QUOTE(Ranma @ Dec 14 2006, 09:45 AM)
I read this thread with great interest. IMHO there is no point arguing about the superiority of US insurance policy compared to Malaysia. Most of us live here and have to make do with what's offered here. I agree with Dreamer though that it is important for us to understand our insurance needs and the T&C of our insurance policy.
Our insurance policy is written as a contract which covers what the policy covers and what not. The problem, even for those educated, is we are usually not familiar with the medical conditions and terms. I believe it is the insurance agent's job to explain clearly to their clients this very important aspect.
So here are a few questions for the insurance agents here:
1. Do you know at the back of your mind which medical conditions are not covered during the first year of the medical card your company offers? Do you explain this one by one to your clients?
2. Do you know at the back of your mind which medical conditions are not covered at all by the medical card your company offers? Do you explain this one by one to your clients?
3. There are specific conditions. For example, can you claim TPD with one kidney failure? Or two? Do you know for sure? Do you explain to your clients?
4. My wife had a medical condition known as Arteriovenous malformation (AVM). You know what is it? Can claim?
5. Do you carry a medical encyclopedia and study it from time to time to better inform your clients?In terms of percentage, I believe no other sales person can beat an insurance agents' commission. We buy insurance in the hope to cover our uncertainties. Due to the various conditions imposed by local insurance companies, agents MUST have the knowledge and sense of responsibility to explain such conditions to their clients. Those who don't, consider yourselves as the same "lousy agent" that you'll readily tell a person with bad experience on insurance.
A very small percentage of insurance agents do take care of their clients. These agents, IMHO deserve whatever million-dollar roundtable that they qualify.

Ranma,
Yes, Lotsa people worrying about the claim. It's actually simple. Read the T&C if there's any other exclusion in the policy. Insurance agents is not a doctor nor have any medical education background. Therefore, agents only knew the basic staff about medical. However, agents normally will tell the customer, incase in the future the customer have one of the illness that are in the exclusion. He/She may not be entitle to claim. As practice by me , I always give customer the copy of exlusion and what are the illness that are not covered by the policy.
Pre-Existing Illness"Pre-existing illness" shall mean disabilities that the Insured Person has reasonable knowledge of. An Insured Person may be considered to have reasonable knowledge of a pre-existing condition where the condition is one for which :-
* the Insured Person had received or is receiving treatment;
* medical advice, diagnosis, care or treatment has been recommended;
* clear and distinct symptoms are or were evident; or
* its existence would have been apparent to a reasonable person in the circumstances.
Exclusion: * All Pre-existing Illnesses must be declared and will not covered by medical insurance. Specific IllnessesSpecific illness under the policy shall mean:-
* Hypertension and diabetes mellitus
* Cardiovascular diseases and varicose veins
* All tumours, cancers, cysts, nodules, polyps, stones of the urinary system and biliary system
* All ear, nose (including sinuses) and throat conditions
* Hernias, haemorrhoids, fistulae, hydrocele, varicocele
* Vertebro-spinal disorders (including disc) and knee conditions
* Endometriosis, adenomyosis, prolapsed uterus, and uterine conditions requiring hysterectomy (including disease of the Reproductive System)
Exclusion:
* All Specific Illnesses stated above, are not covered for first 120 days (4 months) of the policy irrespective of whether the Insured Person was aware of disability or not.
* Any Specific Illness will be covered beginning with the 121st day after original inception, provided it is not excluded as an Underwriting Exclusion. Exclusions
This policy shall not cover :
*
All Pre-existing Illness.
*
All Specific Illness for first 120 days (4 months) of insurance, subject to the Pre-existing Illnesses clause in the "Definitions" Section above.
*
Illness that commenced within the Waiting Period of thirty (30) days, except for accidental injuries.
*
Out-Patient treatment not related to in-patient or day surgery, except as a result of an accident.
*
Pregnancy including childbirth, abortion, miscarriage, treatment for infertility and all complications arising therefrom.
*
Conditions arising from surgical, mechanical or chemical contraception methods of birth control.
*
Routine physical examinations, health check-up or any other tests where there are no objective indications of impairment of normal health or any treatment of a preventive nature including vaccinations, acupuncture, treatments specifically for weight reduction or any treatment which is not medically necessary.
*
Treatment for Congenital Conditions and any physical birth defects arising out of or resulting therefrom.
*
Non-Hospital Nursing Care or Ambulatory Care, rest cures or sanitaria care, treatment arising from any geriatric, psycho-geriatric or psychiatric condition, treatment of alcohol dependence syndrome and drug addiction.
*
Sickness or disease directly or indirectly arising from AIDS or any AIDS-related condition
*
Suicide or attempted suicide, self-inflicted injuries, self-destruction or any attempt thereat while sane or insane.
*
Dental care and related treatment except as necessitated by accidental bodily injury to sound natural teeth.
*
Cosmetic or plastic surgery, circumcision unless medically necessary, eye tests, refractive errors of the eyes, provision of appliances, including spectacles, hearing aids, wheelchairs and prostheses including lenses.
*
Sexually transmitted diseases.
*
Hospitalization primarily for diagnosis, X-ray examinations, general physical or medical check-up.
*
Charges for telephone, television, radio, newspaper, admission kit/pack and other ineligible non-medical items whilst admitted as in-patient.
*
Sickness or injury arising from racing of any kind (except on foot) professional sports, parachuting, skydiving, boxing, wrestling, professional scuba-diving, bungee jumping and violation or any attempt of violation of the law or resistance to lawful arrest.
*
Flying or other aerial activity except as a fare-paying passenger in a fully licensed aircraft operated by a licensed commercial air carrier or recognized charter company.
*
Treatment arising from any consequence, whether direct or indirect, of nuclear or chemical contamination, war, invasion, act of foreign enemy hostilities (whether war be declared or not), civil war, rebellion, revolution, direct participation in riot, strike and civil commotion, insurrection or military or usurped power, or active duty in any of the armed forces.
*
Any person who resides outside Malaysia for more than three (3) months continuously while the Policy is in force.
*
Investigation and treatment of sleep and snoring disorders, treatment for Hepatitis B and Hepatitis C, and hormone replacement therapy for menopausal conditions.
*
Psychotic, mental or nervous disorders, (including any neuroses and their physiological or psychosomatic manifestations).
*
Expenses incurred for sex change.
Underwriting ExclusionsThese are illnesses which are excluded from the policy or excluded for a duration specified by the Insurance Company.
Waiting PeriodIllness or Hospital Confinement, except for accidental injuries, which commence within the period of thirty (30) days from the date of original inception is excluded from the policy
This post has been edited by Civil: Dec 14 2006, 04:35 PM