QUOTE(blibala @ Oct 1 2021, 10:32 AM)
Should have declared accordingly. Now you are at risk of being denied of claims.Insurance Talk V7!, Your one stop Insurance Discussion
Insurance Talk V7!, Your one stop Insurance Discussion
|
|
Oct 1 2021, 10:33 AM
|
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]()
All Stars
10,162 posts Joined: Nov 2014 |
|
|
|
|
|
|
Oct 1 2021, 10:34 AM
|
![]() ![]() ![]() ![]() ![]() ![]()
Senior Member
1,913 posts Joined: Jan 2005 |
QUOTE(Ewa Wa @ Oct 1 2021, 10:08 AM) Is clearly written as "non disclosure" to decline the claim regardless is related or non related on the death which compliance with the FSA 2013 act. Else the FSA can be challenged and revise. If claim is payout, insurer is charity center and not profit orientated. Actually i wonder how insurance company know she had thyroid. If they can find out when she want to making claim, why dont insurer check before approve their application.. Cant say winning in court because already breach the FSA compliance, if insurer pay the claim is in GOOD WILL or known as Charity. They have no obligation to pay due to the breach of non disclosure. I want to question the single mother who knew she had thyroid problem WHY didn't disclosure? or The agent FAULT didn't write in the proposal form?? Whose fault? Agent or Client? The initial step when applying the policy is based on upmost good faith We as an insurance agent must must remind ourselves, all the health questionnaires must ask and answer honestly. read this article https://www.enanyang.my/%E8%A8%80%E8%AE%BA/...-IfW2D3BvFz5x4E In e-nanyang which written in Chinese. Is a good article on reviewing all the recent rejected claim. I really puzzle on this. |
|
|
Oct 1 2021, 10:36 AM
|
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]()
All Stars
10,162 posts Joined: Nov 2014 |
QUOTE(blibala @ Oct 1 2021, 10:34 AM) Actually i wonder how insurance company know she had thyroid. If they can find out when she want to making claim, why dont insurer check before approve their application.. I've explained this in another thread.I really puzzle on this. "Yes that's the practice now in Malaysia. Otherwise you wait long long before you can get your policy coverage. The turnaround time today for your policy to get activated is less than 15 minutes if it's a clean case with no illness history. If there is any investigation, it will probably take months before you can get your insurance policy issued. Keep in mind that your policy needs to be underwritten by an underwriter after assessing your risk profile before they decide to take you in, not just because you "paid" for the initial premium and already means it's considered an acceptance from the insurance company." |
|
|
Oct 1 2021, 10:42 AM
Show posts by this member only | IPv6 | Post
#1364
|
![]() ![]() ![]() ![]() ![]()
Senior Member
859 posts Joined: Feb 2008 |
QUOTE(blibala @ Oct 1 2021, 10:34 AM) Actually i wonder how insurance company know she had thyroid. If they can find out when she want to making claim, why dont insurer check before approve their application.. When policy sign up , insurer will do a brief check only , they expect customer declare everything.I really puzzle on this. When claim happen , many money gonna pay out , so they will trace every single record before payment is issues. But it really & case to case basis , have to see in details each case. Some court case win by customer, some win by insurer. This post has been edited by ping325: Oct 1 2021, 10:44 AM |
|
|
Oct 1 2021, 10:42 AM
|
![]() ![]() ![]() ![]() ![]() ![]()
Senior Member
1,913 posts Joined: Jan 2005 |
QUOTE(lifebalance @ Oct 1 2021, 10:36 AM) I've explained this in another thread. I see. Just my point of view. i understand insurer want to fast approve the application. However they can still investigate or review, say in 3 momth time on the history. If any info they found out from investigation they can always ask customer to clarify or cancel the policy. Then it is fair to both parties. Shouldn't when people want to make a claim then it rejects lor."Yes that's the practice now in Malaysia. Otherwise you wait long long before you can get your policy coverage. The turnaround time today for your policy to get activated is less than 15 minutes if it's a clean case with no illness history. If there is any investigation, it will probably take months before you can get your insurance policy issued. Keep in mind that your policy needs to be underwritten by an underwriter after assessing your risk profile before they decide to take you in, not just because you "paid" for the initial premium and already means it's considered an acceptance from the insurance company." Honestly i pity that single mother case. Her kids need the money to survive. |
