what is your estimated of Covid19 coverage amount to be?
any idea cost of Covid19 stage 5 treatment at a private hospital?

There are plenty of plans now that covers COVID 19 for Stage 3 - 5.

Etiqa's limit is up to RM150k so if it so happens to fall under Category 5 then it may not be able to cover for the entire cost (assuming the fee is 200k and above).

That being said, insurance is a long term plan so it's advisable to get something that will last you for a long time as well without having to change it so frequently.

If you're looking for something slightly higher than 150k Limit then you can consider AIA's which covers 500k per annum.

For now, all I can see is etiqa stand alone for RM150K ( for RM650 a year).

I would be willing to pay more if there was a medical stand alone for COVID19 at RM250K /300K incase of ICU hospiitalisation


What risk I am trying to counter: In case hospital GH is full and I need to go private

according to this,...
"All non-Covid-19 patients admitted to private hospitals need not worry about the cost of treatment as it will be borne by the government and private entities."
https://malaysia.news.yahoo.com/head-privat...-093127381.html

what if unless one decided to go to private hospital on their own decision/choice?.....

This post has been edited by MUM: Aug 27 2021, 09:51 PM

The Headline and the body story of this article does not match, quite confusing.

Header says COVID19 patients but the rep Dr Kuljit was explaining that NON COVID patients would not bear the private hospitalcharges

ya lor...


not sure if it is for self walk in or government initiated transfer....
Covid-19 patients in private hospitals will have to foot their own bills, said Association of Private Hospitals of Malaysia (APHM) president Datuk Dr Kuljit Singh.

He said patients would have to pay on their own or via their health insurance if their provider was willing to bear the cost.
"For now, the private sector is empowered to treat Covid-19 patients who can afford to pay for the medical costs and treatment themselves," he said in a statement here today.

Earlier Health director-general Tan Sri Dr Noor Hisham Abdullah said expatriates, the business community who can afford treatment at private hospitals are free to do so and do not need referrals from public health facilities.
https://www.nst.com.my/news/nation/2021/01/...-covid-19-costs

This post has been edited by MUM: Aug 28 2021, 11:24 AM

If you are looking specifically for covid 19, the best bet is to work with ILP as it has a higher limit. Period.
Your agent would guide you on the options to work within the set perimeters on the premium.

Hi all,
Previously I remember someone mentioned GE SPE2 Plan cannot directly upgrade from SMX to SmartMedic Million, wondering is that still the same for now?

hi thediablo, GE AIA and Manulife standalone medical card to pay out for covid19 hospital admission. only thing you need to take note is that now no medical card will issue GL for hospital admission due to covid19. so on top of medical card, you might wanna look into comprehensive critical illnesess coverage that will pay out if admitted into ICU for certain number of days (check respective companies coverage on this).

hi TaiGoh, if im not mistaken, now SPE2 can add in SmartMedic Million medical card already.

Hi, is anyone here have insurance from Gathercare.

Monthly less than 50, RM 1,000,000 Medical Protection
Increase by RM 200,000 yearly

from its website
https://gathercare.com/

GatherCare is not an insurance or takaful, but an alternative solution to medical costs by providing a platform for people to come together to form a community and share their medical bill through program.

name changed from previously Life Engineering.
there is a active thread on it too,...
Life Engineering Health pooling scheme, Anyone got participate?
https://forum.lowyat.net/topic/4636224/all


This post has been edited by MUM: Aug 29 2021, 10:20 PM

Apply at your own risk since it's non-regulated.



To me, it makes no sense as peeps are just contributing RM50, while the claim is quite high in their sharing. Unless someone behind them is giving free money to pay claims / charity + assuming they are earning nothing out of this (which I highly doubt so).

Anyways, enter at your own risk.

Thanks. I see that you have made some comparison.
Its not a complete package but still good enough for someone who really cant really affford normal ilp insurance. Maybe can supplement it with some other insurance since their monthly also only around RM10-15 monthly average

Yup its not regulated maybe cause its a first of its kind i think
Their claim not high as you can check they will share every month total cost divide with all sharer. Till date their average per month less than 10
They have a annual fee of 360. Hope so in future they have many other coverage.

