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 Insurance Talk V7!, Your one stop Insurance Discussion

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tyenfei
post Jan 20 2024, 11:47 PM

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QUOTE(Jack&Guild @ Jan 20 2024, 06:46 PM)
Does insurance companies have centralise data centre for sharing information like bank ccris system? Wandering if I got rejected by A company and i went to B company, does B gona know that if i hide the history?
*
I don't answer the data centre part. I'm answering to "rejected" part.

Certain policy, company A might be strict underwriting to level 99. Then reject or postponed your application.
You may try company B, underwriting control might be level 90 then accept your application. You still need to be honest answer all questions during application. Declare health report / medical history.

What ever information you hide that causing the contract break FSA 2013 act .. eventually is not valid by law. Just by luck.

Unless you applying Guaranteed Insurability Offer (GIO) type of policy then no issue.
lifebalance
post Jan 21 2024, 12:00 AM

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QUOTE(Jack&Guild @ Jan 20 2024, 06:46 PM)
Does insurance companies have centralise data centre for sharing information like bank ccris system? Wandering if I got rejected by A company and i went to B company, does B gona know that if i hide the history?
*
My answer is really short and simple.

Be truthful.

If you got things you don't wish disclose, don't apply for the insurance.
tman2017
post Jan 21 2024, 12:27 AM

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Hi sifu-sifu Prudential.

Need your your advice.

Can you confirm my understanding is correct based on scenario 1 below?

Scenario 1
My current policy has Med value Point - RM 1 Million
Based on policy, Prudential covers up to limit 1.5 times the Med Value Point chosen (eg 1 Million). In my case, it will be 1.5Million ( 1.5*med value point).

Let's say I have a 2 Million claims for Outpatient cancer + Dialysis treatment. The breakdown would be

First 1.5 Million - full payment by Prudential (minus Med Saver Rm300)
Subsequent 0.5 Million - Prudential will only cover 80% ( i will pay 20%).

In total - I only need to pay RM 100k only.

In short , after exceeding 1.5Million, the coverage will still be unlimited but on a 80%(prudential) :20%(customer) co-insurance basis.

Please confirm/correct my understanding?

Scenario 2
Similar claim scenario as scenario 1, but now I have added Pru Value Med Booster.

Could you please advise how the calculation works for this?

Could you confirm that Prudential will cover RM 2.0 Million in full , even though my med value point is Rm 1M?

Many thanks
MUM
post Jan 21 2024, 06:46 AM

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If i want to seek confirmation, (especially when it involved large sum of money)....with posting like this
"Could you confirm that Prudential will cover ..........."

I would write in to Prudential and get their "confirmation" in writing rather than asking in public forums....especially in forums where the true identities of the forumners are obscured.

Btw, Since you had already had a policy, what are the "confirmation" response from your agent? He had already earned from you, let him do some extra work?

This post has been edited by MUM: Jan 21 2024, 06:56 AM
adele123
post Jan 21 2024, 09:21 AM

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QUOTE(ronnie @ Jan 16 2024, 10:37 PM)
typically i know the returns are poor via insurance... does this plan also falls into the same category ?
*
Short answer: yes.

Long answer: if you want high ish return, you are looking for something like this

here

Or

more discussion here in 2023

QUOTE(Jack&Guild @ Jan 20 2024, 06:46 PM)
Does insurance companies have centralise data centre for sharing information like bank ccris system? Wandering if I got rejected by A company and i went to B company, does B gona know that if i hide the history?
*
Short answer: yes. Even if they accepted you with a condition, for example, something that my mother kena from another company, the other company knows. They have a list of codes to determine.

This post has been edited by adele123: Jan 21 2024, 10:04 AM
zhengdek
post Jan 22 2024, 11:41 AM

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QUOTE(tyenfei @ Jan 20 2024, 11:47 PM)
I don't answer the data centre part. I'm answering to "rejected" part.

Certain policy, company A might be strict underwriting to level 99. Then reject or postponed your application.
You may try company B, underwriting control might be level 90 then accept your application. You still need to be honest answer all questions during application. Declare health report / medical history.

What ever information you hide that causing the contract break FSA 2013 act .. eventually is not valid by law. Just by luck.