|
|
Oct 1 2021, 10:47 AM
|
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]()
All Stars
10,162 posts Joined: Nov 2014 |
QUOTE(blibala @ Oct 1 2021, 10:42 AM) I see. Just my point of view. i understand insurer want to fast approve the application. However they can still investigate or review, say in 3 momth time on the history. If any info they found out from investigation they can always ask customer to clarify or cancel the policy. Then it is fair to both parties. Shouldn't when people want to make a claim then it rejects lor. That's not how it works. Firstly, manpower are required, are you willing to pay extra cost for insurance companies to hire 100 investigators to check on the applications? there are 1000+ applications for insurance everyday.Honestly i pity that single mother case. Her kids need the money to survive. And in the first place, Insurance companies are not health investigators, they are there to sell insurance. |
|
|
|
|
|
Oct 1 2021, 01:31 PM
Show posts by this member only | IPv6 | Post
#1367
|
![]() ![]() ![]() ![]()
Junior Member
685 posts Joined: Jul 2012 From: Kuala Lumpur |
QUOTE(blibala @ Oct 1 2021, 10:32 AM) Better ask ur agent to send in a letter signed by you to declare the above minor surgery. Then let the company to decide further investigate or remain the same conditions.One recent declined CI claim was non disclosure of back pain check up with no treatment too. The back pain was slip disc and did a MRI. This post has been edited by Ewa Wa: Oct 1 2021, 01:52 PM |
|
|
Oct 1 2021, 01:39 PM
|
![]() ![]() ![]() ![]()
Junior Member
685 posts Joined: Jul 2012 From: Kuala Lumpur |
QUOTE(blibala @ Oct 1 2021, 10:27 AM) My agent also never asked me on past medicsl record although all small case and minor surgery. Everything tick ok by himself. So what action csn i do? Bought aince many years ago. Just ask me give him blood test report. That's ur agent who a small group who didn't ask all the health questionnaire and infact putting customer in a dangerous situation when come to claim.Alot responsible agents outside including myself, who read line by line all health questionnaires which consist of lots medical term. by doing so, client heard the term then they remembered they have done the surgery or had this condition b4. A great reminder for all insurance agents who reading this. we can't pay the price of non disclosure for customer. |
|
|
Oct 1 2021, 02:00 PM
|
![]() ![]() ![]() ![]() ![]() ![]()
Senior Member
1,913 posts Joined: Jan 2005 |
QUOTE(Ewa Wa @ Oct 1 2021, 01:31 PM) Better ask ur agent to send in a letter signed by you to declare the above minor surgery. Then let the company to decide further investigate or remain the same conditions. Just curious. Actually how many years record can insurance company trace back? 5 years, 10 years or 20 years?One recent declined CI claim was non disclosure of back pain check up with no treatment too. The back pain was slip disc and did a MRI. |
|
|
Oct 1 2021, 03:42 PM
Show posts by this member only | IPv6 | Post
#1370
|
![]() ![]() ![]() ![]()
Junior Member
685 posts Joined: Jul 2012 From: Kuala Lumpur |
QUOTE(blibala @ Oct 1 2021, 02:00 PM) Just curious. Actually how many years record can insurance company trace back? 5 years, 10 years or 20 years? There are no specific time frame I heard some after 20 years still encountered claim declined. Any claim raised within 2 years of policy inforced, company will have a very detailed investigation compare those after 2 years but again don't try to hide any information and breach the non disclosure. I have one customer has forgotten about a Brain MRI he did 5 years ago and policy has been inforced for 3 years. So I have to resubmit this non disclosure information in and let the policy re-underwrite. Although with lots of hassle by running in out hospital to get doctor report and finally the same policy was imposed exclusion. So at least death happen claim still payout. Peace of mind ah.. |
|
|
Oct 1 2021, 11:41 PM
Show posts by this member only | IPv6 | Post
#1371
|
![]() ![]() ![]() ![]() ![]() ![]() ![]()
Senior Member
4,147 posts Joined: May 2005 |
|
|
|
Oct 2 2021, 12:13 AM
|
![]() ![]() ![]()
Junior Member
