This is a heavily discussed subject among general public.

I like to use situational example in this:

Patient A went for a checkup after not feeling well and was confirmed by doctors that he contracted cancer stage 4. He had to be immediately admitted to hospital and get further checks and medication done. Its a surprise to him since he was never been diagnosed with it or know about it before. He also aware that he had signed for an insurance policy 3 months back and he would like to use it for the treatment purpose [some insurance type may also provide lump sump of money!]

Now what happen next?

Well in this case, it is likely that when he intend to use the insurance policy, the request is going to be suspended by the insurance company. Why?

The 'incontestability' refers to the assumption that you were 100% healthy at the time you signed up for the policy. Any major illness that you are diagnosed over later such as cancer commonly, if the stage of severity or size of the tumor is not relevant to the timeline i.e you have larger than 5 cm tumor within 3 months of enforced policy, the insurer reserve the right to suspend or even reject the usage of the insurance. Insurer will have a panel of doctors who review and confirm this.

Reason being is to avoid fraud while at the same time protect the insurer themselves as well as other subscribers. Its almost the same as the 120 days imposed if you newly sign up a policy.

I have no comment on Tokio Marine Policy as I do not represent it. The only way to know is to read the policy document and possibly ask around a few hospitals on their claim.

However, it could be challenging for a layman to read an insurance contract as some clauses co-relates with one another. The insurance contract is to be read as a whole, rather than part by part.

Whenever a new policy is started, there is a 120 days Waiting Period for illness that falls under "Specified Illnesses", e.g., kidney stones, slip disc etc. In addition there is a 2 years of "Incontestibility Period" that prevents the insurer from null and void the policy (unless there is clear evidence of misrepresentation of material fact)"

With that being said, let us SWITCH ROLES, shall we? You become the insurer and I become the client. I cancel my old policy (due to "better benefits") and buy a new one from you. I pay you Rm150/mth x 4 mths = Rm 600.

Immediately after the 120 days I want to claim for Slip Disc and the cost is Rm40,000. Will you pay without any form of investigation? No investigation? Sure?

For upgrade, there is no Waiting Period. Any claims below 30 days from the upgrade, it is still claimable under the old policy.

Of course you are required to disclose all material fact that may impact how the poicy is being underwritten before the coverage can be granted.

When you change a new policy, you will need to adhere to the 120 days waiting period for Specified Illness.

At the same time, there is a contestability clause for 2 years which says that the insurance company have the right to deny your claim if it is found to be a fraud (hiding facts upon signing of the new policy).

Meanwhile, instead of just upgrade your medical card, you should also look into your portion on Life Insurance and Critical Illness coverage.

Ok, thank you.
It is almost as the 120 days for newly signed policy, but why it is 2 years for this (incontestablility period)? Isn't this refer to the same situation, how come one is 120 days, another one is 2 years...

For the 120 days. you basically could not use your medical card at all. Some may allow for pay and claim.

For the 2 years, you can use the card/policy as normal but at times depending on the illness, insurer have the right to suspend or deny the request. This heavily depend on their consideration.

Hence the term, take insurance as when you are young as possible. Some parents nowadays even equip their newborn with a policy. 

I did follow what others advice, take insurance as young as possible. But the problem is, the old policy around 10 years ago, the coverage is so low.
New policy with same premium have so much better coverage nowadays. It make me in dilemma now. Need find time to ask my agent how much the premium increase if upgrade. Hopefully not too much.

For the 120 days. you basically could not use your medical card at all. Some may allow for pay and claim.

For the 2 years, you can use the card/policy as normal but at times depending on the illness, insurer have the right to suspend or deny the request. This heavily depend on their consideration.

Hence the term, take insurance as when you are young as possible. Some parents nowadays even equip their newborn with a policy. 

Could we safely say that the insurer(Prudential) will disburse all the medical claim whatsover including any pre-existing illnesses which were not disclosed in the insurance proposal form(i.e insurance application form) after the 2 years incontestablility period?

Thanks for answering.

Short answer, yes they do.

Could we safely say that the insurer(Prudential) will disburse all the medical claim whatsover including any pre-existing illnesses which were not disclosed in the insurance proposal form(i.e insurance application form) after the 2 years incontestablility period?

Thanks for answering.

Hi, prudential expert

If i only want to buy for additional CI coverage, which products of prudential will be good for it? Others basic coverage i ord hav it with other insurance companies

Thanks

No, otherwise what is the point of the 2 years of Incontestability Period?

I mean after the 2 years incontestability period, will prudential disburse any medical claim for the medical expenses that incur after 2 years incontestability period?

So if the client did not disclose that he had cancer / diabetes / hypertension at the time of signing up for the policy and as the matter of fact he had known that he had that health problem upon checking with one of the doctors and choose not to disclose it and so happen that luckily more than 2 years later, nothing happen to him in terms of making a claim and on the 3rd year, he's admitted to the hospital and decides to file for a claim for cancer / stroke / diabetes.

Prudential gonna pay for the claim ?

I have endoscopy last 1 and half year ago due to gastric and found polip in my colon and doctor said it is ok.
Until now seldom have gastric and no medication.
Now I'm applying new policy Life and CI but my agent told me not need to disclose this incidents.
Because i'm no on medication and underwriter can view my health record in the general health system in malaysia.

I want to be disclose and transparent but my agent said not need to disclose, is it ok?

The product you are looking for is PruMultiple Crisis Cover.
<< PruMultiple Crisis Cover >>

<< PruMultiple Crisis Cover Brochure >>

Hi roy

1. from what i hav read from multiple crisis cover, the insured person can claim 3 CI each from 6 CI group. Mean to say that let say sum insured is 100k, then insured person can claim up to 300k within the term period? (For none repeating CI)
another questions

2. If a person need 1m sum insured for life, is that preferable to buy 3 life policy ? (Let say 200k, 300k, and 500k)

3. If 500k and 300k life sum insured only needed for 30 years and 40 years each. Is that preferable to buy in terms insurance  or  wholelife insurance and surrender it when reach 30 and 40 years each ?

Thank you

Hi Roy,

I have signed up Pruvalue Med up to 80 years old on 4 July 2017, and the application is still under processing.
Lately, Prudential introduces automatic medical coverage till 100 years. I thought  it is better to take this opt than buying medical coverage till 80 years old.

How to change the period of medical coverage from 80 years old to 70 years old when the application is still under processing.

Thank you.