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 INSURANCE TALK, ok let start

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roystevenung
post Jun 22 2013, 07:50 PM

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The cost of the food at the hospital should not even be an issue. Those are the things that will not impact you financially.

The purpose of getting admitted is for the treatment, and certainly not for the food.

Secondly, it is not everytime you stay at the hospital. I am not sure how old are you but when was the last time you were being admitted to the hospital, albeit the 6 star type.

In Penang, 6th Star here means Island hospital, Loh Guan Lye, Gleneagles.

Just pay the difference in terms of room and board charges if it exceeds your limit.
roystevenung
post Jun 22 2013, 10:15 PM

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QUOTE(danlhct @ Jun 22 2013, 09:39 PM)
To me food is very important coz I don't have relatives here. I can't ask my agent to bring me food everyday... Haha..

I was admitted to GMC Penang in year 2010 for minor surgery. Was there for 5 days. Using company 's group insurance. Excess claim under PMM2 without original bills. Claim is super easy and fast. That's why I trusted Prudential a lot and still keeping the old medic card.

At that time I realised medical card is the utmost important. So I sign up GE SM200 which covers until age 80 with high lifetime limit.

Under GE SM200, if R&B exceeded Rm200, the patient has to pay whooping 20% coinsurance for total bill.
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You can order food from outside as well bro.

The excess dont need original bills as it is stated in the summary bill what is covered by your company insurance and what is not covered. We pay what is not covered.

I see your point on the 20% whistling.gif
roystevenung
post Jun 25 2013, 08:52 PM

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QUOTE(danlhct @ Jun 25 2013, 06:56 PM)
Glad to hear that. In that case it is still worthwhile to keep the GE SM200 card since the charges is so low thumbup.gif
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When you agree to share cost with the insurer and absorb part of the bill, naturally it will lower down the insurance charges.

Another type of cost sharing is called Deductible.

Deductible is slightly different from co insurance in the sense that for the co insurance, it is payable on every disability whereas deductible is only payable per every 90 days from the last date for the same disability.

For example cancer treatment with a Rm300 Deductible option:-
1st Jan Rm 10k cost, client pay Rm300 deductible
1st Mar Rm 10k cost, client pay nothing as it is less than 90 days from the date of the last treatment of the same disability
1st Apr Rm 12k cost , client pay nothing as it is less than 90 days.....
1st Dec Rm 13k cost, client pays Rm300 deductible

For co insurance, the client ais required to pay the co insurance for each and every disability.

Of course the insurance charges for deductible is slightly higher than the co insurance, unless the deductible is high, ie, Rm3k or Rm10k deductible.

But it provides the client a peace of mind of not having to worry about having to pay for the co insurance should repetitive admission/treatment is needed, Rm300 per the above is still manageable.

Alas plans that comes with full claim is good for client not having to worry about the co insurance or the deductible, but it comes with higher insurance charges.

In a nutshell, insurance in hokkien is liak teng por tey. Either you pay for it now, or pay for it later.
roystevenung
post Jul 11 2013, 12:03 PM

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New medical card from Prudential BSN Takaful Bhd coming soon ETA 15thJuly2013, "A medical card that defines you" brows.gif
roystevenung
post Jul 12 2013, 09:47 PM

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QUOTE(mcfeemo @ Jul 12 2013, 09:14 PM)
Hi guys, let assumed i have 2 policies from different companies.. If i die.. I have to submit only copy of death cert right? No need to submit the original? So i can claim from both companies??
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If you die and you submit it to your agent, your agent will freak out man. sweat.gif

But if you are referring to your beneficiary, then yes, a certified true copy will suffice.
roystevenung
post Jul 12 2013, 11:50 PM

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QUOTE(ExpZero @ Jul 12 2013, 11:43 PM)
All the companies's executioner know that original only got one, imagine that they have to process ton and ton of death claim per day, they are very experience in the claim process as they knew if they are late to pay by even one day, they will get complain up to BNM level.

Verdict: Death claim is claimable in certified true copy format.
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roystevenung
post Jul 13 2013, 11:00 AM

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QUOTE(netmask8 @ Jul 13 2013, 09:11 AM)
For medical bills/expenses, ONLY ORIGINAL medical REPORT can be submitted for claims..

Medical Report thru Certified TRUE COPY by lawyer/Doctor/Hospital is NOT ACCEPTED .. I challenges any insurance agents here on this
if they can claim using true certified copy.. For medical bills/expenses matter.

