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 Insurance Talk V7!, Your one stop Insurance Discussion

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mini orchard
post Oct 4 2023, 10:06 PM

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QUOTE(Moneylust @ Oct 4 2023, 09:23 PM)
Thanks, mini orchard.  Yes, please share your contacts. Can PM me if you prefer.
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Will do and fyi those contacts are not related to me and don't need to quote me also.

You decide if you want to deal with either one or none. No obligations.

This post has been edited by mini orchard: Oct 4 2023, 10:35 PM
mini orchard
post Oct 4 2023, 11:00 PM

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QUOTE(Ramjade @ Oct 4 2023, 10:18 PM)
I can't give you advice cause you need to decide what is best for your own money.

I was with GE for one reason because their total premium for standalone is cheaper than AIA if I choose to cover until 80. Yes I count my premium. But then I exercise my cooling period within 14 days of buying my insurance. Why? For 2 reasons.
1. You see I have friends working in private hospitals and I asked their opinion, among all the insurance which you guys deal with, which one is the one most problematic (denied insurance or ask lots of questions)
The answer came out to be cuepacs care and GE. I was like if it is one person saying it, it might be nothing. If 3 people telling me the same thing, something is not right. Don't get me wrong about GE, they do approve your GL but the way they asked lots of questions and try delaying your admission shows they are "not sincere". Yes even simple food poisoning GE asking reasons for admission.
I then asked them the next question. Which do you guys prefer? They tell me AIA or prudential. Usually no questions asked as long as you pay on time and in full (insurance not lapse and you let your insurance mature 2 years). Since prudential have no standalone and I am not getting an ILP after all the research I found, AIA it is.
For me very simple. I am honest with my insurance company, already pay on time and in full. I want to be covered when I need the coverage. I expect them to honour their part of the bargain as I already honour mine.
2. Saw the news about GE denied someone their cancer payout in the news just because they didn't declare anxiety? Yeah. That. What does anxiety got to do with cancer? Maybe got I don't know.
https://www.thestar.com.my/news/nation/2021...surance-company

What should you be need to be aware of if you buy a new standalone plan from GE?
1. You no longer have investment part to cover your insurance premium. You are now your own ILP. You are not paying anyone to manage your investment part anymore and you want to use your insurance when you are old right?
If you cannot pay your premium when you are at 50-80 years old (the time when you will use the insurance the most), then how are you going to use your insurance?
So if you were to go down the standalone route, whatever savings you have dump it into EPF (the difference between paying for standalone premium Vs ILP). This is the easiest way for people don't want to invest overseas or think about opening foreign brokerage. Do not spend this money in any way. Many people spend this money. This is you doing your own ILP without paying additional fees and you are getting more or less fixed 5%p.a (being conservative here).
At age 55 years old, you can take out your EPF money and slowly use it to pay your insurance premium. If you have been doing this regularly every year until you retire, you have quite a large sum. The large sum can sustain your medical insurance until it expires or you expire. You got RM100k by the govt. Use it if you want.
Remember by going ILP route first 2-3 years only 60% of what you pay is premium and investment. The rest is commission. So you lose 2-3 of compounding already.
2. Any new medical insurance does not cover any existing illness. If you got any existing illness, read back mini orchard post to see if you want get new insurance.
3. You likely will get back less money than you paid for your ILP. Cause as mentioned money paid out as commission already and possible market loss
4. Waiting period of 2 years. This applies to all medical insurance. Apart from viral fever, dengue and accident, all insurance have the right to ask you to pay and claim first if you want to use the insurance within 2 years. During this waiting period, by asking you to pay and claim first, they are trying to dig up info and see if you committed any fraud.
5. You lose access to premium holiday. Unlike ILP you can choose to not pay for few months and insurance won't lapse. No such thing with standalone. You don't pay within 30 days of deadline, it will be lapse. If you pay after the 30 days, your waiting period starts again. No issue if you are a good pay master.
6. There is no cash value in stand alone medical insurance. It's money burn yo. Some people cannot accept this fact. Only way to get your money back is get yourself admitted. There is no other way.
7. You lose your rider like your life insurance, critical insurance, waiver if you have them as it is now a pure medical insurance.
8. Be prepared for the premium increase as you age. What you see is generally what you pay. Increment is normal. You cannot run away. Embrace it. Prepare for it. But on the upside you are not subjected to more increase if market is not doing well cause as mentioned you are your own ILP now.
9. The above stuff about GE.
10. You save on management fees as you are not paying annual management fees for your unit trust anymore.

