If you are working in Arm Forces, the exclusion will take effect if you are injured while active in duty. However, if you are injured while crossing the road and fall into a drain or a snatch thief injured you, then you are covered.

The way the premiums are refunded are usually stated clearly in the contract, you may want to read it. Typically, for investment linked products, when a policyholder pays a RM3,000 premium they are first used to buy unit links at the prevailing unit price and credit the units into the policy Unit Account. Then the insurance charges and other charges are made by selling off the number of units that correspond to the total charges. Say, if total insurance and service charge are RM 50 and the Unit Price is RM 1, hence 50 units will be sold off to get RM50 to pay for it every month. Balance of the units are still kept in the account following the unit pricing.

When a plan gets terminated, all the charges paid so far will be refunded, in this example RM 50 plus the value of the units in the Unit Account at the prevailing market rate. This way the policyholder bear the investment risk (Profit & Lost) because unit price can go up or down.

Good names or bad names of a life insurance company really depends very much on the conduct and professionalism of the insurance agents. All life insurance companies have both good and not so good insurance agents. As consumers, we have to have some basic understanding of what we are buying be it insurance or a car or a house. Never rely 100% on the person who sell you a product because it is their interest to make the sale successful.

If I were you, I am OK with PRUlink One + Crisis Shield and PRUacci Guard, but check to see if the Crisis Shield accelerates the PRUlink One sum assured upon claim. If it does, then upon claiming any of the 36Critical illness, the PRUlink sum assured will be reduced by the amount paid under the Crisis Shield i.e., RM500K - RM500K = 0. If Crisis Shield does not accelerate the PRUlink sum assured upon claiming, then it is OK.

Otherwise, you have two options, (1) Buy a Critical Illness plan that does not accelerate the PRUlink sum assured upon claim, this will be more expensive in premium or, (2) Depending on how much you need upon claiming the 36 critical illness, and how much you want to leave behind upon death. If you want to leave behind say, RM200K upon death and claim RM 300K upon diagnosis of any of the 36 Critical Illnesses, then your PRUlink Sum assured can be RM 500K, while the Crisis Shield sum assured be RM 300K, this way premium is cheaper.

If I were you, PRUacci Med and PRUmed are really nice to have. What you need is a good overall medical card covering hospital admissions and surgeries due to both illness and accident up to age 85 or 100. Kiasu people like me bought one upto 100 years old, hahaha. 70 years old (or young) is really too early to terminate a medical plan and at that age you may no longer be eligible to buy another medical plan. So buy it when young.

Enhance PruPayor Basic and premium Waiver the premiums should not be too expensive, I will include them because upon diagnosis of 36 Critical illness or becoming TPD, the premiums for the policy will be paid by the company into your account, and these premiums can be used for purchasing the units for investment purpose after the sum assured for CI or TPD been paid to you.

Hope this helps. At the end of the day with the escalating cost of medical fees, we need to cover ourselves well with a good life and health insurance plan. Happy buying!

This post has been edited by zest168: Jun 4 2014, 11:54 AM

Some slight amendment here, if I may based on my understanding about investment linked insurance.

Eg.
investment linked premium 1000
When started time, the first few years, not 100% of your premium goes into investment, of RM1000 for first year
maybe RM600 is allocated into investment converting cash into units (based on unit pricing at time of purchase), each month units are sold to pay for insurance charges, say if insurance charges are RM100, and unit price at that time was RM1, then 100 units be sold to pay for the insurance charges of RM100.

As you grow older each year, the insurance charges keep going up following your age. But that does not mean that you will have to sell more units depending on how quick your unit price increases. If 1 year later, your unit price becomes RM 2 and your insurance charges gone up to RM120, you will only need to sell 60 units each month to pay for the insurance charges. However, unit price may also go down when market is not good, this is when you have to sell more units a month to pay for your insurance charges.

Hope this is clear.

This post has been edited by zest168: Jun 12 2014, 03:50 PM

Over the years you may have moved or changed your correspondence address, hence upon policy maturity, the Maturity Letter could have sent to an old address.

If you like, you can PM me your policy number, date of maturity and full name, let me check for you with AIA SG as I have friends working there.

This post has been edited by zest168: Jun 16 2014, 01:26 PM

Cost of insurance esp medical insurance has increased very sharply over the years. As we all know, insurance premiums are calculated based on risk pooling basis. Hence in order to maintain cost every policyholders have their role to play so that their premiums are not increased drastically.

