Insurers Insurer refuses to pay under "as charge" plan

Hi Mr Tan
I insured with NTUC Income medical insurance under the Enhanced Preferred plan with rider scheme, whereby I am entitled to seek medical help in any private hospital.

I am over 70 years old. Recently I was in great pain when I walked and I seek medical help from a well known spine surgeon. I had MRI taken and the doctor recommended a spinal injection instead of surgery because of my age. The procedure was done at Mt E and I had to pay upfront ( more than $xx,xxx, of which I had to take a loan).

Now, NTUC Income holds back settling my medical claim. NTUC Income wanted the doctor to reduce his fee charged. The doctor obliged and reduced his fee but NTUC Income wanted more. They wrote to me that they would only consider my claim when the doctor further reduce his fee.

Isn’t that very unfair to me? I had to borrow money to pay upfront and NTUC Income will not settle my claim until the doctor buckle and further accede to NTUC demands.

REPLY
My understand is the NTUC Income has to pay the full bill based on "as charged". They do not have the right to hold back the claim. You should ask NTUC Income to deal with the doctor directly on his charges. 

I suggest that you ask a lawyer to submit your claim. You can ask the lawyer to get NTUC Income to pay your claim in full, including interest for the delay and the legal fees. 

I am not sure if the policy condition by NTUC Income require you to consult them on the fees before you incur it. You should ask NTUC Income if there is such a requirement. 

You can have avoided this problem by asking NTUC Income for approval before you commit to the treatment.

Tan Kin Lian

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