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 Insurance Talk V7!, Your one stop Insurance Discussion

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mini orchard
post Aug 6 2021, 03:42 PM

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QUOTE(JIUHWEI @ Aug 6 2021, 02:58 PM)
Yes of course a diarrhea or headache can be symptoms of more severe underlying illnesses.
And Covid-19 stage 1 and 2 is considered "minor" and it is also possible that if left untreated, can lead to more severe stages.

For a diarrhea and headache, we can take the steps of a Dengue infection.
First, we go to the clinic because we're showing symptoms such as (for diarrhea) exhaustion, dehydration, on top of frequent trips to the toilet; (for dengue) fever, exhaustion, pains and aches.
Then, the GP may confirm on the condition and in turn refer us to the hospital.
That's when we go to the hospital and be admitted based on the GP referral letter, and a further diagnosis by the specialist.

For Covid-19, as of now, the hospitals are filled with patients (stages 3 and up) across the spectrum of the variants.
As opposed to exposing you to the other, more severe patients (more aggressive Covid-19 variants), it is actually in your best interest to either quarantine yourself either at home or at a hotel... health-wise.

I believe rn, we have a choice to quarantine between
1. quarantine centers (i think it's free) is at the lowest tier of comfort
2. Hotel rooms
3. Your own home (highest tier of comfort).

Why do I say your own homes is at the highest tier of comfort?
- you are with your loved ones.
- in the worst case scenario, you are surrounded by your loved ones.
- someone who loves and cares for you is right there, all the time.

Can we all agree that this is the worst time to be sick and/or die?
Proper funerals cannot be held, we will be physically isolated from everyone we know and love..
Whatever rituals you may or may not have in mind will be thrown out the window, replaced by the SOP for death, handled by people who probably do not agree with the SOPs and are exhausted from handling "just another body".
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A simple explaination for a layman to understand instead of shooting insurance terminology.

I always believed a good agent should go down to level of a layman in explaning things instead of expecting the layman to understand terminology.
mini orchard
post Aug 7 2021, 09:46 PM

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QUOTE(ping325 @ Aug 7 2021, 05:59 PM)
i see…I don’t see any terms that don’t allow customer do that

Basically the bank have 200k ready to bank in to you but you ask the bank bank in 50k now first , another 150k no need first and in future only bank in…. For sure they welcome you  biggrin.gif

Once CI claimed doesn’t mean the policy ended, you still need to continue pay if no payor purchased. The policy still jalan but without CI portion only…. That’s why payor also quite important, once a person diagnose with CI but survived , the cash value inside policy still jalan and pay by insurance company until policy term ended.

Let’s say ALI purchases :
AIA CI 200k , payor , rm200 monthly
Prudential CI 50k , payor rm100 monthly
GE CI 50k , no payor , rm80 monthly

Suddenly CI strike ,  ALi claimed from AIA , so AIA pay 200k to him and help him continue pay rm200 monthly until policy contract end , this mean the cash value inside gonna be a lot because CI portion gone already…

Ali don’t claim from prudential or GE , so he need to continue pay for 180 monthly , but if I’m ali for sure I will claim all….since they money is ready to bank in to you. Plus GE , prudential can reprice you anytime in future.

If I’m Ali , I will claim from prudential and let payor kicks in & terminate GE if don’t want burden with cash flow from insurance anymore. In future , I still covered for life by prudential and AIA + I can withdraw emergency cash anytime from cash account..
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Does a payor rider kicks in upon a diagnosed of a CI ?

The purpose of a CI policy is to obtain a lump sum payment and is there a reason why would an insured add a payor rider to continue the policy?

Isnt a payor rider kicks in only upon TPD or death to protect the dependents.
mini orchard
post Aug 7 2021, 10:06 PM

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This post has been edited by mini orchard: Aug 7 2021, 10:07 PM
mini orchard
post Aug 14 2021, 08:17 AM

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QUOTE(dp82 @ Aug 14 2021, 12:23 AM)
Any1 can suggest a child insurance that comes with education savings?
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My opinion as a consumer ....

Insurance products are for protection and seldom an investment tools.

I dont think it can happen where a buyer buys a cake and the seller pays for it.

Medical and Critical Illness should be the main concern for kids. Is always cheaper to buy at younger age when the kids have no medical conditions ..... less health and medical declaration to tick 'Yes' which will affect acceptance for coverage, exclusion clauses and premium loading.

I bought policies for my kids before entering school age. Now they are working and are continuing the policies.

Never surrender old policies unless necessary. If is not adequate, buy additional to compliment.

I have surrended my life policy after the children started working. Kept the surrender payout for future premium payment of my current medical policy.

In my opinion, is not necessary to make the children 'rich' with a life policy payout after death. They should be able to take care on their own once they started working.

