Your Insurance Claim Was Denied in Singapore: Exactly What to Do Next

If your insurance claim denied Singapore and you don't know where to turn, you're not alone. Singapore's insurance system has clear, fair rules that give you multiple paths to challenge a rejection. This guide walks you through every option, from internal appeal to independent mediation.

The good news: Singapore has one of the world's strongest consumer protections for insurance disputes. The Monetary Authority of Singapore (MAS) oversees all insurers, and you have legal rights to appeal any decision you believe is wrong.

Let's get you unstuck.

Your Rights When an Insurance Claim Is Denied in Singapore

Singapore law protects you. Here's what you need to know immediately:

MAS Regulations: All insurers must follow the Insurance Act and MAS guidelines. No insurer can simply reject your claim without proper cause or a clear explanation tied to your policy terms.

Your Appeal Right: You have the legal right to appeal. This isn't a favour—it's your protection.

The FIDReC Route: If your insurer doesn't resolve your complaint internally, you can escalate to the Financial Industry Disputes Resolution Centre (FIDReC), which is free and independent.

Timelines Matter: Your insurer must respond to your appeal within 4 weeks. If they don't, that's a regulatory breach.

The key point: You are not powerless. The system is built to let you be heard.

Step 1: Understand Your Insurer's Reason for Denial

Before you appeal, you need to know exactly why your claim was rejected. Your insurer must have given you a written reason. Find that letter—right now.

Look for these details:

• The specific policy clause or condition they cite
• What they claim you didn't meet
• References to exclusions or waiting periods
• Any medical or factual basis for their decision

If the reason seems vague (like "not covered" without detail), that's already a red flag for your appeal. Vagueness is often a sign the insurer hasn't properly reviewed your case.

Common denial reasons in Singapore include:

• Pre-existing condition exclusion
• Waiting period not met
• Claim falls under policy exclusion
• Insufficient medical documentation
• Non-disclosure of health information

Each of these can be challenged with the right evidence and argument. The question isn't whether you can appeal—it's how to appeal effectively.

Step 2: File Your Internal Appeal with the Insurer

Your first step is always an internal appeal. This is your chance to convince the insurer to reconsider.

Timeline: File your appeal within 14 days of the denial letter. Don't wait—most policies have time limits, and regulators expect prompt action.

How to Appeal:

1. Write a formal letter addressed to the insurer's Claims or Compliance department
2. Reference your claim number and policy number
3. State that you are formally appealing the denial
4. Attach any new evidence (medical reports, treatment guidelines, letters from your doctor)
5. Explain calmly why you believe the denial was wrong

What to Include:

• A clear statement: "I am appealing your denial dated [date]"
• Reference to specific policy clauses you believe support your claim
• New or overlooked medical evidence
• Any documentation showing you met the claim conditions
• A polite but firm tone (not emotional, not aggressive)

What NOT to Include:

• Accusations or insults
• Emotional language or complaints about the process
• Threats
• Information not directly related to your claim

Send this by registered mail or email with delivery confirmation. You need proof you sent it and when.

What to Expect: The insurer has 4 weeks to respond. They should either approve your claim or explain in detail why they're still rejecting it.

Step 3: Escalate to FIDReC (Financial Industry Disputes Resolution Centre)

If the insurer rejects your internal appeal, or doesn't respond within 4 weeks, you can escalate to FIDReC for free.

What is FIDReC? FIDReC is Singapore's independent dispute resolution body for financial complaints. It's impartial, doesn't charge you anything, and can order insurers to pay compensation up to SGD 100,000.

Who Can Use FIDReC?

• Any person (individual or business)
• Any claim value up to SGD 100,000
• Any dispute with a regulated financial institution

How to Lodge with FIDReC:

1. Gather all documents: denial letter, internal appeal, medical evidence, policy document
2. Complete FIDReC's complaint form (available at fidredc.org.sg)
3. Submit online, by mail, or in person
4. Include a clear summary of why you believe the denial was wrong

What Happens Next:

• FIDReC reviews your case
• They may ask both you and the insurer for more information
• They aim to resolve it within 6 months
• If they determine the insurer was wrong, they can order the insurer to pay your claim plus interest and compensation for inconvenience

FIDReC decisions are binding on the insurer (up to SGD 100,000). Once they rule in your favour, the insurer must comply.

Step 4: Use the ISP Scheme (If Applicable)

For certain complaints, Singapore also has the Insurance Intermediaries Scheme (ISP), which covers disputes with insurance agents and brokers.

