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 Insurance Talk V7!, Your one stop Insurance Discussion

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coolguy_0925
post May 24 2025, 11:32 PM

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QUOTE(john123x @ May 24 2025, 11:17 PM)
Can I ask whats your action for your own case?

- close policy and jump to another insurance company?
- endure and pay the hiked premium?
- maintain paying same premium amount?
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Like I mentioned there is no way for Prudential to maintain same premium, in epay they will 'up' the amount automatically

Change policy, for me, is like now or later. Yes you might get better benefit now but don't hope for lower premium as agents will 'siam' when you asked them to do that and you also know insurance cost also inflated already. And sooner or later the same premium hike will still hit your new policy.

I stopped paying and let my cash value pay the insurance charges after discussing with some of the forummers here (adele123 and some of the less 'profit-oriented' agents here, thx to them) Also when I was in Prudential office I asked the counter about it. Also I wrote an email to triple confirm as logn as cash value sufficient = policy inforce but you know la since e-mail involved B&W the reply wording also 'siam' here and there but basically yes cash value sufficient = policy inforce

Probably due to the bull market after COVID I don't see reduction in my cash value even after few years not paying my premium. And I keep an eye on my cash value by logging into the portal.

BUT, you will need to pay more later. Because if you look at the schedule when you get older the insurance charges will be very high so you need to take into consideration of this when deciding. Anyway from your earlier posts I guess you are already well aware of this. Basically, is pay now or pay later only.

This post has been edited by coolguy_0925: May 24 2025, 11:45 PM
john123x
post May 25 2025, 11:24 PM

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QUOTE(coolguy_0925 @ May 24 2025, 11:32 PM)
Like I mentioned there is no way for Prudential to maintain same premium, in epay they will 'up' the amount automatically

Change policy, for me, is like now or later. Yes you might get better benefit now but don't hope for lower premium as agents will 'siam' when you asked them to do that and you also know insurance cost also inflated already. And sooner or later the same premium hike will still hit your new policy.

I stopped paying and let my cash value pay the insurance charges after discussing with some of the forummers here (adele123 and some of the less 'profit-oriented' agents here, thx to them) Also when I was in Prudential office I asked the counter about it. Also I wrote an email to triple confirm as logn as cash value sufficient = policy inforce but you know la since e-mail involved B&W the reply wording also 'siam' here and there but basically yes cash value sufficient = policy inforce

Probably due to the bull market after COVID I don't see reduction in my cash value even after few years not paying my premium. And I keep an eye on my cash value by logging into the portal.

BUT, you will need to pay more later. Because if you look at the schedule when you get older the insurance charges will be very high so you need to take into consideration of this when deciding. Anyway from your earlier posts I guess you are already well aware of this. Basically, is pay now or pay later only.
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i fundamentally agree with your idea, but i wont like to comment a bit.

i agree with your "pay now or pay later". The difference is pay now means the future return is based on poor insurance funds return, pay later will using returns from our own investments.

coolguy_0925
post May 29 2025, 09:56 PM

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QUOTE(john123x @ May 25 2025, 11:24 PM)
i fundamentally agree with your idea, but i wont like to comment a bit.

i agree with your "pay now or pay later". The difference is pay now means the future return is based on poor insurance funds return, pay later will using returns from our own investments.
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The reason replying you earlier purely because someone helped me when I had the same doubt few years back

And I think I should do the same

On the investment part, I leave it to you to decide
kerolzarmyfanboy
post Jun 1 2025, 01:22 PM

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finally got the premium revision letter for my zero deductible plan, now will be RM2132 instead of RM2.5k pre-revision, a little better. AIA pretty crappy for giving this letter just a month before renewal tho.
I'm still asking my agent for higher deductible plans that I could switch to.

john123x
post Jun 1 2025, 06:25 PM

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I would like to confess that I say something stupid. Today, i accidentally filled the wrong amount when paying, and it got rejected.

It make me heartbroken

I just realized, even if you want to pay the same amount, the system dont let you

This post has been edited by john123x: Jun 1 2025, 06:32 PM
john123x
post Jun 3 2025, 05:36 PM

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QUOTE(hafizmamak85 @ May 11 2025, 12:38 AM)
There is no such thing as age-related increases in the annual premiums of long term level premium IL policies.

There can be no changes in the annual premium amounts or any of the other policy charges during the on-going term of a long term level premium IL policy.

Only cost of insurance (COI) charges may increase by age band. The level premiums had accounted for these age-banded COI increases at the policy's inception.

It is not lawful or legal for any insurance or takaful operator (ITO) to increase the premium amounts or COI charges, to something other than set at the policy's inception, for long term policies unless the ITO's going concern is at stake.

Malaysians have to truly consider initiating a class action case against these ITOs for not only mis-selling and mis-representing their products but for also breaching their own contract terms.

