Bait and Switch from Prudential Insurance

[sreejithb]

Hi Everyone,

I am writing this to see if anyone else felt cheated by Prudential, specifically their Hospitalization policy.

I signed up for Prudential's Prushield + PruExtra (rider) in 2014. At that time, their policy looked quite attractive. We were told that for the premium we pay, private and public hospitals were covered with no additional charge.

Come 2017 and my agent calls me up to tell me that they are implementing a "Claim based premium" for private hospitals. According to this, if you claim anything from a private hospital, you will be charged 2x the premium the following year which will go to 3x if we make any further claims. My wife, who is also under Prudential (with a separate agent), also received this news from her agent. We were obviously pissed because it felt like a bait and switch. However, both of us were ASSURED by our respective agents that "every other insurance company will soon adopt this model. ".

Based on this reassurance, we did not check with other insurance companies or look into switching our policy. It is only this year we realized that Prudential is the ONLY company that is doing Claim based premiums. But by now, Singapore govt does not allow for 100% coverage and also, my wife has a pre-existing condition that makes switching insurance harder. We are frustrated because this is in fact a classic case of bait and switch.

We called our respective agents and asked them why they lied to us about other companies adopting this model and their response simply was "We never said that". We even heard the same story for another friend of ours. It can't be a coincidence that three of us were told by our respective agents in 2017 that all insurance companies will adopt claim based policy. Sounds like a script they were made to follow back then.

Here is the kicker. From what we have heard, Prudential is going to extend this Claim Based Premiums to public hospitals as well. Meaning, despite paying expensive premiums for years end, you are discouraged to visit any hospital and penalized for making a claim. How is this ethical? What can we do against this?

I am curious if any of you have experienced this? Did any of your agents assure you that "all other companies will follow claim based model soon"? Anyone else trusted their agent blindly only to get screwed later?

 

[reddevil0728]

Hi Everyone,

I am writing this to see if anyone else felt cheated by Prudential, specifically their Hospitalization policy.

I signed up for Prudential's Prushield + PruExtra (rider) in 2014. At that time, their policy looked quite attractive. We were told that for the premium we pay, private and public hospitals were covered with no additional charge.

Come 2017 and my agent calls me up to tell me that they are implementing a "Claim based premium" for private hospitals. According to this, if you claim anything from a private hospital, you will be charged 2x the premium the following year which will go to 3x if we make any further claims. My wife, who is also under Prudential (with a separate agent), also received this news from her agent. We were obviously pissed because it felt like a bait and switch. However, both of us were ASSURED by our respective agents that "every other insurance company will soon adopt this model. ".

Based on this reassurance, we did not check with other insurance companies or look into switching our policy. It is only this year we realized that Prudential is the ONLY company that is doing Claim based premiums. But by now, Singapore govt does not allow for 100% coverage and also, my wife has a pre-existing condition that makes switching insurance harder. We are frustrated because this is in fact a classic case of bait and switch.

We called our respective agents and asked them why they lied to us about other companies adopting this model and their response simply was "We never said that". We even heard the same story for another friend of ours. It can't be a coincidence that three of us were told by our respective agents in 2017 that all insurance companies will adopt claim based policy. Sounds like a script they were made to follow back then.

Here is the kicker. From what we have heard, Prudential is going to extend this Claim Based Premiums to public hospitals as well. Meaning, despite paying expensive premiums for years end, you are discouraged to visit any hospital and penalized for making a claim. How is this ethical? What can we do against this?

I am curious if any of you have experienced this? Did any of your agents assure you that "all other companies will follow claim based model soon"? Anyone else trusted their agent blindly only to get screwed later?

got black and white or voice recording about those "claims" (not insurance claims) that they made? if not quite your word against theirs leh.

 

[boredboiboi]

Hi Everyone,

I am writing this to see if anyone else felt cheated by Prudential, specifically their Hospitalization policy.

