Etaoin Shrdlu

I had a couple of BMW 3 series back in the day. Fun cars to drive. Pricey service and spare parts.

If you enjoy driving and can afford it, go for it!

7 minutes ago, madmitch said:

You're right, however with travel insurance, the laws and jurisdiction of the home country would apply, however many countries do have similar rules. A policy should of course be drafted accordingly.

Yes, of course.

In the other post I was responding to someone who had his Thai medical policy cancelled due to non-disclosure of a condition that wasn't the subject of the claim he was submitting. It was probably something that would have triggered an exclusion for a pre-existing condition and likely not declination of cover.

6 minutes ago, madmitch said:

Good to see a post from someone that actually understands the subject (there are a couple more as well) but I chose just to quote one.

 

You are absolutely right about the small print certainly in UK policies, as insurance regulators have decreed that consumer policies, i.e. individuals and small businesses, must be made more simple and easy to understand. Those talking about small print must be living in the past or they're American, where the wordings are still pretty dreadful.

 

It is no longer permissible under the UK Insurance Act 2015 to decline a claim based on a misrepresentation or breach or warranty or condition if the claim had nothing to do with the breach. So the poster who had a heart issue declined as a result of not answering the mental health question should have been paid out under UK law but not necessarily in other jurisdictions.

 

All policies have complaints clauses and insurers take complaints very seriously. If you think you've had a claim wrongly declined then complain and if you get no joy from the insurers take it further. Details will be in the policy.

 

EU law, which is still in force in the UK, insists that an Insurance Product Information Document (IPID) be issued for all consumer and SME products. This sets out in a simple list form the coverages and exclusions. It's not a perfect document as the size is limited but those that don't want to read the policy can get the basics from this document.

 

It was also stated by someone that exclusions should actually be in larger print, rather than the imaginary small print. French law does insist on exclusions being clearer and Insurers lost a high profile case fairly recently based upon this law. It is uniquely French, however.

 

Good claims assessors/adjusters will know pretty soon whether or not they should be looking at the exclusions, terms and conditions but many claims are very straightforward and will be paid out without question. It's commonly believed that the first thing they do is find a reason not to pay a claim. This might be the case with some but not any I've ever worked with. Underwriting ability should be such that the company should still make a profit after paying out all genuine claims and actuaries are employed universally to help calculate the premiums.

 

I could go on but I believe that most insurance companies and Lloyd's Syndicates are rather more scrupulous than most on here perceive. And I wonder how many disparaging posters have had genuine claims, without breaches of terms and conditions, declined? Or how many simply believe the hype!

In another post I cited the Thai Civil and Commercial Code's section 865 that defines an insurer's ability to void coverage for non-disclosure. Under this clause, it appears that non-disclosure needs to be intentional and there is also an apparent five-year time bar. I wonder how many ab initio cancellations could have been overturned if the policyholder had appealed to the OIC.

6 hours ago, richard_smith237 said:

Recently when switching medical insurance policies (for my Wife and Son) I narrowed the choice down to a selection of 5 Companies / Policies - I requested the details (the detailed Policy cover - including what some would call the small print). 

 

I was told I could only receive this once confirming / taking out the cover. 

I’m not sure if this was down the broker or the individual companies themselves. 

 

 

 

 

 

A policy of insurance is a legal contract between two parties. To deny one party the ability to review the contract before entering into it is in my opinion a sign of bad faith.

If the insurer is denying a chance to review the policy, that's reason to exclude it from your search. If your broker is too lazy to get you a copy of the policy, you need a new broker.

May have been a Forest Crested Lizard. The spots look similar to this one:

https://www.thailex.info/THAILEX/THAILEXENG/LEXICON/Indochinese Forest or Blue Crested Lizard (Calotes mystaceus) กิ้งก่าหัวสีฟ้า.htm

2 hours ago, spidermike007 said:

I couldn't disagree more adamantly, which seems to be the theme of our recent exchanges. There is so much evidence to the contrary. Though, I am sure the industry appreciates your faith in them. 

 

Even calling it "insurance" is a sick joke. Insurance implies a guarantee, and no matter what we pay, there are never any guarantees. I propose replacing the word "insurance" with the word "maybe?" -- including the question mark -- as in "health maybe?" Maybe they'll pay when we get sick. Maybe they won't randomly hike our monthly premium by 30 percent. Maybe they'll cover our preexisting conditions without gouging us -- that is if they agree to cover us at all. Maybe they won't let our family members die after refusing coverage.

 

Allstate is a great example of intentional insurance fraud, committed against policy holders. 

 

https://www.decof.com/documents/the-ten-worst-insurance-companies.pdf

 

 

Good article. 

Unfortunately, it is a tenet of our capitalist system to put shareholders' interests above policyholders'. A better balance is needed, but I think that will be difficult under the present circumstances.

As far as fraud is concerned, CEOs and other corporate officers will probably have to be put in jail in order for this to stop, and that does not seem to happen very frequently unless shareholders are harmed.  Better regulation, oversight and enforcement is needed. 

