Another case of DPS claim denied - a very useless insurance...

[TopSage]

Person cannot even eat and bath without assistance yet cannot claim because the person can walk a few steps. Doctor already confirm
the person is unable to work.

Many purchasers of the DPS are unaware of the difficulty in claims until they were alerted to these cases.
This highlights the need for insurance reform to have transparency on the payout ratio, claim success rates,
etc of policies so that buyers can better assess the effectiveness of these policies.
----------------
I WAS saddened to read of Ms Wendy Tan's story ("Disabled from waist down but insurance claim denied"; last Tuesday).

My friend had a massive stroke last year. The front part of her skull was removed and temporarily covered with a titanium plate as the malformation in her brain had not shrunk despite treatment. She is scheduled for another operation this year and needs a full-time caregiver.

Her Dependants' Protection Scheme (DPS) insurer is Great Eastern Life.

Her claim was denied because her doctor wrote "cognitive function is intact, unlikely to perform professional job", implying that my friend is still capable of some form of work.

He has certified that she cannot perform all six activities of daily living unassisted. Nonetheless, going by the report, she did not fulfil the criterion of "permanent incapacitation where he or she cannot work".

There was no mention of her constant severe headaches, mood swings, occasional fits and memory loss.

This permanent incapacitation clause existed long before DPS was privatised in 2005. Great Eastern Life and NTUC Income were appointed to merely administer the scheme and abide by the terms and conditions laid down by the Government.

I urge the Government to look into adopting the definition of total and permanent disability used by private insurers, so that those who are genuinely in need will be able to claim on their insurance.

Being a national scheme, the DPS has a larger premium pool, which brings premiums down.

But what is the use of having cheap insurance if it does not pay when it is needed most?

Catherine Choong (Madam)

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[SingaporeNINJA]

Scam!!!!!!!!!!

 

[soIsee]

It was scam since Day 1 when gov like the PAP sought to protray that insurance scheme of whatever sort was able to 'give medical protection' so percevied that even they themselves jumped into the same boat to scam the rest with scheme like Medi-Shield.

Similiar scams of such that take the following line of reason like ' the PAP have to retain every individual's
CPF upon 55 else he would squander it mirrors exactly of scams of such medical insurance.

 

[winnipegjets]

NTUC should be compelled to hire those who are denied the benefits since the insurer is so adamant that the individual can work.

 

[songsongjurong]

looks like its gathering steam to be the mother scam of all scams ! even madoff would be smitten by such ingenuity...

 

[kopiuncle]

the whole saga is dependent on the medical report submitted by the doctor

maybe the claimant should consult other doctors to have a second or third opinion

but i understand that certain companies only accept medical reports from their panel of doctors

the issue here is not one of scam but the severity of the disability as defined by the doctor

as long as there is no permanent disability , there is no payout - it is very clear

we should not simply jump to conclusion and blame the company or the government

my friend had a terminal condition, certified by the doctor approved by the company, and he got all his payout including his medishield....

 

[TopSage]

There are serious problems with this insurance policy...it is sold as an insurance for the purpose of
Giving your family something when you cannot work due to accident or illness but in 2 cases
the insurance fail to deliver for the purpose.

The main problems is the nonstandard term permanent incapacity. In the insurance world, the term 'permanent disability' has more specific definition e.g. loss of use of both legs is considered disability... but NTUC claimed that the woman who was paralysed waist down is not permanently 'incapacitated'....so what is permanent incapacity? It is an ambiguous term that can be used easily to deny claims.
Like the woman who cannot perform any of the 6 basic activities without help like feeding herself, bathing, changing her clothes, the insurance company can still argue she is not permanently incapacitated which is ridiculous

the whole saga is dependent on the medical report submitted by the doctor

maybe the claimant should consult other doctors to have a second or third opinion

but i understand that certain companies only accept medical reports from their panel of doctors

the issue here is not one of scam but the severity of the disability as defined by the doctor

as long as there is no permanent disability , there is no payout - it is very clear

we should not simply jump to conclusion and blame the company or the government

my friend had a terminal condition, certified by the doctor approved by the company, and he got all his payout including his medishield....

 

[TopSage]

looks like its gathering steam to be the mother scam of all scams ! even madoff would be smitten by such ingenuity...

