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Claim Story

Group Medical Insurance Helps To Pay For Renal Transplantation
 

Claim Service Centre         Filing Claim on : Life & Health Motor General
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Document Date: 28-June-1996

Ms Lee is a promising thirty year old executive of a large Multi- national Corporation. She has always lead an active lifestyle; however two years ago, she was diagnosed of having renal failure. Not only did it change her personl life, it also hindered her work as she had to undergo regular renal dialysis and treatments at the hospitals.

One year ago, doctors informed her that they had found a suitable kidney donor for her. She was delighted. She had found hope at last. However, she was also worried as she knew that a renal transplantation would incur hefty medical costs.

Fortunately, like all other colleagues in her company, she is covered under a group medical insurance plan with NTUC Income taken up by her company as part of its staff welfare benefit. NTUC Income will reimburse the company's employees all medical expenses claimed for surgery/hospitalisation up to the insured's benefit entitlement under the respective plans.

To facilitate hospital admission for the insured's employees, NTUC Income has specially made arrangements with several government and private hospitals to admit its policyholder's employees without the need for cash deposit when the employees produce the lettter of guarantee or hospitalisation identity cards issued by NTUC Income during hospital admissions. Under the arrangements, NTUC Income undertakes to make payment direct to the hospitals on the balance bill after medisave deduction, up to an agreed liability with the respective hospitals. When NTUC Income subseqently calculates its claim liability and find that it is less than the amount paid to hospital, it may recover from the company.

In Ms Lee's case, she stayed for more than 30 days in the hospital after the renal transplantation. The hospital bill had amounted to $35,000. Prior to her discharge, the hospital had called up the company and NTUC Income on the high medical costs. It wanted a form of undertaking from a third party to pay the hospital bill as Ms Lee's medisave account was not adequate to meet the full hospital bill; the company was delighted to learn that the letter of guarantee provided by NTUC Income for the group medical insurance plan was able to serve the purpose. NTUC Income was able to pay to hospital promptly the full $30,000 as stated in the letter of guarantee agreement following Ms Lee's medisave deduction of $5,000.

Several months after Ms Lee's discharge, the company received a letter from NTUC Income seeking recovery for $10,000 as its claim liability based on Ms Lee's benefit entitlment was $20,000. She requested for an instalment repayment and was very thankful and surprised that NTUC INCOME acceded to her request.

It is almost a year now after the operation. Ms Lee has recovered remarkedly well since and is currently leading a very healthy and normal lifestyle. She is very grateful that her company has chosen to take up the group medical insurance plan with NTUC Income which has saved her from both emotional and financial hardship during a most difficult period of her life.

 
 

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