There is one US political party that stands opposed to almost any form of corporate regulation and many of the people most at risk of being hurt by corporate avarice and fraud seem to be keen to vote for that party. Perhaps preventing women and their physicians from making reproductive healthcare decisions is more important than reining in rogue companies and sending CEOs to jail for fraud.

2 hours ago, Terry2905 said:

I am 1 the unfortunate individuals who had an insurance claim (locally purchased from a reputable company) cancelled and not paid out for an urgent heart operation. I "accidently missed" declaring a previous condition. 2 pages of "yes or no", and I missed answering 1 yes!

 

Why?

 

Because the application form quite clearly stated if I had been diagnosed with a mental health issue in the last 10 years.

 

Yes, I had been misdiagnosed with a variety of mental health issues, ranging from anxiety, insomnia, MDD, bipolar 1, bipolar 2, et al! My records were from more than 10 years ago, but still on record at Bangkok Hospital. 

 

And some of the questions are there deliberately to refuse payment! For example? Have you ever had a headache in the last 10 years! Hmm! Does that include the occasional hangover! LOL!

 

I did declare all my previous pre existing conditions, but even though I had never been diagnosed or treated for a heart condition, my heart operation claim was refused!

 

And now, because I have had a health insurance policy refused/cancelled, no insurance company will cover me!

 

Thankfully I am on a non O extension, so insurance is not mandatory.

 

Anyway, the crux of the matter is that 1 very small mistake in the application form resulted in me "losing" the 65,000 baht cover fee, and then having to pay out of my own pocket 450,000 baht hospital fee for the heart operation.

 

I did appeal to the local insurance company, telling them that it was a very genuine misunderstanding/error on the application form, but to no avail!

 

 

 

 

 

 

 

 

Section 865 of the Thai Civil and Commercial Code imposes strict disclosure requirements on insurance applicants. It also appears to only allow an insurer to void a policy if non-disclosure was material and intentional. There also appears to be a five-year time bar, however it is not clear how this would work with a recurring disclosure requirement at renewals.

https://library.siam-legal.com/thai-law/civil-and-commercial-code-insurance-section-861-868/#:~:text=Section 865.&text=If such right of avoidance,contract%2C such right is extinguished.

This is something that may have been worth appealing to the OIC.

41 minutes ago, richard_smith237 said:

It comes down to age as well....  when I was young I was under the impression that the travel insurance provided by my ‘credit card’ sufficient cover... why wouldn’t I ????.... when I took the card that was one of the main points of the advertising (full travel insurance) so when I received the card I thought I was covered whenever I travelled (turns out I needed to book the travel through the ‘cards travel provider, or some such similar technicality’). 

 

I’m sure many others have fallen into that trap / been mistaken and look back and realise they were lucky. 

 

 

The No Helmets / Riding while drunk / without a licence etc are also issues - I know this is common sense, but Insurance companies could be a lot clearer with their exclusions, particularly in key areas of cover. 

(i.e. on front page - NOT COVERED IF RIDING WITHOUT A LICENCE, WITHOUT A HELMET OR WHILE INTOXICATED)

 

 

Regarding the main article: 

Since when was this considered a ‘hazardous sport’ ??....   I’ve done this, my family have all done this - IF such activities are considered dangerous insurance policies need to **list them, not hide behind vague wording ‘DANGEROUS ACTIVITIES’ because what I considered dangerous may be different and if an insurance company is not specific on this, their wording simply gives them wiggle room when the underwriter decides the claim is too high and ’rafting down a river’ or ‘falling off an elephant’ (or horse etc) was a ‘DANGEROUS ACTIVITY’....

 

 

This is untrue - Driving in Thailand on a UK licence is legal, there is also misconception that an IDP is needed (it not for a Licence issued in English from a country which is signatory to 1968 Vienna convention on road traffic).

(*Note: if the driver is a resident (i.e. on a Non-Immigrant Visa) they need to have a Thai Licence).

 

I don't care to get into the nth debate about these facts and the various interpretations surrounding the vagueness of the Thai Land Traffic Act etc (That said: I would advise any tourist to also get an IDP and any resident to get a Thai licence to avoid such debates with ether the police or an insurance company etc).

 

----------

 

**Regarding Elephant tracking being considered a dangerous sport. 

No insurance policy I have ever read mentions this. 

A while back it took me two months to obtain clarification from an insurance company regarding their wording ‘dangerous activities’...    their response was repeatedly vague and ambiguous... 

At one point the response was something along the lines of “cover (for skiing) will be decided upon based on the extent of the injuries in the event of an accident”, when pushed on this they responded that they’d decided IF in the event of injury they’d interpret if we were skiing dangerously based on the extent of injury... Which, IMO was utterly ridiculous. 

Eventually after a lot of back and forth and pushing them into corners I received a list and of specifics regarding cover. 

