Forum: Do I have to be at death’s door to claim medical insurance?
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I wish to highlight a concern about how certain insurance companies interpret the term “life-threatening” in critical illness policies – in a way that appears to defeat the very purpose of such coverage.
I bought a critical illness policy from AIA several years ago. In 2018, I was diagnosed with a benign brain tumour. At that time, my doctor advised me that surgery was unnecessary because the tumour was small and not causing symptoms. I was placed under annual MRI surveillance.
In November 2024, my MRI scan showed that the tumour had grown significantly and could begin to affect my quality of life. My neurosurgeon then recommended surgery, which I underwent. However, when I submitted my critical illness and hospitalisation claims, both were rejected.
AIA’s main reason for denying the $100,000 critical illness payout was that my tumour was “not life-threatening”. This interpretation is deeply troubling. Must a policyholder wait until his condition becomes fatal before a claim can be accepted?
No responsible doctor would advise a patient to delay essential surgery until he is at death’s door just to meet an insurer’s definition of “life-threatening”.
This narrow reading of policy terms not only undermines medical ethics but also betrays the trust of consumers who purchase critical illness insurance to protect themselves before a condition turns deadly. It creates a perverse situation where a patient is penalised for taking preventive medical action.
Insurance companies should be guided by medical reasonableness and the principles of fair dealing, not by rigid technicalities that erode confidence in the industry. I urge the authorities to review how such clauses are being applied and to ensure that policyholders are treated fairly.
Frankie Yee Kok Wah