Hope this help. Again sorry for the wall of text.
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This GE is f*C* up.

My spouse with them for over 20 years and beginning of this year was ask to pay first and claim later 😡.

Ask agent why, also cannot explain.

Spouse so upset and will try another admission year end or next year.

Just for lipoma operation only wor.

This post has been edited by mini orchard: Oct 4 2023, 11:01 PM
mini orchard
post Oct 5 2023, 05:20 AM

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QUOTE(denion @ Oct 4 2023, 11:34 PM)
hi mini orchard, more like agent didn't put effort to find out. by right, you should be informed of the reason of the GL decline. btw the medical card that your spouse is currently using is already more than 20 years?
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Yes. And first time trying to admit for surgery.

I suspect the insurer didn't want to approve is because we didn't agreed to the proposed premium increment but choose the minimal option.

I am not sure how the agent works as there was no further purchase of new policy.

QUOTE(Ramjade @ Oct 4 2023, 11:09 PM)
Surprisingly they are ok in Singapore. Talked to few agents in Singapore selling other company insurance they told me Great Eastern so far no issue in Singapore.

Maybe can do outpatient?
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We did ask the operations procedure and dr said to admit.

My spouse never like hospital esp the needle and knife and rather hold on to the operation.

If not because of my nagging and encouragement, we wouldn't have gone for the appointment.

Premium is due in Dec and has adjusted from 3.5k to almost 6k. If I compare the new premium to the standalone policy for the same age band, is 50% higher .... what ILP 😡 are we talking here?

Maybe after the operation, will decide to cancel the policy and buy another. See how the next hospital admission goes. Cannot afford to take risk if something more serious and ask to pay first claim again 😡

This post has been edited by mini orchard: Oct 5 2023, 07:49 AM
mini orchard
post Oct 5 2023, 09:45 AM

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QUOTE(Rinth @ Oct 5 2023, 09:40 AM)
under what circumstances ins co will ask pay 1st claim later?

What i understand is if ins co issue Guarantee letter to hospital, then thats mean we no need to pay anything except the small fees (should be the so call deductible)

So your spouse case is they dun issue Guarantee letter to hospital? and ask you to pay everything then later only submit to ins co & claim?

Ins Co have all the rights not to issue guarantee letter?
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The policy came with a medical card for easy admission.

The hosp called to inform our admission is declined and to pay all first claim later. Co insurance is RM300.


mini orchard
post Oct 5 2023, 10:56 AM

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QUOTE(denion @ Oct 5 2023, 10:22 AM)
based on my experience, company got no rights to decline GL because you don't agree to the premium increment. if you don't mind to call the hotline on your medical card, you can actually call and ask. remember to record down the conversation. the reason of decline must tally with what is stated in contract document for example:
1. maybe got premium due
2. policy on premium holiday
3. condition is fall under exclusion clause

find out first before having the thought of cancelling the medical card and purchasing a new one after the op. if it falls under exclusion clause, then likely even you change to another medical card, same thing will occur again.
hi Rinth, insurance company got the rights to not issue GL and ask us to pay 1st claim later but not without reason, there will be a reason, need to find out either via agent or the GL hotline.
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For over twenty years, never missed a payment.

Even if there is exclusion clause applicable, the insurer will inform, right ?

Will call cs when ready for next admission.

.
mini orchard
post Oct 5 2023, 02:01 PM

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QUOTE(Ramjade @ Oct 5 2023, 11:15 AM)
From what I know
1. Usually still under waiting period 2 years
2. Questionable admission. Eg they know it is daycare stuff but admit?

Actually wrong. There are some stuff not covered by GL. Supplements, vitmains, experimental drugs, investigations which don't tally with what you are admitting for, plus some small stuff.

Yes. That is correct. So you pay first and submit. They can then investigate and see if want to pay you. sad.gif

mini orchard wow. That is a very steep jump for ILP.
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I oredi advised her about ILP and now she realised her mistakes 😭.... I no agent lar, got return ma, no money pay no problem, after X years can self pay blah blah blah.

I am a conservative investor and don't like too much risks. As long can make some little money and don't lose my principal, I am ok.

For 3 years the insurer oredi ask her to top up her premium or pay the minimum and she choose the latter. Not sure how long the policy can sustain.
mini orchard
post Oct 5 2023, 02:15 PM

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QUOTE(denion @ Oct 5 2023, 10:22 AM)
based on my experience, company got no rights to decline GL because you don't agree to the premium increment. if you don't mind to call the hotline on your medical card, you can actually call and ask. remember to record down the conversation. the reason of decline must tally with what is stated in contract document for example:
1. maybe got premium due
2. policy on premium holiday
3. condition is fall under exclusion clause
4. non-disclosure
5. contestable period (we can exclude this since you said the policy is more than 20 years old)

find out first before having the thought of cancelling the medical card and purchasing a new one after the op. if it falls under exclusion clause, then likely even you change to another medical card, same thing will occur again.
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I called CS and they said lipoma is not covered under GL but can pay first claim later for consideration.