This post has been edited by mini orchard: Aug 14 2021, 09:01 AM
mini orchard
post Aug 16 2021, 11:54 AM

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QUOTE(JIUHWEI @ Aug 16 2021, 11:00 AM)
The picture you uploaded...
That is the sub-total. As clearly stated in the picture that went viral and you chose to upload

The actual total is over 600k.
Yes, the person paid it himself. After all, he was hospitalized for close to 2 months consecutively.

Just for education sake, KKM has been playing an active role in managing and regulating ceiling prices that private hospitals can charge for whatever services or procedures. Should there be unreasonable charges, you can actually call up the hospital and have it reversed or refunded.
Your statements seem to undermine the ministry's efforts and also subject to libel and slander against KPJ Damansara Hospital (which my customers frequent and I have a good working relationship with members of its staff).

May I so humbly suggest (with your best interests at heart) that you either amend or remove your posting above.
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How would a patient know the charges are not reasonable ?

Can a patient request for a review based on a 'similar' treatment of another hospital charges ?
mini orchard
post Aug 19 2021, 05:36 PM

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QUOTE(Johnhun @ Aug 19 2021, 01:24 PM)
if anything happen can claim the most out of it
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Only if you have swear to tell the truth and nothing but the truth.....bless you.

This post has been edited by mini orchard: Aug 19 2021, 05:37 PM
mini orchard
post Aug 22 2021, 03:08 PM

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QUOTE(JIUHWEI @ Aug 22 2021, 01:05 PM)
Even if its due to Covid, those are not claimable as well.
It is unfortunate that those items are deemed not claimable, with the reason being those gears are essential to protect the medical service providers, as opposed to necessary for the well-being of the patients.
Our unions brought it up against the company last year and this was the reply, which despite being a bitter pill to swallow, it is in-line with policy wording.
AIA being the only insurer that does not exclude coverage on diseases requiring quarantine by law, it is already a blessing in disguise.

However, we do our best to social distance, limit our outdoor exposures, and continue to cater our level best on platforms such as this, for everybody's benefit.
In times such as this, helping each other is essentially helping ourselves too.

I am actually very grateful to forum contributors like yourself, providing accurate info and advice without prejudice, and embodying the whole person concept of the MDRT.  :thumbsup:
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The insurer cant expect the doctors to perform 'naked'. Is not only to protect the medical officers but at the same time to further protect the patient from any further infections by 'outsiders'.

If the patient gets further infection, it will only prolong the stay and the claim will shoot up.

Is like saying in a one to one meet only 1 requires to wear mask.

Based on the insurers reasoning, then is better for the patient to wear to quicken the recovery.

This post has been edited by mini orchard: Aug 22 2021, 05:09 PM
mini orchard
post Aug 25 2021, 11:52 AM

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QUOTE(BacktoBasics @ Aug 25 2021, 09:18 AM)
hey bro, thanks for the reply.

however, i think it is unfair to the new agent as the new agent will be serving the client for free?

can new agents reject these kind of clients who wants to transfer out from original agent?

i dont see any merit for new agents to take up these cases.
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If your main concern is who is earning your money, then is better to terminate and buy new to have peace of mind.

On the other hand, if you think is a waste to terminate, tben leave it to them to sort it out.

Lastly, if is neither the above two, then just liaise with CS in the future .... which is what I am doing.
mini orchard
post Aug 25 2021, 12:23 PM

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QUOTE(avelian @ Aug 25 2021, 11:51 AM)
I have a question if im not sure anyone can answer. Assuming a person has passed away, is there a way i can find out what insurance company he has insurance with? I checked out life Insurance Association of Malaysia and they said that i have to call each company. Any other way apart from that? Thank you
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Unless you are someone related, you can 'ransack" his place. I am sure if he has a policy, there will be a file somewhere. You can try checking for hardcopy of CC statements. I also believed there will be some old insurer's letter too.

If you are non related, I am not sure of your purpose.

This post has been edited by mini orchard: Aug 25 2021, 12:23 PM
mini orchard
post Aug 25 2021, 06:58 PM

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QUOTE(BacktoBasics @ Aug 25 2021, 03:30 PM)
I think the option to terminate and re-purchase is not viable because it will be subjected to under-writing again with the cooling period for no claims.

I just felt it is unfair for the new agent that takes over the bad agent who is not performing.
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When you said not performing .... meaning ? Or is it your expectation or answers or services is beyond what he can provide ?

Perfect and reasonable services are two end of a pole.

I have seen customers in public places whom are demanding. Is their way or no way even if a third party says is wrong.

Since your issue is just general about 'poor performance' which is subjective and unless you can give specific examples, the agents here will comment whether how an ordinary agent will act based on the situations. From their answers, you can conclude whether he is good or otherwise and to escalate it to higher level.

Even if you intend to sue someone for poor performance, you need to prove in court that he did not act within his scope of duty which another would have done under the same situation.

You wanted badly to deny him his commission which is beyond your control, so the only way is to terminate which is in your control. I also know is not viable to terminate and therefore to leave it alone. You cant have the best of both.

