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     More Medisave-Approved claims settled faster by insurers

Continued from FrontPage of Article

Annex A

 

(I) Claims Return Rate

               

Under the "Claims Return Rate" category, we publish:

 

(a) The percentage of claims processed by insurers for cases with positive payouts, within one week, two weeks and a month (called cumulative claims return rate);

(b) The median number of days it takes for each insurer to process claims with payouts.

 

After insurers complete claims assessment, the claim is forwarded to CPF Board, who typically takes one additional day to finalise claims assessment. Payment is subsequently made to the claimant through the hospital.

 

Table 1: Claims return rate (1)

 

 

 

<= 1 week

<= 2 weeks

<=  4 weeks

Median (Days)

AIA

62% (+6%)

80% (+9%)

87% (+6%)

6 (-1 day)

AVIVA

62% (+12%)

67% (+2%)

75% (+4%)

5 (-2 days)

Great Eastern

63% (+21%)

71% (+8%)

84% (+3%)

4 (-6 days)

NTUC Income

27% (+26%)

41% (+31%)

74% (+22%)

18 (-10 days)

Prudential

- (2)

- (2)

- (2)

- (2)

 

 (From July to Sept 2006.  Figures in brackets show change from 15th August publication)

 

Note (1): The number of days insurers take to process claims includes the time it takes to obtain medical records from claimants or medical institutions.

 

Note (2): Insufficient claims in the time period for statistically significant results


 

 

(II) Letter of Guarantee

(III) Absorption of Cost of Medical Records

 

The letter of guarantee, provided by insurers to hospitals, is an assurance of payment on behalf of the patient for the portion of the hospital bill covered by insurance. It alleviates the financial burden on patients by reducing the amount that patients have to pay upfront to hospitals.

 

Medical records can be requested from medical institutions by either the insurer or claimant. Medical institutions levy a charge for medical records due to the administrative costs of retrieving and collating medical information.

 

 

 

Provides

Letter of Guarantee

Absorbs costs of obtaining medical records (1)

AIA

No

No

AVIVA

No

No

Great Eastern

No

Yes

NTUC Income

Provided to Restructured Hospitals and Institutions

Yes

Prudential

No

No

 

(As of 15 November 2006)

 

Note (1): Insurers who are shown to absorb the cost of obtaining medical records do so in the majority (more than 90%) of cases. There might still exist situations where the claimant is requested to pay for medical records.

Source: www.moh.gov.sg Media Release 15 Nov 2006