Unless you applying Guaranteed Insurability Offer (GIO) type of policy then no issue.
*
Bro wondering how much to create a will under RHB? TQ
contestchris
post Jan 22 2024, 04:06 PM

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Heads up everyone. A centralised medical claims database is coming soon, spearheaded by BNM. It is one of the measures to contain medical claims experience.
adele123
post Jan 22 2024, 11:04 PM

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QUOTE(tman2017 @ Jan 21 2024, 12:27 AM)
Hi sifu-sifu Prudential.

Need your your advice.

Can you confirm my understanding is correct based on scenario 1 below?

Scenario 1
My current policy has Med value Point - RM 1 Million
Based on policy, Prudential covers up to limit 1.5 times the Med Value Point chosen (eg 1 Million). In my case, it will be 1.5Million ( 1.5*med value point).

Let's say I have a 2 Million claims for Outpatient cancer + Dialysis treatment. The breakdown would be

First 1.5 Million - full payment by Prudential (minus Med Saver Rm300)
Subsequent 0.5 Million - Prudential will only cover 80% ( i will pay 20%).

In total - I only need to pay RM 100k only.

In short , after exceeding 1.5Million, the coverage will still be unlimited but on a 80%(prudential) :20%(customer) co-insurance basis.

Please confirm/correct my understanding?

Scenario 2
Similar claim scenario as scenario 1, but now I have added Pru Value Med Booster.

Could you please advise how the calculation works for this?

Could you confirm that Prudential will cover RM 2.0 Million in full , even though my med value point is Rm 1M?

Many thanks
*
baca sini

according to this leaflet your scenario 2 is correct. after you add booster to your PVM, no lifetime limit on outpatient cancer / kidney treatment. for more info, why not reach out to prudential? i'm also just a bystander.
coolguy99
post Jan 23 2024, 07:56 AM

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QUOTE(contestchris @ Jan 22 2024, 04:06 PM)
Heads up everyone. A centralised medical claims database is coming soon, spearheaded by BNM. It is one of the measures to contain medical claims experience.
*
What's with all the new database coming up these days? Hope they beef up the cybersecurity to prevent data leaks.
MUM
post Jan 23 2024, 08:46 AM

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Unless there are changes to the PDPA, why would they have spend more resources in preventing data leakages... ha ha fa.

For, in its current form, the PDPA only covers commercial entities and transactions, exempting both the federal and state governments from its rules and principles, including those requiring data users to properly secure personal information provided to them.
https://www.google.com/url?sa=t&source=web&...vJsnFsiQ68kSvNG


Katrinah
post Jan 23 2024, 10:02 AM

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Hi there, want to seek advise re illness declaration for medical insurance.

Back in 2019, I received letter from Pusat Darah Negara as they suspected that I have Hep-C. Their process requires 2-3 visits, 6mths apart, for them to confirm whether I have it. I didnt manage to complete the follow-ups (only attended the 1st appt) as we were in MCO by then.

Fast forward 2022, I had body checkup in ADMC and Hep-C was non reactive (means I did not have it at the time, nor have I ever had an active Hep-C infection before).


In my case, does this "hep-C suspect from PDN" need to be declare? Is PDN considered medical institution and I therefore received "medical advise"? Thank you !

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Holocene
post Jan 23 2024, 10:04 AM

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QUOTE(Katrinah @ Jan 23 2024, 10:02 AM)
Hi there, want to seek advise re illness declaration for medical insurance.

Back in 2019, I received letter from Pusat Darah Negara as they suspected that I have Hep-C. Their process requires 2-3 visits, 6mths apart, for them to confirm whether I have it. I didnt manage to complete the follow-ups (only attended the 1st appt) as we were in MCO by then.

Fast forward 2022, I had body checkup in ADMC and Hep-C was non reactive (means I did not have it at the time, nor have I ever had an active Hep-C infection before).
In my case, does this "hep-C suspect from PDN" need to be declare? Is PDN considered medical institution and I therefore received "medical advise"?  Thank you !

user posted image
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Declare with supporting document and let underwriters decide.
engyr
post Jan 23 2024, 01:49 PM

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QUOTE(Katrinah @ Jan 23 2024, 10:02 AM)
Hi there, want to seek advise re illness declaration for medical insurance.

Back in 2019, I received letter from Pusat Darah Negara as they suspected that I have Hep-C. Their process requires 2-3 visits, 6mths apart, for them to confirm whether I have it. I didnt manage to complete the follow-ups (only attended the 1st appt) as we were in MCO by then.

