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 Insurance Talk V3, Anything and everything about insurance

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plumberly
post Jan 14 2016, 03:51 PM

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Need advice from sifu here.

My siblings have just completed paying off a shop loan. Like to see whether there are windows for us to save some insurance money.

AA
How is the insured amount arrived at for shop insurance? x% of the current market shop price?

BB
Are there different insurance policies, say, for fire only, for flood only, physical damage etc?

CC
Is the fee payable the same from all insurance companies for the same shop insurance coverage? That is standardised/controlled by the govt? If so, then no need for me asking around.

Thanks.
plumberly
post Jan 15 2016, 08:46 AM

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QUOTE(lifebalance @ Jan 14 2016, 07:54 PM)
AA
based on market value

BB
There is fire, you can add on flood, physical dmg etc.

CC
Almost standard, unless the insurance company see that you're purchasing a high sum, they can drop abit of price to compete. They have a rate book for each risk.
*
Noted and thanks.

AA
Market value includes the land price etc. Insurance will only cover for the reconstruction, maybe x% of the market value?

Suppose I insure for RM0.5 million. After reconstruction, the bill is only RM0.4 million. Can I claim for RM0.5 million?

BB
So the costs will be different depending on the extent of coverage. I thought there is only a standard building coverage.

CC
So I should pool all my insurance with 1 company and try to get a better deal. Ha.

Many thanks.
plumberly
post Jan 15 2016, 09:15 AM

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QUOTE(lifebalance @ Jan 15 2016, 09:03 AM)
It's better to over insure than under insure because if it's under insured say the market value was found to be 0.5m that time and insurance is only 0.4% that will be lesser by 20% of the original insurance coverage so the insurance company will only compensate 80% of 0.4m

Fire insurance is main coverage for a building policy and from there you can add on other perils if necessary

Yeap provided all the building belong to the same company
*
Many thanks!
plumberly
post Jan 16 2016, 03:26 PM

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QUOTE(lifebalance @ Jan 15 2016, 09:03 AM)
It's better to over insure than under insure because if it's under insured say the market value was found to be 0.5m that time and insurance is only 0.4% that will be lesser by 20% of the original insurance coverage so the insurance company will only compensate 80% of 0.4m

Fire insurance is main coverage for a building policy and from there you can add on other perils if necessary

Yeap provided all the building belong to the same company
*
One question came to mind.

If a shop (with shop insurance) got burnt down, can the owner claim for the insured amount after all the legal things have been sorted out (police report etc)?

Or the insurance company will only pay for the reconstruction cost up to the insured value over a period of time?

Thanks.

P/S Will this be fair estimation of the insured value?

AA Purchase price = 0.5 million
BB Each year, add 3% inflation
CC Insured value = 80% of BB


plumberly
post Sep 9 2016, 04:19 PM

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For shop reconstruction insurance how can I decide on the insured amount?

For following years, based on construction index?

Thanks.
plumberly
post Sep 9 2016, 07:03 PM

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QUOTE(lifebalance @ Sep 9 2016, 06:10 PM)
For Shop, if it's landed, can take in about 70 - 80% of the value of the property as the sum assured. If it's not landed, then cover 100% of the value of the property.
Thanks.

AA
If the purchase price is RM1 million today and I insure it for RM1.5 million, something happened resulting in complete demolition, will they pay RM1.5 million or only the market cost?

BB
How much to insure for 2nd, 3rd ... years?

Just add inflation?

Thanks.
plumberly
post Sep 13 2016, 10:45 AM

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QUOTE(cherroy @ Sep 13 2016, 10:27 AM)
You are wasting your money when over-insured.

Insurance will only compensate based on the market price of insured property.

But if one wants to insure 1.5 mil, and paying the premium based on 1.5 mil, I don't think insurance company will reject though.  laugh.gif
*
Thanks.

Realised a few months ago that I have over insured my house contents as I used the same values as when I started the insurance some 4 years ago.

Checked with the insurance company and he said the same thing, can only get the market values, not the insured values whichever are lower.

Not really fair that they will take your premium for over insured items, knowing that they will not pay the insured values! I know, we should know as customers but they should also do their part as an ethical business.

Ha.
plumberly
post Sep 26 2016, 09:18 AM

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I have been wondering why insurance company will only accept claims for in-patient treatment and not for day patient treatment. For patient's medical claim, doctor may state treatment is in-patient and thus charge a bigger bill. OK for the patient as the insurance company is paying for the bigger bill. Not really the case.

* patient does not incur higher cost with the in-patient bill
* insurance company pays the bill
* doctor gains extra $$ for no extra work
* insurance company profit is less, increase insurance premium
* patient pays higher premium

I may be wrong with my logic above, patients pay more in the end with the in-patient policy.

See The Star article below.

