New Clauses for NTUC incomeshield ?

[Asure7]

1. Does this apply only to "advantage" or all incomeshield policies?

2. Are there such clauses in other competitors' shield plans?

3. If "medical and specialist consultations, medical examinations, lab tests and admission to high-dependency wards" and "surgical fees, charges for anaesthesia and oxygen administration, and even usage of hospital operating theatres and facilities" are NO LONGER covered, I do not see the value in such shield plans anymore

If NTUC can get away in it, pretty sure other competitors will follow suit.

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The Straits Times
Published on Oct 03, 2013

Can insurers impose new clauses on existing policyholders?



I UPGRADED my IncomeShield Plan A to an Enhanced IncomeShield (Advantage) plan with a Plus Rider in 2006.

Last December and in August this year, I received revised policy documents and a letter informing policyholders that the Advantage plan no longer covered a list of items.

For ward charges, the insured will now have to pay for daily meals, prescriptions, medical and specialist consultations, medical examinations, lab tests and admission to high-dependency wards. This would also apply to intensive care wards.

A policyholder would also have to pay for surgical fees, charges for anaesthesia and oxygen administration, and even usage of hospital operating theatres and facilities.

Can NTUC Income impose new conditions and clauses on existing policyholders? There is nothing in my old IncomeShield policy documents that states these exclusions.

The Government has been encouraging citizens to purchase hospitalisation Shield plans. But if insurance companies keep changing their coverage, these plans would fail to serve their purpose.

Elizabeth Ng Boon Kwan (Mrs)
Copyright © 2013 Singapore Press Holdings. All rights reserved.

 

[SpinFire]

The changes look extremely disadvantageous. The ward charges form a large portion of the total bill. What's the point of getting IncomeShield when it doesn't cover these charges?

 

[chopra]

I caught this in the ST forum too.
Correct me if im wrong. Integrated shield plans are called integrated for a reason -- whoever run Medishield should address this.

 

[FP_IFA]

Have to see the original letter from NTUC. Can't comment on a forum post like that.

 

[lzydata]

Although I am not under the Advantage plan, I get the same documents for my Basic plan. The letter from Aug contains the document called Endorsement E1301 "to be attached to and forming part of the policy" that starts like this:

(B) With effect from the Renewal Date, the following changes will apply:

(i) A new Clause 1.1(a) shall replace and supersede the existing Clause 1.1(a) of the Policy:

"(a) Room, board and medical-related services

Ward charges the insured has to pay for each day in a hospital including:

• meals;
• prescriptions;
• medical consultations;
• miscellaneous medical charges;
• specialist consultations;
• examinations;
• laboratory tests;
• being admitted to a high-dependency ward.

If the insured is in a short-stay ward, we will pay for the ward charges. We do not cover pre-hospitalisation treatment which is given before and post-hospitalisation treatment which is given after the stay in a short-stay ward.

If the insured is in a luxury or deluxe suite or any other special room of a hospital, we will only pay the equivalent of a room, board and medical-related services for a standard room in the hospital. We will also apply the pro-ration factor if the insured is admitted to a ward or hospital that is higher than their ward entitlement."

However, the policy document's Clause 1 starts like this:

1. What your policy covers

Your policy covers the following benefits.

...

1.1 Inpatient hospital treatment

The inpatient hospital treatment benefit pays for the type of costs set out below, and depends on the limits in the schedule of benefits under the heading 'inpatient hospital treatment'. Except for pre-hospitalisation treatment and post-hospitalisation treatment, these costs must be for treatment received by the insured while staying in a hospital.

Inpatient hospital treatment benefit is made up of the following sub-benefits.

(a) Room, board and medical-related services

...

I suspect that this letter writer zoomed in on the words "ward charges the insured has to pay for each day" in the new Clause 1.1(a), without reading it in the light of the whole policy. So this is a terrible misunderstanding.

 

[hungryfriend]

join the preferred then!

 

[lifeishard]

join the preferred then!

all 3 plans have same policy conditions,hopefully lzy interpretations are correct.

 

[modestmeans]

lzydata's right. If you read the whole section, you'll see that what Elizabeth Ng thinks are new exclusions... well they are actually benefits. The paragraph before the list states quite clearly that what follows are the ward charges covered by the policy.

"What the insured has to pay" probably refers to the patient's hospital bill, which NTUC Income then covers. It needs to be read in context.

 

[torrent06]

Yeah I think it's a misunderstanding also. Surprising though that ST just published the letter without checking the story first.

I think it would be good if Income can reconsider how they present revisions to sub-clauses. It can be quite difficult to make head or tail without having the first paragraph of the relevant Clause for reference.

 

[Asure7]

http://www.straitstimes.com/st/print/1585793

Ward charges covered


MRS ELIZABETH Ng Boon Kwan said she recently received her revised policy documents, and asked why NTUC Income had imposed new conditions on her IncomeShield policy ("Can insurers impose new clauses on existing policyholders?"; Forum Online, Thursday)

Her impression was that ward charges had been removed from her policy's inpatient hospital treatment benefit.

This is not the case. Mrs Ng might have misunderstood because of a reference to "charges the insured has to pay".

Taken in the full context of the policy, these charges that the insured has incurred will be covered by NTUC Income.

We thank Mrs Ng for her feedback and for making the effort to understand her policy benefits. We will continue to review and improve our policy wording to make our contracts as clear and easy to understand as possible.

Lau Sok Hoon (Ms)
Vice-President
Group & Health Division
NTUC Income

Copyright © 2013 Singapore Press Holdings. All rights reserved.