If your issue involves:

• An agent or broker's negligence
• Misrepresentation in the sale
• Failure to disclose information properly

...then the ISP may be your route. This is separate from FIDReC and handles intermediary disputes.

Check whether your initial issue was actually caused by your agent (e.g., they didn't disclose a health condition, so the insurer has grounds to reject) or by the insurer itself.

Step 5: Know the CCRP Process

Some insurers are part of the Claims, Complaint and Redress Policy (CCRP) framework set by MAS. This adds extra protections:

• Insurers must have clear, documented claims procedures
• They must treat you fairly during the claims process
• They must respond to complaints in writing with full explanations
• They must have an independent internal reviewer for appeals

When you appeal, ask the insurer: "Is this claim being reviewed under your CCRP process?" If it is, that's good—it means they're following stricter rules.

What Evidence Will Strengthen Your Appeal?

Don't just argue—prove your point. Gather:

Medical Evidence:

• Doctor's letter stating your condition was not pre-existing (if applicable)
• Medical reports or test results showing the condition existed before the exclusion period
• Treatment records showing medical necessity
• Clinical guidelines (Milliman, InterQual) showing your treatment aligns with industry standards

Policy Clarity:

• Highlighted copy of the relevant policy clause
• Written confirmation from the insurer's agent about what was covered (if available)
• Comparison to similar cases you may know of

Timeline Evidence:

• Proof you notified the insurer within required timeframes
• Emails or letters showing your communication history

Documentation:

• Receipts, invoices, or bills for the treatment
• Records of all previous claims (to show patterns or discrepancies in how the insurer treats similar claims)

The stronger your evidence pack, the faster your appeal will be approved.

Common Denial Reasons in Singapore—And How to Fight Them

"Pre-existing condition": Insurers often use this to exclude chronic conditions. Fight back with: doctor's letter stating the condition wasn't present before the exclusion period, medical records proving the timeline, or evidence showing you disclosed the condition honestly.

"Not medically necessary": The insurer claims the treatment wasn't clinically justified. Respond with: doctor's letter explaining why the treatment was necessary, clinical guidelines supporting the treatment, similar case precedents.

"Waiting period not met": Your claim is for something that has a waiting period, and you haven't waited long enough. This is harder to challenge unless you can prove the condition existed before you purchased the policy.

"Insufficient documentation": Ask exactly what's missing. If the insurer is vague, that's a sign of a weak case. Push back with detailed medical records from your doctor.

"Exclusion applies": The insurer says the policy excludes the type of treatment. Counter with: policy wording that contradicts this interpretation, evidence of industry standards for what "exclusion" means, or a letter from your doctor explaining the medical necessity.

Practical Timeline: How Long Will This Take?

• Internal appeal: 4 weeks
• FIDReC complaint: 6 months (from date of lodging)
• Total: 7 months in most cases

If the insurer rejects quickly (within 1-2 weeks), that's a red flag. A good review takes time.

In the meantime, don't pay medical bills yourself if you can avoid it. Many healthcare providers will wait while you appeal.

What If You Need Help Writing Your Appeal?

Writing a formal appeal is stressful. Getting the legal language wrong can hurt your case. That's where professional help can save you time and stress.

ClaimBack can analyse your case and write your appeal letter in minutes — Start Free →

Our AI reviews your denial letter, your policy, and your medical records, then generates a professional appeal tailored to Singapore's FIDReC and MAS requirements. You review it, send it, and let the insurer see how serious you are.

Final Checklist Before You Appeal

• I have my denial letter
• I know the exact reason for denial
• I have gathered all medical evidence
• I have my policy document highlighted with relevant clauses
• I have drafted or obtained a formal appeal letter
• I have proof of how I'll send it (registered mail or email with read receipt)
• I know the 4-week deadline for the insurer's response
• I have FIDReC's contact details and website bookmarked
• I have the MAS website saved (mas.gov.sg) for any regulatory questions

You don't need a lawyer to win. You need clarity, evidence, and persistence.

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Disclaimer: ClaimBack provides AI-generated appeal assistance for informational purposes only. ClaimBack is not a law firm and does not provide legal advice. Always review your appeal letter before sending and consider professional advice for complex or high-value claims. Regulatory processes vary — always verify current procedures with your insurer or regulator.

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Ready to fight your denial? ClaimBack analyses your case and writes a professional appeal letter in minutes — Start Free →