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 medical / critical illness insurance enquiry

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PJusa
post Aug 14 2009, 02:53 PM

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i dont think they are simpler. its the structure per se that is complicated. i find life even more complicated because of its nature. i rather stick with plain insurances that cover what they are for and thats that smile.gif

but yes CI is simple cause not many offers and they all are almost the same.

mtsen,

can you share the policy wording for ING with me? i am really interested in it smile.gif for personal reasons too. i am running behind quite a bit with my comparison but i will continue doing it so i have an overview once and for all. i am basically stuck with trying to get PRU running and well i dont really want to skip it. the plan might actually be interesting to some esp. when taken up very early.

This post has been edited by PJusa: Aug 14 2009, 03:35 PM
Vitorbarbosa
post Aug 14 2009, 05:34 PM

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Of course, it's almost the same across industry.

All regulated under the same body. Cannot goes wrong. Or all are wrong.

Justin1000
post Aug 14 2009, 11:05 PM

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QUOTE(c.o.o.l @ Aug 14 2009, 01:19 AM)
Yes I know this.

The fact is what Im saying is based on what a patient that went to government hospital for H1N1 diagnosis said. He went to private hospital to do checking, but the hospital refer him to government hospital with the reason short of medicine.
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These are suspected cases, not confirmed case. There have been confirm cases treated at the private hospitals and passed away subsequently. Previously in the case of SARS, no private hospital is allowed to treat.
numbertwo
post Aug 15 2009, 12:04 AM

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QUOTE(mtsen @ Aug 14 2009, 10:20 AM)
at the end, the most important part is to find a doctor who is willing to review your insurance plan before writing the medical report ... or is that not ethical ?

I remembered reading somewhere on a detail assessment on why H1N1 is not covered and admitted by the insurer, I will dig that one out and see there are any new info we haven't covered here ...


Added on August 14, 2009, 10:26 am

About above 'alteration' from ING, my ING friend commented that it is a common clause across all insurers.  He also highlight another clause that says,

" ... insurer also remains the right to withdraw the whole plan (where everyone will be affected) ... generally after approval from ... blah blah blah ... "

so insurer typically do not change your plan specifically, but when too many people claim too much in the whole plan, they may stop the whole thing entirely ... legally.

can some experts other than ING also confirm these are the 2 common clauses in medical coverages ?

Thanks !
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Hi mtsen, PJusa.,
Here are the exact wordings on ING MediPlus plan:

QUOTE
4. Portfolio Withdrawal Condition
The Company reserves the right to cancel this Policy if it decides to discontinue transacting hospitalization and surgical business. Cancellation of the portfolio as a whole shall be given by written notice to the Policy Owner at least thirty (30) days prior to expiry of the period of cover (i.e. the next policy anniversary) and the Company will run off all policies to expiry of the period of cover (i.e. the next policy anniversary) within the portfolio.

5. Alterations
The Company reserves the right to amend the terms and provisions of this Policy by giving 30 days’ prior notice in writing by ordinary post to the Policy Owner’s last known address in the Company’s records, and such amendment will be applicable from the next renewal of this Policy. No alteration or endorsement to this Policy shall be valid unless authorised by the Company and such approval is endorsed thereon.


While 'Portfolio Withdrawal' clause is common in all 'Good' medic plans, 'Alteration' clause is NOT COMMON. At least I've not seen such wording in any other contracts that I've had a chance to read. And even if they do, usually the word 'portfolio' will be there under the alteration terms..And this 'Portfolio' word is missing in this clause 5. Alterations.. wink.gif

So, Better to get clearance from their underwriting department that to be sorry later on...

Rgrds


Hi PJusa,
Why bother PRU's med card? I thought they are always linked to ILP and that won't be an apple-to-apple comparo to the other plans that we have been talking so far?

This post has been edited by numbertwo: Aug 15 2009, 12:07 AM
PJusa
post Aug 15 2009, 09:19 AM

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numbertwo,

first the clauses. i like number 4) "if it decides to discontinue transacting hospitalization and surgical business" - means as long as ING offers H&S plans the portfolio withdrawal does not apply.

5) is not that bad "this policy" refers to the policy jacket not the individual terms. and it does pop up in pretty much every policy - it has to since this also allows the company to improve the cover. for example AXA adjusted rates and improved coverage with room categories and additional cover. but you always double check with underwriting.

i am bothering with PRUhealth because while this plan is linked to life it does offer some benefits to interested parties who intend to cover their kid from early on. while there are various disadvantages i like to have all the plans so it's a proper evaluation but yes, for now i shall skip the premium comparison - it's a pain to compare like that. have entered the benefits though.
Vitorbarbosa
post Aug 15 2009, 06:42 PM

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Yeah, not easy to compare at all.