The insurance companies must have made tons of profits from this policy. But it is really incompetent and useless of the pap not to underwrite this and give the citizens the best payout and most compassionate claim assessment possible ...instead have the people feed their money to these insurance companies

 

[winnipegjets]

the whole saga is dependent on the medical report submitted by the doctor

maybe the claimant should consult other doctors to have a second or third opinion

but i understand that certain companies only accept medical reports from their panel of doctors

the issue here is not one of scam but the severity of the disability as defined by the doctor

as long as there is no permanent disability , there is no payout - it is very clear

we should not simply jump to conclusion and blame the company or the government

my friend had a terminal condition, certified by the doctor approved by the company, and he got all his payout including his medishield....

Uncle, your friend is dying ...no doctor would dare to deny that. The answer for such cases is clear.
What is permanent disability? If the insurer wants to define it so narrowly, then the onus should be placed on the insurer to provide jobs for the claimant. Or the PAP government will absorb the responsibility. Both insurers and the PAP government should be blasted for this abuse.

 

[whoami]

The insurance companies must have made tons of profits from this policy. But it is really incompetent and useless of the pap not to underwrite this and give the citizens the best payout and most compassionate claim assessment possible ...instead have the people feed their money to these insurance companies

And its deductible fm our Ord a/c. Not fm Medisave a/c. And max sum assured miserable $46K.

Tell me wat is $46K in todays value??

 

[winnipegjets]

And its deductible fm our Ord a/c. Not fm Medisave a/c. And max sum assured miserable $46K.

Tell me wat is $46K in todays value??

The nickle and dime attitude of the PAP and its cronies lives on. Until they can squeeze every cent from us, they will never be satisfied. That's how greedy the PAP is!

 

[kopiuncle]

There are serious problems with this insurance policy...it is sold as an insurance for the purpose of
Giving your family something when you cannot work due to accident or illness but in 2 cases
the insurance fail to deliver for the purpose.

The main problems is the nonstandard term permanent incapacity. In the insurance world, the term 'permanent disability' has more specific definition e.g. loss of use of both legs is considered disability... but NTUC claimed that the woman who was paralysed waist down is not permanently 'incapacitated'....so what is permanent incapacity? It is an ambiguous term that can be used easily to deny claims.
Like the woman who cannot perform any of the 6 basic activities without help like feeding herself, bathing, changing her clothes, the insurance company can still argue she is not permanently incapacitated which is ridiculous

i totally agree with you
permanent disability as defined by the doctor writing the report
or it is a terminal illness...

if the medical report specifically states that the claimant is suffering from permanent disability and the condition is terminal, i am very sure the payout will be delivered without any hesitation...

if i am not wrong, the DPS specifically mentioned total disability, permanent disability, terminal and death....

 

[sickpuppy]

Wonder how those doctors sleep at night writing such reports and causing such sorrow for the unfortunate.

 

[winnipegjets]

i totally agree with you
permanent disability as defined by the doctor writing the report
or it is a terminal illness...

if the medical report specifically states that the claimant is suffering from permanent disability and the condition is terminal, i am very sure the payout will be delivered without any hesitation...

if i am not wrong, the DPS specifically mentioned total disability, permanent disability, terminal and death....

You agree with our stand or you still supporting the insurance companies?

 

[winnipegjets]

Wonder how those doctors sleep at night writing such reports and causing such sorrow for the unfortunate.

These doctors are just like the PAP ministers ...they count their money to fall asleep

 

[whoami]

These doctors are just like the PAP ministers ...they count their money to fall asleep

Two mths ago, 1 of my relatives warded at certain hospital. Dont wish to mention race here either. FT doctor recommended my relative to go for ops. Seek 2nd opinion fm another specialist. The rest history leow.

Always seek 2nd or 3rd opinion if $$ permits..

 

[escher]

The nickle and dime attitude of the PAP and its cronies lives on. Until they can squeeze every cent from us, they will never be satisfied. That's how greedy the PAP is!

But that is already known so well!

Sinkies to keep head down down and arseholes up high high to be screwed and fucked of all the money PAP can get from them

 

[hokkien]

No wonder old people always say...can die but cannot afford to fall sick

 

[winnipegjets]

Two mths ago, 1 of my relatives warded at certain hospital. Dont wish to mention race here either. FT doctor recommended my relative to go for ops. Seek 2nd opinion fm another specialist. The rest history leow.

Always seek 2nd or 3rd opinion if $$ permits..

Agree. When a FT doctor recommends anything, always get a second opinion from a non-FT doctor.

 

[songsongjurong]

are these DPS insurance lehman-mini-bond grade ?