I signed up for Prudential's Prushield + PruExtra (rider) in 2014. At that time, their policy looked quite attractive. We were told that for the premium we pay, private and public hospitals were covered with no additional charge.

Come 2017 and my agent calls me up to tell me that they are implementing a "Claim based premium" for private hospitals. According to this, if you claim anything from a private hospital, you will be charged 2x the premium the following year which will go to 3x if we make any further claims. My wife, who is also under Prudential (with a separate agent), also received this news from her agent. We were obviously pissed because it felt like a bait and switch. However, both of us were ASSURED by our respective agents that "every other insurance company will soon adopt this model. ".

Based on this reassurance, we did not check with other insurance companies or look into switching our policy. It is only this year we realized that Prudential is the ONLY company that is doing Claim based premiums. But by now, Singapore govt does not allow for 100% coverage and also, my wife has a pre-existing condition that makes switching insurance harder. We are frustrated because this is in fact a classic case of bait and switch.

We called our respective agents and asked them why they lied to us about other companies adopting this model and their response simply was "We never said that". We even heard the same story for another friend of ours. It can't be a coincidence that three of us were told by our respective agents in 2017 that all insurance companies will adopt claim based policy. Sounds like a script they were made to follow back then.

Here is the kicker. From what we have heard, Prudential is going to extend this Claim Based Premiums to public hospitals as well. Meaning, despite paying expensive premiums for years end, you are discouraged to visit any hospital and penalized for making a claim. How is this ethical? What can we do against this?

I am curious if any of you have experienced this? Did any of your agents assure you that "all other companies will follow claim based model soon"? Anyone else trusted their agent blindly only to get screwed later?

Not that we know of about the claim based model of other insurers.
Is your under the old scheme of 100% fully claimed?

 

[sreejithb]

got black and white or voice recording about those "claims" (not insurance claims) that they made? if not quite your word against theirs leh.

I get your point. But this was discussed in person (so no black and white) and you obviously don't feel the need to record the agent that you trust. But like I said, so far there are 3 people who have the same experience. I am just trying to see if there are more.

 

[sreejithb]

Not that we know of about the claim based model of other insurers.
Is your under the old scheme of 100% fully claimed?

Yes. It is the 100% fully claimed. And we had a chance to switch to a 100% coverage on another company if they had not falsely assured us that all other companies will adopt this model.

 

[reddevil0728]

I get your point. But this was discussed in person (so no black and white) and you obviously don't feel the need to record the agent that you trust. But like I said, so far there are 3 people who have the same experience. I am just trying to see if there are more.

I think no harm raising this to prudential for investigation to see if it’s the company position to make such claims.

Can say 3 such instances of “miselling” and there might be more.

 

[exterminazn]

Your title is a bit different from your situation, this is not even a bait and switch

In fact if you and your spouse have done claim, then of course it would be best to remain with Pru

Otherwise, what the agent proclaim other companies following suit is just a guessing game

Prolly if you feel the trust is destroy, then move on. No amount of investigation is going to help, unless you have hard evidence

And even if you do have hard evidence, technically the agent also did no wrong from my personal opinion

 

[iceblendedchoc]

I get your point. But this was discussed in person (so no black and white) and you obviously don't feel the need to record the agent that you trust. But like I said, so far there are 3 people who have the same experience. I am just trying to see if there are more.

very hard . i have a complaint case against Prudential as well. Become one man's words against another. I was so mad , i went to FIDReC and complain further. Now still waiting.

 

[Perisher]

Law should make it legal to record all conversation with agent, be it insurance or property etc.

https://singaporelegaladvice.com/can-i-record-a-conversation-without-consent/

 

[BBCWatcher]

Let's make sure the basic facts about what Prudential currently does and doesn't do are clear.

First of all, all the Integrated Shield plan providers reserve the right to make changes to their policies as long as they're not legally prohibited. (And you have the right to cancel your policy.) All of the Integrated Shield carriers have made changes to their policies since 2014, and all of them have specifically restricted/limited private hospital coverage in various ways. It's highly likely there will be further changes, further restricting/limiting private hospital coverage in various ways.

