Tuesday 23 April 2024

Using Hospitalisation & Surgical Insurance To Get Free Medical Checkup and Medical Treatment at Private Specialist Clinics- Beware of the Consequences.

Yup, you folks read the topic and subject header correctly- it is not a typo. What the heck am I talking about? Apparently, there are a number of people out there who has found a hidden "hack" to make use of their Hospitalisation & Surgical ("H&S") insurance plan to get free health check-up or medical treatment by specialist clinics. According to my friend (let's call him Kenny for the purpose of today's sharing session), as long as you know the right doctors at the private hospitals, they will know how to write in their medical report for one to file a H&S claim against their insurance companies to cover their medical examination costs and also 5 star hotel stay equivalent at A Class ward in private hospitals.

1.  "It is stupid to spend your own money on medical checkup. Make use of your H&S plan"- per Kenny.
My "friend" Kenny is a very street smart guy. A few months back, when I mentioned that I had recently spent S$1.5K in medical consultation and treatment for my chronic illness (asthma) at a respiratory specialist clinic, Kenny immediately commented that I should have consulted him earlier for alternative route. He and his spouse never waste their money for health-checkup or specialist treatment. As aforesaid mentioned, Kenny asserted that he knows of ways to be able to make a claim on H&S. He also remarked that "It is stupid to spend your own money on medical checkup. Make good use of your H&S plan". 

Coincidentally, Kenny has some chest pain issues then. So, he checked himself into a private hospital for 1 day to do a battery of tests which came up to S$13K in total bill. The results of the tests did not reveal any medical issues. True enough, the insurer approved the entire H&S claim of S$13K and made a full payment on behalf to the private hospital (The H&S plan of Kenny was purchased many years back hence it is the only one that I knew of that still covers "all charges" if one has bought the Extra Rider under the old scheme while rest of insurers such as NTUC Income Insurance Limited had already forced a co-payment in cash by policy holders under the old H&S scheme). 

2. Insurance Companies are not stupid- they have safeguards in place to mitigate such occurrences and deal with folks with these mindset for claims. 
To continue with the above story, Kenny got a shock when his H&S insurer wrote to him that due to this claim, they will be increasing his premiums by  three-fold for 1 year which amounted to increase of S$2k-$3K per annum. Kenny was very upset and told his insurance agent that he will be terminating his H&S with the insurance company. Currently, he has asked for quotes from a few other H&S insurers in the market for H&S replacement coverage.

It turns out that there is no free lunch after all. The consequences just came in a bit later.    


  1. someone has to pay for these losses. Thats why insurance premiums are higher.

    1. Hi SecretA, yup....fully agree with you. The weird thing is that most of the medical bills paid are still borne by other policy-holders despite the insurer levying an extra S$2k to S$3k on the policy-holder who made the claim. S$13k less off (including the original base premium) still left a hole of S$9k. If everyone use loopholes to use H&S for medical check-up, then the future premiums payable by all policy-holders will keep spiralling upwards.

  2. Why change? The insurer paid up.

    1. Hi Damn, good to hear from you again. How have you been? Oh...the change of insurer intention arises because as per my friend, the "free" checkup will no longer be free if the current insurer load his premiums for 12mths over the claim. He is very upset over the unfairness that he is made to pay extra premium. Since there are other insurers in the market, he believes that he can get the same H&S coverages at normal premium level.

    2. Hi blade, doing not bad actually. Seculating Seatrium this month.
      Btw on my side, did a procedure a few years ago about 25k claims. Rider premium next year trippled.
      I did contemplate dropping rider all together. But the main idea of insurance is peace of mind when you really need it. So I just paid.
      Update: last year, exact same procedure required. Good thing I didn't change provider, since it wouldnt be covered as existing condition.

    3. Hi Damn, thanks for sharing your experiences. Hope that you have recovered fully from your medical procedure already. :)