- Skiing (any country On Piste and / or Off-piste with a guide) - [full cover]

- Bicycling (in Thailand, on roads) - [full cover]

- Mountain biking  (on and off road) - [full cover]

- Wakeboarding / water skiing  (in Thailand) - [full cover]

- Motorcycling (in Thailand, on roads) - [full cover when licensed]

- Motorcycle Taxi  (in Thailand) - [full cover / no mention of helmet or not]

- Taxi  (in Thailand) - [full cover / no mention of seatbelt wearing or not]

- Diving - [full cover - when recreational diving IF certified (PADI) or with an instructor]

- Competitive Sports - [when not professional - fully covered]

 

Things I didn’t think of... 

- Rafting / Elephant riding / Bungee jumping / SkyDiving / *crossing the road !!!... 

 

(*potetnially one of the most dangerous activities in Thailand !)

 

The Point with my List is that it took two months to push the insurance company to be specific - their initial ambiguity provided them with sufficient wiggle room to avoid a claim, I accused them of such. 

At that point I was a few months away from needing renewal cover and wanted to ‘win’ and push them to give specific responses just to see how far they would go to avoid specifics and potentially avoid responsibility.

IMO, they’re [insurance companies] are all as bad as each other and look for the smallest of reasons not to pay out. 

 

 

 

 

 

You did the right thing in seeking clarification. It should not have taken two months to extract this information from the insurer, however. 

I suspect the vague answers came from a lower-level underwriter or claims handler and your query did not receive appropriate attention until it was escalated to a senior person by your repeated requests.

Non-Thai insurers tend to offer a bit broader coverage with higher limits and are more professional when it comes to claims-paying approach than Thai insurers. They're also usually subject to a stricter level of regulation and better consumer protection laws.

Thai insurers tend to exclude almost all types of pre-existing conditions. Some non-Thai insurers may cover some pre-existing conditions subject to premium loading.

I would suggest you work with a good insurance broker to find a good solution. Note that insurance brokers based in Thailand may not be able to help with non-Thai insurance policies since they are prohibited by local regulations from doing so.

42 minutes ago, Celsius said:

 

Why?

If you need to change your airline bookings for any reason, you'll have to go through the aggregator to do so. In addition to any airline change fees you'll probably also have to pay hefty fees to the aggregator. That has been my experience and I now only book directly with airlines, too. 

2 hours ago, jerrymahoney said:

As stated: Usually.

It isn't possible to form any kind of opinion on the claims-paying ability of an insurer if its identity is not known or if financials and ratings aren't available.

15 minutes ago, bkk6060 said:

I have no idea if this is true.

I was told by a broker that their assets for paying claims are only from premiums. In other words, if 100 people are paying $2,000 a year their claim payout bank is $200,000.

It seems as far as this forum is concerned, there have been very few claims.  So, in theory they may be solvent at this point with limited claim exposure.

This is one of the reasons why it is important to know where an insurer is licensed and regulated. Some countries have very low capital and reserve requirements and may not employ sophisticated analytics when reviewing an insurer's financials. Some offshore "financial centers" are known for their light regulatory touch and ease in securing a license.

1 minute ago, scubascuba3 said:

the fact there's so few reviews suggests it's not being marketed in UK, maybe only Thailand, Buakhao

Licensing, regulatory and compliance issues would likely keep some companies from offering insurance in the UK market.

Just now, KannikaP said:

Link to these reports please.

I'm referring to the OP and you have yourself enumerated the reports on AN. I do not have any others to provide.

1 minute ago, KannikaP said:

Agree, but they still seem to be going, and paid ONE claim recently that we have been made aware of.

Are there no other members on here who are successfully covered by WR?

From the reports of policyholders who have had their claims paid, it certainly appears that WRLife has the willingness to pay claims, and that is very important. Policyholders should be encouraged by this.

In addition to willingness to pay, the financial ability to pay going forward is important. Usually a review of an insurer's financial statements and ratings by agencies such as Standard and Poor or AM Best can give an idea as to an insurer's longer-term ability to meet claims obligations. One can't begin to perform this kind of review if one does not know the name and address of the insurer.

2 minutes ago, KannikaP said:

No, because the WR claim would count as pre-existing condition, whereas WR ignore those ocurrences, according to Patrick, who told me that he & his family live here, but does his business from offices in France & London.

While a new insurer may exclude a pre-existing condition and deny related claims, an insolvent insurer isn't able to pay any claims. 

14 minutes ago, KannikaP said:

I would also like to know these things, but why should OP bother.........he's been paid.

And the next claim? 

Or will he switch insurers now that this one claim was paid?

16 minutes ago, scubascuba3 said:

maybe @Liverpool Lou has the answers to that?

Maybe.

But even if he does not, I suspect he might know why these things are important.

Freeze-dried water.

I carry some around in a plastic bottle and when I get thirsty I just add water.

Lipoma. 

Benign, fatty tumors.

Very common.