Policyholders should adopt some basic best practices:-

1. Do not admit to a hospital if the condition can be treated as out patient. Of course this is not easy as we are not doctors, and also is it in the interests of the doctor to get you admitted so that you can be closely monitored. So, most of us will listen to doctor's advice esp the patient is our child. Ask doctor the severity of the condition and necessity with hospital admission before deciding whether to get admitted or not.
2. Show concern with the doctor on the hospital charges, scrutinize and negotiate with them on the fees as if you pay it from your own pocket. Do not think that just because you have a medical card, it is Ok to pay whatever that is charged because ultimately when claims experience deteriorates then premium will be increased.
3. Ask for second opinion on options for treatment, this is good for own health.

Medical insurance plans are great plans but policyholders have to do their part to ensure that the premiums can be maintained. Insurance companies are actively trying to manage costs of claims and this task is much easier to be managed if policyholders work hand in hand.

For Life and CI, when you bought the policies you were a Malaysian and later on migrated elsewhere, as long as you maintain the policy and keep them in force by continuously paying the premiums, then you are covered.

The longer the policies were kept in force, the better. Before you surrender your IC for change of your citizenship, make some copies and get them certified by the insurance company counter officers and keep them for future use. You still keep your birth certificate which can be another alternative supporting evidence about your identity.

Depending which country you are migrating, if too far you may have some inconveniences of submitting the claim and sometimes ding-dong of requirements are very frustrating and time consuming.

Also depending on your policy duration and sum assured, if you are moving to certain countries where death certificates or medical reports can easily been forged, the Claims Assessor will be very wary about such claims, hence also be troublesome during claims processing. Cannot blame the Claims Assessor because they are not sure whether such claims are genuine or not because there were past experience of fraudulent claims from such places.

This post has been edited by zest168: Jul 7 2014, 12:39 PM

Questions:-

1. Are you salaried-employed or self-employed? If salaried-employed, normally they have group medical cover for you.

2. Depends what your poor health record is all about - is it reversible with lifestyle change? or will it get worse with age in general?

If you stated that it is not really a big issue, perhaps there is something that could be done to get you a medical card or a critical illness - with exclusion and/or loading. Unless in the eyes of the underwriter, there is something more.

As you already know that you want to get a medical insurance for your girl, then a medical insurance that is.

So depending on what you want for your girl:-

1. A plan that covers her medical needs from now as well as a fund for her education 20 years later?
2. A plan just to cover fund for her education 20 years later?
3. A plan just to cover for her medical needs from now onwards?

I believe RM200/mth or RM2400/year premium for a 30 yo male can buy you a much bigger sum assured than just RM12K.

As this is an investment linked policy as mentioned, that means a larger chunk of the RM2400 yearly premium goes into investment.

So question comes back to you whether you are seeking insurance coverage more or investment for the RM200 savings that you paid into the monthly premium?

Please take note that for a pre-existing condition, i.e., a condition that has manifested itself before the policy is issued is forever not payable.

However, on the validity of the policy beyond the two years contestable period, such condition will be reviewed on case to case basis. For example, if a person has mild hypertension before taking up the policy and did not disclose it during the application, and after two years make a claim, then the claim is not payable on basis that the hypertension was a pre-existing condition, at the same time whether the insurance company can cancel the policy from inception depends on the severity of the illness not disclosed in order to establish the intent of fraud.

This is because according to Sec. 147 sub-sec (4) of the Insurance Act 1996, it reads, "A licensed life insurer shall not dispute the validity of a life policy after the expiry of two years from the date on which it was effected on the ground that a statement made or omitted to be made in the proposal for insurance or in a report of a doctor, referee, or any other person, or in a document leading to the issue of the life policy, was inaccurate or false or misleading unless the licensed life insurer shows that the statement was on a material matter or suppressed a material fact and that it was fraudulently made or omitted to be made by the policy owner."

This post has been edited by zest168: Jul 29 2014, 02:55 PM

Life Insurance policy is a legal contract enforceable by law. As in any contract, it is bound by its terms and conditions, hence any breach in the contract will render it null and void.

Firstly, the insurance company must have concrete evidence supported by a medical report from the insured's attending physician over the diagnosis of anaemia. Whether the doctor explained to the patient about the condition or not is really between the patient and doctor. As far as the medical report concerned, it would be stated that a diagnosis of anaemia was made on ddmmyyyy. Unless the doctor clearly wrote in the medical report that he/ she did not tell the patient about the diagnosis, then the nominee may have a case, but I doubt so the doctor would write such medical report.

Now, the diagnosis of anaemia which was a pre-existing condition, but the insured in fact died of heart attack, which is not related to anaemia. Question is whether is this fair? Did insurance company cheat? Let's go back to the basis of contract.

The insurer issued the policy based on utmost good faith. However, the diagnosis of anaemia was not disclosed. Whether such non disclosure was intentional or not is secondary, the fact remained it was not disclosed. If such condition of anaemia was disclosed during application, would the insurer still issue the policy as applied for? In the case of anaemia, usually the insurer will ask for the underlying cause of anaemia, if such underlying cause was not found, they would have postponed the application until the cause is known. So, if this fact was disclosed during application, the insurer would not have simply issued the policy as applied. We may not know the final outcome because there are many dependencies after that.

