Mothership - AIA denies S$100,000 payout to S'pore man with benign brain tumour, said condition 'not life-threatening' at time of surgery & not includ

[mummynew]

@GoodEnergy

The below extracted from AIA blog post, and confused over stage 1 breast cancer not covered under normal CI.

"Know the difference: Early critical illness vs Critical illness insurance plans​

#1 Scope of coverage​

A typical critical illness insurance policy only provides payouts on 37 critical illnesses on Life Insurance Association (LIA) Singapore industry list. However, these illnesses must have a certain severity level to qualify. For example, a disease is not considered a "Major Cancer" until it is in its late stages, meaning a stage 1 breast cancer patient cannot make a claim."

https://www.aia.com.sg/en/health-we...rly-critical-illness-insurance-what-it-covers

 

[NintendoSwitch]

insurance companies earn money by customers paying premiums and not claiming anything. what u think?

if all customers claim, how u think they can earn money. is a sure earn job.

they earn by doing nothing and moving money from right to left pocket.

Wasn't dat how Lloyd's names ended up in trouble; when the claims came in.

 

[dxdx999]

Benign should be under hospitalization ba.

 

[lowveld]

Law is law. Rules are rules. If you buy CI only, you must have CI to claim. This one belong to early CI.. which he or she didnt buy.
You stir in media also useless for this case!

How do u know he bought ci and not early ci

 

[camoguysg]

gov needs to step in

Our sg government? Forget it.

 

[mummynew]

re-reading the mothership writing in details, AIA rejected with this:


"We thank Mr Frankie Yee for sharing his feedback and bringing his concerns to our attention. We have reached out to Mr Yee to clarify that his claim was carefully reviewed, with diagnostic tests and medical opinions considered, as well as a statement from his treating doctor.

Unfortunately, his Benign Brain Tumour did not meet the criteria outlined in his Critical Illness policy."


So, rejection not based on pre-existing condition (which if it is = zero chance of fighting). Now will be curious to know about why AIA not paying his ISP claims.

*basically if his own treating doctor submitted a medical statement to AIA who used it to determine whether to admit claims = low chance of challenge the case.

 

[mummynew]

This Frankie Yee (the forum writer) seems like a nice man:

https://www.asiaone.com/singapore/n...raise-150k-finance-6-students-university-fees

 

[The Legionnaire]

Another scam made legal..in fact, there are many disputes triggered by insurance claims which are undisclosed!

 

[3G SAINT]

this month got another insurance claim dispute too right?

https://www.straitstimes.com/singap...s-ntuc-income-for-wholly-unreasonable-conduct


no wonder my friend refuses to buy any insurance ...

 

[Akky85]

So insurance is a scam??

Insurance and it's concept is not a scam.

The corporations and erroneous/greedy supporters and individuals are the problem.

I buy insurance, i tio taiji, i get payout within X days is the core concept of insurance. It's even in their own ads.

Of cos reality is often much different, from not being able to get text returns to their admin telling you he's on ''holidays until X'' to '' oh this actually dun cover Y'' to whatever other nonsense they come up with.

Insurance companies have to be heavily regulated and some of these regulation cost have to be soaked up WITHOUT passing it on to customers. Then they will have to fight each other and give the best package to fulfill that duty that they were supposed to do.

Cannot do it? Close down lor. Nobody force them to enter insurance business.

 

[articland05]

The strange thing is why hospitalisation claims rejected.

CI I can understand.

In fact I got my CI payout . No questions asked.

But I'm lucky to be alive

i also thinking the same...
hospitalization should be claimable
it is different from CI claim

 

[Akky85]

This Frankie Yee (the forum writer) seems like a nice man:

https://www.asiaone.com/singapore/n...raise-150k-finance-6-students-university-fees

He is, he still keep in contact with many of his ex students, i was taught under him when i was in Kaplan myself.

One of those that knows how to teach lessons and life lessons at the same time.

 

[animeonegai]

Yup. Contractual agreements. Be mindful of what u sign for.

don’t be resistant when insurance agent wants to meet for review. Yes it’s true that they want your money. But it’s also through that some policies will become obsolete in coverage.

Agreements always change. Definition also can change. Also, what u signed 10 years ago, might not be applied for current diagnosis. Insurers can go word for word one.

 

[itedino]

Wow aia why dun pay

 

[mummynew]

He is, he still keep in contact with many of his ex students, i was taught under him when i was in Kaplan myself.

One of those that knows how to teach lessons and life lessons at the same time.

Think he is pursuing a PhD now.

See for insurance fine prints, even PhD level also got problems interpreting them.

 

[Shingoz]

Will he be happier claiming 100k but have an invasive tumor instead??

Insurance plan for benign tumors will be extremely costly, if there'll be such a product.

He should be able to claim for hospitalizaton....

 

[paperplane1943]

That one is for hospitalisation. They will pay part of the total bill if it is a co-payment and total bill if it is a rider. I think for this man's case, he is claiming under "Critical illness" and not for the hospital bill. If successful, the amount is extra pocket money for him.

My sister could claim for Critical illness after she has had a heart attack and went for a bypass surgery.

Why cannot ask AIA about the operation if can claim before proceed?

 

[lycanboy]

I am more curious on why and how is his hospitalisation claim denied?

Pre existing?

 

[lemefirefly]

Reading page 26 about benign brain tumour:

"Benign Brain Tumour

Benign brain tumour means a non-malignant tumour located in the cranial vault and limited to the brain, meninges or cranial nerves where all of the following conditions are met:

• It has undergone surgical removal or, if inoperable, has caused a permanent neurological deficit and

• Its presence must be confirmed by a neurologist or neurosurgeon and supported by findings on Magnetic Resonance Imaging, Computerised Tomography, or other reliable imaging techniques.

The following are excluded:

• Cysts;
• Abscess;
• Angioma;
• Granulomas;
• Vascular Malformations;
• Haematomas; and
• Tumours of the pituitary gland, spinal cord and skull base."

---------------------

*judging from even his ISP got rejected = high chance of his is a pre-existing condition after AIA investigated (then he has to get his surgeon to 'dispute' etc).

How u know? U selling insurance?

 

[lemefirefly]

Will he be happier claiming 100k but have an invasive tumor instead??

Insurance plan for benign tumors will be extremely costly, if there'll be such a product.

He should be able to claim for hospitalizaton....

Yea hospitalisation for tumour removal shd be claimable ma, some more in the brain.. not like he is very happy to remove it. He bo pian also, its a high risk surgery I would think