So is not an exclusion clause.

So what is your advise ?

If cannot claim, then I will advise her to do it in PPUM which is cheaper. So much uncertainty ... can claim or cannot claim, can claim, how much ?

This post has been edited by mini orchard: Oct 5 2023, 02:22 PM
mini orchard
post Oct 5 2023, 02:42 PM

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QUOTE(Ramjade @ Oct 5 2023, 02:26 PM)
You can still claim from ppum. Just recipe from ppum. Maybe RM50-100 only? Unless you do under plum private branch.There is govt and private branch. It's whether they want to payout when you file your claim is another question. Claim can always be submitted. But payout subject to approval by insurance company.
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I am not sure how much is the charges in PPUM but from exp it won't be expensive.

When I did my triggered finger operation in PPUM, it was RM180. Ramsay est cost is 3k 😲

So my spouse policy has a co-pay of 300. If charges for example is 300 - 500, then I would just be wasting time submitting a claim ... get medical report, waiting time, fill in forms etc 😡
mini orchard
post Oct 5 2023, 07:03 PM

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And does sharing info in a forum deserved a report ?
mini orchard
post Oct 6 2023, 03:10 PM

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QUOTE(denion @ Oct 6 2023, 01:04 PM)
there is no exclusion for lipoma. i think to be precised, this day care surgery is not covered under GL. if it's under exclusion, you can even demand for the exclusion clause from the personnel. but from my understanding, no, lipoma is not in the exclusion list.
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For day care surgery claim, what are normally not approved other than dr fee and hospital facilities ?

Is medication, pre and post hospitalisation consultation fee claimable ?
mini orchard
post Oct 6 2023, 04:06 PM

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QUOTE(denion @ Oct 6 2023, 03:28 PM)
whatever is claimable/non-claimable is exactly same as admission. yes even pre/post hospitalisation consultation/medication is claimable. btw, better to clarify, what is the medical card name that your wife has?
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Great Eastern Protectlink.
mini orchard
post Oct 6 2023, 07:09 PM

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QUOTE(denion @ Oct 6 2023, 06:56 PM)
the plan of the name is Great ProtectLink. what about the medical card name?

is it IL Health Protector?
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This is the card attached with the policy.

The bottom are name and ic no.

During admission application, we just gave the card and ic.


Attached Image

Attached Image

The letter received through email.

Attached Image

This post has been edited by mini orchard: Oct 6 2023, 08:00 PM
mini orchard
post Oct 7 2023, 12:19 PM

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QUOTE(denion @ Oct 7 2023, 12:13 PM)
okay, good that you have the letter. likely is due to day care surgery for lipoma excision. i did this claim before but for Prudential, also file and claim basis. so i assume the surgery is not yet done based on what you mentioned? did the size of lipoma grow from diagnosed till now (around 8 months+?)?
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Is growing but have to convince my spouse to do it.

Since you mentioned earlier that claim is similar to admission, so we go to private and just co pay the 300.

Thanks for the info.

Good day.
mini orchard
post Oct 10 2023, 05:37 PM

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QUOTE(Seybold @ Oct 10 2023, 05:24 PM)
my friends dad 40 years old didnt purchase any insurance card. can he still purchase although he is healthy?
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Buy when one is young and in good health.

Having said the above, those with previous or existing illness can still buy if the insurer is willing to undertake the risk. Of course it will comes with some terms and whether the applicant is willing to share the risk.

Examples of risk sharing .... higher premium or deductible. The next will be exclusion clause and the final is rejection.

This post has been edited by mini orchard: Oct 10 2023, 05:41 PM
mini orchard
post Oct 12 2023, 05:42 PM

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QUOTE(Gaza @ Oct 12 2023, 04:52 PM)
Has any agent here registered a client with "sleep apnea" before? Has it caused problems when getting insured? I have snoring problem but scared to do sleep study and find out the result because may affect my future insurance applications.
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I don't think you should approach insuring yourself in that manner.
mini orchard
post Oct 14 2023, 08:39 AM

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QUOTE(smallgiant @ Oct 13 2023, 07:43 PM)
Possible, but lapse is only one or two yeas, so highly unlikely the the account value had dropped to 0, mind you this policy is from 2007; if it did drop to 0, their fund manager must be really, really shitty.
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Most people are generally lousy 'investors' in any investing co for few reasons only known to the investor or promoters.