Fast forward 2022, I had body checkup in ADMC and Hep-C was non reactive (means I did not have it at the time, nor have I ever had an active Hep-C infection before).
In my case, does this "hep-C suspect from PDN" need to be declare? Is PDN considered medical institution and I therefore received "medical advise"?  Thank you !

user posted image
*
Submit medical report and latest result from ADMC. Hepatitis C infection needs confirmation test. I guess that is the reason PDN called you for follow up.


This post has been edited by engyr: Jan 23 2024, 01:57 PM
Human Nature
post Jan 23 2024, 02:33 PM

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For Prudential:

When the policy holder is diagnosed with one of the critical illness, the monthly premium will be waived, correct? Until death?

Also, is this a new thing or has always been there under Crisis Cover policy taken say, 20-25 years ago?
lifebalance
post Jan 23 2024, 02:35 PM

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QUOTE(Human Nature @ Jan 23 2024, 02:33 PM)
For Prudential:

When the policy holder is diagnosed with one of the critical illness, the monthly premium will be waived, correct? Until death?

Also, is this a new thing or has always been there under Crisis Cover policy taken say, 20-25 years ago?
*
Kindly refer back to your policy contract on the exact wording.
Ramjade
post Jan 23 2024, 03:16 PM

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QUOTE(Human Nature @ Jan 23 2024, 02:33 PM)
For Prudential:

When the policy holder is diagnosed with one of the critical illness, the monthly premium will be waived, correct? Until death?

Also, is this a new thing or has always been there under Crisis Cover policy taken say, 20-25 years ago?
*
Waive until end of contract and if it fulfilled the definition of critical illness. Give you one real life example. Heart attack if there is > 70% blockage in the artery. One of my agent client only had 67%, hence not waive. Have to continue paying. So be careful of critical illness.
adele123
post Jan 23 2024, 06:47 PM

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QUOTE(Human Nature @ Jan 23 2024, 02:33 PM)
For Prudential:

When the policy holder is diagnosed with one of the critical illness, the monthly premium will be waived, correct? Until death?

Also, is this a new thing or has always been there under Crisis Cover policy taken say, 20-25 years ago?
*
It's not a "given feature". It's usually an add on feature but highly depends on what you bought. So best you revisit your contract.

It is a common add on.


However if attached to an investment linked policy, there may be a situation where it does not fully waive your premium.

For example your premium is rm200 a month initially. Then this person kena ci and claim the waiver benefit.

So the insurance company pay rm200 for you. Now if your policy is attached with medical plan, which is likely for most people, you may have received notification on the repricing. For example, the company may say actually for the policy to be sustainable, rm280 per month is needed to be paid.

Given this scenario, the policy holder has to pay rm80 per month, but the insurance company will continue to subsidise rm200 per month.
Human Nature
post Jan 23 2024, 07:19 PM

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QUOTE(adele123 @ Jan 23 2024, 06:47 PM)
It's not a "given feature". It's usually an add on feature but highly depends on what you bought. So best you revisit your contract.

It is a common add on.
However if attached to an investment linked policy, there may be a situation where it does not fully waive your premium.

For example your premium is rm200 a month initially. Then this person kena ci and claim the waiver benefit.

So the insurance company pay rm200 for you. Now if your policy is attached with medical plan, which is likely for most people, you may have received notification on the repricing. For example, the company may say actually for the policy to be sustainable, rm280 per month is needed to be paid.

Given this scenario, the policy holder has to pay rm80 per month, but the insurance company will continue to subsidise rm200 per month.
*
Thanks for the expanation. It's one of my relative and couldn't locate the policy. Yes, it is investment linked too. Anyway, have asked the agent to process the claim and see what Prudential says.
tyenfei
post Jan 24 2024, 11:30 AM

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QUOTE(zhengdek @ Jan 22 2024, 11:41 AM)
Bro wondering how much to create a will under RHB? TQ
*
From RM450 onward .
Depending how many "gifts" to distribute
Any testamentary trust required (can be cash in bank / insurance policy).
MUM
post Jan 25 2024, 06:42 PM

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While doing spring cleaning, I saw this printed on the cover of my 30 yrs old policy....

I liked the message that it wanted to convey.

This post has been edited by MUM: Jan 25 2024, 06:43 PM


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