International health insurance in Thailand

[brewsterbudgen]

8 hours ago, internationalism said:

how it is, that when looking for their contact phone number on google, there are no search results, bar their own page?

that's even worse than with wrlife.

maybe they are just front for wrlife?

do they have selection of different insurers when they quote premiums?

check "+66 85 821 9646"

Sure. I've used them for over 7 years for my and my family's insurance. 

[brewsterbudgen]

7 hours ago, WhiteBuffaloATM said:

er, that’s not a benefit mate, it’s something though…….wouldn’t touch any such company on principle….

Yeah, Sheryl said much the same. I'm not so sure myself. If you claim, future premiums are adjusted to your current age. My wife's premium with another insurer shot up when she turned 30. Having a fixed premium for her, through her 30s/40s seems good to me. If she has to claim the premium goes to what it would be if she joined at the age she is at the time.

 

I've always liked no claims bonuses.

[internationalism]

but https://www.expatinsuranceservices.com/

is just brokers.

as wrlife.

from which insurer they got their policies?

 

actually, pacific cross gives no claim bonuses - first renewal if no claim is 5% lower, later 10% and 15% lower.

 

clearly there is something wrong with insurance industry - my last year April premium was 56k, this year they wanted 76k. Probably it would be even higher, if I would extend and they will see I have claimed accidental tooth repair for 30k (that same repair would be less than half price at street clinic, not samitivej hospital)

[brewsterbudgen]

37 minutes ago, internationalism said:

but https://www.expatinsuranceservices.com/

is just brokers.

as wrlife.

from which insurer they got their policies?

 

 

Previously I've used Regency for Expats, Luma and Healthcare International through this broker (over around 7 years).  

 

I'm not sure I understand about WRLife being a broker, rather than my insurer.  As far as I know they are providing my insurance and will deal with any claim I may make.  As long as the premiums are reasonable and claims are met expeditiously, I'm OK.

[timoti]

4 hours ago, internationalism said:

but https://www.expatinsuranceservices.com/

is just brokers.

as wrlife.

from which insurer they got their policies?

 

actually, pacific cross gives no claim bonuses - first renewal if no claim is 5% lower, later 10% and 15% lower.

 

clearly there is something wrong with insurance industry - my last year April premium was 56k, this year they wanted 76k. Probably it would be even higher, if I would extend and they will see I have claimed accidental tooth repair for 30k (that same repair would be less than half price at street clinic, not samitivej hospital)

This is for April global? What age? Does it include inpatient only or plus outpatient?

 

Seems big jump.

[internationalism]

49 minutes ago, timoti said:

This is for April global? What age? Does it include inpatient only or plus outpatient?

 

Seems big jump.

it was for 16mln only outpatient, no deductible.

Thai April, the french was dearer.

Now I do with pacific 300k deductible and 1mln accident for only 1200b. I do also have 2 covid policies for below 1k, to cover me up to 300k.

[Sheryl]

12 minutes ago, internationalism said:

it was for 16mln only outpatient, no deductible.

Thai April, the french was dearer.

Now I do with pacific 300k deductible and 1mln accident for only 1200b. I do also have 2 covid policies for below 1k, to cover me up to 300k.

April Global comes under EU insurance regs and is not allowed to raise premiums based on claim history. April Thailand (policy issued by LMG) comes under Thai insurance regs which do allow this.

 

April France underwrites their own policies. April Thailand just administers a policy underwritten by local Thai insurer LMG. LMG has the final word on the policy.

 

I reccommend using foreign (Western) based companies which underwrite their own policies.

 

Thai based policies sometimes seem less expensive at first but usually prove not so over the long run. 

[Sheryl]

6 hours ago, brewsterbudgen said:

Sure. I've used them for over 7 years for my and my family's insurance. 

Out of curiosity..what does your  policy say regarding disputes and applucable regulatory aurhority? 

[Sheryl]

A post commenting on Moderation has been removed in keeping with Forum rules

[internationalism]

48 minutes ago, Sheryl said:

April Global comes under EU insurance regs and is not allowed to raise premiums based on claim history. April Thailand (policy issued by LMG) comes under Thai insurance regs which do allow this.

 

April France underwrites their own policies. April Thailand just administers a policy underwritten by local Thai insurer LMG. LMG has the final word on the policy.

 

I reccommend using foreign (Western) based companies which underwrite their own policies.

 

Thai based policies sometimes seem less expensive at first but usually prove not so over the long run. 

there is no long run for me.

I took last year health policy, first in my life, because of the 1st wave.

This year because of the 3rd wave (now upgraded to over $50k) for travel purpose.

I can even cancel this very policy, if in practice turns out, that one month travel policy is good enough to legally enter thailand.

I am healthy, perfect yearly check ups. No hereditary ilnesses.

