Below is the Straits Times Article on NTUC clearing the air on why they paid the amount they paid for a certain case. Many times, people have no idea what they purchase from the insurance companies because of ignorance and also complicated rules and jargon used by the insurance industry. It is time that the government starts a compulsory education for all in Singapore.
I REFER to Mr Ong Kok Lam's Forum Online letter last Wednesday, "Puzzled by insurer's payout for medical claim".
Mr Ong wrote that his wife could claim only $240 of her $7,995.15 hospitalisation bill under her IncomeShield MA Plan, and inquired why the payout was not higher. Generally, the amount that a policyholder can claim depends on the type of insurance plan that he is covered under.
All shield plans currently available on the market have a "deductible" and a "co-insurance" feature.
A "deductible" is the amount a policyholder has to pay before the insurance benefit is payable.
"Co-insurance" is the percentage of the medical expenses that are in excess of the deductible, and which must be borne by the insured. In addition, there are limits imposed on how much a policyholder can claim under each category of the insurance plan.
We have since contacted Mr Ong to discuss his wife's bill and to explain how the final payout amount was arrived at. Mr Ong has assured us that he understands the calculations.
We would like to assure our customers that we process claims in accordance with the terms of the insurance policy and based on principles of consistency and fairness. We recognise that customers vary in their expectations of health care and payouts and we have therefore made available a range of plans that provide choices in deductibles and benefits to cater to different needs and budgets. As individuals' needs change over time, we encourage our policyholders to review their health insurance plans regularly to ensure that the plans remain suited to their needs.
We thank Mr Ong for sharing his experience and for giving us the opportunity to make this clarification.
Lee How Teck (Ms)
Senior vice-president & general manager
Group & Health Insurance
NTUC Income
I REFER to Mr Ong Kok Lam's Forum Online letter last Wednesday, "Puzzled by insurer's payout for medical claim".
Mr Ong wrote that his wife could claim only $240 of her $7,995.15 hospitalisation bill under her IncomeShield MA Plan, and inquired why the payout was not higher. Generally, the amount that a policyholder can claim depends on the type of insurance plan that he is covered under.
All shield plans currently available on the market have a "deductible" and a "co-insurance" feature.
A "deductible" is the amount a policyholder has to pay before the insurance benefit is payable.
"Co-insurance" is the percentage of the medical expenses that are in excess of the deductible, and which must be borne by the insured. In addition, there are limits imposed on how much a policyholder can claim under each category of the insurance plan.
We have since contacted Mr Ong to discuss his wife's bill and to explain how the final payout amount was arrived at. Mr Ong has assured us that he understands the calculations.
We would like to assure our customers that we process claims in accordance with the terms of the insurance policy and based on principles of consistency and fairness. We recognise that customers vary in their expectations of health care and payouts and we have therefore made available a range of plans that provide choices in deductibles and benefits to cater to different needs and budgets. As individuals' needs change over time, we encourage our policyholders to review their health insurance plans regularly to ensure that the plans remain suited to their needs.
We thank Mr Ong for sharing his experience and for giving us the opportunity to make this clarification.
Lee How Teck (Ms)
Senior vice-president & general manager
Group & Health Insurance
NTUC Income
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