More time needed for processing as policyholder's medical claim is complex

A view of the NTUC Income building at Tampines Junction.
A view of the NTUC Income building at Tampines Junction.PHOTO: SHIN MIN DAILY NEWS

Ms Pauline Low queried in her letter (Why the delay by insurance firm, June 29) about NTUC Income's requests for information following her sister's insurance claims for stomach cancer treatment and asked if there is a time frame during which an insured person must stay in good health after buying an Integrated Shield Plan (IP) before claims can be reimbursed.

First, we would like to clarify that Income's IPs admit claims that are covered by the specific plans as long as they are in force. However, for newly incepted or upgraded IPs (which is the case for Ms Low's sister, who is the insured), additional due-diligence checks apply to claims that are submitted early in the inception of the plans.

The checks mitigate potential non-disclosed medical information which may impact claim proceedings, and are industry practice. More significantly, such a practice safeguards Income policyholders against escalating healthcare and health insurance costs in Singapore.

Due to her medical condition, the insured's claim is complex. As such, we requested additional information to support the claim, and the release of medical reports by healthcare institutions from where the insured had sought treatment. This has resulted in a longer assessment duration.

We apologise if the intent of the requests for additional medical information was not clearly communicated to the insured and has caused her and her family unnecessary stress and concern. We would also like to reassure the insured that the request for and verification of additional medical information are material to the claim proceedings and would like to seek the insured's understanding on the matter.

To expedite the claim proceedings, we have reached out to the insured to offer an alternative claim solution. We are also working alongside the hospital to ensure that the insured's cancer treatment is not disrupted.

We will continue to reach out to the insured to offer her assurance and will refrain from discussing the details in a public forum to respect the insured's privacy and confidentiality.

Serene Chua

Head, Life and Health Operations

NTUC Income

A version of this article appeared in the print edition of The Straits Times on July 04, 2019, with the headline 'More time needed for processing as policyholder's medical claim is complex'. Print Edition | Subscribe