The lists that you mention are for pre-existing illness for major claims.

For your information, if someone happens to have claimed from the list, sorry to say that there is NO INSURANCE COMPANY will want to accept, including PM. Of course you can tick 'No illnesses" when declaring the health declaration part, but should the insurer finds out, it'll falls under non-disclosure and insurance company is not liable to pay for the claim.

I apologize for my bluntness, but I do believe that whenever someone do insurance they will want to claim it, sooner or later. I'm sure you do not want to be paying the premium for something that you may not be able to claim, right?

Generally most policies unless stipulated multiple claims, can only claim the major claim once.

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Added on July 24, 2012, 8:45 amWhat it means by alternative is that, should you claim out the CI, the policy will cease as it accelelates the payment for the death claim.

Eg, if Life is RM100K, CI=RM100K, if you claim out CI RM 100K, policy ends.

Termination of contract...
b. a claim is made on diagnosis of a Critical Illness or upon death or total & permanent disability benefit.

Do note its "OR"

On the claims of multiple CI claims I don't see any statement that says one can claim for multiple CI claims.


This post has been edited by roystevenung: Jul 24 2012, 08:45 AM

The Importance of The Nomination

Friends, getting yourself the life insurance coverage is just the first step towards your Financial Planning goal.

Make sure you review the Nomination from time to time, especially when there are changes, for example when we are single, we nominate our parents, but when we get married, please do not forget to nominate your spouse/children. The same goes to the Employee's Provident Funds (EPF)/Mutual Funds etc.

I've just spoken to a lady who lost his husband in a freak accident 3 months ago. The husband did a life & CI policy for Rm50K (not that much, but at least its better than nothing) when he started working 6-7 years ago. The nomination was to the mother and he had not changed it ever since.

Now that the husband had passed away, she is trying to claim for the life policy and until today she is not able to because there is a misunderstanding with the mum in law.

She had to resort to begging her relatives to put basic necessities like milk powder for the 3 year old son and food on the table as she is not able to get a job yet.

SO PLEASE CHECK YOUR NOMINATION - No excuses please

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Added on August 20, 2012, 6:39 pmPlease help me to help you built the FAQ on Insurance.

I'm setting up a blog and if possible would like to have LYN posters to help with the common questions from the non-insurance agent view point.

If you have any questions on insurance/medical card please PM to me your questions and I'll add them to the blog.

Thank you



This post has been edited by roystevenung: Aug 20 2012, 06:41 PM

No, dental surgery expenses are excluded.

Exclusions - Excerpt from the Brochure
Dental conditions including dental treatment or oral Surgery except as necessitated by Accidental Injuries to
sound natural teeth occurring wholly during the Period of Insurance.

+1 FAQ to my blog, thanks mate

This post has been edited by roystevenung: Aug 21 2012, 11:52 AM

No problem my friend, although it would be better if the answers were positive to what you want to hear.

Can you tell me more on why the Gastroscopy claims was rejected? The doctors did not find anything wrong or perhaps they did not know how to write the report? What prompted you to be admitted to the KPJ hospital and why did the doctor advice you to do gastroscopy?

PM me if you feel the need to. Thanks

Ps. I've added your question to my blog FAQ, thanks

This post has been edited by roystevenung: Aug 21 2012, 12:06 PM

If there is no surgery or findings that can conclude the reason for the hospitalization, the client is required to pay. Even if the GL has been issued, it can be withdrawn.

"Hospitalisation primarily for investigatory purposes, diagnosis, X-ray examination, general physical or medical examinations, not incidental to treatment or diagnosis of a Disability or any treatment which is not Medically Necessary and any preventive treatments, preventive medicines or examinations carried out by a Physician, and treatments specifically for weight reduction or gain."

For a lists of exclusions, do check out the blog on exclusions. I'm currently working on the 36 CI lists...

This post has been edited by roystevenung: Aug 22 2012, 09:53 AM

1. As for Life or Total & Permanent Disable (TPD), Personal Accident & Critical Illness (CI) insurance, touch wood happens, you (CI/TPD) or your beneficiary can claim all.

However, for medical you can only claim up to the maximum of the hospital bills. For example if you hold 2 medical cards (one from company and another is from your personal), and the total medical bill is RM 100K and the employer is only able to cover you up to RM 80K, you can claim the remainder of RM 20k from your personal.