Just maintain the IL policy's premium payments as per the premium amounts set at the policy's inception.

Ignore notices from the ITO on increases in annual premium amounts.

Notices are not contractually binding. Only contract amendments are binding. And amendments can't be done unilaterally.

Or, we can all remain pliant and subject to the whims n fancies of these larger than life corporates where rules can be written and rewritten on the go to suit their other broader agendas.
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so, any lawyer that I can contact to join class action?

I dont want to burst your bubble. You dont realize we are living in a shithole country. Class Action, isnt this something only available to developed countries with respectable judiciary?

I am ready to join.

So, where can I join?

1 Jul is coming soon. All insurance policy owners need to be prepared for this.

And you are right, BNM are making policies detrimental to its own citizens. It has commit treason to this country.


This post has been edited by john123x: Jun 3 2025, 05:41 PM
hafizmamak85
post Jun 5 2025, 12:58 PM

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QUOTE(john123x @ Jun 3 2025, 05:36 PM)
so, any lawyer that I can contact to join class action?

1 Jul is coming soon. All insurance policy owners need to be prepared for this.

And you are right, BNM are making policies detrimental  to its own citizens. It has commit treason to this country.
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You'll have to organize and find your own lawyer.

What's happening on 1 July?





john123x
post Jun 5 2025, 02:05 PM

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QUOTE(hafizmamak85 @ Jun 5 2025, 12:58 PM)
You'll have to organize and find your own lawyer.

What's happening on 1 July?
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first insurance premium increase
1 jul 2025 rise 10%
1 jul 2026 rise 10%
1 jul 2027 rise 10%
kazekage_09
post Jun 6 2025, 03:19 PM

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Hi can anyone explain what is AIA Smart option is? Will it reduce the premium if I opt for it?
JIUHWEI
post Jun 6 2025, 04:10 PM

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QUOTE(kazekage_09 @ Jun 6 2025, 03:19 PM)
user posted image

Hi can anyone explain what is AIA Smart option is? Will it reduce the premium if I opt for it?
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Yes it does reduce your premiums.
JIUHWEI
post Jun 6 2025, 04:49 PM

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QUOTE(john123x @ Jun 3 2025, 05:36 PM)
so, any lawyer that I can contact to join class action?

I dont want to burst your bubble. You dont realize we are living in a shithole country. Class Action, isnt this something only available to  developed countries with respectable judiciary?

I am ready to join.

So, where can I join?

1 Jul is coming soon. All insurance policy owners need to be prepared for this.

And you are right, BNM are making policies detrimental  to its own citizens. It has commit treason to this country.
*
https://www.fmos.org.my/en/

Have you tried reaching out to these guys?
Their services are free.

Formerly OFS
kazekage_09
post Jun 9 2025, 07:03 PM

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QUOTE(JIUHWEI @ Jun 6 2025, 04:10 PM)
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Yes it does reduce your premiums.
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What happens if, after attending the SMART clinic and receiving a referral to a SMART-affiliated hospital, I choose to go to a hospital that is not on the SMART panel? Will I be required to pay 20% of the total bill? Did a check and found the nearest and my favourite hospital is not in the list.
MUM
post Jun 9 2025, 08:30 PM

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QUOTE(kazekage_09 @ Jun 9 2025, 07:03 PM)
What happens if, after attending the SMART clinic and receiving a referral to a SMART-affiliated hospital, I choose to go to a hospital that is not on the SMART panel? Will I be required to pay 20% of the total bill? Did a check and found the nearest and my favourite hospital is not in the list.
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While waiting for his response, I googled and found this.
Hope it is correct and valid.

https://www.aia.com.my/content/dam/my/en/do...sting_Apr25.pdf






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JIUHWEI
post Jun 10 2025, 11:04 AM

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QUOTE(kazekage_09 @ Jun 9 2025, 07:03 PM)
What happens if, after attending the SMART clinic and receiving a referral to a SMART-affiliated hospital, I choose to go to a hospital that is not on the SMART panel? Will I be required to pay 20% of the total bill? Did a check and found the nearest and my favourite hospital is not in the list.
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As per the wording presented by kazekage thumbsup.gif
hafizmamak85
post Jun 10 2025, 07:23 PM

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QUOTE(kazekage_09 @ Jun 9 2025, 07:03 PM)
What happens if, after attending the SMART clinic and receiving a referral to a SMART-affiliated hospital, I choose to go to a hospital that is not on the SMART panel? Will I be required to pay 20% of the total bill? Did a check and found the nearest and my favourite hospital is not in the list.
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AIA has no right to discriminate against your choice of health service provider by levying an arbitrary 20% co-pay requirement solely because you did not follow the treatment process laid out by them or opt for their preferred service provider.

They can't impose an arbitrary co-pay for the medical claim if the medical treatment was medically necessary and the fees/charges were reasonable and customary.

