Anyone have Personal Accident Insurance

[scubascuba3]

1 hour ago, KrishnaCameb4Buddha said:

 

Many ‘accident’ policies in Thailand provides medical/hospital.  But only for accidents OTHER than driving/riding motorcycle.  But brokers will tell you that you are covered while riding a motorcycle.   

Putting faith in brokers is touching.  Understand this point: that brokers can say ANYthing, but it is the POLICY which is the legal document.  A broker is the reason I am making these posts: because the broker told me this 7,000 baht policy would pay my Medical/Hospital bills of 200,000 baht for driving/riding a motorcycle.  It will not.  The policy WILL pay for accidents but NOT for Medical/Hospital for motorcycle accidents. An 'Accident Policy" from, for example, BKI does NOT cover MEDICAL/HOSPITAL for driving/riding on a motorcycle--and it may not even cover loss of life/limb/eye/disability for driving/riding motorcycle (see below).

 

Words from brokers are NOT what determines what the policy pays for. 

 

Please note re any insurance being sold to you in Thailand, before you buy you need to obtain a copy of the actual Policy.  The Policy is *not* the ‘coverages’ or ‘Declaration’.  The Policy is a booklet or long PDF document.  When you get the policy you need to first jump to the Exclusions section.  Read that.  That is what your policy specifically excludes. If your broker tells you different, then you are smelling a fish. 

 

Because what the Policy actually covers is in the actual Policy.

 

Weasel words, and weasel sentences and weasel posts cannot change the wording of the Policy and that brokers in Thailand can get away with saying all sorts of things they couldn't get away with in a place with strict rules for insurance misrepresentation.

 

The wording of the Policy is what rules.  If a broker tells you that your medical bills are covered while driving/riding a motorcycle but the POLICY THE BROKER SENT YOU  says this--“This insurance does not cover loss or injury while the insured is riding or traveling on a motorcycle"--then THAT is what rules.

 

And if the coverage page--for ex, the "Personal Accident Happy 45+"--says NOTHING about Medical/Hospital for driving/riding motorcycle, then that is even more proof BKI PCL will not be paying your Medical/Hospital bills for driving/riding motorcycle.  (The 'Personal Accident Happy 45+" coverage page just says 'medical for accidents' but the 'accidents' they are talking about are accidents EXCLUDING driving/riding motorcycle.  Always read the Exclusions section)

 

And if you point these things out to your broker, they may then send you an Extended Cover page, as they did with me.   But if the so-called 'extended cover rider' they send you does not say clearly something like 'This policy is hereby amended to pay his Medical/Hospital bills while driving/riding a motorcycle', then you know beyond a reasonable doubt that they are full of s*#t.  What you WILL see on their so-called 'Extended Cover' is the following--just note that nowhere on that so-called 'Extended Cover' does it CLEARLY say you will be covered that way.  What is says goes like this: " Medical Treatment will be paid “but not exceeding the sum insured specified in the POLICY schedule”.

Get it?  The broker sends you emails telling you "Our Personal Accident Happy 45+ will pay your medical/hospital for driving/riding motorcycle".  Then when you point out the language in their legal documents (the actual Policy) that says they will Not pay for that then your broker says 'Hey, we can send you an extended cover" and when you read it you notice that nowhere in the document does it say your Medical Hospital for driving/riding motorcycle. What it says goes like what was sent me: Medical Treatment will be paid “but not exceeding the sum insured specified in the POLICY schedule”.

 

The full ‘sentence’ is actually this: “The coverage description of item 4 Medical Expense under the Insuring Agreement of Or (sic) Bor (sic) 1. (sic) is deemed to cancel and to replace (sic) by herebelow (sic) stated: “Coverage for….medical treatment..etc “but not exceeding the sum insured specified in the Policy schedule”.

 

And we all know what the Policy and the Policy Schedule says about medical/hospital-riding-driving-motorcycle.  Nothing!

 

And note one more thing.  No extra money was being asked of me for this so-called 'Extended Cover'.  Why?  The reason is: there really is no extended cover! 