Call up the insurance companies and you will be SURPRISED to know the tedious/very Mafan procedures/process when come to claim..
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What are you trying to claim? From two insurance company for the same amount or the difference? Say if the bill is Rm 30k, and your company only allow you to claim Rm20k. Are you trying to claim from the second insurer another Rm30k or Rm10k?
roystevenung
post Jul 14 2013, 12:09 AM

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QUOTE(netmask8 @ Jul 13 2013, 11:05 PM)
E.g medical bills and 36CI claims..
My colleague fainted during office working hour and we sent him to hospital and Dr/Specialist performed angioplasty
test and found that he have 3x blocked/clogged/hardening artery. Operation Bills includes inserting a catheter (thin tube) into
vessels and passing a device (tiny balloon) through the tube to open the artery costed him total RM80K ..
He submitted medical report expenses using medical card from 2nd medical card insurance(company B).
Medical Report and Medical Bill = 1x original bill.. Now, he want to claim 36 Critical Illness from insurance company A but do not have genuine medical report and medical bill sweat.gif

Conclusion:-
Medical Report (Original/Genuine) = 1 .. Medical Bill = 1  (RM80k)
Medical Card (Company B for the past 3 years ) with higher limits= got the medical report during claim submission.

rclxub.gif
Whole Life c/w TPD, 36 CI, Saving/Investment, PA and Medical Card (Insurance Company A for the past 15yrs) = cannot claim 36CI ( rm100k), as original medical report has submitted to Company B as above. Note:- Medical Card for this company A got lower limit(as 6-in-1 package)
compared to high medical card limits of company B.

During emergency case like above, will you want to claim 1) Medical Card/Bill Cost  or  2)  36 Critical Illness ??    For average/poor ppls.
Good Thoughts..
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For the medical card portion, you can only claim up to maximum of the bill, in this case Rm80k. Since it has been taken care off by the 1st insurer, you cannot claim the medical portion from 2nd insurer to get Rm160k.

As for the CI, you can get the hospital help to fill up the CI report, which you can get from the insurer if the agent is no longer around. The hospital is also able to provide certify true copy of the bill and report but your friend will need to pay for the report.

It is best to bring the policy document to the insurance company and to understand which part of CI can be claimed, if the agent is no longer with your friend.

roystevenung
post Jul 14 2013, 12:13 AM

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QUOTE(danlhct @ Jul 13 2013, 10:17 PM)
Not really. I'm not sure about other medical cards. But with Prudential medical card... no worries.

I was admitted to GMC Penang in 2010 for surgery. Below are the documents I submitted to Prudential (reimbursement method):
1. Summary of Claims (letter) from other insurance company stating which is claimable and which is non-claimable (scanned copy -- as I do not have original copy)
2. Certified true copy of medical bills by GMC Penang.
3. Photostat copy of medical report (hospital said they cannot certified true copy for medical report)

I got my cheque 2 weeks after submissions  thumbup.gif
The only thing which is not claimable is RM10 of registration fee  tongue.gif
I have another new medical card which is Great Eastern (SM200). But I'm a bit worry about this card.
My friend admitted to GMC Penang 2 years ago using his GE medical card (SM200) due to food poisoning, he has to bear the injection (to relief the pain) cost (RM100 - RM200). Not all medical expenses are claimable.  sweat.gif
Another friend of mine was admitted to GMC Penang (for 2 days) using standalone GE medical card due to complication after stung by bees. GE does not allow doctor to use any medical equipment for my friend's case.    sad.gif
I believe not all insurance companies are same. So it is better for you to clarify with your insurer.
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roystevenung
post Jul 14 2013, 09:46 AM

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QUOTE(netmask8 @ Jul 14 2013, 08:51 AM)
Get hospital to fill up the CI report is not the same with copy of the bill and report ?    hmm.gif

Need original medical bill and medical report to claim 36CI from insurance company B ..
The original medical bill and medical report is already submitted to claim medical card expenses from insurance company A.
He checked with the insurance company B agent, he is no longer in insurance field, BUT his upper line/insurance mgr is
be the new servicing agent for him and want ORIGINAL bill/medical report..  This upper line/insurance mgr is got 18 yrs experiences..
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As for the case of Prudential, the attending Doctor will help to fill up a report for CI claim. This form is provided by Prudential and is to be submitted with the policy document along with the certified true copies of the medical report.

Take note the report MUST tally with the insurer definition for CI. So its best to discuss with the Doctor wink.gif

Certified copy is sufficient. BTW, which insurance company is the B insurance? Perhaps agents here are able to guide you in more specific.

This post has been edited by roystevenung: Jul 14 2013, 09:48 AM
roystevenung
post Jul 14 2013, 03:44 PM

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QUOTE(netmask8 @ Jul 14 2013, 03:22 PM)
It is my colleagues whom happen recovered thru artery surgery and now, he go through all the insurance plans he bought..

He will call up his insurance agent or the claim dept and seek proper/right documents.. BUT, the medical
bill (original/genuine) = 1 .. hmm.gif have been submitted..Let him clarify from insurance company on the documents on
claiming 36CI .. If not sure, callup  insurance agent or claim dept for right informations.Don't make own assumption/conclusion.
A phone call may be useful in clearing all the doubts/mess ..
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Yes, don't make any assumptions. There is a procedure to follow when it comes to claims and each insurance company have their own procedures. I'd advise to deal thru email, at least there is a black and white communication.

