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 Insurance Talk V7!, Your one stop Insurance Discussion

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grace_ong P
post Jul 1 2021, 07:47 PM

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QUOTE(ckdenion @ Jul 1 2021, 07:05 PM)
ok grace i give you 2 scenarios:

Scenario 1: this is the first claim using your card (meaning it still have 20k deductible)
in this case, when you admit to hospital, GL wont be issue. you have to pay everything then do reimbursement claim. say if the claimable bill is 50k, you have to pay the 50k first. submit this 50k bill to insurance company, then company will reimburse you back 30k (20k deductible is paid by you or could be other insurer)

Scenario 2: say you have already claim the 20k deductible during that rider year OR say this is a 2nd claim followed by Scenario 1
since the 20k deductible during that rider year is already claimed due to previous admission, the next admission you can use this medical card already and GL will be issued. so whatever bill incurred will be paid by the insurance company to the hospital subjected to your plan's annual limit.
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Now I understand, previously I tot I only need to pay the deductible amount upon discharge, just whether can direct claim on other medical card. Rupa-rupanya have to pay the whole bill if use deductible card.
Thank you very much!
grace_ong P
post Jul 2 2021, 08:17 AM

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QUOTE(lifebalance @ Jul 1 2021, 07:12 PM)
I don't think your issue of understanding is on the deductible. Rather your main issue is "you want to have a claims under one roof" which means you don't want to deal with paperworks for reimbursement.

In this case, you should opt for non deductible plans.
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(Just realise probation got limit daily post)

Although I don’t like the hassle of reimbursement, but I willing to learn how it work to reduce my COI.

But when I understand then I know my main issue will be the ability to pay the bills first, can’t imagine if the bills cost RM300k, although company medical card pay 50k, still how can I afford the balance RM250k… where to find the money…

No choice, I think I only can opt for non-deductible one
Thank you for all the sharing~
lifebalance
post Jul 2 2021, 09:51 AM

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QUOTE(grace_ong @ Jul 1 2021, 07:47 PM)
Now I understand, previously I tot I only need to pay the deductible amount upon discharge, just whether can direct claim on other medical card. Rupa-rupanya have to pay the whole bill if use deductible card.
Thank you very much!
*
QUOTE(grace_ong @ Jul 2 2021, 08:17 AM)
(Just realise probation got limit daily post)

Although I don’t like the hassle of reimbursement, but I willing to learn how it work to reduce my COI.

But when I understand then I know my main issue will be the ability to pay the bills first, can’t imagine if the bills cost RM300k, although company medical card pay 50k, still how can I afford the balance RM250k… where to find the money…

No choice, I think I only can opt for non-deductible one
Thank you for all the sharing~
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Scenario 1: Incorrect
- if you use such method, 20k will not be reimbursed if you use your personal MC with 20k deductible. You are advise to claim from a non-deductible card first and claim back the balance as reimbursement.
- GL is only issued minus deductible amount that you're suppose to pay to the hospital. (i.e you'll have to pay 20k first, GL covers for only 30k)
- The only method to fully claim without doing reimbursement paperwork (unless exceeded on the amount allowed by your policy) is to use the same insurance company for a. Medical without deductible (PMM) + b. Medical with deductible (PVM)

This post has been edited by lifebalance: Jul 2 2021, 11:16 AM
rocketm
post Jul 3 2021, 10:54 AM

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I want to confirm when submitting claim for medical/critical illness insurance, how the insurance company check whether the claimant has similar insurance type with other company and whether they are making the claim?

When the insurance company knowing they are making the claim at the same time, will they will proportionate the claim?
MUM
post Jul 3 2021, 10:59 AM

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QUOTE(rocketm @ Jul 3 2021, 10:54 AM)
I want to confirm when submitting claim for medical/critical illness insurance, how the insurance company check whether the claimant has similar insurance type with other company and whether they are making the claim?

When the insurance company knowing they are making the claim at the same time, will they will proportionate the claim?
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I heard that they required "original" receipts
ckdenion
post Jul 3 2021, 11:56 AM

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QUOTE(rocketm @ Jul 3 2021, 10:54 AM)
I want to confirm when submitting claim for medical/critical illness insurance, how the insurance company check whether the claimant has similar insurance type with other company and whether they are making the claim?

