Popular Post ASEAN NOW Sales Posted August 6, 2021 Popular Post Share Posted August 6, 2021 In Thailand, the health insurance market has grown considerably in recent years. There is now a dense and complex offer, a mix of local / foreign and mixed products, price differences that vary in a ratio of one to ten to cover the same medical risk... Insurers, agents and brokers systematically provide the client with a document called the Table of Benefits, or brochure, in which there is a description of the main benefits and conditions of the insurance policy. This document is generally fairly easy to read. But to fully understand what is hidden in the insurance policy, you must ask for the full policy wording. This document is often technical and long, and not always communicated to the customer. It is nevertheless essential to consult it, in particular concerning the 8 following subjects: 1-Intensive Care Unit (ICU) and surgery ICU and surgery represent the heaviest bills, exceeding 10 million Baths (US$300,000) in the most serious cases. That’s why we have to be careful about it. And this is why some insurers, in order to offer very low rates, strongly cap those benefits. Examples: surgery covered up to US$ 1,000, anesthesiologist covered at 80%; intensive care covered for a maximum of 15 days, etc. Some policies even go further and apply a reimbursement percentage depending on the surgery. Examples: leg 25%; tumor 60%; hernia 50%; knee 5%; cardiac cauterization 35%; etc Obviously, this type of insurances should be avoided, even if their prices are very attractive. 2-Annual renewal Health insurances are annual contracts. Each year the insurer is supposed to offer you the renewal invoice, and if you accept it, the insurance continues without interruption. This is fundamental because it is what protects you in the event of illness and / or long-term hospitalization. Solid contracts guarantee you renewal, without increasing your individual premium (except in the case of aging). But some contracts (often Thai insurances) allow the insurer to refuse renewal, on a discretionary basis, or to increase the premium, individually, if the insured has a worsening risk profile. The danger is immense. Imagine cancer is discovered, treatment begins, the anniversary of the insurance arrives, the insurer refuses to renew…. 3-Pre-existing medical conditions Health insurance does not cover current medical problems or those you have had in the past. The principle is normal, the purpose of the insurance is to cover an unknown and random medical risk. But this principle is sometimes not well understood. Much of the litigation concerns the application of this principle. It is important to take the time to explain it to the client, and if necessary to help him to fill the medical questionnaire. 4-Insurance regulation Local insurers are all insurers who sell in Thai currency, even if they are a subsidiary of a large foreign group. Those are subject to Thailand insurance regulation. It is important to understand that the laws of South-east Asian countries are much less protective of customers than those of European and Anglo-Saxon countries. Foreign insurers, which sell in USD, EUR, GPB currencies, are not registered in Thailand, and therefore are no way subject to the local laws. In this case there is a clause in the insurance policy which mentions that the insurer’s country regulation is applicable. This is a definite advantage in the event of a dispute if this insurer is registered in a European or Anglo-Saxon country. But beware of insurers who are located in countries such as tax havens, where the regulation of insurers is non-existent. 5-Insurance premium increase Insurance premiums increase with age, this is normal. We brokers have access to premiums and calculation methods. We can advise customers of expected increases. The other reason of price increase is medical inflation and insurer’s portfolio results. In theory, that's perfectly normal too. But in practice this is more questionable, when you see some insurers applying large increases almost every year, at a similar rate. For example 9% increase each year. It cannot just be medical inflation and claims experience. This is not to criticize the insurer's internal management, but it is important to alert the client. This is the role of the broker because insurers and agents do not bring up the subject. 6-Lifetime policy This is especially aimed at seniors. If you plan to live indefinitely in Thailand, it is good to ensure that the insurance does not stop once you reach a certain age ... Some insurances are lifetime, meaning there is no age limit. Others, on the contrary, expire at an age limit (eg 70 years old). 7-Insurance premium calculation and age brackets Insurers calculate a premium based on the age of the insured. The premium increases with aging. Some insurers increase the premium each year, but softly. Others use age brackets. Most often these are age brackets of 5 years (eg 20/24; 25/29; 30/34 etc.). This is perfectly normal, but you have to know it. For example, if you are at the end of your age bracket, you have the false impression that insurance is not expensive ... but it is without knowing that the following year a potential huge increase will apply. Depending on the age bracket, the increase can be as high as 50%. This is therefore very important information to give to the customer. 8-Waiting periods There are 3 types. First is the general waiting period, which applies to any medical event. Thai insurances often have a 30 days waiting period. Foreign insurance companies often do not apply any. In second, there is the waiting period that applies to specific serious and / or chronic illnesses. Often 6 months. Almost all Thai insurers apply it. Thirdly, the classic waiting periods, which can be found in all insurances, applicable to dental, optical and maternity. Sometimes also applicable to health checkup, vaccination, HIV, and psychiatry. There are of course many others items to check, but I wanted to highlight the 8 most important that are often hidden in the policy. For additional information, a personalized study, quotations and insurance comparison, you can contact me here: [email protected] Romain CAMILLO Broker specialized in health insurance – Thailand Email: [email protected] Broker firm : Tenzing Pacific https://www.ten-pac.com 3 Link to comment Share on other sites More sharing options...
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