But like I said, the doctors report MUST TALLY with the insurer's definition of Critical Illness. The only way to determine this is to get an agent's or help over the counter, if he/she is uncertain of which CI to claim from.
roystevenung
post Jul 15 2013, 10:20 PM

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QUOTE(Macrusin @ Jul 15 2013, 09:34 PM)
If I want to transfer my policy from a terminated agent to another agent.
What should I do?
Just the amendment form will do? unsure.gif
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Which insurance company is that?
roystevenung
post Jul 16 2013, 12:35 AM

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QUOTE(Macrusin @ Jul 16 2013, 12:18 AM)
Manulife, I request transfer of servicing form.
But they gave me ammendment form, they said it will do for transfer cases.
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http://www.manulife.com.my/cservice/lifein...erservices.aspx

Different insurance companies have their own sets of procedures when its comes to agent transfer.

If you had spoken to the customer service and they had clarified on which forms to use, then just follow their instructions.

A note for you is that when filling up the change request, immediately after your request, draw a big Z to cancel off and do not leave any empty space.


roystevenung
post Jul 16 2013, 01:04 AM

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QUOTE(Macrusin @ Jul 16 2013, 12:48 AM)
But the agent asks me to get the transfer of servicing form.
When I request from the customer service, they seems like unsure what's that.
End up by calling underwriter and I was told by them transfer of servicing form is for internal use only.
If I want to transfer my policy to a new agent, amendment form will do so.
In order to be sure, I think will call to HQ to verify again.
Do you mean before I submit the form, draw a big Z to fill up the empty space?
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Yup, just incase laugh.gif

roystevenung
post Jul 17 2013, 10:01 AM

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QUOTE(izwanz @ Jul 17 2013, 09:49 AM)
Guys, I have health card from Prudential i.e. PRUflexi med. Annual coverage is 50K and lifetime limit is 1mil. I'm 24 this year. Any ideas if this is adequate? Should I topup more for annual coverage limit?
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It boils down to your budget, instead of the agents budget. To be honest, if you re worried of serious prolonged hospital admission at a private hospital, even if you have an annual limit of Rm200k, it may not be sufficient.

If the budget allows, I would recommend to spread out the premium evenly towards Critical Illness and medical.

Do take into account that you would also have your company cover on top of the annual limit from your personal medical card. The annual limit is more important than the lifetime limit.
roystevenung
post Jul 17 2013, 02:27 PM

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QUOTE(izwanz @ Jul 17 2013, 02:09 PM)
Hi Roy

Thanks for your reply.

I am just wondering whether the annual limit is sufficient for myself. My firm does not have medical coverage. How do I "spread out" the premium evenly towards CI because the PRUFlexiMed will cover "as charged". For CI I have Great Eastern already.
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Do ask your agent to quote for adding another RM50k to the medical card, if your budget allows you to do so and if you have the CI covered.

The word "As charged" is still bounded to the annual limit of Rm50k.

roystevenung
post Jul 22 2013, 02:45 PM

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QUOTE(danlhct @ Jul 22 2013, 11:37 AM)
If I work in neighboring countries and back to Malaysia once every 2 months. Can I use the medic card overseas should anything happened? Will the insurer rejects our claim coz we work in overseas?
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Whenever you claim for overseas bill, apart from the bills which are based on re-imbursement basis for 90 days your departure date, you will need to photocopy your passport (to and fro) to be submitted for validation of the claim.
roystevenung
post Jul 26 2013, 07:57 PM

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^ There is absolutely no reason for your comments to be personal, its their choice to go term.
roystevenung
post Jul 29 2013, 01:22 PM

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QUOTE(freewisefly @ Jul 27 2013, 11:58 PM)
Don't get to personal as you might be the one.
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Bos, mind if i ask, your term medical covers till age 70 or age 80?
roystevenung
post Jul 29 2013, 09:55 PM

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QUOTE(freewisefly @ Jul 29 2013, 09:25 PM)
I don't recommend anyone get up till age 70, but none of them afford to get cover up to age 80. I do consider this as one of the fact need to consider. So my answer is covers up to age of 80. How much would your insurance charges for this coverage at this age, if you don't mind sharing with me. Thanks.
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freewisefly, at older age, most of us had fulfilled our responsibility as a parent, whereby the children are all grown up. Hence having a high coverage on life/critical illness after retirement (> age 60) would be a burden.

However, this is also when we lose our company coverage for medical benefits and the chances of us contracting illnesses (diabetes / blood pressure) at older age are much high as compared to when we are young.

Most of the people I had as my client is having one or the other issue at age > 50, which complicates getting a medical insurance.

You could take a look at our PRUsenior med plan, a plan designed for taking care of the huge burst of medical bill. A plan medical card, with possibly the lowest insurance charges around.

<< PRUsenior med >>

The benefit of the plan includes:-
1. Medical Claim up to Rm225K per plan
2. Death benefit (RM5K)
3. The premium is locked and it is based on ENTRY AGE and it will not go up by age.
4. Guaranteed renewal up to age 80 (next birthday)
5. High entry age (up to age 70 next birthday)
6. More relaxed underwriting, for example if someone is with hypertension, under control with meds it is also able to be accepted without loading.

The only catch is it is for in-patient it is subjected to RM3K (Plan 1) & RM 6K (Plan 2) co-insurance and 10% thereafter. For out-patient, there is a 10% co-insurance.



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