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Do i have a case against this insurance company?
Generalso have always wanted to get an insurance policy (hospitalisation) for this family member but said family member (fm) has history of depression with imh. asked agent and agent said can try. with a little procrastinating plus agent said he was overseas and will only be able to meet a week later.
during this time FM has complaints of sore throat and swollen feet. (thought maybe water retention). brought him to see a GP and get a full body blood test done. result came out and gp said there is a slight cancer marker in his nose. he said something like normal people reading is 2.0, fm reading is 2.5. nothing conclusion but better to refer him to an ENT at a medical center.
so 2 months later went to medical center. it was around this day that his policy was approved. let's just say it's 22th of sept. at this neighborhood medical center, doctor said his machine was not equipped to do a scope, so he made some calls and asked us to head down to NUH the very next day.
the next day we went down to NUH's ENT and doctor said according to his experience, FM has cancer in his throat and a cancerous cell on his tongue. a confirmation diagnosis of fm having stage 4 cancer is on 30th sept, they removed a small piece of the tumour and have it tested, result was it was cancerous.
now, after months of endoscopes, and surgery, and hospitalisation, insurance company said it's a pre existing illness and non disclosure on our part, and cancels his policy and said will refund the money back. according to them, the pre existing illness was when we first visited the gp and the blood test result.
what is a pre existing illness. in my book, a pre existing illness is when a person was confirmed to be diagnosed with cancer, by a certified doctor in said field. a gp is not a qualified person. u go to a gp when you have cold, fever, cough, etc. not to get a diagnosis on cancer. the confirmation came from the ENT doctor at NUH, which is roughly 1 week after the insurance was approved. what he experienced, which is a sore throat, is a pre existing symptoms, or a pre existing condition, but NOT a pre existing illness. if thats the case everyone of us who have experienced sore throat before can't claim insurance anymore due to non disclosure of pre existing illness meh???
so do we have a case? any org we can go to to seek help? is there a government entity that oversees and comes in and mediate things?
so just to add, insurance company at first also try to tai-chi by saying the claims were rejected because medishield found out about the non disclosure of pre existing illness. but when i called medishield and asked them, they say no such thing, and will clarify with insurance company. 1 week later insurance company send letter and said will cancel and refund the policy.
what can we do?
thanks in advance