Modernising insurance for fairer claims

I raised a question in Parliament regarding the need to update medical insurance contracts to include modern and less invasive surgical procedures. This was prompted by the recent case involving Prudential where a woman faced challenges claiming for a brain surgery that utilised newer technology. 

My concern is that legacy policy wording might be used to deny claims for more effective treatments simply because they did not exist when the plan was bought. We must ensure that insurers do not prioritise rigid definitions over the well being of their clients and the collective interest of other policyholders who deserve up to date protection.

The Minister explained that while MediShield Life updates its list regularly critical illness policies often stick to older definitions to maintain premium sustainability. He noted that the Life Insurance Association is currently studying the feasibility of allowing policyholders to adjust their existing coverage to include newer treatments.

It is vital that our insurance framework evolves as quickly as medical science. I believe that policyholders should not be penalised for choosing safer and more advanced medical options. We need a system where coverage is flexible enough to recognise medical progress without waiting years for a definition review.

This is the full question and answer from 7 May 2026:

Regulations To Prevent Insurers From Denying Claims On Newer Procedures Not Explicitly Listed In Legacy Policy Wording

Mr Gerald Giam Yean Song asked the Prime Minister and Minister for Finance (a) whether MAS will review medical insurance contracts to ensure that definitions of surgical procedures are updated to include modern, less invasive medical advances; and (b) what regulatory measures are being considered to prevent insurers from denying claims solely because a newer, more effective procedure is not explicitly listed in legacy policy wording.

Mr Gan Kim Yong (for the Prime Minister): With constantly advancing medical care, it is natural for policyholders to ask if their existing insurance coverage keeps pace with newer, less invasive procedures.

Let me explain how this works for two broad types of health insurance. MediShield Life pays for medically necessary treatments and surgical procedures that are listed in the Ministry of Health’s (MOH) Table of Surgical Procedures (TOSP). MOH regularly updates the TOSP to keep MediShield Life relevant and adjusts the premiums where necessary. Integrated Shield Plans generally align with MediShield Life.

Critical illness insurance, or CI, works differently. Severe stage CI policies pay a fixed lump sum when a person is diagnosed with an advanced stage CI or undergoes a specified major procedure. The Life Insurance Association, Singapore (LIA) regularly updates its standardised severe stage CI definitions to reflect medical advances. Insurers will adopt LIA’s latest definitions when issuing new severe stage CI policies. Existing policies, however, do not assume the updated LIA definitions, as the updated severe stage CI definitions and any associated newer procedures and treatments could widen the scope of policy coverage and increase the incidence of claims. Doing so without a corresponding premium adjustment could impact the sustainability of the product.

LIA is studying the feasibility of allowing policyholders of existing CI policies to adjust their coverage to include newer treatments with appropriate premium adjustments. As there are complex implications on the actuarial assessment, the study will take time.

Meanwhile, I encourage consumers to regularly review the type, coverage and affordability of their health insurance policies in line with their evolving needs. As medical technology evolves, some conditions can now be treated through less invasive procedures with shorter recovery times. For coverage of these treatments, insurers offer comprehensive or early stage CI plans, which cover a broader range of procedures. The scope of coverage and cost for these products varies amongst insurers. Consumers can seek financial advice to help determine the level of protection that suits their needs and budget.

Source: Singapore Parliament Reports (Hansard)


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Author: Gerald Giam

Gerald Giam is the Member of Parliament for Aljunied GRC. He is the Head of Policy Research of the Workers' Party of Singapore. The opinions expressed on this page are his alone.