Second, Prudential has adopted "claims-based pricing" for most (but not all) of their PRUExtra riders for their PRUShield Premier private hospital plan. Their claims-based pricing, when it applies, only applies to the rider premium, not to the base plan premium. Policyholders who want to avoid claims-based pricing while maintaining Prudential's private hospital plan (PRUShield Premier) are free to switch to Prudential's PRUExtra Premier Lite CoPay rider. There should be no preexisting condition "reset" if you're switching from any other PRUExtra Premier rider to PRUExtra Premier Lite CoPay. (Please confirm that detail in writing if possible.)

Third, no, Prudential is not increasing any PRUExtra rider premiums with claims-based pricing when you file a claim for care in a public/restructured hospital. It's the opposite: such claims can actually reduce your PRUExtra rider premium via the claims-based premium adjustment formula. As with any other policy provision (and within any legal limits), Prudential can change this provision, too. But the current provision is very friendly to public hospital care.

Fourth, at age 55 and beyond claims-based pricing is limited to 1.5X of the standard premium (50% higher).

Fifth, if Prudential did not adopt claims-based pricing, you would have been charged even higher premiums, at least before any claims-based premium adjustment kicked in if that's what happened to you.

 

[sreejithb]

Let's make sure the basic facts about what Prudential currently does and doesn't do are clear.

First of all, all the Integrated Shield plan providers reserve the right to make changes to their policies as long as they're not legally prohibited. (And you have the right to cancel your policy.) All of the Integrated Shield carriers have made changes to their policies since 2014, and all of them have specifically restricted/limited private hospital coverage in various ways. It's highly likely there will be further changes, further restricting/limiting private hospital coverage in various ways.

While there is nothing "illegal" in the way they conducted this switch to claim based premium, it definitely is unethical in my opinion. And I don't think we should just ignore it when a company does unethical stuff. Especially when their actions "trap" people who might have made claims and have developed conditions after signing up with Prudential which will now be pre-existing conditions if they switch policy. Asa society, there should be ways to respond when corporations act unethically even if its not illegal.

Second, Prudential has adopted "claims-based pricing" for most (but not all) of their PRUExtra riders for their PRUShield Premier private hospital plan. Their claims-based pricing, when it applies, only applies to the rider premium, not to the base plan premium. Policyholders who want to avoid claims-based pricing while maintaining Prudential's private hospital plan (PRUShield Premier) are free to switch to Prudential's PRUExtra Premier Lite CoPay rider. There should be no preexisting condition "reset" if you're switching from any other PRUExtra Premier rider to PRUExtra Premier Lite CoPay. (Please confirm that detail in writing if possible.)

I am not familiar with PRUExtra Premier Lite CoPay rider. I have discussed my issue at length with my agent and my wife's agent. Neither recommended this.

Third, no, Prudential is not increasing any PRUExtra rider premiums with claims-based pricing when you file a claim for care in a public/restructured hospital. It's the opposite: such claims can actually reduce your PRUExtra rider premium via the claims-based premium adjustment formula. As with any other policy provision (and within any legal limits), Prudential can change this provision, too. But the current provision is very friendly to public hospital care.

This was told to us by one of our agents. Why would you think this is unlikely given they had no problem changing their model without any warning to the clients? For that matter, why do you think its unlikely they wont make any more changes to the private hospital claims?

Fourth, at age 55 and beyond claims-based pricing is limited to 1.5X of the standard premium (50% higher).

Your premiums at 55 and above are so expensive that 1.5X is already quite a bit. But sure, let me feel better about the cap of 1.5X when all other companies stay at 1X. Thank you prudential.

Fifth, if Prudential did not adopt claims-based pricing, you would have been charged even higher premiums, at least before any claims-based premium adjustment kicked in if that's what happened to you.

