Tuesday, March 23, 2010

Difficulty with Shield claim

Hi Kin Lian,
Trust & integrity from insurance companies are indeed important especially when it comes to claims. I wish to share my experience.

When I had an operation, I made a claim under my private shield insurance cover which came with enhancement including a rider for 100% coverage. These enhancements were purchased at a later stage and came with certain medical condition exclusions but it was stated specifically in the insurance cert that my original shield cover remains in tact and not subject to the exclusions. So whatever the issues arising on the exclusions, the minimum valid claim at least under my original cover would have been $X which was a substantial amount of the total medical bill. 


The key point I want to share with you and thru you to others is that initially my claim under my insurance policy for 100% cost was Totally DECLINED on the basis of dispute on the exclusions despite the above said minimum claim entitlement. It was errorneous and yet it took me a few months and a string of correspondences on deaf ears and only after finally a visit to their office to physically point out to them the relevant clauses in the insurance before they humbly and embarrassingly acknowledged to pay the $X claim amount unconditionally and immediately. Because of my perseverance and knowledge of the insurance terms, I prevailed. 


But if this is the way insurance companies administer claims and have an apparent built-in resistance to claims (possibly for profit-enhancement reasons), it is very wrong and unethical because there are many insureds out there who are less educated, informed or able to raise these issues and fight for their rights. Why should insureds even have to fight at all for their rightful dues? Shouldn't the company have qualified professionals to process claims independently and objectively according to the T&C of each cover? What form and standard of corporate governance does it have?


As an aside: the good news was that I won on my full claim in due course after almost a year of aggravation because the insurance co. ultimately backed out from the adjudication process. I cannot go into the details of the winning arguments except that one more positive that resulted was that the company was found to be unfair to both charge higher premiums for medical conditions and at the same time impose exclusions on the same medical conditions which amounted to a double whammy, and I got my premium reduced. Something is therefore also unfair with its underwriting process. 


I hope you can share your comments in a general manner on the latter as well as the claim process to alert the public and others who are similarly aggrieved. 



REPLY
It is wrong for an insurance company to reject a legitimate claim in a careless manner. In some states in America, it is illegal for an insurance company to deny a claim without a valid reason. If they make a mistake or are are malicious, they have be fined by the authority or have to pay damages to the policyholders. This is stated in the text book that I used to teach risk management.

An insurance company has a duty to treat its customers fairly. Rejecting a valid claim is a serious breach of duty and breach of trust. The policyholder should not be put to so much trouble or distress in making a legitimate claim.

Land banking product - views of two investors

View of  investor 1
An investor bought a land banking product said:  There is also a similar group of investors - who has hired a corporate investigator in New York - to file a class action suit against X. I received a phone call from New York sometime ago. In Malaysia-KL, X office was raided by the authorities,.investigations still pending. It appears to those who are suspicious - that X is a very cleverly-crafted "legal cheat".

View of investor 2
This investor bought into another land banking product, which carried the name of a reputable legal firm in Singapore. The name of this legal firm gave him the confidence that the product was sound. He learned later that he was cheated, and was not able to take action as the land banking company is based outside Singapore.

Self education on financial planning

Hi!
I have finished the book (Practical Guide on Financial Planning). It is really a good book for me to plan my future, Do you have any relevant book to recommend me?

REPLY
There is a free e-book available in FISCA website, www.fisca.sg.  Ask the webmaster for help, if you cannot locate it. Please recommend my book to your friends.


Toughest Puzzle - Who tells the truth?

This is labelled by www.ft.com as the toughest puzzle of all times. But it is not so difficult after all, as  I was able to solve it. Read the comments for my solution.

There are three guardians, A, B and C. Their ames are Knight, Knave and Chaos. Knight always speaks truly, Knave always lies. Chaos tossed a coin this morning to decide whether today he would behave like Knight or like Knave.
Your task is simple: ask three yes-no questions, each of a single guardian, and determine which is Knight, which is Knave, and which is Chaos. There is, alas, a complication: the guardians understand English but will answer in the local language, in which “Da” means yes and “Ja” means no. Or possibly “Ja” means yes and “Da” means no – you cannot remember.

Posting comments in my blog

When you post a comment, please sign off with your real name. You can continue to be anonymous, if you have a reason to do so, e.g. afraid of being penalized unfairly. By giving your name, you can strengthen the credibility of your statement, and show that you are willing to stand by it and are not malicious.

Some people criticized this blog for being not objective but are not prepared to give their real name. If they feel this way, there is no need for them to visit this blog. It is meant for other people who find the blog to be educational, fair and useful.

ST Forum: More accountability needed for motor insurance

Read this letter in the Straits Times:
http://www.straitstimes.com/STForum/OnlineStory/STIStory_505625.html

The premium for the insurance of my motor car went up 20% on this year's renewal, even though I did not make any claim for last year. Many people would have faced the same experience.

Financial stability of banks

An asset manager offered this interesting perspective. When you put your money in the bank, you do not own the assets of the bank. The bank just give you a fixed deposit certificate or a monthly statement, i.e. just a piece of paper. If the bank gets into financial difficulty, you may lose all of your money. Your protection is up to the amount of the deposit insurance scheme or government guarantee.

During the financial crisis in USA, many large banks were on the verge of collapse. If the government did not step in to bail out the banks, many people would have lost their savings in the failed banks.

He told me that it is safer to invest in shares as the investor directly owns a share of the invested company. A unit trust allows diversification into many companies, with the assets held by the trustee company (and not the fund manager).

My friend, who worked several years in Vietnam, told me that the banks offered high interest rate, but the people were afraid to put their savings in the bank, as they were afraid of bank failure. They invested in other assets, such as life insurance, property and gold. But they avoided the banks.

Singapore banks now enjoy full government guarantee on their deposits, but this guarantee will expire soon. After that, the money will be exposed to the same risk faced by banks elsewhere. Although the local banks have high credit rating, the deposits are still exposed to the underlying risk

People who put their money in the bank should look for a higher interest rate that is much higher than the 0.5% paid by the bank. If not, it is better to invest in a low cost investment fund, and manage the risk through diversification and long term investing.

Tan Kin Lian