From James Wong Chee Wah (printed in Today paper)
Last December, I converted to the Enhanced IncomeShield basic plan after being insured under MediShield since the scheme was introduced.
This year, I was admitted thrice to hospital for heart problems. I decided to stay in the "C" Class ward, even though my insurance plan entitled me to a B2 ward, and incurred a total hospital bill of about S$12,000.
However, NTUC Income did not pay my claim on the grounds that I did not disclose that I had a cancerous kidney removed in 1992 and other conditions which were cured, even though there was no relapse for almost 20 years. The insurer also wanted to cancel my policy and refund my premium.
I understand that for the integrated plan as specified by the Health Ministry, my claims should be covered under the basic MediShield plan, which I had all along.
NTUC Income, though, sent me this statement: "You will remain insured under Basic MediShield if you satisfy the CPF's eligibility criteria."
What does this mean? Surely, it is the insurer's duty to check and then decide if I am eligible to be paid under Central Provident Fund coverage. After four months, my claims have not been settled, causing me stress.
I would advise others to avoid upgrading to an enhanced plan, as they, too, may have claims rejected on unfair grounds. Does the ministry have views on this matter?
This year, I was admitted thrice to hospital for heart problems. I decided to stay in the "C" Class ward, even though my insurance plan entitled me to a B2 ward, and incurred a total hospital bill of about S$12,000.
However, NTUC Income did not pay my claim on the grounds that I did not disclose that I had a cancerous kidney removed in 1992 and other conditions which were cured, even though there was no relapse for almost 20 years. The insurer also wanted to cancel my policy and refund my premium.
I understand that for the integrated plan as specified by the Health Ministry, my claims should be covered under the basic MediShield plan, which I had all along.
NTUC Income, though, sent me this statement: "You will remain insured under Basic MediShield if you satisfy the CPF's eligibility criteria."
What does this mean? Surely, it is the insurer's duty to check and then decide if I am eligible to be paid under Central Provident Fund coverage. After four months, my claims have not been settled, causing me stress.
I would advise others to avoid upgrading to an enhanced plan, as they, too, may have claims rejected on unfair grounds. Does the ministry have views on this matter?
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