hi,

if you are referring to Etiqa's cash back plan, that is more for savings and its a traditional plan.

I would suggest you getting a Prudential's investment-linked plan with full comprehensive insurance coverage (all-in-one package) with investment returns (savings).Pru is the pioneer in Malaysia for investment-linked type of insurance plan. Starting from a min of *rm120 per month based on your age, or as per your budget. Premium should be more or less 10% of your income to ensure adequate amount of coverage. You can actually adjust the premium and coverage amount too in future, that's the flexibility of inv-link policy.

comprehensive coverage means the plan has:
med card
36 critical illness
life/tpd
personal accident
minor accident claim reimbursement
Waiver of Premium (upon diagnosis of critical illness or tpd)
investment returns (savings)

once you have a strong plan with comprehensive coverage, then you can decide to take up a savings plan like etiqa's if you wish too. The point is, always have a strong foundation (protection) before allocating your budget for a savings plan first then only buying a protection plan later. That's 'terbalik'.

pls let me know if you would like to know more about the comparison between the ins plans you mentioned and I can share more too about the benefits of our ins plans.

thanks

If there is no payment from Prudential to hospital during the investigation period of nearly 2months
1)Do the policyholder allowed to discharge within the investigation period of 2 months? example a week after hospitalize or they have to stay in hospital for 2 months while waiting for the investigation result?
2)If the answer on question 1 is "yes, they are allowed to discharge(obviously)", since nothing will be paid to hospital from Prudential during the investigation. Do Prudential policyholder can discharge without the policyholder themselves pay first from policyholder own money to the hospital?

Of course they are allowed to be discharged after a week. No medical card in the market is able to keep them in the ward for no medically necessary for 1-2 months.

There is nothing paid to the hospital. Yes they are allowed to be discharged since the initial GL has been issued.

So, do Prudential policyholder can discharge without the policyholder themselves pay first from policyholder own money to the hospital?

Initial GL has been issued, of course they are allowed to be discharged.

Initial GL has been issued and the claim is in the midst of investigation, who will pay the bill upon the client discharge?
A)Client pay and claim back later
B)Hospital will absorb the bill first and wait for the investigation result from Prudential
C)Prudential will pay on behalf of the client even it's still investigating

This post has been edited by ExpZero: Apr 9 2014, 01:10 AM

Guarantee Letter (GL( from Insurance company. it is between Company and the Hospital. So GL is a form of payment guarantee between this two parties. Client can be discharged of the payment liability hence get discharged.

any other investigations, fraud by policy holder, concealment of health history etc IS Between Policy Holder and the Insurance company. If investigations after GL was issued lead to this; then it is up to the insurance company to deal with the policy holder as it deem fit, as per the insurance companies' own standard of practices.

Ezpro, we all know this is the standard. Pls don't mislead as if GL is not as good as payment. If this is the case then Ned Cards have no use to hospitals because it is not a form of guarantee.

that is why there is an ' INITIAL ADMISSION REPORT' when policy holder gets admitted. This is done once hospital need to admit the policy holder. This will give the ins company time to access the need to admit, the policy holder's health history and if the illness is covered.

GL is not easily given out, and once its given out, its as good as payment.

Prudential med card is always welcomed at all the major hospitals, because of above reasons. We don't pull out the GL once issued. Therefore our underwriting may be strict ad per industry guidelines for new clients before issuing of policy, and reports during admission by Doctors must be detailed.

I can accept what you are saying but not Roy's because GL is an agreement from the insurance company to pay on behalf of the policyholder while in-patient.
I think he has missunderstood the definition of Guaranteed letter and claim status.

I don't see the point of Roy saying that Prudential approved GL and then investigate shall proceed and policyholder have to pay from their own pocket money for the bill first.(Awaiting confirmation from Roy). Because I don't see a point of approving GL without guarantee the payment.

Whatever Roy are explaining is like
1)policyholder went to hospital
2)GL issued
3)policyholder is happy and thought that his claim is approved, so he hospitalize
4)The next day, GL is under investigating for pre-existing non-disclosure and is withdrawn (please bear in mind, there is some possibility but not all in Prudential according to Roy's statement)
5)policyholder gotta pay to hospital first and claim back.

I don't see the reason why GL is issued since Prudential don't guarantee the claim.

I have mentioned multiple times that if the above scenario happen, it simply means that the GL actually has been declined.

Apart from the official statement from Prudential Customer Service Officer as per what I have mentioned few days before. Finally today I have received the official statement from Prudential via email.


As we all know that when GL is approved, it means that the HAS staff determines that the case is coverable and it is an assurance of payment offered by insurers to hospitals, client's claim is absolutely Guarantee by the Insurance company up to the annual limit/lifetime limit.

In the official Prudential statement above, it simply means that Prudential won't 100% issue the Guarantee Letter to policyholder, which is in-line with all my posts before this that all GL is subjected for approval in the whole industry with no exceptional.

The initial GL issued is to help the client of not having to fork out substantial amount.

I stand by my statement that we will issue the GL should initial check reveals that it is not a pre existing illness no matter if it is below 1 year.

There is no clause in the policy document that says the GL will not be issued and client need to pay and claim in a Malaysian hospital if the policy is say 11 months.

That is really absurd.

i have bought my medical card in 2012, which also covers death benefits from Alliaz...is it necessary to get another insurance for life coverage?

I really don't understand the why would "your Prudential"(I used "your Prudential" because your protocol isn't in-line with official Prudential statement) issue the GL without guarantee to pay for the bill upon discharge. What's the different between issue GL and decline GL then? To make client happy for........1 day? and feel tremendously sad afterward if withdrawn?

Your statement isn't the same with ChrisGood which is from Prudential as well. Your statement isn't in-line with Prudential's official reply either from customer service verbally or written in by the email.

