Hi everyone, i have question about AIA A-Plus health medical card. It is specifically mentioned in the brochure that ''specialist consultation'' is covered. Does this means General Practitioner consultation is not covered? and does AIA cover consultation by more than one specialist? Thanks in advanced

Part 1 of your question:
Payment will not be made for clinical treatment (including medications and subsequent consultation after the Disability is diagnosed) or where the Insured Person does not result in Hospital Confinement for the treatment of the medical condition diagnosed.

Part 2 of your question
The number of consultation payable per day is limited to one (1) consultation of no more than one (1) Specialist per day.

For part 1, ''Payment will not be made for clinical treatment (including medications and subsequent consultation after the Disability is diagnosed)'', what is the meaning of ''clinical treatment''? means treating the disease without hospitalization?

For part 2, so lets say we have several scenarios :
Scenario 1: One GP and one specialist on the same day--> can claim specialist only but not GP
Scenario 2: One GP and one specialist on different day --> both can claim
Scenario 3: One GP and two specialists, all three on different day --> all can claim

Is my understanding correct? Thanks in advanced

Clinical = Clinic, it's clear cut, if your treatment in a clinic did not require you to be hospitalized thereafter, any clinical fee incurred will not be entertained by the insurance company.

You can't simply engage with another specialist when you're already consulting an existing specialist unless it's been referred to by the existing specialist that you're engaging. What you're seeking for is a Second Medical Opinion which is not be covered by the insurance company under this Plan.

As for your question on frequency of claim.

For any clinical fees you have incurred within the 60 days prior to Hospitalization with GP, you may file back a claim with the insurance company.

During the time before you're admitted to hospital, you may have consulted a specialist for his medical opinion and resulted in you being recommended to be hospitalized. The fee incurred for the consultation with the specialist will also be covered within the 60 days.

This post has been edited by lifebalance: Aug 1 2020, 09:35 PM

Oh i see, If i consult a GP first, then the GP refer me to a specialist, and the specialist refer me to another specialist, all 3 consultation can claim right if hospitalization is required? thanks

Yes, otherwise after all the consultation and find out there is nothing and you're not hospitalized. Then you're not able to make any claims.

Oh okay understood. What about during my stay in hospital? If i see several doctors when i am hospitalized does AIA have any limit to the number of doctors that i can claim?

A patient is eligible for '2 visits per day per physician'.

oh sorry i overlooked that

For allianz medical card (medisafe infinite +), it specifically mentions immunotherapy , hormonal therapy and targeted therapy are covered under outpatient cancer treatment. Does this means for other companies like prudential and AIA, these 3 therapies are not covered?

This post has been edited by tan71500: Aug 2 2020, 10:20 PM

Subject to approval. Since its not mentioned explicitly, the insurance company you've mentioned may say that they will not cover for it.

Though so far it's on case to case basis

oh i see thank you for your answer

Hi everyone,

Happy Monday!

Would need advise on the insurance plan quoted by an agent last week to me.



First concern: Was wondering if the monthly premium if too high for this ILP (anyone has similar package?) I know that standalone medical card and critical illness policies are definitely cheaper but I have done so much reading/checking and most independent websites recommend that Allianz Medisafe Infinite+ as one of the best choices for medical card but it's a rider type.

My focus right now is only to have better coverage for medical card and critical illness. I already have a few insurance that have higher payout for Life/TPD.

Another insurance agent from GE (a friend) mentioned that nowadays most insurance will always focus on selling ILP to customers for all-in-one package (since it's the trend) and of course, at the end of the day, it's the most commissions agents can get when selling ILP. He did quote me a similar package for GE to match the coverage by Allianz but the monthly premium is higher at RM575 and I need to top up / pay extra since I wanted early payout for critical care, whereas Allianz already have payout at all stages.

Second concern: Allianz definitely have the holistic package but unsure how fast they process guarantee letters and claims.


Thank you!

Good morning,

You will need to check how long is the sustainability of the policy compared to GE.

Allianz does provide a much more comprehensive coverage compared to GE in terms of overall benefits.

However the Cost of Insurance will be much more higher in comparison. GE will on a high side as well since they’ve done a repricing recently and have experience up to 40% increase in cost.

Again I am not able to comment much until I know you myself better in terms of existing policies, risk that you may need to cover & your other plannings.

As for reliability in claims, I believe most of the life insurance company follows the same protocol to ensure the policy holder gets their payout on time. When it comes to admission of hospitalization, it will depend sometimes on the hospital’s side to file in the claim request to the insurance company as soon as possible for the insurance company to respond and check a few things with the policy holder
I.e
is the policy holder covered for such procedure / illness ?
Is the policy still active?
Is the policy holder excluded of such claims
Before they can proceed to issue any guarantee letter.

This post has been edited by lifebalance: Aug 3 2020, 11:20 AM

A lot of times how fast a GL is issued is dependent on how fast the hospital replies the GL processing department for any inquiries, if required.

Otherwise I believe all insurance company have strict KPIs on timely GL approval, it’s only good business sense to do so.

As for the premium quoted, I am not sure how the agent was able to quote you that premium as I am looking at my system and the lowest premium for that coverage is RM7368.

Best,
Jiansheng

As you already have few insurance with better coverage, you can consider to reduce the sum assured for this new policy for a lower premium. A similar package with some variation would probably in the range of RM450/RM500 monthly.

hi glitz2z, reply as per above. very hard to determine whether that premium is high or not. also since you have other active policies. you might wanna hear from an unbiased advice on what you have and what you need/want then only go for what best suits you.

You will need to check about the sustainability of the policy for each insurance company. Some policy designs have longer sustainability and some are shorter.

Another thing to check is the life insurance and critical illness payout whether they are shared or separated during claims.

Hi everyone,

May I know, what is the best insurance for my dad that is age of 66 this year?

Perhaps with lower premium with good coverage.

He is healthy but diagnosed with glaucoma.

Thank you

This post has been edited by TomRiderss: Aug 4 2020, 12:51 AM

Best insurance is the one that is tailored to your personal risk planning.