Attached Image

Can someone in the insurance field help me on why only in-patient claims?

Only the more serious treatments (ie in patient) are covered?

I had a not-so-nice encounter with this day & in-patient thing at the medical center here recently.

Cheerio.


plumberly
post Sep 26 2016, 07:21 PM

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QUOTE(JIUHWEI @ Sep 26 2016, 05:43 PM)
A good rule-of-thumb/guide to whether or not an admission/treatment is claimable (applies to day procedures as well):

1) There is a treatment done, and the treatment is medically necessary.
Examples: dengue, slip disc, cardiac arrest, broken bones, injury due to accident, organ transplant, all critical illnesses, etc.
Some cosmetic advertisements that I noticed on the radio recently are marketing their procedure as a "treatment" for freckles and/or dark spots. These are categorized under aesthetic procedures and are not claimable.

2) What constitutes an injury due to accident:
It is sudden, violent, and/or external impact.
Examples: I waving goodbye to my uncles and aunties. Smart sibling of mine slam the car door shut. My fingers broken.
Verdict: it is sudden, it is external impact. Claimable.

3) Majority of rejected claims are due to incomplete documents.
Example of documents: medical report, claim forms, original receipts, itemized billing, credit card deposit receipt (if applicable).

Is this helpful? Let me know!
*
Many thanks.

AA
What about something which develops overtime and later needs treatment, say, skin rash which later gets infected?

BB
I pick my nose and later bleeding internally?

Thanks.

P/S Wonder why do some clinics at the start ask whether payment is by cash or via claim? Don't think it is because they need to know for their payment process.
plumberly
post Sep 26 2016, 07:42 PM

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QUOTE(lifebalance @ Sep 26 2016, 07:37 PM)
a. Unless it's required to be hospitalized by the doctor if it's deemed very serious then yes, otherwise, normal skin rash you can eat medicine and get well soon.

b.
Falls under Emergency Accidental Out-Patient Treatment, unless it's just some skin got removed then a cotton can be used to stop it, then nothing much you can claim and go back home.

The point is, if the injury is so light that some bandage can just solve the issue, why do you need to claim from the medical card ?

E.g you bump your leg into a chair and got a black and blue bruise, do you just solve it there and then or still head to the hospital ?
*
OK, my scenario is not that good.

Let me qualify further.

Suppose the bleeding is continuous and cotton/bandage at home is barely adequate. Then?
plumberly
post Sep 26 2016, 09:23 PM

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QUOTE(lifebalance @ Sep 26 2016, 07:51 PM)
Then head to the hospital if it's continuously and you fill that you've poked more than just the outer nose. There is no hard and fast rule, just pure logic. Even if you feel that it's not serious but you need to head to the hospital to check thoroughly and end up the doctor said everything is fine, just gave him some plaster and medicine. Then you have to just pay for the plaster, medicine, consultation on your own.

If the doctor that you broke your nose or there is internal bleeding and he needs the ENT surgeon to have an X-Ray and he needs to be warded, then yes, you can claim for it.
*
Thanks.

Some twist and turn here. Ha.


plumberly
post Sep 26 2016, 09:59 PM

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QUOTE(JIUHWEI @ Sep 26 2016, 09:47 PM)
laugh.gif

AA: As long as the treatment is justifiable for a treatment at the hospital, it will be claimable.
Let me share with you my personal experience with a client: She was rushed to the ER, but GL was declined citing procedure can be done as an outpatient. So she paid and later on I proceed to process the claim for her.
All documentations were complete and the claim cheque was delivered few weeks later.
Client happy, I also happy.

BB: Maybe you want to turn it down a notch with the gold digging  sweat.gif
But if it was really serious and require stitches from your inner nostril membrane, technically it is a self-inflicted injury and rightly written in the policy self inflicted injury is excluded.
But you don't so straight arrow tell the doctor you gila korek la. I also dunno how to taichi this one... But you taichi with the doctor lah. Janji the doctor buys your story.  whistling.gif

P/S: Individual medical cards usually only cover hospitalization and not clinics.
But take for example you are holding a corporate card and it includes clinic visits. By cash you can bring the receipts back to your HR dept to process the claim. By medical card, it'll be charged straight through and you won't have to part with that RM50-55 for any period at all.

Did I do a good job at answering your questions/concerns? Let me know!  thumbsup.gif
*
Very good. And funny too.

Much appreciated learning from you.
plumberly
post Sep 27 2016, 07:46 PM

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QUOTE(roystevenung @ Sep 27 2016, 07:28 PM)
If the surgery can be done as Day Care Surgery, it is better as it saves costs.

Most of the insurer is also able to provide the Letter of Authorization for Day Care Surgery if the surgery can be pre-planned.
*
Thanks. Good to know.

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