The first thing most people do when they need to make an insurance claim is to send a panicked WhatsApp message to their insurance agent. But your agent is only human and might not always be able to grant your every wish. So, to be safe, it’s best to educate yourself on how to make claims through your insurance policies.
Before we go any further, when a mishap occurs, you must first know whether the event is claimable in the first place, and if so, under which policy. Not sure? The information will be in your policy documents (not the brochure).
In this article, we’ll run through the common claims procedures for major insurance policies including:
Health insurance claims (MediShield Life or Integrated Shield)
If you have medical insurance in the form of MediShield Life or an Integrated Shield Plan (IP), you must inform hospital or clinic staff that you want to use your IP to pay when you are being admitted (ie. at the reception).
You will be asked to fill in a Medical Claims Authorisation Form. Although you don’t have to, it is a good idea to also contact your insurer (through your agent if he or she is available) just to give them a heads up.
The hospital will submit the claim on your behalf and the insurer will pay their share of the bill. Any amounts to be paid by MediShield Life will be automatically deducted by the CPF Board from your account.
You will then be billed for any remaining amounts, which will include a co-payment portion.
Critical illness insurance claims
If you have an insurance policy that covers critical illness, such as cancer insurance, you can make a claim as soon as you are diagnosed for a condition that is covered by the plan.
You will usually need to submit a form or several forms to your insurer, either available on their website or obtainable through your agent or insurer via email. This will include a doctor’s statement that needs to be filled in by your practitioner.
You should also take note of the supporting documents that you must submit together with your claim. This might include medical reports and/or lab or test results.
Life insurance or total permanent disability (TPD)
If a loved one dies or if you become disabled, you should notify your insurer as soon as possible. This applies whether you have term or life insurance. (Note that if you have term insurance, this event needs to happen within the insured term in order for a claim to happen.)
You will have to submit a claims form and attach supporting documents such as a certified true copy of the death certificate and ID documents.
If you are making the claim on behalf of a deceased family member, you might also be required to furnish proof of your relationship, such as through a birth certificate or marriage certificate.
Disability insurance (CareShield Life) claims
Singaporeans aged 30 and above are automatically covered with long-term disability insurance under the CareShield Life scheme. It pays out a monthly income if you have a severe disability and cannot perform basic functions.
However, before you can successfully make a claim, you must book an appointment with an MOH-accredited severe disability assessor. This appointment will cost either $100 (if you visit the clinic) or $250 (if the assessor is making a home visit).
If you have purchased a CareShield supplement from a private insurer, you should bring along your insurer’s application forms to your appointment too.
The assessor’s job is to certify that you cannot perform a certain number of Activities of Daily Living (ADLs) in order to qualify for the payouts. She will help you submit all the relevant documentation to your insurer as well as to the relevant government agency.
Personal accident insurance claims
Personal accident insurance claims can be made in quite a wide variety of situations, so it is best to obtain advice from your agent or insurer about the supporting documents to submit.
The process is usually set in motion when you submit a claims form to your insurer. Where available, you will need to attach medical certificates, reports and summaries, healthcare bills and police and accident reports. If you are submitting on behalf of a deceased family member, you will also need to submit their death certificate.
The insurer will process your claim and get back to you for further information or supporting documents.
Car insurance claims
If you get into an accident, you should contact your car insurance provider’s emergency hotline immediately. Before any other parties involved manage to escape, make sure you take photos of the scene and any damage, and take down the licence plate number, contact details and insurance information of any other people involved.
Unless it is necessary for safety reasons, don’t attempt to move your vehicle until you have received explicit instructions to do so from your insurer. Your insurer might also send an inspector to the scene of the accident.
It is best to get your car fixed at a workshop authorised by your insurer. The workshop should be able to provide you with documentation to submit with your claim.
Do note that submitting a claim will make you lose your No Claim Discount. After your assessment, you can choose to either make a claim or pay for the repairs yourself, depending on which would be cheaper.
General insurance claims
The procedure for most insurance claims is to submit an insurer’s form(s) together with supporting documents. If you’re not sure what documents to submit, you should contact the insurer for advice asap.
The time limit for insurance claims varies depending on your plan. Most plans require you to contact the insurer within 30 days, but some types of insurance have tighter time limits. Check your policy T&Cs for the exact cutoff date.
While waiting for your insurer to respond, it is always a good idea to document the event as much as possible. Hold on to any receipts or reports and, in the case of accidents, use your phone’s camera to take pictures of the scene and any damage.
Can you file a claim with 2 insurance companies?
You can sign up for as many insurance plans as you want. However, that doesn’t mean that you can receive claims from all of them.
When it comes to plans that work hand-in-hand with government policies like MediShield Life or CareShield Life, you will not be able to claim from more than one at a time. So, it doesn’t make sense to have more than one Integrated Shield Plan or Careshield Life supplement.
For plans that work on a reimbursement basis, you can only claim from one at a time. This can include hospitalisation insurance and motor insurance.
However, some types of plans are stackable, so you can buy more than one plan in order to enjoy more comprehensive protection. Such plans usually pay out a lump sum that is not tied to any expenses you have incurred. Some examples include life insurance and critical illness insurance.
Can you dispute your insurer’s decision?
Did your insurance claim get rejected when you think it shouldn’t have? Good news — you can write an appeal letter to challenge their decision.
However, before you open furiously open your laptop and activate Microsoft Word, be sure to read through your insurance documents to make sure that you are indeed entitled to the claim.
It is a good idea to attach supporting documents to support your argument, such as a statement or letter from your doctor, mechanic and so on. If you are quoting someone, make sure to use their full name rather than simply referring to them as an employee at a particular healthcare provider or company. You should get a response within 7 working days.
If your appeal is rejected and you still think you’re right, you can try to escalate your complaint to the insurance company’s Chief Executive. You should receive a response within 15 working days.
Still not working? Get in touch with the Financial Industry Disputes Resolution Centre. They can take you through the process of resolving the dispute with your insurer, which will hopefully get you some closure.
Found this article useful? Share it with someone who might need it.