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 Great Eastern rejected critical illness in news, What do you think?

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ckdenion
post Jul 15 2021, 08:19 PM

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From: Wangsa Maju, KL



QUOTE(cmk96 @ Jul 14 2021, 04:19 PM)
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hi cmk96, basically, no medical card cover covid-19 expenses except for certain medical cards from AIA. if you come across any, do correct me. those that covers are those from the special relief fund which acts like an allowance/reimbursement to a certain amount.

QUOTE(aspartame @ Jul 14 2021, 05:13 PM)
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hi aspartame, if this insured got history of hypertension and say he knew about it (meaning got medical record in any clinic/hospital/lab), if such claims happen, company still got the right to reject the claim and void the policy because this falls under the non-disclosure clause. for the genuinely overlooked/could not remember, can try to write in and try to appeal. of course final decision of appeal is not guarantee ya but if there's a chance, why not.

also i think during the insurance application process, agent plays important role in asking all the disclosure health questionnaire. by asking in specific, likely can remind the insured of past history unless really something that the insured isnt aware of.

QUOTE(aspartame @ Jul 14 2021, 06:16 PM)
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if there is really something not disclosed, then yes company can deny they claim. how company differentiate is... if they cannot find evidence/proof of medical history, they will treat it as a genuine case. if they dig and find out certain medical history that isn't mentioned in the insurance application, then they will treat it as non-disclosure case and further investigate to find out more.
ckdenion
post Jul 15 2021, 08:47 PM

Financial Practitioner
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From: Wangsa Maju, KL



QUOTE(aspartame @ Jul 15 2021, 08:44 PM)
So basically non-disclosure clause will still rule in spite of the incontestability clause of 3 years? Thx
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yes you are right. in fact if you see those cases with all these disputes, most of the policies are already more than 2-3 years still stuff like that happened.
ckdenion
post Jul 16 2021, 12:25 PM

Financial Practitioner
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Senior Member
2,866 posts

Joined: Sep 2008
From: Wangsa Maju, KL



QUOTE(aspartame @ Jul 15 2021, 09:05 PM)
Ok thx. I think a good agent is important. I can imagine some ruthless agents running through the questions quickly and casually with the clients in a rush to close sales when the disclosures are actually the most important as any omission can potentially come back and haunt us. Yet, I feel insurance companies somehow intentionally or otherwise never put an effort to stress this point .
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companies actually passed this responsibilities to the companies' trainers and to the agency managers/leaders. i remembered when i first joined the industry, the agency leaders didnt stress much on this, in fact didnt use proper form to fill the application. well, i have to find out myself what is going on as i progress through. that's the reason why i quit the first agency i joined and found another agency which is more professional and really stress on this a lot. that's how agency that really do this business properly can grow big and we really won't tolerate agents that simply go through the application form.

 

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