Get one that suits you. You will not overpay.
c.o.o.l
post Aug 15 2009, 11:46 PM

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QUOTE(Justin1000 @ Aug 14 2009, 11:05 PM)
These are suspected cases, not confirmed case. There have been confirm cases treated at the private hospitals and passed away subsequently. Previously in the case of SARS, no private hospital is allowed to treat.
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If you are suspected and already refer to government hospital, will you still get a chance to transfer back to private once you are confirmed case?

Just to update the news, Prudential just announced that prudential's medical card now can be use for H1N1.
amerz
post Aug 16 2009, 01:23 AM

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just got my quotation for GE medical card(GM2),
it seems that GE premium is much more cheaper but with some restriction of course.

Most of the Medical Card that has less restriction, the premium is higher than the one that has more restriction.
it's really hard to decide which Medical Card is the rite one. rclxub.gif

This post has been edited by amerz: Aug 16 2009, 01:34 AM
Justin1000
post Aug 16 2009, 11:48 AM

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QUOTE(c.o.o.l @ Aug 16 2009, 12:46 AM)
If you are suspected and already refer to government hospital, will you still get a chance to transfer back to private once you are confirmed case?

Just to update the news, Prudential just announced that prudential's medical card now can be use for H1N1.
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Do not understand what you meant.

Good to know that Pru and many other insurers now declare they cover H1N1, but the fact remains that they have a clause to exclude Communicable Diseases requiring quarantine at their disposal, while some insurers do not have such clause. As such every time there is disease such as H1N1, policyholders are at uncertainty if they are protected by their medical plan. The peace of mind is not there .
PJusa
post Aug 16 2009, 02:18 PM

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Justin1000,

i have no idea where you get this clause from. i have checked the policies i have at hand (TM, AXA) and neither have a clause like that in the policy wording. in fact H1N1 is a derivative of the flue. it's covered by default (no need to make an announcement for it either) with the medical policy just as a case of the real flue would be covered if it requires hospitalisation. and i have seen other policies (MSIG, Pacific etc. ) which also had no such clause. mind you i am speaking for general insurance and not life insurance here. but i doubt the situation is different with life.
c.o.o.l
post Aug 16 2009, 11:02 PM

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QUOTE(Justin1000 @ Aug 16 2009, 11:48 AM)
Do not understand what you meant.

Good to know that Pru and many other insurers now declare they cover H1N1, but the fact remains that they have a clause to exclude Communicable Diseases  requiring quarantine at their disposal, while some insurers do not have such clause. As such every time there is disease such as H1N1, policyholders are at uncertainty if they are protected by their medical plan. The peace of mind is not there .
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I mean when you are suspected and went to government hospital for diagnosis. After that, doctor tell you that you are confirmed case. You already quarantine inside government hospital. You still have the chance to transfer to private hospital?
PJusa
post Aug 17 2009, 08:48 AM

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c.o.o.l,

a transfer would be a different situation i guess. if you are quaranteened they will surely not agree to a transfer. but i am guessing only there. anyone can confirm?
numbertwo
post Aug 17 2009, 10:49 AM

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QUOTE(PJusa @ Aug 16 2009, 02:18 PM)
Justin1000,

i have no idea where you get this clause from. i have checked the policies i have at hand (TM, AXA) and neither have a clause like that in the policy wording. in fact H1N1 is a derivative of the flue. it's covered by default (no need to make an announcement for it either) with the medical policy just as a case of the real flue would be covered if it requires hospitalisation. and i have seen other policies (MSIG, Pacific etc. ) which also had no such clause. mind you i am speaking for general insurance and not life insurance here. but i doubt the situation is different with life.
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6. Private nursing, rest cures or sanitaria care, illegal drugs, intoxication, sterilisation, venereal disease and its
sequelae, AIDS (Acquired Immune Deficiency Syndrome) or ARC (AIDS Related Complex) and HIV related
diseases, and any communicable diseases required quarantine by law.


This is the clause stated in AXA SCO (found in brochure, not sure about the actual policy/contract as I don't have one)
mtsen
post Aug 17 2009, 04:39 PM

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Prudential's strength is Investment Link, so the key idea is they will provide you the FULL portfolio. Especially when you do not invest in stocks and derivatives anyway, this kind of arrangement is not bad after all.

so once u trust them with your investment money, you can go with any of their plans no matter you have PruHealth ( just a rider ) in it or not. As of today's condition, minimum is 5 years to start seeing profit and 20 years of continuous premium payment would land the policy in pretty much a good state (self-sustain).

statistic and historical wise (Malaysia), Prudential's investment link is quite stable in configuration, ie. does not easily lapse even in bad investment years. Hence, its ILP premium is slightly higher than others too (bigger buffer to protect the downturn etc.).

my analysis on PruHealth here
http://malaysiapersonalfinance.blogspot.co...d-surgical.html

generally insurers have clauses to protect themselves. even if by chance they miss anything, they still can go through court cases to settle certain un-payment. H1N1 clause was meant for war and end of the world outbreak etc. So for now, insurer may pay H1N1 claims. However, if one day more than 30% of the population are claiming it, I doubt if any insurer can keep paying ...

