A man with a brain tumour had his S$100,000 AIA critical illness claim denied. Why?

[Lareina]

Now they making it like no point buy insurance.
They can change the definition and also wont tell you everything you need to know.
Making yourself healthy is the best insurance

 

[David Lai]

Ditching AIA for Prudential now....

first half of prudential’s name is prudent hor…

i wonder for this case, will they sack the accessor who is handling this case or not…

 

[CHINAUSA]

lesson learnt, Never give up ur private insurance IP etc.. for as long as possible

U never know when one might need them !

 

[qOo_oOp]

mdrt? positive vibes? we help people? rewarding career?

 

[pwongkk]

Insurance collect $$$ very fast, but come to claims, very slow and with lots of reasons.

 

[mummynew]

So now the picture is clearer that his:

1. CI policy is with AIA - Claim Denied

2. ISP is with Prudential - Claim Admitted. (extracted from the article: "He does not have any remaining medical debt, as he managed to claim for his hospitalisation and surgery under his Prudential policy.")

One of the earlier reports said both the policies are with AIA and both got rejected which is incorrect (iirc).

 

[CanIsayNo]

Many agents function on the “what’s wrong with collecting more money” mindset so don’t expect much

 

[mummynew]

AIA declined another $1 million life claim which I think was correct when the Insured failed to disclose ('hid') that he actually was applying / subsequently applying big sums concurrently:



Failure to disclose material info bordering along frauds.

Interesting 2021 case (that I got to learn about Loss Adjusters - that insurers may employ to investigate/assess claim legitimacy):

https://www.elitigation.sg/gd/s/2021_SGHC_130

*when applying insurance = always be truthful else risk not getting claims admitted should the need arise.

 

[Lifeinmotion]

LIA 's fault. Since all CI terms are updated by LIA then all policy should be updated to latest term ( if benefitting) to the client. How can you have different terms just because you signed earlier. Since these terms are standard.

Unless contract definition are not governed by LIA

 

[mummynew]

LIA 's fault. Since all CI terms are updated by LIA then all policy should be updated to latest term ( if benefitting) to the client. How can you have different terms just because you signed earlier. Since these terms are standard.

Unless contract definition are not governed by LIA

I also got confused as I have old Life Policies with CI (not ECI) Rider bought 30 years ago.

I remember my then FA told me old CI policies actually have some 'better' (more lenient) definitions as compared to the updated CI definitions, and said I 'lucky' to have the older definitions.

*older CI policies can't be updated to have the same definitions as per the latest - one reason could be the underwriting risks and premiums charged were based on the definitions then. Premiums always correspond to risks assessment as per actuarial science.

 

[Lifeinmotion]

I also got confused as I have old Life Policies with CI (not ECI) Rider bought 30 years ago.

I remember my then FA told me old CI policies actually have some 'better' (more lenient) definitions as compared to the updated CI definitions, and said I 'lucky' to have the older definitions.

*older CI policies can't be updated to have the same definitions as per the latest - one reason could be the underwriting risks and premiums charged were based on the definitions then. Premiums always correspond to risks assessment as per actuarial science.

I do understand the the "underwriting" risks. But we are not talking about buying a new policy. It was a policy with the same broad stroke definition. And LIA knows that there's better terms to benefit more people.

It's the same that all MediShield definitions are updated and everyone (including) company is subjected to it. So why are CI plans any difference ? Thats a question that LIA need to answer. unless the policy was signed before the standardisation. If I were insurance firm I will also not pay using the old clause.

They are an actuarial firm and "should" have priced in accordingly.

 

[mewmew]

can lucas da boss do a review on his own company

 

[koster]

These insurance companies damn zek ark.

 

[sciprof]

that time my insurance agent want to sell me early stage critical illness insurance..he said my current one cover late stage, like stage 4 cannot cure type. then I ask why in the first place he pitch that policy to me, he said coz stinkies usually don't go for health screening until it's too late, that's why he sold me the late stage critical illness insurance.

then I ask back then why now u want me buy early stage. he said just in case diagnosed early still can cure.

simi sai..

Those agents sibei jialat one like cursing people meet accident. That time tell me if I don't buy her accident insurance later meet traffic accident, lost limbs lost arms how.

 

[Lifeinmotion]

Those agents sibei jialat one like cursing people meet accident. That time tell me if I don't buy her accident insurance later meet traffic accident, lost limbs lost arms how.

Wah. Can ask them today I accidentally cut off your limbs. Would they get paid. If they say yes, you proceed to help them cut. Ask them steak knife or kitchen machet

 

[lchua6]

Don't buy critical illness policy. These kind of policies are very expensive and almost sure die illness then can claim.

Instead, buy life policies which are 10 time cheaper. Die already then claim.

 

[Hakuna Matata]

Need the doc to certify it's life threatening. Otherwise, claim likely not approved and rejected.

 

[rilo]

Govt better step into moderate all such policies

 

[sciprof]

Wah. Can ask them today I accidentally cut off your limbs. Would they get paid. If they say yes, you proceed to help them cut. Ask them steak knife or kitchen machet

They ownself also never buy. Like every year say review policy with you will intro you new policies to buy. Like we are their atm

 

[mummynew]

I do understand the the "underwriting" risks. But we are not talking about buying a new policy. It was a policy with the same broad stroke definition. And LIA knows that there's better terms to benefit more people.

It's the same that all MediShield definitions are updated and everyone (including) company is subjected to it. So why are CI plans any difference ? Thats a question that LIA need to answer. unless the policy was signed before the standardisation. If I were insurance firm I will also not pay using the old clause.

They are an actuarial firm and "should" have priced in accordingly.

I briefly googled and LIA refined the Brain Tumour CI in 2019 and the claimant with CI bought several years ago before diagnosis of benign brain tumour in 2018. So likely the claimant's CI contains the old definition.

To recap:
https://www.straitstimes.com/opinio...-be-at-deaths-door-to-claim-medical-insurance

*Extracted from TS' article:

"In Singapore, the illnesses covered by a critical illness policy — regardless of the insurance provider — are determined by the Life Insurance Association (LIA) Singapore."