Hey Roy,

I don't really understand about your screenshot as I saw that the "registration date" was 1/10/2012 and the "decision made" is 18/12/2012 for the PruHealth hospitalization amount, not pre/post hospilization. Is this the way Prudential show GL as accepted in system?

To all,
Even in Great Eastern do approve GL within the first half of the year for illness that can't be pre-exist. However, I will surely let my client to say that GL will approve first prior investigation within the first year. In Great Eastern, once the GL is issued, it won't be withdrawn.

Yeap, there is no clause in the policy document that mention GL will not issued for new policies even if it had surpasses the waiting period, it's the same that in the policy document do not have a clause to say that GL will surely issue after the waiting period.

Utmost good faith by declaring all the actual fact of client's physical health is definitely a must in the whole industry. However, do policyholder have the practise to return the money back to Prudential after the GL is withdrawn after discharge? Or Hospital is the one who will assign someone to collect the money from policyholder if the GL is withdrawn after discharge?

How quick Prudential for the investigation period to check for evidence of pre existing illness?

Edit: Typo

How if GL issued, but after 1-2months and get withdrawn?

I'm not sure why do Prudential's Customer Service Officer Shanti, told me about not covering the minor illness regardless of waiting period, I'm suggesting you to call the Prudential hotline and ask for clarification from Shanti.

In your paragraph 5, In the case of further investigation, there is no way that the insurer will be able to check for hospital or clinical records within an hour or two. Are you suggesting that Prudential will issue the GL, then Prudential will proceed with the investigation for 1-2months? Let's say client discharge after a week, If and only if the investigation result came out after 1-2months to be pre-existing and non-disclosure and since Prudential issued the GL and paid for the bill, will Prudential ask the client to pay back the bill?

For paragraph 4&5, in short, that means Prudential will decline for GL shall they suspecting pre-existing illness non-disclosure.

After I have cross check with 3 customer service officer, I'm pretty sure that Prudential will declined the GL if they suspect there is pre-existing. They will triple confirmed with me that such protocol of issue GL and investigation follows afterward doesn't exist in their protocol.

In Great Eastern, once GL issued, investigation will be ceased and the claim is approved, there will be no withdrawal of GL. Shall Great Eastern is suspecting the claim could be pre-existing non-disclosure, the GL will be declined and client will have to pay and claim. Investigation will start upon claim process and this exact protocol is in-line with the Prudential Customer Service Officers statement.

Just call to the hotline and you will understand the procedure and protocol of claim.

If Prudential issued GL, policyholder discharge after 2 days, Prudential made the payment to hospital. Prudential continue with the investigation 1-2months and found out to be pre-existing non-disclosure, how do Prudential request the policyholder to return the large sum of medical bill back to Prudential?

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?

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

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.

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

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?

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.

^ again you are twisting the facts. You can't even differentiate between a statement and a question.

Where in my statement that says we will Guarantee to issue GL? If during the admission and the initial check does not indicate it is not a pre existing or non disclosure, the GL will be issued.

Even if the GL is being issued and the insurer is being slap with a hefty bill (when the policy is still new), you can bet that there will still be investigations and even negotiations with the hospitals of why the bill appears higher.

This was the reason why there is a delay of 1-2 mths as we need to determine the legitimacy of the claim and why both kidney stones costs Rm30k.

Otherwise during the admission if there is evidence of it being a pre existing or non disclosure the GL will still be rejected.

If the GL is being denied, and if it is a life threatening situation most of the client will still go ahead with the hospital procedure and they will have to pay first the amount and file a claim of appeal later.

If the investigations shows evidence of a non declaration of material fact that has substantial impact on how the policy is being underwritten, the entire policy maybe null and void.

However if there is no such evidence, of course the appeal claim will be honored and the policy will continue.

Edit: for clarification

For Prudential, even though if it is below 1 year the GL will still be issued and investigations will follow.

If it is found that it is a pre-existing illness prior to inception, then the GL will be withdrawn. However, if there is no evidence showing that it is a pre-existing illness, then the medical card will be accepted.

Don't misleading readers in forum to think that Prudential will issue the GL and investigations will follow. In fact, if the GL is issued, investigation is ceased, no investigation will be continue.

Guarantee Letter means that the insurance company is taking up the responsibility to bear the hospitalization bill up to annual/lifetime limit of the client medical card. It does not simply issue and withdrawn, the word of "Guarantee" in the context of "Guarantee Letter" is not light.

I'm giving you one example in car insurance of how ironic are you in explaining Guarantee Letter
Let's say a person is claiming for car insurance, the insurance company is guaranteed for the claim. Upon the car finish repaired, the company withdraw the "guarantee" for the claim and client have to pay for it.

In fact, the Prudential Customer Service Officer even told me that GL will be decline if they suspect there is non-disclosure in the policy upon admitting to hospital after the initial medical report is submitted and reviewed. Which I think she makes some sense there but not you.

There is no point to issue GL if there is some possibility of company not paying the claim upon discharge. What's the point of issue GL, Prudential pay the bill upon client discharge, if the investigation after discharge result shows non-disclosure and who will bear the payment?

Prudential will give a court order for the client to return the money? If it's not so, then what's the point of investigate?

Please call your own company and ask for the procedure for your claim knowledge.
Prudential Call Centre: 03 - 2116 0228
Operating Hours : Mondays to Fridays, 8.30am - 5.15pm (excluding Public Holidays)

On a separate note, would like to ask here,
when the GL is already decline, and the client still proceed to warded,
then try to claim back later and then found out that its pre-existing/undeclare,

thus the entire policy become null and void?

So, its also mean the insurer should not receive the payment (client not need to pay anymore) for month to come since its already null and void?

what about the premium paid over the years before the policy is nullified.....do they refund all, partly or none....and what happened if it is an investment linked....all burn....can withdraw or can still top up....

Hi

I new to insurance..so any help is very much appreciated
Would like to know regarding the table attacted
Is this the yearly payment that I need to do according to my age?
Tq

Faced with higher claims from rising medical costs, many insurance companies have increased their charges and premiums by up to 20%.
So which company already increase their price?

As I know the greedy prudential is the first one to increase the price.

http://www.thestar.com.my/News/Nation/2014...e-for-coverage/