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[Vegetative state claim dispute] Which insurers include this exclusion clause?
A recent episode of the television programme Scoop reported a medical insurance claim denial case. In that case, the insurer stated that the insured was in a “vegetative state”, which fell under the policy exclusions, and therefore rejected a substantial medical claim. The incident sparked heated discussion online, with many people worrying whether a “vegetative state” is a common exclusion. In response, 10Life reviewed medical insurance products on the market and has so far found several products with exclusions related to a “vegetative state”.
Table 1: Comparison of “vegetative state”-related exclusion clauses across different medical insurance products
Product | “Vegetative state”-related exclusion clause |
AIA | No relevant clause. |
AXA | No relevant clause. |
Chubb Life | The insured has continuously been in a vegetative state with preserved wakefulness but no awareness for more than 28 consecutive days and has received treatment in hospital for more than 90 consecutive days. |
Cigna | Artificial life support, including mechanical ventilation, where such treatment will not, or is not expected to, lead to the “insured person’s” recovery or restoration of the “insured person’s” previous state of health. |
FWD | If the insured person is in a persistent vegetative state with wakefulness but no awareness for more than 4 weeks and has received treatment in hospital for more than 90 consecutive days. |
FTLife | The insured has continuously been in a vegetative state with preserved wakefulness but no awareness for more than 28 days and has received treatment in hospital for more than 90 consecutive days. |
Manulife | If the insured person remains in a persistent vegetative state with wakefulness but no awareness for more than 4 weeks and has received treatment in hospital for more than 90 consecutive days. |
Prudential | If the insured person remains in a vegetative state and has received treatment in hospital for more than 90 consecutive days. |
Voluntary Health Insurance Scheme (VHIS) | No relevant clause. |
| Note: The above list will be updated continuously, where applicable. | |
As shown in Table 1, the vegetative state exclusion clauses under Chubb Life, FWD, FTLife, Manulife and Prudential all refer to situations where the insured remains in a specified vegetative state and receives treatment in hospital for more than 90 consecutive days. In other words, the insurer will only cover the first 90 days of related expenses, while any subsequent costs will have to be borne by you. As for Cigna, it has an exclusion related to a vegetative state, refusing cover for “artificial life support” situations that cannot be recovered from.
On the other hand, AIA and AXA’s premium medical insurance plans do not have any relevant clause, while all VHIS plans on the market also have no vegetative state-related exclusion in their approved product policy template.
As can be seen from the above, the terms and conditions of premium medical insurance plans vary among insurers. Readers should compare carefully. If you have any questions, feel free to WhatsApp our insurance advisers for a free professional opinion.
Further reading:
[Insurance Consultation Room] Minimally conscious state mistaken for vegetative state — is the insurer trying to cut costs?
[CEO’s View] The fallacy of “full reimbursement” medical insurance
Note: This article was last updated on 10 October 2022.
This English version of this article has been generated by machine translation powered by AI. It is provided solely for reference purposes. In the event of any discrepancy or inconsistency between this translation and the original Chinese version, the Chinese version shall prevail.
10Life Editorial Team
Our team of professional content researchers focussing on insurance
10Life Editorial Team
Our team of professional content researchers focussing on insurance
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10Life Product Comparison and 10Life Insurance Ratings are developed by 10Life Financial Limited, an authorised insurance broker company licensed with the Insurance Authority under License Number FB1526. 10Life Product Comparison and 10Life Insurance Ratings are developed for generic customer segments using mathematical calculations based on product information, facts and data, and are not influenced by any partnerships with or fees received from insurance companies. Any information on 10Life Platform ("10Life Information"), including but not limited to Product Comparison, Product Ratings, Blog Articles are intended for general education purpose and reference only. None of the 10Life Information is intended, nor should they be considered or relied upon, as regulated advice, insurance, financial, investment or professional advice, recommendation, approval, endorsement, invitation or solicitation in respect of any insurance, financial or investment products. 10Life Information does not take into account your individual needs. Reading 10Life Information should not be considered as conducting a suitability assessment, and is not sufficient to form the basis of any decisions to purchase any insurance products. You should rely on information authorised by insurance companies, carry out your own research and/or seek independent advice from licensed intermediaries before purchasing any insurance products or making any insurance decisions. While reasonable effort is used when collecting, validating and updating 10Life Information from various channels, none of 10Life Group and its subsidiaries, affiliates, agents, directors, officers and employees will be responsible for any liability, claim or loss arising from or associated with you using 10Life Information. No warranty, representation or guarantee is given by 10Life Group and its subsidiaries on the accuracy, completeness and timeliness of the information. If you have any questions on 10Life Product Comparison and 10Life Insurance Ratings, please email us at enquiries@10life.com
