Shield plan vs company insurance

[iamleonard]

Quick question here.

If new shield plans can only allow you to claim 95% of the total bill, but you also have company insurance that you can do partial claims with, can I use company insurance to claim the 5% portion not covered with my shield plan so effectively I am covered 100%?

 

[BBCWatcher]

If new shield plans can only allow you to claim 95% of the total bill, but you also have company insurance that you can do partial claims with, can I use company insurance to claim the 5% portion not covered with my shield plan so effectively I am covered 100%?

First of all, rule compliant Integrated Shield riders still allow insurers to pay 100% above a co-pay cap of no less than $3,000. You pay 5% only until reaching the annual cap. Terms vary depending on which rider and insurer you have, but that’s what the regulation allows. Moreover, that 5% (capped) is ordinarily MediSave payable if you wish.

OK, with that said, absolutely you can file claims with both insurers, and that’s common. You just need to make sure you inform both insurers so they can coordinate with each other. Whether you do better than a 5% co-pay (with a cap) isn’t a given. It depends on what your company-provided insurance includes.

 

[moejoseph]

Will suggest to do a claim using your company insurance first, and then settle the balance with your Shield Plan if the insurer allows. Most company insurance are pretty comprehensive. You can check with ur HR on it as well.

Personal Shield Plan has got claim limit, hence better not touch it first especially if you have company insurance.

 

[Mecisteus]

I just happened to make a claim on my surgery back in late June.

First of all, kudos to NTUC. They even sent me a notice letter saying that my bills are fully settled even before the hospital bill arrived to me.

On the letter, NTUC has a special note something like the following:

Medisave approved ISP should only be used if the insured does not have any other medical coverage like company insurance. If there is, you may wish to submit the claim to them.

My question is, is it mandatory to claim from the company insurance?

Since my bill was already settled by NTUC, I thought of skipping the hassle of claiming from my company insurance.

 

[tangent314]

If your company insurance provides full cover while your ISP requires you to pay deductible/co-insurance, then yes it is to your advantage to claim from company. Otherwise I'm not so clear about the advantage of claiming from company because like you said, it's an extra hassle. Of course, it is to the insurer's interest to push the liability to another insurance company.

 

[Mecisteus]

I wonder if I can claim from company Insurance and NTUC can pass on some of the savings to me?

Basically, each insurer will try to push the liability back at each other.

I'm sure there must be a general guideline on who should shoulder the liability first.

I was quite stunned to read the note I mentioned in italics above.

 

[tangent314]

Double claiming is illegal

 

[Mecisteus]

An old discussion here.

https://forums.hardwarezone.com.sg/...ance-works-private-shieldplans-5356131-2.html

 

[BBCWatcher]

I wonder if I can claim from company Insurance and NTUC can pass on some of the savings to me?

If NTUC’s costs are lower then they’ll pass on some of their cost savings to you along with other policyholders. That’s an indirect benefit, to be sure, but why not?

Double claiming is illegal

Double (or duplicative) collection of payouts can be illegal. It’s a form of insurance fraud. But filing two (or more) claims with insurers is perfectly fine and common as long as you notify every insurer of the claims you are filing with the other insurers so that they can coordinate payouts. On the claim form (or electronic equivalent) you’ll probably see a question to that effect, but even if you don’t just make sure all the insurance companies you’re dealing with know about any overlapping claims, that’s all.

Generically speaking, some policies are explicitly secondary to others. In other cases the insurance companies figure it out, usually splitting the difference. As a policyholder you should end up with the most generous coverage among the policies.

You are not required to file multiple claims for the same loss (with cross-notification), as Moejoseph points out. Although I might disagree about which one insurer you should choose. Often the company-provided medical insurance has a lower annual limit but does not exclude pre-existing conditions. The latter aspect can be quite valuable, something you might want to “spend” a little more carefully. As another example, you might have a public hospital Integrated Shield plan and ordinarily get all you care from public medical providers, but you hold back the company-provided coverage for those rare events when you want to dabble in the private sector. “It depends,” but just remember that if you file two or more claims for the same loss (medical bills) you have to make sure all the insurers are aware of the others.

 

[blurpandasg2014]

I wonder if I can claim from company Insurance and NTUC can pass on some of the savings to me?

Basically, each insurer will try to push the liability back at each other.

I'm sure there must be a general guideline on who should shoulder the liability first.

I was quite stunned to read the note I mentioned in italics above.