 

Note that it does not say "medical treatment for driving/riding motorcycle'.  And the most important language is the following "the sum insured specified in the POLICY schedule".  And, guess what!!?? The 'Policy Schedule" says NOTHING about Medical/Hosp driving/riding motorcycle. The Policy Schedule talks about loss of life, limb, eye, disability.  But the real kicker--the real reason even THIS life/limb/etc coverage is in doubt is because the actual Policy Exclusion says -“This insurance does not cover loss or injury while the insured is riding or traveling on a motorcycle". 

If Bangkok Insurance PCL (BKI PCL) wants to claim their 'Personal Accident Happy 45+ will pay for Medical/Hospital (or loss of limb/life/disability) while riding/driving a motorcycle then the policy and the coverage page needs to clearly say this.  But if anywhere in the documents it says (as the BKI PCL says) the following--“This insurance does not cover loss or injury while the insured is riding or traveling on a motorcycle"--then that should be a huge WARNING sign. 

 

Words from brokers are NOT what determines what the policy pays for. 

 

How many people do you think have been fooled by this kind of sleight-of-hand language?

I questioned my agent (AA) about this with my AXA policy when i purchased it, they seem to get uncomfortable when you ask them questions they don't know the answer to, they don't want to ask someone who may know the answer. Disappointing really they can't field questions professionally

[topt]

3 hours ago, scubascuba3 said:

I questioned my agent (AA) about this with my AXA policy when i purchased it, they seem to get uncomfortable when you ask them questions they don't know the answer to, they don't want to ask someone who may know the answer. Disappointing really they can't field questions professionally

When I have needed a clear answer from them they normally end up going back to the insurance company concerned but I have to push to get the clarity needed. I have had to accept it as one of the things you have to do here. 

 

For an important query with AA in Pattaya I would suggest pushing for a call back from one of the foreign "principals" and get them to put it in an email.

 

I refuse to buy any policy where i don't get a full copy of the Ts and Cs in English that I can read beforehand - pretty much as the other poster Hari Hari mentioned.

[scubascuba3]

10 hours ago, topt said:

When I have needed a clear answer from them they normally end up going back to the insurance company concerned but I have to push to get the clarity needed. I have had to accept it as one of the things you have to do here. 

 

For an important query with AA in Pattaya I would suggest pushing for a call back from one of the foreign "principals" and get them to put it in an email.

 

I refuse to buy any policy where i don't get a full copy of the Ts and Cs in English that I can read beforehand - pretty much as the other poster Hari Hari mentioned.

Good advice I'll do that, i know the farang are in the background usually dealing with health insurance stuff

[canopus1969]

I had to tell AXA I was riding a bike on the application form so that they accepted me for bike accidents

[Katy Gorice]

On 12/28/2019 at 5:00 PM, CharlieH said:

FREE with many (most?) bank debit cards.

please, which one's? I'll open a bank account directly on real advise

[spiekerjozef]

yes

[Just Weird]

On 12/28/2019 at 5:14 PM, scubascuba3 said:

reports of people being charged 6k for this very poor cover

Where are those reports?

[CharlieH]

54 minutes ago, Katy Gorice said:

please, which one's? I'll open a bank account directly on real advise

Most of them do I think, but I use Kasikorn.

[scubascuba3]

1 hour ago, Just Weird said:

Where are those reports?

on this forum, have a look

[scubascuba3]

On 2/15/2020 at 6:59 PM, topt said:

When I have needed a clear answer from them they normally end up going back to the insurance company concerned but I have to push to get the clarity needed. I have had to accept it as one of the things you have to do here. 

 

For an important query with AA in Pattaya I would suggest pushing for a call back from one of the foreign "principals" and get them to put it in an email.

 

I refuse to buy any policy where i don't get a full copy of the Ts and Cs in English that I can read beforehand - pretty much as the other poster Hari Hari mentioned.

I checked with Axa and they triple checked that it does cover motorcycle accidents (they fielded the questions professionally and weren't fazed), the lady even confirmed in an email.

