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 All about PRUDENTIAL & insurance updates!, any insurance related issue are welcome

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NyD-WiLL
post Sep 20 2017, 03:27 PM

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Guys, i bought my Prudential medical card insurance around 6 years ago.

RM50k annual limit, RM1 million life time, no outpatient available, only cover to age 70, RM20k for CI, RM30k for Death/TPD.

I met one agent from Tokyo Marine, he quote me below with RM150+ premium:
No annual limit, RM1 million life time, As charged and opened up to life time limit for outpatient, cover till age 90, RM60k for CI, Life Assured to age 70, RM60k for Death/TPD.

With my situation, upgrade current medical card or surrender and buy the new one from Tokyo Marine? If surrender and buy new, how long period i need to wait before i can claim IF something happen in the future? This agent tell me only need to wait 4 months but i read somewhere need wait at least 2 years when change plan or else the company have the right to reject claim?

Please enlighten me. Thanks.
NyD-WiLL
post Sep 21 2017, 04:38 PM

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QUOTE(roystevenung @ Sep 20 2017, 04:03 PM)
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.
QUOTE(lifebalance @ Sep 21 2017, 10:25 AM)
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.
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So i guess upgrade should be a better option for me. Thanks for the help guys. thumbup.gif
NyD-WiLL
post Sep 22 2017, 12:06 AM

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QUOTE(bluepenguinKills @ Sep 21 2017, 04:47 PM)
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.  thumbsup.gif
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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. sad.gif
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. sad.gif

 

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