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Anonymous
AXA shield plan revises a clause on Reasonable and Customary Expenses that it now states their medical advisers or physicians opinion shall prevail. Pointless to use non-panel Doctors as end of day AXA side has the final say on the bill amount? Is this clause unique to AXA?
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Tan Li Xing
16 Jan 2020
Financial Consultant at Prudential Assurance Company (Singapore)
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Pang Zhe Liang
13 Jan 2020
Fee-Based Financial Advisory Manager at Financial Alliance Pte Ltd (IFA Firm)
In order to answer this question, we will need to conduct a detailed study on the policy contract and its associated terms for renewal. Generally, the insurance company reserves the right to alter the terms of coverage upon renewal so long as sufficient notice period is given and the offered terms are reasonable.
Having mentioned that, different insurance companies have different practices. Therefore, we will need to have a detailed look at the policy contract before we can determine whether such changes is allowed.
In general, different insurance companies provide different scope of coverage for its private integrated shield plan. Hence, it will be different to determine whether such clause is unique to a specific insurance company. On the whole, it will be valued to understand your concern and how we can resolve it in the best possible manner. That is the best way to get yourself insured for the long term - to get a coverage that you will be comfortable with.
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Hi Anon,
I think for shield plans, the insurer that issued the plan has the right to change the terms and conditions. Also just to highlight, the shield plan is one of the highest loss making product for insurers so I am not surprised that they are making changes to the policy terms. There might even be changes to the premiums as well due to this loss.
Of course, you might also want to look at whether you do need to have the highest possible coverage as some of us might just go to a restructed (government) hospital when we seek medical treatment.