Denial of MediShield Life Claims Due To Non-disclosure of Minor Unrelated Health Conditions

Mr Melvin Yong Yik Chye asked the Minister for Health (a) in the last three years, how many MediShield Life claims have been denied annually due to the non-disclosure of minor unrelated health conditions; and (b) what recourse is available for those who feel aggrieved about an unfair rejection of their claims.

Mr Ong Ye Kung: MediShield Life does not deny claims due to non-disclosure of health conditions. All Singapore Residents receive universal and lifelong protection under MediShield Life, including for pre-existing conditions.

The Member may be referring to Integrated Shield Plans (IPs), which are private and optional plans that provide additional coverage on top of MediShield Life. IP claims are assessed by the private insurers based on the contractual terms agreed between the insurer and policyholder. We do not track the number of IP claims denied due to non-disclosure of minor unrelated health conditions. Nevertheless, we expect private insurers to be fair and reasonable to policyholders. Insurers should not reject major illness claims on the basis of undeclared conditions that are minor and unrelated.

Policyholders who feel that their claims have been unfairly rejected and are unable to reach a satisfactory resolution with the insurer may file a claim for mediation or adjudication at the Financial Industry Disputes Resolution Centre (FIDReC). MOH is also establishing a Clinical Claims Resolution Process (CCRP) for IP claim disputes of clinical nature. More details will be released later this year.