there is usually a threshold ... perhaps Victorbarbosa can share ? How many of us have to die before insurer stop paying H1N1 claims ? biggrin.gif
PJusa
post Aug 17 2009, 09:49 PM

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numbertwo,

many thanks for the pointer. found it also - well hidden behind AIDS wink.gif - but i got a clarification: the exlcusion applies to quarantine only if not mistaken i.e. to individuals who are not currently ill—but who are known to have been exposed to the illness. if you get ill, the exclusion does not apply. will double check with underwriting on this.

mtsen,
while you do have a point i dont see why investment should be linked with insurance. it just doesnt feel right - i use my savings and put them in unit trusts and other things. at the end of the day i dont think the performance will be much different on a 30 yrs horizon. the disadvantages have been highlighted (rider, higher premium, higher overhead etc.). its the most convenient way to get cover - like set it and forget it wink.gif but its most likely not the cost efficient or most flexible choice.
Justin1000
post Aug 17 2009, 11:26 PM

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QUOTE(numbertwo @ Aug 17 2009, 11:49 AM)
6. Private nursing, rest cures or sanitaria care, illegal drugs, intoxication, sterilisation, venereal disease and its
sequelae, AIDS (Acquired Immune Deficiency Syndrome) or ARC (AIDS Related Complex) and HIV related
diseases, and any communicable diseases required quarantine by law.


This is the clause stated in AXA SCO (found in brochure, not sure about the actual policy/contract as I don't have one)
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It should be in the contract also.
mtsen
post Aug 18 2009, 03:15 PM

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QUOTE(PJusa @ Aug 17 2009, 09:49 PM)
numbertwo,

mtsen,
while you do have a point i dont see why investment should be linked with insurance. it just doesnt feel right - i use my savings and put them in unit trusts and other things. at the end of the day i dont think the performance will be much different on a 30 yrs horizon. the disadvantages have been highlighted (rider, higher premium, higher overhead etc.). its the most convenient way to get cover - like set it and forget it wink.gif but its most likely not the cost efficient or most flexible choice.
*
if one already know how to invest through mutual fund, then investment link may carry less weight yes. Like wise, if one is good at managing her own portfolio ( like you ), ILP may become expensive. However, most people still can't manage their own portfolio better than the industry's offer yet

QUOTE(prudential @ Aug 18 2009, 02:08 PM)
back to the term of Law of Large Numbers in Insurance
How many of us have to die before insurer stop paying H1N1 claims ?
When there are deaths occur at the same place and the same time , like 100 of people die at the same University and at the same time. Insurers stop paying for H1N1.
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wow, 100 is not that high. I should find a good place to die so that my death is more noticeable ... smile.gif
PJusa
post Aug 18 2009, 03:19 PM

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prudential,

could you elaborate where you get this information from? on what grounds would this be possible? i have a contract and the insurer has little room to refuse a claim that is covered - H1N1 is flue like any other. if i get hospitalised for it my insurance will have to pay the bill. wether 1 person died from it or 200,000. the deathtoll should be entirely unrelated anyway.

mtsen,

i am not sure about the investment part. i gives a potentially false sense of security. i prefer to know what i really have to pay and go along with it. furthermore if PRU is publishing the average premium due subject to investment results, its lowering the perceived premiums to some degree by incorperating expected profits. it effectivel clouds the actual costs of the insurance. i am also not sure how the problem of medical inflation is handled here. the way i see it is that this policy is not transparent. c.o.o.l might be of great help in sheding some light to the actual costs though.
i however dont like it when costs are placed in a way that is mostly uncomparable to the general public. it keeps people from beeing able to compare apple to apple.

This post has been edited by PJusa: Aug 18 2009, 03:29 PM
Vitorbarbosa
post Aug 18 2009, 11:41 PM

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Why say 100? I heard from a prudential agent that all prudential medical card covers H1N1 as they do not have the exclusion on the communicable disease requires quarantine by law.

And Mr. Prudential, I think your 100 figure is very misleading. It might be best if you do not answer to that unless you are right.

MTsen, to be honest, I'm not sure how many needs to be hospitalised before the insurance company says no. At this moment, what I know in the industry is that, although there is this exclusion clause in the policy, most insurers still willing to pay for H1N1 cases.

I really can't answer you on that as that is out of my area of expertise (risk management + claims experience + future experience + shareholder's money + company's position + .... + ...)

But I thought death from H1N1 is covered? Only medical plan is not covered (according to the T & C but heard still covered at this moment).



allenultra
post Aug 19 2009, 11:24 AM

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Medical plan that bought before 1st of Jan 2006 is covered for h1n1.
Those who bought after that, LIAM still having discussion on that.

That's the latest news I know. smile.gif

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