2. Life/CI & Accidental insurance is able to work globally, but medical is only restricted to 90 days if you leave Malaysia. On the rig, what do you work as? Diver? How long will you be at the rig? Is this a permanent thing for life or do you intend to stop at age 30?

There is a list of questions that needs to be answered before coverage can be given.

However due to the danger of the work, the premium may be loaded.

Ps. You can also get the medical as a standby should next time you no longer work at the rig as the medical is something that needs to take care of us till we are 6 feet down under.

Here is a stand alone, Term Coverage up to age 60 - The Standard premium are as follows. Do note that this may be rated up due to the job.

1. Life - Rm 500K, Accidental Death & Disablement - RM 500k premium RM 317.20/mth, if add Critical Illness RM 500k add another RM 275.00/mth.

2. Life - Rm 1M, Accidental Death & Disablement - RM 1M premium RM 592.20/mth, if add Critical Illness RM 1M add another RM 550.



This post has been edited by roystevenung: Aug 31 2012, 02:31 PM

Hi,

If in the near future your job changes (say after you've been assigned desk job _not_ on an off shore rig) the premium can be adjusted to lesser risk by giving a job change application to the insurance company. Apart from job change, you are also required to inform the insurance company the following:

1. Smoking status change (example, now you're non-smoker, and later if changed to smoking status because your premium is for non-smoker)

2. Occupation changes

3. Lifestyle changes (for example you do dangerous sports like you became a diver, or do parachuting etc)

4. Health change (obese or lost weight tremendously)

Insurance is definitely a long term commitment and most importantly, make sure you do nomnation. Should later you get married, do remember to change the nomination.

Do let me know if you're favourable with the quote or would like to have an investment linked plan instead of a standalone plan.

Thank you my friend. Happy holidays to you too. Should you need further information, do post.

With such high cover of RM100K in 1994, be prepared to be paid peanuts as bonus as most of the premium goes to the insurance charges. It is after all an insurance product, giving you protection.

Questions you need to ask are:

1. How much are you paying for the premium?

2. What is the cash value now if you decide to surrender?

3. What is the projected amount that was stated in the product disclosure / proposal? How far off are the projections vs the actual?

4. How much 'bonus' will you get if you wait until the end of the term?

5. The term as per the above example is 94 years. Are you sure the "term" mention is for 20 years only and not whole life? Many people are caught by surprise that they were not sold as endowment plan, but a life policy. Hence it is no surprise that they were told that they need to still continue to pay the premium in order to enjoy the coverage even after 20 years.

6. If the cover is RM100K why do you want to stop at the year 20? How old are you when the policy is 20 year old? Do you still have dependents? Spouse/children/mother/father/MIL/FIL to take care off?

Do note you will never be able to buy the same amount of cover vs the amount of premium because insurance charges goes up by age. Hence if you surrender and later need the cover, you may need to pay more premium to get the same amount of cover.

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Added on September 7, 2012, 8:52 amPandah, not all treatment needs to be hospitalized. Do note that the medical card is not meant for routine medical checkup & investigative or diagnostic test admission. Should these tests are performed and the Doctors found nothing, the client is required to bear for the hospital services/charges.

Here are a Day surgery List:-

ENT & Ophthalmic Procedures
a. Cataract with or without intra occular lens implant
b. Retinal Detachment surgery
c. Surgical excision of pterygium
d. Removal of foreign body from Ear, Nose or Throat (applicable to child below 12 years old only)
e. Myringotomy & Grammets insertion

Orthopeadic Procedures
a. Antroscopy knees
b. Removal of orthopeadic implants
c. Manipulation / reduction of joints under GA
d. Excision of growth / tumours under GA
e. Release of trigger fingers, carpal tunnel/tarsal tunnel syndrome

O&G Procudures (Exclude all pregnancy & infertility related conditions)
a. Marsupialisation / Excision of Bartholin's gland
b. Laparoscopy
c. Diagnostic D&C
d. Excisions biopsy / I&D abscess breast lump

Genito-urinary Procedures
a. Cystoscopy
b. Insertion / Removal of J stent
c. Ultrasound guided renal biopsy
d. Urethral dilatation
e. ESWL (Lithotripsy)

General Surgery Procedures
a. Gastroscopy / Colonscopy
b. Branscoscopy with or without washout
c. Insertion of Hickman line / chemopart
d. Creation of AV Fistula
e. Haemorrhoidectomy (stapled / rubber banding)
f. Ultrasound guided liver biopsy
g. Therapeutic aspiration of abdomen / pleural cavity
h. Chemotherapy/Radiotherapy for cancer
i. Kidney dialysis

Cardiac Procedure
a. Coronary angiogram

Please note that the procedures are Day Surgery as recommended from the insurer. The decision and any necessity for any in-hospitalization shall be at the discretion of the attending Doctor.

