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 Does insurance covers "avoidable injuries"

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xpole
post Jan 19 2025, 09:47 AM

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QUOTE(Chanwsan @ Jan 17 2025, 12:57 PM)
Sports injury during for-profit competition has always been under exclusion, at least for the PA products I'm aware of. If they say injury during normal friendly badminton game is not claimable then only you have a case to fight for. This is similar to let's say police hurt when fighting robbery, or firefighter burn injury during work, all of which are excluded under typical PA policies.

If you willing to commit fraud like one above suggested, then that is down to your character. I won't go further into that.
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That's the reason why a lot of people unaware about the exclusions for claiming the medical cards.

A lot of agents out there doesn't even bother to do proper interview for their clients background.
Clients background in terms of what kind of hobbies they are doing, and so many things.

We can't expect clients to know everything on the terms & conditions that stated on the insurance agreement.

When you told this thing, this is the first time I know. Most of the agents just inform me only me "extreme sports" are not covered.


Boomwick
post Jan 19 2025, 09:47 PM

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QUOTE(ernie ball @ Jan 17 2025, 10:07 AM)
Guys just FYI, I attended an insurance briefing, apparently now insurance won't cover if you attend competitive sports as well, except for running only.

Ie if you join badminton competition and you got injured, insurance won't cover you.
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Wow new rule ad?

Like futsal football now all cant cover ad ?
TSking99
post Jan 20 2025, 03:19 AM

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QUOTE(Boomwick @ Jan 19 2025, 09:47 PM)
Wow new rule ad?

Like futsal football now all cant cover ad ?
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I assume " competitive sports" means like u play for club or country , etc.

If your weekly casual futsal with friends should be covered. Correct me if I am wrong.
moiskyrie
post Jan 20 2025, 09:07 AM

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so now insurance company encourage people dont exercise?
Boomwick
post Jan 20 2025, 10:27 AM

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QUOTE(king99 @ Jan 20 2025, 03:19 AM)
I assume " competitive sports" means like u play for club or country , etc.

If your weekly casual futsal with friends should be covered. Correct me if I am wrong.
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They put an exception - running only..

Meaning competitive for prize money or not for prize money also can be not covered..

Orthopedic earning a lot ka?

So the ball is at the doctor now.. how he write will be very crucial..
WinkyJr
post Jan 20 2025, 01:57 PM

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casual weekend hiking cover or not?

if sport like badminton not covered, might as well wait and stay indoor tunggu mati lol

woi, jom badminton weekend
cannot la, later mati insurance tak cover

why u dont like sport? only running je
why? ask insurance company

This post has been edited by WinkyJr: Jan 20 2025, 02:00 PM
TSking99
post Jan 20 2025, 02:02 PM

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QUOTE(Boomwick @ Jan 20 2025, 10:27 AM)
They put an exception - running only..

Meaning competitive for prize money or not for prize money also can be not covered..

Orthopedic earning a lot ka?

So the ball is at the doctor now.. how he write will be very crucial..
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Later scare they count "e-sport" as sports also...


Boomwick
post Jan 20 2025, 02:08 PM

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QUOTE(king99 @ Jan 20 2025, 02:02 PM)
Later scare they count "e-sport" as sports also...
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Lose ad smash monitor, or get into brawl
Boomwick
post Jan 20 2025, 02:09 PM

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QUOTE(WinkyJr @ Jan 20 2025, 01:57 PM)
casual weekend hiking cover or not?

if sport like badminton not covered, might as well wait and stay indoor tunggu mati lol

woi, jom badminton weekend
cannot la, later mati insurance tak cover

why u dont like sport? only running je
why? ask insurance company
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If badminton and mati, is ok.. sure cover for life..

But the non cover mentioned is probably medical surgery tat require admission.. medical kad
panafone
post Jan 20 2025, 02:24 PM

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No need to assume. Just check your policy document and find out the exclusions lah.

This is one of the exclusions from my policy- Sickness or Injury arising from illegal activities, playing professional sports, racing of any kind (except foot racing) or hazardous sports such as but not limited to skydiving, base jumping, cliff diving, flying in an unlicensed aircraft or as a learner, martial arts, free climbing, mountaineering with or without ropes, water skiing, scuba diving to a depth of more than 10 metres, trekking to a height of over 2,500 metres, bungee jumping, canyoning, hang gliding, paragliding or micro lighting, parachuting, potholing, skiing off piste or any other winter sports activity carried out off piste.

Judging from the "hazardous sports" listed, I'm sure badminton as a hobby is not a problem. Only if I'm a professional badminton player will it be excluded I think.

If not sure just email your agent or insurance company.
As long as you disclose everything, it shouldn't be a problem.
Steponlego
post Jan 20 2025, 04:58 PM

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QUOTE(panafone @ Jan 20 2025, 02:24 PM)
No need to assume. Just check your policy document and find out the exclusions lah.

This is one of the exclusions from my policy- Sickness or Injury arising from illegal activities, playing professional sports, racing of any kind (except foot racing) or hazardous sports such as but not limited to skydiving, base jumping, cliff diving, flying in an unlicensed aircraft or as a learner, martial arts, free climbing, mountaineering with or without ropes, water skiing, scuba diving to a depth of more than 10 metres, trekking to a height of over 2,500 metres, bungee jumping, canyoning, hang gliding, paragliding or micro lighting, parachuting, potholing, skiing off piste or any other winter sports activity carried out off piste.


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This sounds like great eastern.

hallojohnnycash
post Jan 20 2025, 08:47 PM

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Amateur sports covered. Not competition type.
Generic policy (over the counter) type of insurance has similar wording, similar exclusion list. Regardless which brand you buy.
Simply bcoz, its the treaty leader clause wording the insurance company use. & there is only a handful of them.

What is a treaty leader?> In layman terms, its like insurer for insurance company. i.e Munich Re, Swiss Re. Annually, there is treaty arrangement of how much risk is pass on to the leader, also means premium as well.
Got big brother, so follow big brother rule. That sort.

Insurance company underwriter wont create new clause unless really needs to. Coz, the clause wording needs pass on to treaty leader and BNM for approval. It is super hassle.
All policy in MY MUST to cede certain % to MNRE or MLRE (depends whether its life of general policy). Eg, 5% of the premium means they take 5% of the risk. Different insurance class has different % ceded.

& All insurance companies are members of PIAM or LIAM (General insurance or life). Takaful operators has their own.
Means, standardization of the industry must be practiced by all members.
There is no 1 bad guy. Its whole bunch together gether.

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To answer OP, if got H&S policy, cedera can go hospital for treatment.

If PA policy, its reimbursement basis. Means you bayar first, claim later.
Small injury/cost, no one will ask anything. Insignificant to bottom line. UNLESS, its proven that the claimant is ambulance chaser sort. Repeater claimant.
Also, the medical part in PA policy is with its own limit. Sort of window dressing to the policy.

Unless, the incident damage is loss of whole hand (permanent disability), then need to see police report.
No illegal activities, nothing to worry.
Self defense. No problem. Subject to how the police report is written.









 

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