From my experience when I was warded

Initially, wanted to claim with my company insurance but had to call the HR to provide LOG and still had to co-pay 10%.

Went to Seng Kang hospital business office to ask if I could claim from company insurance first and remainder from personal insurance, the lady told me can only choose one.

So I decided to claim with personal insurance since I had 100% rider. And still given $150 for ward downgrade benefit

 

[edmwing]

From my experience when I was warded

Initially, wanted to claim with my company insurance but had to call the HR to provide LOG and still had to co-pay 10%.

Went to Seng Kang hospital business office to ask if I could claim from company insurance first and remainder from personal insurance, the lady told me can only choose one.

So I decided to claim with personal insurance since I had 100% rider. And still given $150 for ward downgrade benefit

Hmm from my recent claim from KKH.. I just claim company's AVIVA hospital plan 100% except GST (yes, read the terms and conditions) then the GST paid using MediSave. If I would have chosen to use both my company and self's Integrated Shield Plan(ISP) then the GST will be largely covered I think (still need co-pay). Noob decision then but was unwell and first time dealing with all these.. the office staffs also not very certain.

Now I read the policies better, like what other bros mentioned, better to claim company first and then self. The ISP will cover most or all of the shortfalls. As our ISP got annual limit one.. that's why better exhaust company plan and 'reserve' some in case later in the year got another episode *touch wood*.

 

[Mecisteus]

If NTUC’s costs are lower then they’ll pass on some of their cost savings to you along with other policyholders. That’s an indirect benefit, to be sure, but why not?

I don't think NTUC will pass on that savings to me. But I will update once my settlement is done.

I understand if you are on the higher plan and you choose to be warded in a lower class, then insurer will give you some cash benefits.

 

[BBCWatcher]

I don't think NTUC will pass on that savings to me.

I think you misunderstood.

Your premium at renewal will be based in large part on claims history. If you and/or other policyholders help NTUC avoid unnecessary payouts, you also help NTUC keep premiums in check, for everybody.

 

[Mecisteus]

I think you misunderstood.

Assuming my hospital bill is $2k.

If I claim from company insurance, NTUC will save $2k.

I'm referring to this savings. This is the double claim that tangent highlighted.

 

[FP_IFA]

Some insurers will give you vouchers to encourage you to inform them you have company covers.

 

[mummynew]

Some insurers will give you vouchers to encourage you to inform them you have company covers.

I ever tried to 'save money' for my IP insurer by 'co-claiming' from my alternative health insurer. However, I gave up helping them coz they required me to furnish doctor's report at my own cost to the other insurer (that will cost me about $100 per doctor's report + other hassles vs the about $30 they dangling in front of me).

IP insurers need to make things simpler at no additional cost to the insured for people like me who genuinely want to help them to recover part of the total cost.

 

[Samaritan101]

Which IP compang is this?

 

[Mecisteus]

I ever tried to 'save money' for my IP insurer by 'co-claiming' from my alternative health insurer. However, I gave up helping them coz they required me to furnish doctor's report at my own cost to the other insurer (that will cost me about $100 per doctor's report + other hassles vs the about $30 they dangling in front of me).

IP insurers need to make things simpler at no additional cost to the insured for people like me who genuinely want to help them to recover part of the total cost.

This is the thing.

MOM and MOH should get the Singapore registered companies and their group insurance to handle claims directly with the hospital.

I haven't furnish a medical report for my company insurance yet.

If I am required to, I will just check with NTUC if they can reimburse me.

If no reimbursement, I will just drop the claim from my company insurance.

 

[HWZ1973]

Now the hospital can e-file to insurance coy directly...
But they still give me the doctor discharge summary report in case I need to claim from other insurer.

I just did my op today, everything is e-file....
My insurer is NTUC income.

I did thought about claiming from my coy insurer but too much hassle.

 

[BBCWatcher]

To repeat, if you’re not claiming a company benefit then you’re effectively increasing your Integrated Shield plan provider’s costs for every policyholder, including you. Your premiums will go up accordingly. A $2,000 higher payout spread across 200,000 people in the risk pool is a fraction of a penny, but if everybody did this....?

It’s probably better to put that claim onto the company’s shoulders since you don’t pay directly for that benefit and probably won’t work for that company for the rest of your life.

You’re not required to claim benefits you’re entitled to claim, but if you do just make sure both insurers are fully aware of what you’re doing (filing claims with both).