Assuming the best case scenario, the anaemia was nothing sinister as the insured just recovered from dengue fever two weeks ago. Then the policy would have been issued at standard rate.

The medium case scenario, the anaemia was due to low iron in the blood. Hence, the insurer need to charge a higher premium and/ or impose loading on medical card (if any). The insurer counter offer this to the insured, depending on the insured whether to take it up or not, hence there are two outcome - accept the counteroffer or reject it.

Worst case scenario, the anaemia was due to cancer. Obviously, application would be declined right away by the insurer.

Therefore, as long as any material non disclosure affecting the original decision of the insurer in issuing the policy, the contract will become null and void from inception. Now, whether the insured subsequently passed away due to heart attack or even an accident, is irrelevant.

Bottomline is, better to tell all the truth, nothing but the truth on utmost good faith.

Waiting Periods and Exclusions are contractual terms, meaning to say that if an event falls within them, the Insurance Company has full legal rights not to pay.

As for any events falling out of the Waiting Periods or Exclusions, the company will still have a right under the 2 years incontestability clause to challenge the validity of the policy on basis of any non-disclosure of material facts at time of policy application. This is only applicable to claims which are made within the 2 years period counting from the date of policy issuance or date of reinstatement or inclusion of the benefit.

Under such circumstances, the insurance company will usually conduct an investigation on the medical history of the insured. Under this situation, they will not issue any letter of guarantee, instead the insured has to pay the medical expenses first and file the claim later for reimbursement. Of course, not all illnesses are thoroughly investigated. For example, if an insured is admitted to hospital after six months policy issued due to diabetes or hypertension, then the insurance company will normally investigate if during the application, such condition was stated as nil. It could be true that diabetes or hypertension may be diagnosed just after buying the policy but it could also be possible that there were diagnosed much earlier prior to policy application and during application there are questions asking about diabetes and hypertension which were answered as No.

Acute conditions such as acute gastroenteritis or appendicitis would have been paid out with a blink of an eye.

However, being ethical the insurance company should not take forever to conduct their investigation. They must conclude it after some time depending on how cooperative the insured is in providing the information required and how soon the attending physicians complete the medical report. So you need to constantly follow up with them to check the progress, otherwise you will wait for a long long time.

Bottom line is during policy application, be 100% honest and truthful with your medical conditions that you know. It is better to declare every health condition so that when claims arises, it will be as smooth as silk.

This post has been edited by zest168: Aug 19 2014, 10:02 AM

For older policies, Circumcision is covered if it is warranted due to repeated infection or balanitis. However, circumcision for personal hygiene reason would not be covered.

Hence, insured needs to read their contract carefully on the Exclusion portion to see what was written there with regards to circumcision, etc.

As per contractual terms, cooling off period starts from the date the policy is issued as it is the company policy to despatch all policies the next day it was printed out.
The company cannot control or manage the administration of the cooling off period if it is based on the date the policyholder receives it because sometimes the agents are busy. Some may never get the policy if you dun follow closely with the agent.

So to better protect yourself from your rights in exercising your cooling off period, follow up with the agent for it, and on the day when you receive the policy contract, check the Issue Date stated on the policy against the calendar day, if the difference is very long or beyond the 30days Cooling Off period, get him to write on the covering Welcome Letter/ Covering Letter admitting that he delivers the policy to you on dd/mm/yyyy with his name and signature.

Then go to the insurance company and file a complaint. If the cooling off period is not your concern, then it does not matter as long as you get the policy.

Yes, this would be a true example of the need of insurance so that we can get better medical treatments when need arises. Not saying that Government Hospitals are no good, they have the most complete facility and the greatest professors, however, they are also packed with patients from all walks of life. If you need treatment/ surgery, you need to be in long queue at Government Hospitals unless it is emergency. Otherwise, you go to Private Hospitals that could have more time to look into your ailments and quicker resolution to your sickness but it costs you a bomb.

So, medical insurance is a solution. Of course, in any product, there is limitation of usage/ coverage and things that are not covered under the premium pricing.

Well said Our Government Hospitals are really full of patients, we need more such hospitals but it is also not easy to say that if we need hospitals then just build as many as required. We need funding, we need doctors, surgeons, nurses, etc, we need land to build them.....so while giving the Government to catch up on this, we really got to think for our own preference of medical treatment when the need arises, what to do, where to go, how much can we afford, how long wait time can we hold ?

At the end of the day we have this forum to share and finally everyone is entitled to his/ her opinion. Like the Silver Surfer said, "Everyone Has a Choice"