They only realised when things make a U-turn.

Some are 'forced' to cont playing the 'game' while others will just accept the losses.

This post has been edited by mini orchard: Oct 14 2023, 09:40 AM
mini orchard
post Oct 15 2023, 10:21 AM

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Attached Image

Attached File  prudential_claims_payout_2023_h1_2.pdf ( 2.31mb ) Number of downloads: 7

mini orchard
post Oct 16 2023, 07:37 AM

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QUOTE(Gaza @ Oct 15 2023, 03:58 PM)
Self diagnose. Just worried if i do a proper test the doctor will recommend CPAP machine or surgery which may cause problems with future insurance?
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You are trying to be an underwriter and a doctor ?

Just submit the application form to the best of your knowledge and let others do their job. Insurers also know no human is perfect, whether knowingly or otherwise.

Avoid using medical terms in application forms unless confirmed by a doctor, otherwise it is only digging own grave.

Why worry over small matter ? If insurer wants to insured you with certain TNC, then good. Otherwise, just take care of your health and be your own insurer. Is not only you facing this problem.

The only fault is you didn't buy early. The longer you think, think and think, other medical issues may appear and you can forget about buying insurance.

This post has been edited by mini orchard: Oct 16 2023, 08:12 AM
mini orchard
post Oct 19 2023, 08:16 AM

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QUOTE(JIUHWEI @ Oct 18 2023, 09:25 AM)
Hi guys,
I just wanna make clear again, that the purpose of Life Insurance is not for any sort of returns. The same goes to ILP as well.
ILP exists just as another option to serve the upper-middle market segment and up, as a whole-life non-participating product.

It also does not mean that those in the upper-middle market segment and up cannot access products like a Term Life insurance.

I hope we can steer this great thread back towards needs-based, rather than going off on a tangent, needlessly pegging one product against the others.

I mean, we don't see supermarkets trying to convince anybody why GMOs are one way and organic or local produce are another way kan?
They just have it there, as an option for those who prefers or has certain dietary habits/requirements to get it.


Same goes to just about everything else in our lives la kan.
Can a rich person go squat at roadside stall with me? Can mah
But can I day day spend 3-400 drinking with top 1% people? Cannot mah
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I don't agree that buying insurance is similar to buying from a supermarket.

Buying insurance is a personal service by agents similar to visiting a doctor.

Someone enters a clinic and tells the doctor he is sick. The doctor asked few questions and then prescribed some medications and the patient goes home.

If he doesn't get well after few days, he goes back to the clinic and the doctor will prescribed another round of medication and payment.

The patient says he can't afford another payment and the doctor will advise him to either cont with the old medication or visit the public hospital.

The above may not relate 100% to selling insurance but in most personal services, a buyer will normally take 'advise' from his agent that is decided for him.

Coming back to the clinic, the doctors doesn't give options to the patient that there are few other medications that he can take and the charges or even suggesting to buy from a pharmacy. It can be cheaper or more expensive but the choices were never given similar to a supermarket where all products and prices are displayed 🤔

The patient will not doubt the doctor intention that he is doing it for his best interest but then again if the patient financial situation changes, is not his fault thou, there is always a public hospital.

But if the doctor gives option to the patient, then I guess he will rather work in a public hospital and draw a fixed salary instead of thinking how to pay his rental, nurses, utility bills etc.

Bank borrowings are more transparent personal service. They will tell outright whether a borrower is qualified for a loan or a lowered amount. They don't give borrower the money first and sue later because it is their money !

Good sharing from you as an agent pov.

Hopefully my post won't get reported from anyone just because my thoughts differ.

This post has been edited by mini orchard: Oct 19 2023, 08:28 AM
mini orchard
post Oct 19 2023, 08:45 AM

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QUOTE(poweredbydiscuz @ Oct 19 2023, 08:28 AM)
The problem is MOST agents are only pushing for the ILP, whether rich or poor.

I said most. If you are not, good for you.
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Is normal in all marketings and sales that MOST will sell the 'best' product.

If a sales person sells a lower priced product, he may even get blasted by the customer for selling an 'inferior' product 😂

If one is not doing the norm, he will never be a sales person in the first place.

The only question is whether there is an entire displayed of products for customer to make his own decision after the explanation by the agent.

This post has been edited by mini orchard: Oct 19 2023, 09:52 AM

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