When the insurance company knowing they are making the claim at the same time, will they will proportionate the claim?
*
hi rocketm, for critical illness insurance claims, there are no receipts required, usually requires living assurance claim form filled by doctor backed with diagnosis report. so it is also fine that you have critical illness insurance from multiple insurance companies because it is a living assurance claims and not medical claims.

for medical insurance claims, usually there is a section to fill whether that particular claims is it paid by any other insurer. so usually agent will fill this section as well to make sure that claim is already partially paid by other insurer (if applicable).
lifebalance
post Jul 3 2021, 12:12 PM

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QUOTE(rocketm @ Jul 3 2021, 10:54 AM)
I want to confirm when submitting claim for medical/critical illness insurance, how the insurance company check whether the claimant has similar insurance type with other company and whether they are making the claim?

When the insurance company knowing they are making the claim at the same time, will they will proportionate the claim?
*
Critical Illness claim has no issue to claim with your respective insurance companies if you have policies with different companies.

Medical claims are subject to reimbursement basis so you'll have to claim from one insurer first and if the amount is insufficient then you can claim the balance as reimbursement basis with the 2nd insurer.
adele123
post Jul 3 2021, 12:20 PM

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QUOTE(lifebalance @ Jul 1 2021, 07:12 PM)
I don't think your issue of understanding is on the deductible. Rather your main issue is "you want to have a claims under one roof" which means you don't want to deal with paperworks for reimbursement.

In this case, you should opt for non deductible plans.
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My policy can be under GL even if deductible 5k 10k 15k. At least that was what i was told. Not all deductible plans have to be self pay. But i am not familiar with pruvalue med. Unless you are pru agent?

QUOTE(grace_ong @ Jul 1 2021, 07:47 PM)
Now I understand, previously I tot I only need to pay the deductible amount upon discharge, just whether can direct claim on other medical card. Rupa-rupanya have to pay the whole bill if use deductible card.
Thank you very much!
*
lifebalance
post Jul 3 2021, 12:22 PM

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QUOTE(lifebalance @ Jul 2 2021, 09:51 AM)
Scenario 1: Incorrect
- if you use such method, 20k will not be reimbursed if you use your personal MC with 20k deductible. You are advise to claim from a non-deductible card first and claim back the balance as reimbursement.
- GL is only issued minus deductible amount that you're suppose to pay to the hospital. (i.e you'll have to pay 20k first, GL covers for only 30k)
- The only method to fully claim without doing reimbursement paperwork (unless exceeded on the amount allowed by your policy) is to use the same insurance company for a. Medical without deductible (PMM) + b. Medical with deductible (PVM)
*
QUOTE(adele123 @ Jul 3 2021, 12:20 PM)
My policy can be under GL even if deductible 5k 10k 15k. At least that was what i was told. Not all deductible plans have to be self pay. But i am not familiar with pruvalue med. Unless you are pru agent?
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it's been explained above @ Post #805
https://forum.lowyat.net/index.php?showtopi...ost&p=101481044

This post has been edited by lifebalance: Jul 3 2021, 12:26 PM
ckdenion
post Jul 3 2021, 12:39 PM

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QUOTE(adele123 @ Jul 3 2021, 12:20 PM)
My policy can be under GL even if deductible 5k 10k 15k. At least that was what i was told. Not all deductible plans have to be self pay. But i am not familiar with pruvalue med. Unless you are pru agent?
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hi adele, which medical card are you holding?
mini orchard
post Jul 3 2021, 02:24 PM

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QUOTE(adele123 @ Jul 3 2021, 12:20 PM)
My policy can be under GL even if deductible 5k 10k 15k. At least that was what i was told. Not all deductible plans have to be self pay. But i am not familiar with pruvalue med. Unless you are pru agent?
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I think GL is issue based on estimated medical procedures and deductible.

If your deductible is for example 10k and your estimated procedure is 9k, I dont think GL can be issued. In the event the total bill exceeded 10k, then you need to submit a claim.
lifebalance
post Jul 3 2021, 02:35 PM

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QUOTE(mini orchard @ Jul 3 2021, 02:24 PM)
I think GL is issue based on estimated medical procedures and deductible.

If your deductible is for example 10k and your estimated procedure is 9k, I dont think GL can be issued. In the event the total bill exceeded 10k, then you need to submit a claim.
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rclxms.gif correct
jutamind
post Jul 3 2021, 04:44 PM

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any online portal that can recommend to purchase standalone family PA policy?
z800r
post Jul 3 2021, 06:44 PM

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Hi. Need a suggestion for medical card + critical illness + tpd.