This post has been edited by Aghi: Aug 29 2021, 11:19 PM

just for discussion, I have been wondering why AIA (& Etiqa?) included communicable disease in their policy?(of course this is good for consumers)

Does it mean AIA already priced in communicable disease in their premium?

This post has been edited by onthefly: Aug 30 2021, 12:11 AM

Reading the finer prints are more important than the general coverage disclosure.

In addition, the final claim is still subject to their approval. From experience, they can just pick a word from the policy to reject a claim.

Yes, of course.

Mind sharing the experience where any insurer "just pick a word from the policy to reject a claim" ?

When I first bought the CI policy, the brochure did indicate SLE claim in general (I misplaced tbe brochure btw). Layman then, wouldnt know the finer details until the sickness came.

Even the specialist then advised to make a claim as SLE can attack any organs anytime and to seek follow up treatment throughout one lifetime.

But insurer rejected the claim stating the current sickness didnt attack the 'major' organs ... heart, kidneys and lungs.

Of course after reading the finer details, it is stated.

Dr said is SLE, and how would a insured know it have to be 'major' organs then ?

When SLE attacks other than 'major' organs ... for example the joints, the patients cannot move as the pain is unbearable. He can only lay on bed and the dr will inject steriod on the joint parts. I cant imagine the after effect if is 'major' organs.

What use is the claim when it oredi attach the 'major' organs ?

The 8 days bill came to over 10k then which is covered by the medical card. If is major organ, I wonder how much will it be.

I dont think all agents would know if they dont have experience with such claim or any claims for that matter to explain clearly to their client. Even if a client do ask such detailed questions for a specific CI, more likely, he has the underlying illness and the application will be rejected.

With 36 CI, I doubt any agent would have the medical knowledge to be specific.....what can and cant....or would he spend the whole day explaining in finer details ?

This post has been edited by mini orchard: Aug 30 2021, 12:54 PM

Maybe you can let us know about the product name? There are many archived brochures that we can find online.
Secondly, you may also refer to your policy contract, because that is a legally binding document.
There are many different kinds of CI coverage, which provides coverage at different levels. Perhaps you can refer to the company CS rep over the phone for clarity.
I know it sounds like I'm handing out assignments, but I'm just trying to live up to your level to be specific here.

Just like you said, we are agents, aka intermediaries. We are not the claims officer nor are we fit to assess medical reports.
What we can do during a claim is to assist with the claims process.
However, regarding the CI products that we sell, they have different levels of coverage and come with different costs.
I think it does require some level of proficiency from us in order to sell these products.
It may not be specific to the conditions, but those are explicitly mentioned and printed too.
In fact, should your condition qualify on other terms such as "unable to perform self-caring activities", some CI policies have such terms, there is no reason for the insurer to deny your claim.

Perhaps I can encourage you to hangout with more insurance agents, and talk to them about insurance products in the market.
Nobody is trying to sell you something all the time.

As an agent, can you answer this truthfully and not based on my post but your knowledge if I will to ask you during proposal stage .....

Is SLE claimable under CI ?

The short answer is Yes.

The long answer is this:
Under Early Critical Illness coverage products (pretty generic), yes it covers. Once diagnosed, there will be a payout (usually at a certain predetermined percentage).

Under accelerated Critical illness coverage products, it requires not only SLE, but also with severe kidney complications before it qualifies for a payout.

During proposal stage... when such a specific question comes up, it's so easy, just dive into the policy wording and it will be printed there.
After that is done, the next question to ask is "does it run in your family? Or have you been diagnosed before? How come so interested in SLE?"
Fact-finding mah, sure will ask if the prospect is being oddly specific.

Note that I'm trying to be as generic as I can, the statement above should only be taken as a reference, kindly refer to your own policy contract for more certain terms of your own coverage.

Also note that I do not know mini orchard's condition, I have not seen his/her report, I have not seen his/her policy contract, I am not his/her writing or servicing agent, nor have I ever assisted him/her with any claims, I never met him/her in my life.

The person to determine your condition: your attending physician
The person to assess your claim: claims officer

I'm merely providing generic information.

This post has been edited by JIUHWEI: Aug 30 2021, 01:39 PM