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 Insurance Talk V7!, Your one stop Insurance Discussion

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Azuuu
post Apr 23 2024, 05:27 PM

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QUOTE(pharaoh5312 @ Apr 20 2024, 05:33 PM)
hi sifu can I ask a question?

Let's say if someone has done a genetic testing more than 10 years ago and was found to have a genetic mutation in BRCA (the one that increases risk of getting breast cancer in the future).

This said person had bought a medical insurance but did not declare about the BRCA gene.

If at all this person ever gets a breast cancer diagnosis in the future, will this person ever get to claim medical insurance?

Because from what I understand, having a BRCA mutation does not mean it is a 100% thing that the person will get breast cancer, just higher chance than normal people. Also, at the point of buying said medical insurance that person has not ever been diagnosed with breast cancer.

By this logic, it shouldn't be considered as a "pre-existing condition" related to breast matters and should not affect any claims related to breast matters, right?
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Hi, underwriter here.

I dont think it will directly cause the exclusion or decline of the application.

Genetic testing is something i believe isnt really common here yet hence the legality to assess them is still debatable i'd say..

Currently for breast cancer risks, we would usually look at
1) own personal history of breast /ovarian tumour/growth
2) family history ( >2 close members at young age would warrant more concern)

If one has been tested positive for these gene mutation which raises concern for cancer, i would suggest to just declare on the test, whether any preventative treatment or monitoring is required from the dr.

Most likely, if your profile is just the dna testing, no family history, clean ultrasound/tumour marker, it would be just standard imo.

Back to your question, idk much how claims will handle this in terms of t&c etc. I have handled non disclosure cases tho, usually if during the proposal, had u provided further details , report etc and if decision by uw would remain standard , then there should be no issue with the claims.


Azuuu
post Apr 23 2024, 06:03 PM

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QUOTE(MUM @ Apr 23 2024, 05:38 PM)
What will happens to the claim if when the insurance company found out that she did not declare that she had that gene mutation issue during the application?

She posted earlier "This said person had bought a medical insurance but did not declare about the BRCA gene mutation ......"
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Idk how the claims would handle it, would they directly cancel from inception the policy or would they ask for more details or investigate with dr etc aka to reunderwrite.

If they chose to do the latter, all the medical reports/declaration would be assessed by uw and if decision remains as standard, the claim should be approved.
Azuuu
post Mar 25 2025, 05:25 PM

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QUOTE(tzxsean @ Mar 24 2025, 07:31 PM)
[attachmentid=11511528]

I was quoted RM500 + RM200 loading for this GE ILP plan.

Is this quotation fair/reasonable for medical insurance based on my profile/background?

Age - 36
Existing conditions - previous history of mild hypertension (currently normal range), blood sugar at pre-diabetic range + slightly high BMI
Existing medical insurance - very old/outdated AIA standalone plan at 110k annual limit and 330k lifetime limit
Insurance/Take home salary ratio - around 10%
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Coming from an underwriting background, i find it impressive that GE was able to offer u a medical card. Some may just straight decline your medical rider.

I am not able to offer u any advise on whether it is fair in terms of pricing, however i did a quick check with my employers rate.

Assuming u (36/male non smoker) with similar sum assured and riders, were offered substd of +50% on only the medical rider costs , the pricing would be similar to my employer's.

I do not know how the rate will change in the future if u decide to wait for better decision (assuming your health maintains the same risk). Pre-diabetes is quite common and is usually treated with just lifestyle modifications. However it is the precursor to diabetes, in which you wont be able to get any medical card.

Future medical researches in terms of morbidity etc may end up convincing the insurance company to give you a better rate. Or maybe along the line, insurance company may act more stingy and be risk averse when it comes to this current economy.

 

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