Insurance Claims In Singapore: How They Work And What To File
The first thing most people do when they need to file an insurance claim is to send a panicked WhatsApp message to their insurance agent. But your agent is only human and may not always be able to accommodate your every need. So to be on the safe side, it is best to do your research on how to make claims about your insurance policies.
Before we go any further, in the event of a mishap, you must first know whether the event is eligible at all and, if so, under which policy. Not sure? You can find the information in your insurance documents (not in the brochure).
In this article, we're going to go through common claims procedures for major insurance policies, including:
Health insurance claims (MediShield Life or Integrated Shield)
If you have health insurance in the form of MediShield Life or an Integrated Shield Plan (IP), you must inform the hospital or clinic staff that you want to pay with your IP upon admission (i.e. reception).
You will be asked to complete a medical claims authorization form. While not mandatory, it is a good idea to contact your insurer as well (through your agent, if available) to give them an advance warning.
The hospital makes the application on your behalf and the insurer pays their share of the bill. All amounts payable by MediShield Life will be automatically deducted from your account by the CPF Board of Directors.
You will then be billed for the remaining amounts, which include an additional payment.
Continue reading: Health Insurance In Singapore – Everything You Need To Know To Survive
Insurance claims for serious illnesses
If you have insurance that covers critical illnesses such as If you are diagnosed with a condition that is covered by the plan, for example, cancer insurance, you can make a claim.
Typically, you will need to submit one or more forms to your insurer, either available on their website or available via email through your agent or insurer. This includes a medical certificate that must be completed by your doctor.
Please also note the supporting documents that you must submit with your application. These can be medical reports and / or laboratory or test results.
Read more: Critical Illness Insurance in Singapore: The Complete Guide (2021)
Life Insurance or Permanent Disability (TPD)
If a relative dies or you become unable to work, you should inform your insurer as soon as possible. This applies regardless of whether you have term or life insurance. (Note that with term life insurance, this event must occur within the insurance period for a claim to arise.)
You will need to submit an application form and include supporting documents such as a certified copy of the death certificate and identification documents.
If you are making a claim on behalf of a deceased family member, you may also need to provide evidence of your relationship, such as a birth certificate or marriage certificate.
Continue reading: Life Insurance in Singapore – The Basics of Life and Term Life Insurance
Claims from disability insurance (CareShield Life)
Singaporeans aged 30 and over are automatically covered with long-term disability insurance under the CareShield Life program. It pays out a monthly income if you have a severe disability and cannot perform basic functions.
Before you can successfully make a claim, however, you must make an appointment with a MOH-accredited severely disabled assessor. This appointment costs either $ 100 (if you visit the clinic) or $ 250 (if the appraiser makes a home visit).
If you purchased a CareShield supplement from a private insurer, you should also bring your insurer's application forms with you to your appointment.
The assessor's job is to confirm that you cannot perform a certain number of Daily Living Activities (ADLs) in order to qualify for the payouts. It helps you to submit all relevant documents to your insurer and to the competent authority.
Read more: CareShield Life Guide 2021: What It Is And How To Make The Most Of It
Claims from private accident insurance
Accident insurance claims can be made in a wide variety of situations. It is therefore best to seek advice from your broker or insurer about the documents to be submitted.
The process is usually started by submitting a claim form to your insurer. If available, you must enclose medical certificates, reports and summaries, health bills, and police and accident reports. If you are filing on behalf of a deceased family member, you must also submit their death certificate.
The insurer will process your claim and contact you for more information or supporting documents.
Read more: The 7 Best Accident Insurance Plans Under $ 150 In Singapore (2021)
Claims from motor insurance
If you have an accident, you should contact your car insurance provider's emergency hotline immediately. Before other participants manage to escape, be sure to take photos of the crime scene and any damage, and make a note of the license plate, contact details and insurance details of everyone else involved.
Do not attempt to move your vehicle unless it is necessary for safety reasons before you have received specific instructions from your insurer. Your insurer may also send an inspector to the scene of the accident.
It is best to have your car repaired in a workshop authorized by your insurer. The workshop should be able to provide you with documents to file with your claim.
Note that if you submit a claim, you will lose your no-claim discount. After the appraisal, you can either complain about the repair or pay for it yourself, whichever is cheaper.
Continue reading: How to apply for a car insurance in Singapore
General insurance claims
General insurance includes all types of insurance with the exception of life insurance. That includes home insurance, maid insurance, and travel insurance (not that we need it now).
The process for most insurance claims is to submit one or more forms from an insurer along with supporting documents. If you are not sure which documents to submit, you should contact the insurer as soon as possible.
The deadline for insurance claims varies depending on the tariff. Most plans require you to contact the insurer within 30 days, but some types of insurance have shorter deadlines. You can find the exact deadline in your insurance conditions.
While waiting for your insurer's response, it is always wise to document the event as well as possible. Keep any receipts or reports and in the event of an accident, use your phone's camera to take photos of the scene and damage.
Read more: Guide to Travel Insurance Claims – What To Do, What Receipts to Keep, and More
Can you apply to 2 insurance companies?
You can take out as many insurance policies as you want. However, that doesn't mean you can get claims from everyone.
When it comes to plans that work hand in hand with government policies like MediShield Life or CareShield Life, you can't have multiple claims at once. Hence, it doesn't make sense to have more than one Integrated Shield Plan or Careshield Life Supplement.
You can only make one claim at a time for plans that work on a reimbursement basis. This can be hospital and car insurance.
However, some types of plans are stackable, so you can buy more than one plan for broader protection. Such plans usually pay out a lump sum that is not tied to any expenses you have incurred. Some examples are life insurance and serious illness insurance.
Can you appeal your insurer's decision?
Has your insurance claim been denied even though you thought it shouldn't have been? Good news – you can write an appeal letter to appeal your decision.
However, before you furiously open your laptop and activate Microsoft Word, be sure to read your insurance records to make sure that you are actually entitled to the claim.
It's a good idea to include supporting documents to support your reasoning, such as: B. a statement or letter from your doctor, mechanic, etc. When quoting someone, make sure you use their full name instead of simply referring to them as an employee of a particular health care provider or company. You should receive a response within 7 working days.
If your appeal is denied and you still think you are right, you can try referring your complaint to the insurance company's manager. You should receive a response within 15 working days.
Still does not work? Contact the financial industry dispute settlement center. They can walk you through the process of settling the dispute with your insurer who will hopefully get you a deal.
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