Last week, I published a post on the unethical practice of NTUC Income, pertaining to the interpretation of the term “permanent incapacity”. While the industry norm is to use the term “permanent disability”, which has an objective interpretation, the cleverly crafted term “permanent incapacity” is worded such that insurance companies are able to worm out of their way from payouts. Here is that post – Unethical practice by NTUC Income
Yesterday, another insurance policy holder wrote to the Straits Times forum, highlighting the same problem. This time the company is Great Eastern.
The forum letter -
Relook definition of disability
Published on Sep 09, 2013
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)
‘Permanent incapacity’, the new dirty term concocted by insurance gangsters -
Again, like the NTUC Income case I mentioned last week, this is a play of words. By cleverly and craftily wording the term ‘permanent incapacity’, the insurance gangsters have avoided payment to bona fide cases. From the above forum letter, if the patient needs to have a permanent caregiver because she is unable to perform all activities of daily living, doesn’t this mean that she has been permanently disabled? The norm of the industry is that this is enough to trigger a payout. But the insurance gangsters are adamant.
Once again, I have to make mention that this is against the principle of “in good faith”. If these insurance gangsters don’t have the intention to make such payouts in the first place, they should have made it clearly and explicitly known to all policy holders. But because the DPS is unethically in the opt out scheme, there is no need to have a signature or acknowledgement from the policy holder. The insurance gangsters simply assume the policy holders know the terms. Then come the day when these policy holders try to make a claim, the gangsters simply point out the terms not known to the policy holders earlier.
Well, if these gangsters have made it known to the policy holder in the first place, perhaps the policy holder may not want this policy and would have opted out. On the other hand, if the policy holder accepts such terms, then truly the policy holder knows what he or she is in for and there would be no cause for complaint.
But the above is not the case. The above is a clear ripoff, with the insurance gangsters keeping this term of no payout hidden from the policyholders, eating the premiums and refusing to make payments. This truly is against the principle of “in good faith” that is supposed to be practised in the insurance industry.
Far reaching implication for all opt out and forced insurance gangster like schemes-
The implication of the two cases of non-payout is far reaching. Under all opt out and forced gangster schemes, the insurance companies NEED NOT have the policy holders to sign any document. They NEED NOT make sure that the policy holders know every single term of the policy. All they need is to collect your money from your CPF. And if you don’t have enough money in your CPF, the gangsters will send in the lappy dogs, that is the relevant govt dept, to force you to top up your CPF. Isn’t this no different from the Ah Long who uses strong arm tactics to force you make payments?
Then to add insult to injury, after these gangsters have siphoned and forced your money out of you, there is this chance that you will not be paid compensation, simply because they tinker with certain interpretation of terms.
But wait, here is the biggest whammy of them all. While the DPS is an opt out scheme, which means you can choose not to be conned by these gangsters, the Medishield Life is forced on you. That means even if you don’t agree to an unfavourable term that explicitly states they won’t pay you, you still have to pay them the premiums. You can’t opt out. A con job true and true.
Meet the tripartite mobster gangsters who will siphon your money dry -
NTUC INCOME – “Made different so that clients pay us instead of we pay them.”
GREAT EASTERN LIFE – “It sure is a great life when we get paid without us giving payouts.”
And finally, CPF – The Crooked PAPpy Fraudster. The authorised running dog and money collector cum fleecing agent of the insurance gangsters. If you don’t pay the gangsters, the Crooked PAPpy Fraudster will knock on your door.
Barrie
*the writer blogs at http://wherebearsroamfree.blogspot.com