Hopefully your next agent will be better ....and pray you must.

This post has been edited by mini orchard: Aug 25 2021, 07:04 PM
mini orchard
post Aug 26 2021, 07:48 PM

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QUOTE(ryan18 @ Aug 26 2021, 12:29 PM)
Thanks for the answer
The bad news is the current quote I get from my current insurer comes with special condition with loading and also not paying a single cent should there be a need for hospitalisation/surgery related to pre existing condition. I asked my agent to appeal and still waiting for the outcome and I am also looking for plan B should appeal fail I.e. get a quote from another insurer
Previously my medical and life insurance also comes with the loading but since it was low around RM10/month so I just asked the agent to proceed
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The result should be similar or outright rejection .... there is a declaration statement from the applicant whether he has applied to other insurers prior.

If your existing condition happens during your existing policy period, I suggest you buy another policy from the same insurer even with the exclusion and or loading, if increasing coverage is your intention for other claims

I did it for one for my family member. One with no condition, the other with one and is with higher coverage. Hospital claim will then depend on which policy to submit.


mini orchard
post Aug 30 2021, 06:56 AM

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QUOTE(onthefly @ Aug 30 2021, 12:11 AM)
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?
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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.
mini orchard
post Aug 30 2021, 12:00 PM

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QUOTE(JIUHWEI @ Aug 30 2021, 10:55 AM)
Mind sharing the experience where any insurer "just pick a word from the policy to reject a claim" ?
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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
mini orchard
post Aug 30 2021, 01:16 PM

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QUOTE(JIUHWEI @ Aug 30 2021, 01:00 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.
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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 ?
mini orchard
post Aug 30 2021, 01:39 PM

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QUOTE(JIUHWEI @ Aug 30 2021, 01:35 PM)
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.

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.
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I have oredi stated must read the finer terms in Post 1218 and cannot rely of the brochures.

A new buyer will just take the short answer.....no ?

If every agent will to go into details, I doubt he can sell many policies....I am not saying he is dishonest, but is just a general question which only a general answer is needed.

A contract is one after signed.

This post has been edited by mini orchard: Aug 30 2021, 01:44 PM
mini orchard
post Sep 13 2021, 08:21 PM

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QUOTE(brando_w @ Sep 13 2021, 06:09 PM)
Oh gosh, 'criminal or terrorist activities' is also not covered.

Does insurance providers have the practice of buying over policies from another insurer?

Is it advisable to port over to another insurer after close to 20 years?

What are the pros n cons to consider?
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https://www.ing.com/Newsroom/News/Press-rel...ysia-to-AIA.htm
mini orchard
post Sep 19 2021, 05:46 AM

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QUOTE(Barricade @ Sep 18 2021, 11:03 PM)
Guys i wanna ask about car insurance. Is PrOmilej the only company that can insure based on selected mileage?
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There are few insurer offering now. Check with your current insurer. I know etiqa does.
mini orchard
post Oct 5 2021, 05:46 AM

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QUOTE(lamode @ Oct 4 2021, 02:17 PM)
If i have two medical plans, can i claim the full room and board from both plans?

Example: R&B hospital charge at RM300 / day

Card 1 - R&B coverage RM100
Card 2 - R&B coverage RM200

icon_question.gif  icon_question.gif  icon_question.gif
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Buy the 2 plans from the same insurer....for ease of claim procedures.
mini orchard
post Oct 27 2021, 06:17 AM

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QUOTE(a8dee @ Oct 27 2021, 02:54 AM)
user posted image

Saw this in my insurance proposal from Prudential. Is this normal for new applications? I'm applying Life+Medical+ILP for my children, noticed this at the end of the proposal. Does it apply only to Prudential or other insurance providers charged for this as well?
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Looks like in the near future, if policyowners call CS, it will also be charged time cost ....lol.
mini orchard
post Nov 5 2021, 07:06 AM

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QUOTE(Deathscythe@@ @ Nov 4 2021, 06:58 PM)
Hi, my mother medical card recently price hike from rm248 to rm404 . Age 61.  Coverage 100k and room and board rm150. Any advise to cancel and find a new policy? The price hike seems too much while the coverage unchanged.
Policy bought year 2016. Never claim before and no long term illness etc.
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Is not easy to advise you on the matter.

On one hand the increased premium is taxing and yet no increase in coverage. Then the coverage is low and in my opinion not sure is able to cover for today and future medical cost.

The worst part to come is when someone is admitted and the bill exceeded coverage and still rising .... is indirectly a false hope that one is actually 'protected'.

Is no problem if the family can settle the difference. What 'IF' cannot ?

Some may disagree ... have some better than nothing but will it solve the problem 'IF'.

When coverage is low, always check estimated medical cost b4 admission.

This post has been edited by mini orchard: Nov 5 2021, 08:23 AM

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