NTUC sucks big time.. see article:
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15 years after stroke, he wins full payout
Judge ticks off insurer for its treatment of client
By Crystal Chan
August 16, 2007
WHEN Mr Chiang Soong Chee suffered a stroke, he went from a man
capable of lifting drums of paint to someone resigned to signing
cheques in the family-run paint store.
He was no longer able to handle his old tasks.
Never mind, he thought, he could always rely on his insurance
payout.
But after making the first five instalment payments, NTUC Income
held back on the remaining amount.
The insurance company, which is the biggest here with more than 1.8
million policy holders, argued that Mr Chiang was not totally and
permanently disabled.
And he was able to work, though not at the same job he held
previously.
Mr Chiang, disagreeing with the insurer, sued for the remaining
$90,000.
And won.
SEVERELY PARALYSED
Mr Chiang became severely paralysed in his left limbs after a
stroke in 1992.
He had bought a life insurance policy in 1988, which said that
Income (then NTUC Co-operative Insurance Commonwealth Enterprise)
was to pay $150,000 in 10 annual instalments if he became totally
and permanently disabled.
But after the stroke, Mr Chiang was told by his insurance agent
later that year that his disability did not meet Income's
criteria.
The agent was not named in the court papers.
In March 2001, during a chat with friends, Mr Chiang was urged to
go ahead and make the claim.
He decided to act on their advice and registered his claim.
By this time, after nine years of being treated by neurologist Dr
Tong Hoo Ing, he was able to walk, albeit with a limp.
In August that year, Mr Chiang was examined by Dr Tong and another
doctor. Both doctors certified him as totally and permanently
disabled.
Initially, all went well with his claim.
The insurer accepted the doctors' findings and in Sep 2001 told Mr
Chiang that it would pay him four annual instalments of $15,000
each.
The first payment was made in late 2001. A final instalment of
$90,000 would be paid in 2005.
Mr Chiang was paid the first $60,000, but things then went
awry.
Before Income made the final payment in Jan 2005, it asked Dr Tong
to clarify Mr Chiang's current condition, which it was entitled to
do under the policy.
This time, Dr Tong certified that Mr Chiang was not totally and
permanently disabled, but maintained that he was
unemployable.
This was because while Mr Chiang was mobile, he still carried a
limp and had poor short-term memory.
Income then decided not to pay Mr Chiang the remaining $90,000,
saying he was no longer totally and permanently disabled.
So Mr Chiang filed a suit.
He was awarded judgment last month in the Subordinate Courts by
District Judge Lim Wee Ming, who rapped the insurer for its
treatment of Mr Chiang.
The judge said the insurer could not provide a clause to attract
potential customers, only to make it difficult for them to claim
the money.
Said District Judge Lim: 'Income cannot on one hand have a clause
that appears more acceptable to potential customers but when they
seek to enforce it, Income be allowed to take advantage of the
ambiguity against the customer.'
In his affidavit, Mr Chiang said that before the stroke, he
handled, stacked, moved and delivered drums and tins of
paint.
His lawyer argued that because of the stroke, he was no longer able
to carry out such work.
As a result, his work with his family business is limited to
signing cheques and bank documents.
Mr Chiang's present role in the family business was minor compared
to what he was doing before, and he remained employed only out of
his siblings' sympathy.
His doctors also testified that Mr Chiang was unable to do manual
work.
The main issue for the court was the interpretation of the policy,
which stated that the disability must be total and permanent such
that the insured person is unable to earn a living.
In its defence, Income said it had observed a strict interpretation
of the policy, which meant that Mr Chiang, even if only signing
cheques and bank documents, was gainfully employed.
Under a broader interpretation, the court would consider work as
that which the insured was doing when he bought the policy.
But Income claimed that Mr Chiang would have to show that he could
not do any work whatsoever, regardless of his occupation when he
bought the policy.
The judge disagreed, saying that the phrase 'regardless of the
usual occupation of the Life Assured' was not mentioned in the
policy.
In his judgment, Mr Lim wrote: 'Obviously, such a provision would
have made the policy less palatable to potential customers.'
The judge also noted that Income's strict interpretation of the
policy would then apply only to extreme cases, such as brain damage
or vegetable-like existence.
And that was not fair.
He was satisfied that Mr Chiang qualified for the payout as he
could not continue the work he did before the stroke.
Mr Chiang declined comment when contacted at his home, but a staff
member at his family's shop, Sai Sia Paint, said he still works
there.
Income's lawyer, Mr Sundararaj Palaniappan of Straits Law Practice
LLC, told The New Paper that his client plans to appeal.
