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Declined MRTA Insurance Claim
180 days disclosure clause in relation to MRTA policy

New MessageDeclined MRTA Insurance Claim (modified 0 times) Alex
Dear All,

Would greatly appreciate your comments.

My elder sister recently passed away due to cancer and we put forward a claim to the insurer, disclosing all the relevant information. However, the claim was declined as the insurer insisted that my sister did not disclosed her illness as per the clause “this offer is valid for 180 days subject to no change in health status from the date of application” (stated in the Letter of Approval).

My sister applied to purchase the MRTA in April 2003 and was only diagnosed with cancer in Sept 2003 (5 months later). I know it's not more than 180 days later but my questions are as follows:

1) Is it reasonable for Insurers to impose such clauses? (When one is diagnosed with a fatal illness, the main thing on their mind is finding a cure, not to inform the insurer about some policy which they purchased 5 months ago. Who would remember such things?)

2) Wouldn't this be superseeded with the clause in the Insurance Policy stating that “this plan does not cover pre-existing condition for 12 months from the effective date of coverage”? My sister passed away about 18 months after insurance policy was in force (i.e. in Year 2 of the MRTA policy).

3) What recourse (e.g. legal action) do I have against the insurer, if any?


All comments are welcomed. Thank you very much.

Warm regards,

Alex Ng

04 Oct, 2005 18:21:16

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) LoyerBrook
You should consult a good lawyer.

Insurance policies are always written unilateral, meaning favouring the insurance company, thus, most lawyers are not interested to fight insurance cases.

If your lawyer can prove that there is no misrepresentation of material facts during/in the course of signing the proposal form then, you might have a case.

06 Oct, 2005 00:26:48

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) Amarmekber
Alex,

The insurance company is well within its rights in refusing the claim arising from your sisters death. The first clause you mentioned, the 180 day 'no change of health' circumstances clause covers their risk. A risk did arise which in their assessment was an uninsurable or unacceptable risk.

What would have been appropriate under the circumstances involving your sisters case would have been for her and any of you to have complied with the condition by informing the insurer and then seeking to negotiate a newer and perhaps higher premium policy considering her diagnosis. Not all cancers result in death. It would have put the parties in an equal bargaining position because whilst your sisters risk would be her health and surviving her condition, the insurer's risk would have been whether to risk covering her and for how long and how much.

It is sad especially for those of you left behind to mourn her loss. However, to go after the company now as someone suggests on the knowledge of an apparent breach on your sisters part in failing to inform the company whereby they are prima facie covered, would be to throw good money after bad.

Insurance companies work on the basis of risk and insurable risk, probabilities and yes profits and losses. Those who do not understand it make fictitious claims of bias and unilaterality etc and thats not correct although it may appear so.

I am sorry for your plight and, No don't go after the insurer for misrepresentation. It is unlikely to succeed. If an insurance agent made misrepresentations you will only have a claim against him or her and not the company.

The second clause you mentioned is mutually exclusive in the context of the first clause if read with the policy which I think is universally standard although I have not read your particular one.

I hope this helps.

06 Oct, 2005 12:31:17

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) MKiller
Amarmekber, you see but don't look. You are a NUT.

Don't bllaarrr your aaasss off everyway and anywhere without reading carefully.

06 Oct, 2005 21:31:19

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) Amarmekber
Sorry Alex did you change your name to MKiller?? it must be a stress on you.
07 Oct, 2005 13:25:51

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) Amarmekber
MKiller. If you remain at the low level you obviously are at, you will receive only the Blaaaar from peoples Arses. Thats inevitable. On occassion try, try to raise yourself above the levels you were born into. Many have tried and become human and at least acceptably intelligible.

It must be a horrible existence having to be sprayed with the expulsions of other peoples rear end orifices when you are at that level.

07 Oct, 2005 13:29:16

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) Mkiller
Amarmekber Junkie, you are excreting your stinking garbage out of target!!!
08 Oct, 2005 06:56:13

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) Amarmekber
Hope you're at least enjoying it. You're the one complaining about it. So out of the way if you don't like it pal.
08 Oct, 2005 11:39:48

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) MKiller
CONGRATULATION!!! DON'T PROSTITUTE YOUR ENERGIES!!! YOU ARE IN...FOR AN ABSOLUTE JUNK PARTY!!!
08 Oct, 2005 22:20:08

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) Amarmekber
MKillwer dog you must be a Bumi from the way you shout Kampong man Orang Utan. jakun Senoi Kera
18 Oct, 2005 19:51:00

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) Mkiller
AMARMEKBER #####!!! YOU ARE IN...FOR IT!!!!!
19 Oct, 2005 18:30:28

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) Mkiller
AMARMEKBER BBIITTCCHH!!!!! YOU ASKED FOR IT!!!!!
19 Oct, 2005 18:31:40

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) Amarmekber
Makan Thai MKiller. Ibu kaMu Makan Thai saya
19 Oct, 2005 20:18:49

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) Mkiller
OOOOOIIIII!!! AMARMEKBER AMOEBA !!! YOU CAN KEEP YOUR STINKING CCOORRKK TO FFUUCCKK YOURSELF!!!! DON'T SSHHIITT AND FFUUCCKK EVERYWAY!!!!FFUUCCKK YOURSELF AND FFUUCCKK OOFF!!!!!
19 Oct, 2005 21:51:28

New MessageRE:Declined MRTA Insurance Claim (modified 0 times) Jordan Low
Dear Alex,

I'm financial planner. Regarding the case you face, i can explain to u is the MRTA didnt cover critical illness, is only cover death and total disability only, if for additional coverage u must add the premium.

*Subject to policy term and condition*

Jordan
wealthplan2u@yahoo.com

23 Nov, 2008 16:09:55


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