My Accident and Insurance claims

My Accident and Insurance claims

I met with another accident while playing football. You can read about the injury here. This is my second major accident and after my first, I decided to sign up for another accident plan. I know some will say accident plans are a waste of money let alone having two. However, being an accident prone person accident plans are important to me.

Time Line of the accident:

16 July (Day of the accident)

Went to A&E @East Shore and took X-rays. Referral letter to see a specialist. | Total cost $220

19 July

Went to see a private specialist. Took X-ray and MRI. Was told to try to see if it can heal on its own and come back in two weeks. | Total cost: $1,500

2 August

Took another X-ray and was inform by the Specialist that surgery is required. I went to see another specialist for a second opinion and surgery is also required. | Total cost: $440

4 August

Went for Surgery at Mount Elizabeth. Warded for 1 day (4 bedder). | Total cost $26,200

12 August

Follow up and dressing. | Total cost: $220

19 August

Follow up and remove stitches. | Total cost $260

Yet to come: Follow up consultation, physiotherapy and removal of screws.

Insurance utilised:

Personal Accident Plan

Health Shield Gold

Health Shield Gold Rider

Pink of Health – a hospitalisation income plan


Here are my thoughts on the entire claim process:

1) Insurance only accept original receipts so keep it properly. If you misplace it, you can request for another copy from the hospital but this will delay your claims and also add to your inconvenience.

2) Request for a referral letter before seeing a specialist. Insurance may not accept your claims if you do not have a referral letter. Ask it from the doctor who attend to you on your first visit. It is not going to cost you extra.

TIP: The doctor will usually recommend a few specialists but you are free to go home to consult your family and friends before choosing your own specialist. In the referral letter, tell the doctor not to write the doctor name, ask him to write something like “Dear Orthopaedic colleague…”

3) If surgery is required, ask for a estimated cost break down. I think this is now the norm as both specialists I consulted gave me a estimated cost break down. Having a second opinion also allows you to compare the cost – they should not differ too much.

Ask if the hospital requires you to pay a deposit. Mount Elizabeth Orchard was able to do a e-file with my insurer of up to $50K during my admission, hence I do not have to pay any cash upfront.

4) Do not delay your claims. Some insurance has a number of days for you to file for your claim. We also want to get reimbursed as soon as possible ya.

5) Check every document carefully. When I was checking into the hospital, the surgery claim indicated the wrong foot. I made sure they amend it else there might be a problem with my insurance claims.

6) You will be given a discharge form when you are discharged else ask for it. This may be required if the insurer needs proof on the duration of your hospital stay.

7) Keep your agent updated and check with him if you have any queries. This is where having a good agent really shines. I will like to thank her again and will buy her a meal once I recovered.

8) The importance of having a emergency cash. Although insurance will eventually pay for my claims, except for my surgery of $26.2K, I have to pay every bill with my own money first.

I just found out that the crutches and boot are not covered under insurance. Which is why the insurer now comes out with another rider – “Mobility Aid” rider. I was upset as I have never heard of such a rider – apparently it was launched recently. I am not going to argue with the insurer and I am glad to have my emergency fund.

Final Thoughts

I went directly to a private hospital and specialist because I wanted to cut down on the waiting time. For my injury it is best to have surgery within 6 weeks to have the best possible result – I was able to consult two specialist within the same day and arrange for surgery two days later.

This is the first time that I am sedated and wheeled into an operating theatre. Come to think of it, it should be a scary experience but insurance gave me the peace of mind to focus on finding the best possible treatment and recovery.

Comments

  1. says

    Nice. Make me think about whether I should purchase a Personal Accident Plan. Only hold a hospitalisation plan from NTUC currently. Which insurer did you get your Accident Plan from? And, am I right to say that, other than your hospitalisation bill, the rest of the costs like Xrays are claimed from the Accident Plan?

    • says

      Hi Cherry,

      My accident plan is from AIA. My Medi-shield and hospitalisation income plans are also from AIA. It makes claims submission easier as I only have to liaise with one insurer. You can read about my insurance portfolio here.

      You are right that all the expenses incurred prior to my operation is claimed under my accident plan. The follow ups after the operation can be claim under MediShield. I can still use back the accident plan if the claim amount exceed the MediShield limit.

      Like all insurance, get the Personal Accident when you are healthy because any existing injuries e.g. fractures may not be covered.

      Getting a accident plan depends on the individual. I am not promoting it but it is one of the most inexpensive type of insurance and I think the agent don’t earn a lot of commission from it. If you are still worried about the cost, you may consider plans with a no claim bonus i.e. if you don’t make a claim for 2 or 3 years, the insurer will refund a portion of your premiums paid.

    • says

      Hi Lazy Singaporean,

      The accident plan can be used to claim for the surgery but my claim limit is only $2,500 per accident. Since I can use H&S for my surgery, it makes sense to use it.

      There are some accidents where major surgery is not required – e.g. having a cast, physiotherapy etc. This will not be covered under H&S and that’s where having an accident plan comes in handy.

      Hope this answers your question.

    • says

      Hi Ellen,

      Thanks. Just to re-iterate, the surgery which is the bulk of the cost is covered by H&S. The PA is to cover for all other costs leading to the surgery.

      • ELLEN CHOW says

        So upon discharge, based on ur H&S plan, you need not settle the bill in full based on Private Hospital Norm???

        • says

          Hi Ellen,

          Yep. Mt. E @Orchard filed the H&S claim online with AIA and it was approved on the spot. Hence I do not have to pay anything. They did ask me to sign the CPF Medisave form just in case there is a delay from AIA.

          Do note that every Hospital (even if they are from the same company) practice is different. I understand that for Mt E @Novena, you have to pay a initial deposit first.

          • ELLEN CHOW says

            Hi Derek,

            WoW… That’s great that you do not need to fork out $26k+ and wait for 1 momth+ for AIA to reimburse you. That’s the perk of getting the Top H&S Plan.

          • says

            If AIA delayed…amount deduct from medisave will be weird. Medisave is kind of our own saving. So can get the money back from AIA later ?

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