 

I recommend Axa, might as well go direct

[Just Weird]

23 hours ago, scubascuba3 said:

On 2/16/2020 at 2:43 PM, Just Weird said:

Where are those reports?

on this forum, have a look

Can't find one.  If you know that they're there, perhaps you could back up both of your comments?

[scubascuba3]

15 minutes ago, Just Weird said:

Can't find one.  If you know that they're there, perhaps you could back up both of your comments?

One example is my personal experience of going to Central Festival Kasikorn and they would only open an account if i bought the 6k insurance, many other reports, try the opening a thai bank account threads

[scubascuba3]

1 hour ago, Just Weird said:

Can't find one.  If you know that they're there, perhaps you could back up both of your comments?

what have you added to this thread? zilch as far as i can see

[internationalism]

axa still has those policies covering up to 625k medical for up to 15k premium.

as they have many policies I put a link to this https://www.axa.co.th/en/AXA-PA-Sabuyjai-My-Exclusive

 

I would like to exclude "accident while travelling on a motorcycle", because I never drive or ride on motorcycle. Can it be done and how? Instead I would increase medical or lower premium.

 

I don't have health insurance, so I want PA be one of the best. If you know any other company offering high medical, please do let me know. I have written to several brokers and waiting for their replies

Edited April 18, 2021 by internationalism

[RubbaJohnny]

On 12/29/2019 at 3:55 PM, GalaxyMan said:

I have personal accident insurance; cost: 5,000 baht/year; coverage: 1,000,000 baht

 Hope you have being smote insurance , or fill the dashboard with lucky charms 

[scubascuba3]

6 hours ago, internationalism said:

axa still has those policies covering up to 625k medical for up to 15k premium.

as they have many policies I put a link to this https://www.axa.co.th/en/AXA-PA-Sabuyjai-My-Exclusive

 

I would like to exclude "accident while travelling on a motorcycle", because I never drive or ride on motorcycle. Can it be done and how? Instead I would increase medical or lower premium.

 

I don't have health insurance, so I want PA be one of the best. If you know any other company offering high medical, please do let me know. I have written to several brokers and waiting for their replies

With Axa they won't reduce premium for no MC that's bespoke for the polices above but they may have cheaper policies, many companies offer no MC but cover is usually low.

 

For higher cover try SCB https://www.scb.co.th/th/personal-banking/insurance/accident-insurance/pa-happy-plus.html

[Dario]

The problem here is that I'm just over 75 years old. Until now I paid near 9'000 Baht for 100'000 Baht medical insurance covering me and my wife of 60. Anywhere cheaper?

[internationalism]

On 2/15/2020 at 1:34 PM, KrishnaCameb4Buddha said:

Imglobal.com will sell you good insurance that has no 'motorcycle' exclusion.  68 yr old man, $2500 deductible, $100,000 health/accident insurance, about $1000 per year. Pre-existing conditions *not* excluded.  No health exam required.  A reputable company with very little negative reviews on the internet.  Based in the USA, underwritten by large entities, can be sued under laws of the United States (try suing a Thai company, haha). 

 

Insurance can be purchased for short term, weeks (maybe even days) to a month, or months, or a year.  Unused months are refunded if you cancel.

Nobody commented on this lead. 

They have 3 policies, that one below is silver (the middle range), covers $5mln per life (not per year).

Looks good value, with some $200/month, which can be lowered below $100 per month with $10k deductible (so comparable to

I think would be good if some insurance agent/professional looked at it to evaluate. Problem, that because they don't have this policy on their books, they won't likely comment on it. Unless to pay them some 1000 baht to get their opinion.