At the moment i already subscribed w a cheapo medical card that covered up to max 150k per year. With the cost of everything gone up, so i think i need to get a better ones w a better coverage.

Anyone can suggest me which one is good.

Also, better if the plan can be applied online. Looking at manulife manuez-med now. Prudential must get an agent to ask first/ get quotation. Etiqa too can be applied online
mini orchard
post Jul 3 2021, 08:02 PM

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QUOTE(jutamind @ Jul 3 2021, 04:44 PM)
any online portal that can recommend to purchase standalone family PA policy?
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There are few reputable co where you can purchase online .... AIA, Etiqa etc.

QUOTE(z800r @ Jul 3 2021, 06:44 PM)
Hi. Need a suggestion for medical card + critical illness + tpd.

At the moment i already subscribed w a cheapo medical card that covered up to max 150k per year. With the cost of everything gone up, so i think i need to get a better ones w a better coverage.

Anyone can suggest me which one is good.

Also, better if the plan can be applied online. Looking at manulife manuez-med now. Prudential must get an agent to ask first/ get quotation. Etiqa too can be applied online
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Is better to maintain the existing and buy another policy with the same insurer than buying everything new. Unless you have a personal reason for changing insurer.

This post has been edited by mini orchard: Jul 3 2021, 09:07 PM
z800r
post Jul 3 2021, 09:31 PM

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QUOTE(mini orchard @ Jul 3 2021, 08:02 PM)
There are few reputable co where you can purchase online .... AIA, Etiqa etc.
Is better to maintain the existing and buy another policy with the same insurer than buying everything new. Unless you have a personal reason for changing insurer.
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I bought the medicard from online too. So i dont have any agent. And the 150k already max limit for the package.

So i think its better if i change to other medicard provider with better coverage and add on critical illness and tpd as well.
lifebalance
post Jul 3 2021, 09:35 PM

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QUOTE(z800r @ Jul 3 2021, 06:44 PM)
Hi. Need a suggestion for medical card + critical illness + tpd.

At the moment i already subscribed w a cheapo medical card that covered up to max 150k per year. With the cost of everything gone up, so i think i need to get a better ones w a better coverage.

Anyone can suggest me which one is good.

Also, better if the plan can be applied online. Looking at manulife manuez-med now. Prudential must get an agent to ask first/ get quotation. Etiqa too can be applied online
*
QUOTE(z800r @ Jul 3 2021, 09:31 PM)
I bought the medicard from online too. So i dont have any agent. And the 150k already max limit for the package.

So i think its better if i change to other medicard provider with better coverage and add on critical illness and tpd as well.
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You can only get Investment linked policy that offers comprehensive coverage (Life/TPD + CI + Medical) with insurance agents and not through online portals.


Ewa Wa
post Jul 4 2021, 03:05 PM

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QUOTE(z800r @ Jul 3 2021, 06:44 PM)
Hi. Need a suggestion for medical card + critical illness + tpd.

At the moment i already subscribed w a cheapo medical card that covered up to max 150k per year. With the cost of everything gone up, so i think i need to get a better ones w a better coverage.

Anyone can suggest me which one is good.

Also, better if the plan can be applied online. Looking at manulife manuez-med now. Prudential must get an agent to ask first/ get quotation. Etiqa too can be applied online
*
Those online medical card max limit ard 100K-150K per year due to non underwriting, if u r looking for 1mil-3mil annual limit then u need to go through insurance agent.

This post has been edited by Ewa Wa: Jul 4 2021, 03:06 PM
mini orchard
post Jul 4 2021, 05:22 PM

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QUOTE(Ewa Wa @ Jul 4 2021, 03:05 PM)
Those online medical card max limit ard 100K-150K per year due to non underwriting, if u r looking for 1mil-3mil annual limit then u need to go through insurance agent.
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Do insurance companies need to go to such extend to sell 1mil-3mil annual limit ?
onthefly
post Jul 4 2021, 05:38 PM

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QUOTE(mini orchard @ Jul 4 2021, 05:22 PM)
Do insurance companies need to go to such extend to sell 1mil-3mil annual limit ?
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they said medical cost increase, to counter inflation in the next decade, etc

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