You are missing the point. We knew the prudential premiums were not the cheapest when we signed up. But we were ok with that because the coverage was good. The problem is the bait and switch attitude. What good is a cheaper premium if we are discouraged and penalized from using the service we are paying for? Its like saying "remember how you used to pay 10$ for watching a movie? Now you pay only 9$, but we will charge you up to 18$ every time you even look at the screen". I rather take the 10$ ticket.

 

[sreejithb]

very hard . i have a complaint case against Prudential as well. Become one man's words against another. I was so mad , i went to FIDReC and complain further. Now still waiting.

What is your complaint about? Same issue?

 

[sreejithb]

Your title is a bit different from your situation, this is not even a bait and switch

They sold me a product that advertised full coverage in private and public hospitals with no additional cost. Then overnight they changed the terms and started penalizing people (using additional costs) from going to private hospital. This is the definition of bait and switch.

And even if you do have hard evidence, technically the agent also did no wrong from my personal opinion

I agree that there is probably nothing I can do. But I still want to emphasize that just because something is not illegal, doesn't make it ethical. The agent, through their false narrative, costed us a chance to move to another agency and get 100% coverage. How can you say that this not wrong? Perhaps not illegal (you can claim she was guessing), but definitely not ethical and certainly wrong.

 

[havetheveryfun]

I get your point. But this was discussed in person (so no black and white) and you obviously don't feel the need to record the agent that you trust. But like I said, so far there are 3 people who have the same experience. I am just trying to see if there are more.

a lot of agents dont even fully understand their own policies. Its no surprise since a lot of policies are designed to be complicated to confuse the average person.

Only what matters is what you signed on the fine print, and let me guess , its probably like 10 over 20 pages of fine print... which no one in hell is going to bother to read and understand , especially in so small print and with so many cheem terminology.

 

[BBCWatcher]

While there is nothing "illegal" in the way they conducted this switch to claim based premium, it definitely is unethical in my opinion.

I disagree. All the insurance carriers needed to do something to keep premiums from soaring even faster and higher than they have already soared. Otherwise you and/or your fellow policyholders would be bitterly complaining about premiums right now, more than already occurs.

I am not familiar with PRUExtra Premier Lite CoPay rider. I have discussed my issue at length with my agent and my wife's agent. Neither recommended this.

It's possible they didn't recommend this rider because the premium is lower, and consequently it could reduce their commissions. Now you know this choice is available.

This was told to us by one of our agents. Why would you think this is unlikely given they had no problem changing their model without any warning to the clients? For that matter, why do you think its unlikely they wont make any more changes to the private hospital claims?

I believe if you re-check what I wrote I wrote the opposite, that Prudential CAN change its policy terms, within legal boundaries (Integrated Shield plans are regulated to some extent), at any time. And, moreover, I think it's likely all carriers will make further changes, particularly in efforts to control private hospital claims.

You are missing the point. We knew the prudential premiums were not the cheapest when we signed up. But we were ok with that because the coverage was good. The problem is the bait and switch attitude. What good is a cheaper premium if we are discouraged and penalized from using the service we are paying for?

I believe you meant, "What good is the more expensive premium..."?

And the simple answer is that Prudential was genuinely losing money, a lot. Maybe they still are. Something had to change, some combination of premium increases and coverage limits. Every carrier has faced, is facing, this crisis. Prudential is attempting to resolve it a particular way (or ways), and they do have a rider that has no claims-based pricing.

You can still stay on your current rider if you wish, THEN switch to the lower cost rider that doesn't have claims-based pricing AFTER making a claim that increases your premiums.

Its like saying "remember how you used to pay 10$ for watching a movie? Now you pay only 9$, but we will charge you up to 18$ every time you even look at the screen". I rather take the 10$ ticket.

And that choice is available, still with Prudential. Just switch riders, and problem solved. You can do it now and reduce your premium, or you can do it later, as you prefer.

 

[WoShiPro]

I'm on prushield premium 100% too. Cash alone is $700+

The benefits is better thou. 365 pre/post hospitalization. In the event if need to claim go panel specialist. I think claim based tier will only move 1 level.