Here is a copy of their terms, I have chosen exclusion of the US, HK, Sin, Japan, Taiwan, China

Plan Summary A long-term (1+ year), annually renewable, worldwide medical insurance program for individuals and families.
Lifetime Maximum Limit	$5,000,000 per individual
Deductible	$250 to 10,000
Coinsurance	International – 100% U.S. in-network – 100% U.S. out-of-network – 80%
Treatment Outside the U.S.	50% of deductible waived, up to a maximum of $2,500. No coinsurance.
Treatment inside the U.S. - PPO Network	Subject to deductible. No coinsurance.
Treatment inside the U.S. using Medical Concierge	50% of deductible waived, up to a maximum of $2,500. No coinsurance.
Treatment inside the U.S. - Non-PPO Network	Subject to deductible. Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage.
MyIMG Member Account	24 hour secure access from anywhere in the world to manage your account at anytime
Period of Coverage	1 year - annually renewable

Medical Benefits Vision Optional Rider Intensive Care Subject to deductible and coinsurance. $1,500 limit per day – 180 days of coverage per event Mental/Nervous Subject to deductible and coinsurance. Outpatient after 12 months of continuous coverage Physical Therapy Subject to deductible and coinsurance. $40 maximum per visit – 30 visit limit Chemotherapy / Radiation Therapy Subject to deductible and coinsurance Transplants $250,000 lifetime maximum Hospital Indemnity Private Hospitals: $400 per overnight and $4,000 maximum limit per period of coverage. Public Hospitals: $500 per overnight and $5,000 maximum limit per period of coverage. Not subject to deductible or coinsurance (Inpatient hospitalization outside the U.S. only) Prescriptions Prescription Drugs, Dressings, and Durable Medical Equipment: Subject to deductible and coinsurance. 90-day supply per prescription following related covered event U.S. Retail Pharmacy out-of-network: 80% International Retail Pharmacy: 100% Hospital Room and Board Subject to deductible and coinsurance for average semi-private room rate. All subject to $600 per day/240 day maximum Hospital Emergency Room Injury Subject to deductible and coinsurance Interfacility Ambulance Transfer $1,500 maximum limit per event - not subject to deductible or coinsurance. U.S. Only (Transfer from one licensed health care facility to another licensed health care facility) Hospital Emergency Room Illness Subject to deductible and coinsurance. Additional 250 deductible if not admitted as an inpatient Surgery Subject to deductible and coinsurance Assistant Surgeon 20% of primary surgeon’s eligible fee CAT Scans, MRI, Echocardiography, Endoscopy, Gastroscopy, Cystoscopy Subject to deductible and coinsurance. $600 maximum per examination Child Preventive Care $70 maximum per visit, 3 visit limit per period of coverage. Not subject to deductible or coinsurance. (Through age 18) Healthy Travel Preventative Coverage $250 lifetime maximum. Not subject to deductible or coinsurance. Applies to vaccinations and preventative prescription drugs administered by a physician within 30 days prior to the insured person’s initial effective date and before departing to any destination Emergency Local Ambulance $1,500 maximum limit per event. Not subject to deductible or coinsurance. (injury or illness resulting in an inpatient hospital admission) Outpatient $300 maximum per visit - lab tests; $250 maximum per visit - diagnostic X-rays 25 combined maximum visits $70 per visit/examination - specialists/physician charges $50 per visit/examination - chiropractor charges (medical order or treatment plan required)$500 per consultation - surgery intervention consultation charges Subject to deductible and coinsurance Expatriate Prescription Services Program NA Orphan or Biologic Drugs Outpatient and Emergency Department Treatment maximum limit: $250,000. Subject to deductible and coinsurance (Available when all conditions are met) Approved in writing by company Medically necessary Not experimental or investigational Applies to period of coverage max. Max limit applies towards lifetime max

Pre-Existing Conditions

Pre-Existing Conditions

Pre-Existing Conditions Limitation: $50,000 lifetime maximum; $5,000 per period of coverage for unknown conditions. Available after 24 months of continuous coverage. If applicants can verify their prior comprehensive health insurance, with no significant break in coverage (63 days), IMG may accept this as Creditable Coverage and provide a pre-existing conditions waiver (final decision is subject to Underwriters approval). Creditable Coverage is defined as a group health plan provided by a U.S. employer or Health Insurance Issuer, individual major medical health insurance provided by a Health Insurance Issuer, or other Public Health Plan (any comprehensive health plan established or maintained by a State or the U.S. government).   Dental Traumatic Dental Injury $1,000 per period of coverage Treatment at a hospital facility Non-emergency Dental Optional Rider