Protect your interest in private medical shield insurance

On 31st Jan 2007, a report in Straits Times generated a buzz amongst medical insurance practitioners. It was reported that a lady was rejected on her medical insurance claim by the insurer because of the definition of "pre-existing condition". The policy in this case is a private medical shield plan which replaces CPF's medishield if a client purchases it.

I followed the argument of CEO of the insurer, which is very convincing and accurate to the letter of the law. Subsequently, one response by an insurance law specialist, and also one by a health correspondent in StriatsTimes, also equally convinicing in their arguments that the insurer has done the right thing by safe-guarding the interest of majority in rejecting the claim.

I wonder, if the CEO, the insurance law specialist, or the health correspondent journalist is the insured whom claim is being rejected, will they still say the same thing?

This saga points out a few problems about private medical shield plan. Chief amongst those is that the lady in this case CANNOT revert back to her original medishield plan (which will pay the claim) HAD she not being ADVICED to buy the private shield plan. (Do you now see the predicament of the lady in the case. It was not her fault altogether as she genuinely did not know about her breast tumor, and the insurer did not insist on medical check up before REPLACING the medical policy.)

Do we now point the "missile" to the financial advisor who sold her the plan? There is no easy answer.

This is what you can do to protect your own interest.

Step 1: If you are considering purchasing a private medical shield plan, insist that you go for a medical check up with a preferred doctor by the insurance company. EVEN if the application (or the advisor) does not require you to do so.

This is becuase the moment you depart from CPF's medishield plan into private shield plan, there is no turning back IF your health is compromised, whether you know it or not.

Step 2: Declare EVERY illness, however remote or minor you ever have had to the doctor or the underwriter.

Step 3: Once you are into one medical shield plan, STICK to it and try not to hop around amongst insurers. Any changes of insurer will view you health (obvious or hidden) factors as a fresh case. And the chances of being hit by a "pre-existing condition" will be higher.

Back to the cited case and the "experts". Before we talk about "how to protect the interest of the majority" in a heroic manner, let's not forget we are dealing with a human being. If the case is not a fraud, as experts, we are to bring the benefit of insurance to that person, and not leave that person in a no-man's land.

Let me end with the same question earlier: "if the CEO, the insurance law specialist, or the health correspondent journalist is the person whom claim is being rejected like the lady in the case. Will he or she still talk like that?"