 

[ceestudent]

I believe the rider premium for your prudential claim based is much lower than rider with 100% coverage (say from GE/aia). The premium difference can go as high as 2x, not just 10-20%. I know this when i compare my old GE rider premium (100% coverage) with my wife which use prudential claim based premium. If you don't believe, tell us how much your rider cost and the age range? Let me compare with my old GE premium rider (100% coverage)

And the increase in premium will decrease again for the following year right? Unless you keep make a claim to private hospital every year.

The purpose of this policy is to make it fair to the insurer who never make any claim. Many people abuse the 100% coverage rider by going to private hospital for something minor. This will cause the medical fee spiraling up, hence increase the premium for everyone else.

You cannot just see 1 side of the coin..

 

[blurpandasg2014]

It's true. Pru agents also told my friend the same thing but I manage to convince him to quickly trf out

 

[BBCWatcher]

I believe the rider premium for your prudential claim based is much lower than rider with 100% coverage (say from GE/aia). The premium difference can go as high as 2x, not just 10-20%....

Good point, but to clarify Prudential also has legacy “zero dollar” riders in force. What you’re suggesting is that comparable riders have a lower standard premium at Prudential precisely because of claims-based pricing. That could well be true. So if you’re saving money every year on your rider premium, that’s obviously great. You keep that cash, and you can spend it either on possible future claims-based premium hikes or...whiskey?

Yes, agreed, the problem is if you’re the policyholder that goes to a private hospital, convinces a doctor to admit you “for observation,” and you get lots of expensive tests, all because you have a runny nose. And you do that every year, even more than once a year. Unfortunately a few people really do this, and since insurance pays the full bill (with zero dollar riders) these people don’t care. The most expensive Integrated Shield plan with legacy “zero dollar” rider is a great deal for them, just as long as they don’t exceed the annual limit...which they try hard to approach. This phenomenon was predictable and predicted, and I suppose we can blame the government for not getting the rules right at least initially. So all the Integrated Shield carriers had to scramble to stem their real losses and to defend the risk pool against these few “unlimited buffet” medical consumers. (Unlimited buffet isn’t even quite the right analogy. An unlimited buffet is actually limited: you have one mouth and two hours, for example.)

So, here we are, and all the carriers adopted some combination of defenses. Prudential picked one defense (among multiple they adopted), claims-based pricing for most (not all) riders, that (like most other defenses) is purposely designed to disrupt high claim rate policyholders and their providers. Some of these policyholders, a few, are legitimately sick and legitimately need frequent hospital care. But they’re still well defended because they have viable choices, including rider premium caps, public hospital care (which can actually reduce the rider premium if it’s raised), and a rider that doesn’t have claims-based pricing.

Prudential never promised to hold premiums level, and Prudential never promised they wouldn’t discount premiums for certain policyholders. That’s all they’re doing here. Probably what they should have done is flipped the equation: raised the standard rider premiums even higher (to the claims-based pricing max) then offer “PRUWell Rebates.” It’s exactly the same thing but probably better marketing. And, to repeat, they offer a rider without claims-based pricing, and it’s a very reasonable one. Moreover, they offer one of the best overall public hospital plans (PRUShield Plus) if you’d like to save tons of money on premiums and unreimbursed care expenses while still allowing “dabbling” in the private medical sector with some cash/MediSave and decent reimbursement rates.

Anyway, I’m not happy with how Integrated Shield and MediShield Life rolled out in 2014. There were some mistakes of omission at least. Overall it’s positive, but it wasn’t perfect and some cleanup is still underway.

 

[OCamal]

Based on MAS 2018 insurance return form 7A, Prudential was the only ISP provider that made profit in the long term health insurance section. All other 5 were still making underwriting losses (raffles is quite new to the ISP, hence excluded). If we looked from the insurance companies' point of view, insurance companies need to make a profit as they are after all businesses. The other insurance companies are likely to make further restrictions on their policy terms to curb losses.