Great Eastern Insurance Claim Denied: How to Appeal (Singapore and Malaysia)

Great Eastern Insurance Claim Denied: How to Appeal (Singapore and Malaysia)

Great Eastern is the oldest and most established insurance group in Singapore and Malaysia, with roots dating back to 1908. Its scale and longevity make it one of the most commonly encountered insurers for policyholders in both markets. If Great Eastern has denied your insurance claim, this guide provides a market-specific guide to appealing and escalating your case effectively.

About Great Eastern

Great Eastern Holdings Limited is listed on the Singapore Exchange (SGX) and is 87%-owned by OCBC Bank. Its primary operating entities are:

• Great Eastern Life Assurance Company Limited (GEL): Singapore life insurance, regulated by MAS
• Great Eastern General Insurance Limited (GEG): Singapore general insurance, regulated by MAS
• Great Eastern Life Assurance (Malaysia) Berhad: Malaysia life insurance, regulated by BNM
• Great Eastern General Insurance (Malaysia) Berhad: Malaysia general insurance, regulated by BNM

Common Great Eastern Denial Patterns

Non-disclosure and material misrepresentation: Great Eastern, as a large life insurer, regularly investigates non-disclosure in death, critical illness, and TPD claims. Claims investigations often uncover medical histories (obtained via consent to access medical records) that were not declared at application. Great Eastern will then deny the claim citing non-disclosure of the pre-existing condition.

Critical illness — definition-based denials: Great Eastern's critical illness products (including GREAT CareShield and SupremeHealth riders) use clinical definitions that can be restrictive. Common denial patterns include:

• Cancer not meeting the "invasive" standard
• Heart attack not meeting ECG or troponin enzyme thresholds
• Stroke without sufficiently documented permanent neurological deficit
• Kidney failure claims where dialysis dependency is disputed

SupremeHealth and IP claim disputes: Great Eastern's SupremeHealth Integrated Shield Plans generate a significant volume of complaints related to:

• Medical necessity of procedures
• Ward class entitlements
• Pre-authorisation (Letter of Guarantee) issues for elective admissions
• Disputes about whether a procedure is covered under the IP rider

Income protection and early critical illness claims: Great Eastern's income protection products are subject to "unable to perform own occupation" tests that generate disputes, particularly where the insured has returned to modified work arrangements.

Travel insurance denials: Great Eastern's travel insurance products are a common source of claims disputes involving trip cancellation, travel delay, and medical expenses while overseas.

Appealing a Great Eastern Claim Denial in Singapore

Step 1: Internal Appeal to Great Eastern Singapore

File a formal written complaint to Great Eastern Life or Great Eastern General (depending on your policy type).

Contact — Great Eastern Life:

• Phone: 1800 248 2888
• Email: Available through greateasternlife.com
• Written correspondence: Great Eastern Life Assurance Company Limited, 1 Pickering Street, #01-01 Great Eastern Centre, Singapore 048659

Contact — Great Eastern General:

• General insurance queries through the same customer service channels

Under MAS guidelines:

• Great Eastern must acknowledge your complaint within 5 business days
• A final response must be provided within 21 working days

Your appeal letter is critical. It should:

• Quote Great Eastern's denial reasons verbatim
• Address each ground with policy references and supporting evidence
• Include specialist medical reports where clinical definitions are disputed
• Reference MAS Fair Dealing Guidelines (FAA-G11) and the Insurance Act
• State your intention to escalate to FIDReC and MAS if the matter is not resolved

ClaimBack at claimback.app helps you generate a professionally structured, MAS-aligned appeal letter for Great Eastern Singapore disputes. The tool ensures you address all denial grounds effectively and reference the correct regulatory framework.

Step 2: Escalate to FIDReC

If Great Eastern's response does not resolve your dispute:

FIDReC (Financial Industry Disputes Resolution Centre)

• Website: fidrec.com.sg
• Disputes up to SGD 100,000
• Free for consumers
• File within 6 months of Great Eastern's final response

FIDReC mediation resolves approximately half of all insurance disputes without adjudication. Well-prepared parties with strong documentation have better outcomes.

Step 3: Report to MAS

For regulatory conduct concerns (mis-selling of SupremeHealth, unlicensed advisory activity, systemic unfair dealing in claims):

• MAS Complaints Portal: mas.gov.sg/complaints

Appealing a Great Eastern Claim Denial in Malaysia

Step 1: Internal Appeal to Great Eastern Malaysia

File your formal complaint with Great Eastern Life or Great Eastern General Malaysia.

Contact — Great Eastern Malaysia:

• Phone: 1300 1300 78
• Website: greateasternlife.com/my
• Written correspondence: Great Eastern Life Assurance (Malaysia) Berhad, Menara Great Eastern, 303 Jalan Ampang, 50450 Kuala Lumpur

Under BNM guidelines:

• Great Eastern Malaysia must acknowledge complaints within 5 working days
• A substantive response must be provided within 14 working days (extendable to 30 for complex cases)

Step 2: Escalate to OFS

If the internal appeal is unsuccessful:

Ombudsman for Financial Services (OFS)

• Website: ofs.org.my
• Disputes up to RM 250,000
• Free for consumers
• File within 6 months of Great Eastern's final response

Step 3: Report to BNM

For regulatory conduct concerns:

• BNM BNMTELELINK: 1-300-88-5465
• Email: bnmtelelink@bnm.gov.my

Specific Advice for SupremeHealth IP Disputes (Singapore)

Great Eastern's SupremeHealth plans are Integrated Shield Plans regulated jointly by MAS and the Ministry of Health (MOH). For SupremeHealth claim disputes:

• Medical necessity: Obtain a letter from your treating specialist explaining clinical necessity. For elective procedures, document failed conservative treatments.
• Pre-authorisation: If a Letter of Guarantee was not obtained, provide evidence that the admission was an emergency or that you attempted to obtain pre-authorisation and were not able to.
• Ward class: Check your plan's entitlement carefully. Great Eastern SupremeHealth plans cover different ward classes (A, B1, private) depending on the tier purchased.
• Panel vs. non-panel hospitals: Verify whether your hospital and surgeon are on Great Eastern's panel. Using a non-panel provider may result in reduced benefits.

Building Your Great Eastern Appeal: Key Tips

1. Get your diagnosis confirmed in writing by a specialist, not just a GP. Great Eastern's critical illness claims are reviewed by its medical team — you need specialist-level documentation to counter this.

2. Request a copy of Great Eastern's clinical guidelines for the condition at issue. These guidelines define how Great Eastern interprets policy definitions, and knowing them helps you address the specific criteria being applied.

3. For non-disclosure disputes, timeline your medical history carefully. Establish when symptoms first appeared, when you first consulted a doctor, and what was diagnosed versus what was speculative before the policy was issued.

4. Use ClaimBack at claimback.app to generate a structured, market-specific appeal letter that presents your case effectively to Great Eastern's appeals team.

Conclusion

Great Eastern claim denials — whether for critical illness, hospitalisation, or life insurance — are frequently challenged successfully on appeal. The key is a well-documented, legally grounded appeal that directly addresses the denial grounds with strong clinical and factual evidence. Use ClaimBack at claimback.app to build your appeal, and escalate to FIDReC (Singapore) or OFS (Malaysia) if the internal process does not produce a fair outcome.