Please provide further evidence to back your statement up.

I believe yours is Allianz's Powerlink which is a comprehensive plan. Honestly you can just upgrade your life/TBD coverage from your existing plan, no need to have a separate plan (only if there is special purpose).

I believe your agent can help you on this, or you can just call/walk in to Allianz office for assistance.

Regards

Oh come on.

You and I know that it would be very unfair to the client if they are needed to pay Rm30k for the treatment and claim it back later even if they had declared everything and it is not a pre existing illness for policies below 1 year. Not everyone is able to fork out that amount, which is why they took insurance in the first place.

For your procedure do you think the client will be happy to know that since they had paid themselves hoping to claim from the insurer but the investigations by the insurer shows that it is a pre existing, will they be jumping with joy?

There is nothing mention in the policy document that forbids the issuance of the GL if the policy is below one year.

Of course if the initial investigations shows that it is a pre existing, the GL will be declined. Once the initial GL has been issued it is very unlikely the GL will be withdrawn unless there is enough evidence to proof otherwise.

For new policies, of course investigations will be done once the hospital/Doctor submit the reports which happens only after the client is discharge. Without those reports how on earth do you even start an investigations?

Evidence had been snapshot and provided.

Yes. you are right. It is Powerlink Plan. The death benefit as per sign up is only 120K...

Yes just upgrade on the same policy since it is an ILP. No point paying for additional policy charge to start a new policy. In Prudential the policy charge is Rm60 per annum.

You are right in your sense that not everyone can afford to pay the bill upfront, then how can official Prudential email said that they will decline the Guarantee Letter as per my attached email snapshot?

You mean hospital let the client discharged without anyone pay the bill? seriously?

If even the initial investigation during the admission process shows that it is a pre-existing, any insurer will definitely decline the GL. If not GL will be issued within an hour or two.

When someone gets discharged from the hospital, the payment from the insurer to the hospital will only occur once the hospital has submitted the invoice & necessary medical reports to the insurer.

The original hospital invoice is needed for the insurance accounts department to pay. Do you think the insurance accounts department sit in the hospital all day for this?

It definitely won't be paid on the spot when the discharge occurs.

During this time, if the policy is still new and the claim is substantial you can bet the insurer will cross check to the clinics or any other private hospital for pre-existing.

Insurance company account department don't have to sit in the hospital in any day of the month to make the payment, you seriously think that Prudential have an account department in every hospital?

The invoice is guaranteed to-be-paid on the spot when discharge occur, hospital won't allow the policyholder to leave the hospital without payment. It's the same like general insurance for car accident, do you think that without the payment from insurance company or client, the workshop will help you to repair your car first? And let you leave with your car without payment?

Whatever you are saying are totally wrong and not as per the original procedure by Prudential or any insurance company. As long as the claim is substantial and when the insurer is cross checking to the clinics or any other private hospital for pre-existing, no claim is payable to the hospital and the client will have to fork out the money first.

This is the reason Prudential replied my email with "will not ask you to pay back after your admission"(highlighted red). If the procedure is as per what you have described, the Prudential email will be saying "If after the cross checking with other health institution and found out to be pre-existing, we will ask you to pay back after your admission", but this will not occur because this is not insurance company's procedure.

I strongly recommend you to email Prudential and prove to all the readers in this thread that the procedure is as per what you are trying to tell us by attaching the email content here.

Did I say that we have an accounts department in every hospital? Why are you twisting the facts?

The issuance of the GL does not mean money has been transferred and paid. The insurance accounts department will not issue any cheque/transfer money to the hospital without the original invoice in their hands.

Any business for that matter will require the original invoice before any payment is made by the accounting, otherwise how do you declare tax during audit?!

Furthermore the GL letter is not a recognize document in the accounting system for initiating the payment process. It is a rather just a supporting document unlike the ORIGINAL INVOICE.

Prudential will not ask the client to pay back because no money has been paid by the client to the hospital as the initial GL has been issued.

The actual payment from the accounts dept to the hospital (based on the GL/invoice) will only happen after sighting of the original invoices (and other relevant documents) from the hospitals.

--

Fact is we will issue GL even if the policy is below 1 year once the waiting period is over, and the initial check is not a pre-existing illness.

The reason is because the policy document does not have a clause that says the client will need to pay and claim if the policy is below 1 year. It is down right ridiculous and not to mention legally not right if the client is being denied of the issuance of the GL on grounds of suspicion without any hard evidence.

To find that hard evidence of non-disclosure/pre-existing needs time to scan thru the clinics/hospitals. It is impossible to do it within an hour.

The issuance of the initial GL means that the client does not need to fork out RM30K.

This is also my last post to reply to your questions on this. It has been repeated once too many times and it is time wasting.

You are simply implying that insurance do place their staff in hospital to do the payment which I found it ironic.

There is no clause to say that GL will be guaranteed to be issue by Insurance company in the policy nor verbal nor email by Prudential and yet as an Prudential's representative yourself had overwrite the procedure of your own company without their official consent.

I'm requesting the fact(which is not the word you utter) but rather the words from official Prudential to be attached here as a proof to support your statement but I'm yet to see any. Contradictory, I have several proves to back my statement up either verbal or by written. If any of the readers would like to know more, please call to Official Prudential hotline to know more about the procedure as a supporting evidence that I have found.
Prudential Call Centre: 03 - 2116 0228
Operating Hours : Mondays to Fridays, 8.30am - 5.15pm (excluding Public Holidays)

I don't feel that this is time wasting as claim procedure is the major consideration when client are purchasing insurance. Client are purchasing insurance in hoping for a honest agent and not mislead information. I'm writing this to avoid the readers in this thread to be mislead about the procedure of claim by insurance company.