323 posts Joined: Sep 2007 |
Recently thinking to get another insurance to complement existing one. Any recommended agent? Preferably someone who is professional, experienced and not new agent
|
|
|
Oct 2 2021, 12:23 AM
Show posts by this member only | IPv6 | Post
#1373
|
![]() ![]() ![]() ![]() ![]()
Senior Member
859 posts Joined: Feb 2008 |
|
|
|
|
|
|
Oct 2 2021, 09:46 AM
|
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]()
All Stars
10,162 posts Joined: Nov 2014 |
QUOTE(Alvan86 @ Oct 2 2021, 12:13 AM) Recently thinking to get another insurance to complement existing one. Any recommended agent? Preferably someone who is professional, experienced and not new agent My profile: Financial Adviser Representative licensed under BNM, practicing insurance since 2012.What Is The Difference Between A Financial Adviser /Islamic Financial Adviser And An Insurance And Takaful Agent? FA / IFA is an independent party that provides financial advisory services to the customer based on the customer’s financial needs. Therefore, the FA / IFA sources for insurance policies and/or Takaful plans from multiple insurance companies and/or Takaful operators that best suit your needs. An insurance or Takaful agent represents its principal insurance company or Takaful operator and primarily sells insurance policies or Takaful plans issued by the insurance company or Takaful operator it represents. |
|
|
Oct 2 2021, 10:05 AM
|
![]() ![]() ![]() ![]() ![]() ![]() ![]()
Senior Member
2,866 posts Joined: Sep 2008 From: Wangsa Maju, KL |
QUOTE(Alvan86 @ Oct 2 2021, 12:13 AM) Recently thinking to get another insurance to complement existing one. Any recommended agent? Preferably someone who is professional, experienced and not new agent hi Alvan, there are many insurance agents here. you can send a private message to any that you wanna listen advice from. Because I as insurance agent will definitely promote myself. Holocene liked this post
|
|
|
Oct 2 2021, 11:02 AM
Show posts by this member only | IPv6 | Post
#1376
|
![]()
Junior Member
49 posts Joined: Jan 2009 |
Hi, would like to ask is there any medical insurance provides entry age until 75? or able to apply at age of 71?
|
|
|
Oct 2 2021, 11:17 AM
|
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]()
All Stars
10,162 posts Joined: Nov 2014 |
|
|
|
Oct 2 2021, 02:18 PM
|
![]() ![]()
Junior Member
109 posts Joined: Feb 2010 |
Hi guys, I have an AIA plan A-LifeLink 2. Last week I went to see doctor and did a CT scan outpatient. Does the plan allow me to claim the medical fee?
|
|
|
Oct 2 2021, 02:40 PM
Show posts by this member only | IPv6 | Post
#1379
|
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]()
All Stars
14,873 posts Joined: Mar 2015 |
QUOTE(tytung @ Oct 2 2021, 02:18 PM) Hi guys, I have an AIA plan A-LifeLink 2. Last week I went to see doctor and did a CT scan outpatient. Does the plan allow me to claim the medical fee? Not an insurance guy here,My guess is, if the CT scan is just for investigative purposes, then no, cannot claim If the results of the investigation leads to you having needed hospitalization to diagnose the problem detected by the CT scan, then you may submit the cost of this CT scan for claim.... BTW I think there is a duration of claim allowed after doing the CT scan n the hospitalization admission. What it means is, cannot wait too long to claim the cost of this CT scan. Ex, maybe 90 days or 30 days only... Just my wild uneducated guess, while waiting for real insurance sifus to response. This post has been edited by MUM: Oct 2 2021, 02:41 PM |
|
|
Oct 2 2021, 03:37 PM
|
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]()
All Stars
10,162 posts Joined: Nov 2014 |
QUOTE(tytung @ Oct 2 2021, 02:18 PM) Hi guys, I have an AIA plan A-LifeLink 2. Last week I went to see doctor and did a CT scan outpatient. Does the plan allow me to claim the medical fee? It's not covered if Hospitalisation primarily for investigatory purposes, diagnosis, X-ray examination, general physical or medical examinations, not incidental to treatment or diagnosis of a covered Disability or any treatment which is not Medically Necessary and any preventive treatments, preventive medicines or examinations carried out by a Physician (except the Health Screening and Vaccination under Prevention Benefit), vitamins/food supplements and treatments specifically for weight reduction or gain. |
| Change to: | 0.0195sec
0.43
6 queries
GZIP Disabled
Time is now: 8th December 2025 - 07:58 AM |