Latest news with #TanYiaSwam
Straits Times
23-04-2025
- Business
- Straits Times
Forum: Financial advisers must adhere to high ethical standards and industry regulations
Forum: Financial advisers must adhere to high ethical standards and industry regulations We thank Dr Tan Yia Swam for her letter 'Insurance agents asking doctors to change codes to ensure claims go through' (April 17) and refer to the Ministry of Health's reply 'MOH will review MediShield Life coverage for prophylactic mastectomy' ( April 22). We would like to provide more context regarding Integrated Shield Plans (IPs), preventive treatments and ethical guidelines for financial adviser representatives. IPs offer coverage for hospitalisation, surgery and selected outpatient treatments on top of MediShield Life coverage. As IPs are today designed to cover medically necessary treatments, treatments and procedures that are preventive in nature are not claimable. IP insurers are constantly seeking ways to balance the scope of coverage with premium affordability and sustainability for policyholders. Benefits and coverages are reviewed from time to time, taking into consideration advancements in clinical practice and medical science. We note that the Ministry of Health is undertaking a review of the matter. IP insurers will review the scope of IP coverage accordingly. Financial adviser representatives play a key role in providing advice to their clients on insurance products, including IPs, and must adhere to high ethical standards and industry regulations. If consumers or healthcare practitioners encounter potential misconduct, including being pressured to misrepresent medical codes for claims, they should provide the details to the relevant insurers for further investigation and action. We recognise the complexity of the situation and good intentions of all parties involved. The life insurance industry is committed to working closely with all relevant stakeholders to best address the needs of policyholders equitably. Chan Wai Kit Executive Director Life Insurance Association, Singapore More on this Topic Forum: What readers are saying Join ST's Telegram channel and get the latest breaking news delivered to you.
Straits Times
21-04-2025
- Health
- Straits Times
Forum: MOH will review MediShield Life coverage for prophylactic mastectomy
W e thank Dr Tan Yia Swam for her letter 'Insurance agents asking doctors to change codes to ensure claims go through' (April 17), on insurance coverage for prophylactic mastectomy in breast cancer patients with pathogenic gene mutations such as the BRCA gene mutation. In general, MediShield Life does not cover primary prevention, which refers to medical services for generally healthy individuals to prevent diseases, such as screening tests and vaccinations. This is because MediShield Life as a national insurance scheme is focused on protecting individuals when they receive medically necessary treatments for illness or injury. This keeps premiums affordable for policyholders. However, with advances in medical science, the line between preventive and diagnostic care is increasingly nuanced, particularly in cases involving genetic predisposition to serious conditions like breast cancer. Extending MediShield Life coverage for both genetic testing and subsequent preventive interventions needs careful study, as any policy changes can have broad implications and impact on premiums for everyone. The Ministry of Health is therefore reviewing and will issue claim rules to guide practitioners on breast-related surgical claims later this year. We agree fully with Dr Tan that medical professionals should not misrepresent or be pressured to misrepresent medical codes for claims, including those under government schemes and insurance. Medical professionals who encounter situations where they disagree with the advice given by insurance agents to their patients should report these cases to the insurers for follow-up investigation and appropriate disciplinary action where misconduct is established. Lydia Loh Group Director, Healthcare Finance Group Ministry of Health More on this Topic Forum: What readers are saying Join ST's Telegram channel and get the latest breaking news delivered to you.
