.

Tan Kin Lian