Integrated Shield Plans - Potential Claim Dispute

I took up the "Private Hospital" plan for my Integrated Shield (IP) plan and everything is "As Charged". Or is it really "As Charged"?

Beware.

For "Private Hospital" plans it normally covers only the "standard ward". Should someone warded under "deluxe" or "luxury suite" or whatever ward that's non-standard, pro-ration will apply! And it can be BIG pro-ration.

Let's have a look at one of the "Private Hospital" IP plan's policy wording:

E.g. Mr.A covered under Myshield Plan 1 hence entitle to stay in private hospital standard ward. However upon admission, for whatever reasons, he admitted to luxury suite instead.

Room rate for standard ward	$500/day
Room rate for luxury ward	$1,500/day
Pro-ration factor applicable	500/1500 = 33%
Total hospital bill incurred	$100,000
Total claimable (after pro-ration of 33%)	$33,333
Total non-claimable	$66,666

Mr.A has to pay :$66,666


Mr.A might say that it is the hospital who "auto upgrade" the ward type for him or no standard ward available so no choice have to take luxury suite. Whatever the reason, Mr.A has enjoyed the luxury suite and may be "special care" that comes with luxury suite and nothing comes free. In the policy wordings it already stated clearly that they will only pay for expenses incurred when they stay in standard ward, therefore it will be a near zero chance to try and claim for the "luxury comfort".