+1 to blog

This post has been edited by roystevenung: Sep 7 2012, 08:52 AM

90K cover is still high if you're looking at it from ENDOWMENT plan point of view for 20 years unless you opt for HIGHER PREMIUM with shorter term (in this case 20 years).

They can't give you new projections based on the current rates, no one can but what they can do is to give you the what is your current cash value.

And what the staff says are true, 90K at 1993 is definitely geared for protection, not for savings.

Prudential

Best if you call Allianz Insurance directly to get better clarifications. Their number should be stated in the e-cover note. Everything is stated there.

Before I propose a solution, if you don't mind my asking, could you please help to further elaborate on your existing plans?

Without having to understand what you have and what are your objectives I may propose something which is not useful. Its like goiing to the doctor and tell him that you need help and the doctor without even checking you, prescribed the medication (solution).

I. Life insurance
- How much is the cover amount for life and critical illness or accident?
- Is it a whole life plan (matures at age 100) or a term plan that expires at certain years (eg, 20 years term)?

II. Medical insurance (without a medical card)
- From which company and what plan did you take?
- Are there any inner limits that you should be concerned off?
- Since you already have this, why would you want to have another medical card? Considering the fact that you wont be able to claim he hospital bills from both cards. Are you concerned on the annual/lifetime limits?

III. Company coverage is good as long as you remain employed. Insurance planning should start as early as possible so as to be able to take care of the old person that we are going to be. Generally most of us retires at age 60 and without a medical plan that can take care of us till 80 or 100 one may end up using the savings from their EPF or other forms of savings that were meant to be for retirement.

We do have plans that pays you No Claim Bonus if you dont claim for a policy year. The amount depends on the selected plan.

Having said that if you are looking at medical card, the insurance charges at older age is always a concern. Policies like investment linked or life policy do accumulate cash values over time. However if you were to attach a medical card to it, the medical card needs to take care of you till the end of the term. That means the premium will still needs to be paid. Do note that as we grow older our insurance charges will go up. Like our car insurance if you stop payment, can you still drive? Also cars that are over 10 years are subjected to loading.

Example at age 30 the insurance charges maybe Rm1500/year, but when we hit 65, the insurance charges may be as high as RM4K or more. Even though at age 65 you may still be paying RM150 per mth, the variance of insurance charges will be deducted from your cash value. Hence if you were to withdraw the cash value, at older age the policy may not have enough cash values to sustain the policy, which will result in the policy lapse.

Do visit my blog if you have time. Good day.

Just trying my luck. Do you think there is a slightest chance of a Penang agent giving you a quote and possibly be your servicing agent?

Pm already, so when can we start?

Do clarify with your agent whether it is consider an upgrade rather than replacement of policy,. If it is replacement of policy and your budget permits, why dont you consider a plan that dont hv limits on cancer treatment and kidney dialysis?

Older plans do pay for take home drugs, doctors consultation & long term medication.

Kidney dialysis at a private hospital costs Rm230 x 3 times a week FOR THE REST OF OUR LIFE. Try to calculate the cost for 20 years.

Hospital wont appeal to insurance company while insurance company will only pay as per the stated schedule benefits. Some hospitals dont even allow for discussions on the bill unless youre from the claims dept.

The rest of your questions are case by case basis whereby if you were to everytime stay in higher room and board, i'm sure itll be a hassle to write in to appeal, dont you agree?

If youre worried if the r&b why dont you ask your agent to upgrade it to a higher r&b plan. At least if anyhing, youre entitled to that r&b benefit.

Edited to reflect what insurance is all about.

UGPM

Are you looking for medical card as well? If yes, considering that you're still young, investment linked policy would be a better choice as you may need to upgrade/review the card every 5 years (or more) depending on the inflation in the hospitals.