Even if hospital groups were to tie up with digital insurers and takaful operators and their preferred TPAs, they can't deny a claim or arbitrarily impose restrictions on claimable amounts if treatments sought outside the group met the medically necessary and reasonable and customary standards.

Just as an insurer or takaful operator would have to approve a medical reimbursement claim, even if it was from a blacklisted doctor and/or medical service provider, if the above standards were met, the same thought process applies.

QUOTE(hafizmamak85 @ Dec 28 2024, 07:33 PM)
This is another time bomb waiting to explode. It seems to me that there is an unfair contract term here, being the arbitrary imposition of a max 20k deductible per disability if one doesn't follow the so-called smart path. Clearly they are herding policyholders to their favoured hospitals/health service providers instead of doing the hard work and identifying and articulating and being held legally/commercially accountable for what they deem reasonable and customary charges. AIA will go down because of this kind of nonsense and the other claptrap they have esp. their "dance monkey dance" point system. The core contract of a reimbursement model for any medically necessary and reasonable and customary charge is still maintained. Who the health service provider or doctor is doesn't matter.
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This post has been edited by hafizmamak85: Jun 10 2025, 07:38 PM
JIUHWEI
post Jun 11 2025, 10:29 AM

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QUOTE(hafizmamak85 @ Jun 10 2025, 07:23 PM)
AIA has no right to discriminate against your choice of health service provider by levying an arbitrary 20% co-pay requirement solely because you did not follow the treatment process laid out by them or opt for their preferred service provider.

They can't impose an arbitrary co-pay for the medical claim if the medical treatment was medically necessary and the fees/charges were reasonable and customary.

Even if hospital groups were to tie up with digital insurers and takaful operators and their preferred TPAs, they can't deny a claim or arbitrarily impose restrictions on claimable amounts if treatments sought outside the group met the medically necessary and reasonable and customary standards.

Just as an insurer or takaful operator would have to approve a medical reimbursement claim, even if it was from a blacklisted doctor and/or medical service provider, if the above standards were met, the same thought process applies.
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What's stopping you from bringing AIA to court?

I think you make great arguments and I think you should.

This post has been edited by JIUHWEI: Jun 11 2025, 10:31 AM
kazekage_09
post Jun 11 2025, 10:51 AM

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QUOTE(hafizmamak85 @ Jun 10 2025, 07:23 PM)
AIA has no right to discriminate against your choice of health service provider by levying an arbitrary 20% co-pay requirement solely because you did not follow the treatment process laid out by them or opt for their preferred service provider.

They can't impose an arbitrary co-pay for the medical claim if the medical treatment was medically necessary and the fees/charges were reasonable and customary.

Even if hospital groups were to tie up with digital insurers and takaful operators and their preferred TPAs, they can't deny a claim or arbitrarily impose restrictions on claimable amounts if treatments sought outside the group met the medically necessary and reasonable and customary standards.

Just as an insurer or takaful operator would have to approve a medical reimbursement claim, even if it was from a blacklisted doctor and/or medical service provider, if the above standards were met, the same thought process applies.
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This rules will apply if I opt for SMART option and it will reduce my contribution. If i to choose not going for this option, I will just have to bear the increment cost each year stated by the letter and i believe I can claim 100% the total bills right?

Kinda suck. But no choice need to face it.
contestchris
post Jun 11 2025, 11:28 AM

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Hafiz don't be silly. SMART is an option, it is not mandatory and forced on no one.
hafizmamak85
post Jun 11 2025, 11:48 AM

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QUOTE(kazekage_09 @ Jun 11 2025, 10:51 AM)
This rules will apply if I opt for SMART option and it will reduce my contribution. If i to choose not going for this option, I will just have to bear the increment cost each year stated by the letter and i believe I can claim 100% the total bills right?

Kinda suck. But no choice need to face it.
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There is no relationship between the reduction in premium amount and the smart option track other than the expectation the smart option track would help reduce overall claims by hopefully limiting medically unnecessary claims and unreasonable and uncustomary fees/charges.

However, AIA smart option track does not have monopoly on the determination on what is medically necessary and reasonable and customary fees/charges.

The determination of what is medically necessary and reasonable and customary excludes the AIA smart option track consideration.

The contract underpinning the AIA smart option track is still based on coverage for medically necessary treatments/procedures based on reasonable/customary fees/charges regardless of who the health service provider is.

It doesn't make any sense to impose an arbitrary and unfair 20% co-pay on non smart option track claims if the claims fulfill the medically necessary and reasonable/customary standards.

This post has been edited by hafizmamak85: Jun 11 2025, 12:14 PM
SticH
post Jun 11 2025, 01:04 PM

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Hello I just received my premium increment notice from Alliance

Currently it is at RM210 per month, and will be increasing 20% every year with RM420 at the end of 5 years.

What are my options right now apart from downgrading the insurance medical plan?

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