Out of my premiums:

38% fraudulent claims (my travel agent told me)

10% an agent

10% promotion, advertising

10% on taxes

10% on running offices, wages

10% company profits

what if 88% is just wasted and not given to support health and life?

 

"I think expatriates are finding it harder than tourists to find appropriate insurance for the $50,000 coverage. Particularly as they are supposed to be covered for the remaining length of the time left on their visa. I had ten months left on mine and was quoted 30,000 baht for a one-year insurance policy! Foreigners with Permanent Residence or people with long-term Thailand Elite visas, would face a much bigger bill. On this matter, I think I have some good news and some clarification about the rules.

For a start, it doesn’t seem to be written down anywhere that you need to have special insurance to cover you for the time you will be in Thailand if you are on a long-term visa. It was just implied by some embassies. I asked the director general about this, and he said a 30-day policy would be plenty. After all, if you test positive, you will only need to do 10 days in a hospital and a possible 14 day quarantine afterwards. So, a 30-day policy would cover you."

https://www.getrevue.co/profile/richardbarrow/issues/latest-updates-about-the-thailand-pass-849676

[Sheryl]

3 hours ago, internationalism said:

there is no long run for me.

I took last year health policy, first in my life, because of the 1st wave.

This year because of the 3rd wave (now upgraded to over $50k) for travel purpose.

I can even cancel this very policy, if in practice turns out, that one month travel policy is good enough to legally enter thailand.

I am healthy, perfect yearly check ups. No hereditary ilnesses.

Out of my premiums:

38% fraudulent claims (my travel agent told me)

10% an agent

10% promotion, advertising

10% on taxes

10% on running offices, wages

10% company profits

what if 88% is just wasted and not given to support health and life?

The breakdown of where premiums go will vary widely by insurer and plan, there is no universal one. Whatever your agent told you, even if true, would apply solely to the plan in question (which sounds like it was a travel policy).

 

Everyone is perfectly healthy until they aren't.

 

I was in perfect health until a motor cycle barreled into me at ultra high speed in broad daylight in 2019 (at a crosswalk, with not a vehicle in sight when I started across it and despite having seen me from 200 meters away). 3 fractures, 2 surgeries, 2 weeks in hospital, total bill exceeded 600,000 baht. All paid by my insurance.

 

Now in my late sixties, for first time, starting to have some age related spinal issues. This too  being paid, in full, by my insurance and by the time all is done will have come to around 500k.

 

And who knows - at any time I might develop cancer or other condition, or have another accident. Or I might not. My previously perfect health and lack of "hereditary diseases"  in no way precludes these things from happening. And even lacking that, since I plan to stay here throughout my old age, there will surely be things like cataract repair and perhaps other ortho issues in the future.

 

Now if you are here just short term, have health cover in your home country and go back there regulalry, a simple travel or even med evac policy might do. Or, if you have ample savings (as in, millions of baht) and do not mind having those assets at risk, then you can self insure.

 

But tiherwise, yo uare taking a huge risk.

 

[brewsterbudgen]

5 hours ago, Sheryl said:

Out of curiosity..what does your  policy say regarding disputes and applucable regulatory aurhority? 

Thanks. I'll check with my broker and let you know.

[internationalism]

accident insurance, as big as possible, is one thing.

Health insurance, if somebody is healthy, do regular full check ups, is less important.

No matter what age.

There is always time, before age 75, to get thai insurance (I think only pacific cross).

No, I am not on holiday here, but once pandemic ends, covid entry requirements end, and my results are good, I don't need any insurance, than accident.

If unwell I will get good insurance and start treatment shortly after.

I can always sell my 1.5 bitcoin in any emergency 

[Sheryl]

12 minutes ago, internationalism said:

There is always time, before age 75, to get thai insurance (I think only pacific cross).

 

Not if you develop any pre-exisitng conditions, which most people will by age 75.

[Thierry Itsara]

On 11/8/2021 at 1:09 PM, brewsterbudgen said:

I recently changed to WRLIfe as they now have a Bangkok office.  I can't speak for their pre-existing conditions policy, although it looked fine to me (I had kidney stones 25 years ago) but one benefit they offer is that Premiums are fixed (forever) if you don't make a claim.

 

https://www.wrlife.net/

The question is: Does anyone knows someone who actually made a claim with them and that got paid?.... Anyone here?

[brewsterbudgen]

5 hours ago, Thierry Itsara said:

The question is: Does anyone knows someone who actually made a claim with them and that got paid?.... Anyone here?

Not here, as very few people seem to have even heard of them. I will try looking at some general insurance forums and groups and report back. It's a shame the specific thread about them was shut down so soon.

[brewsterbudgen]

Maybe they read this Forum - this is the first time I've seen them advertising on Facebook!

[jackdd]

On 11/11/2021 at 2:17 PM, internationalism said:

Out of my premiums:

38% fraudulent claims (my travel agent told me)

Looks like they know these are fraudulent, so they don't pay them out, and are thus no expense for the company.

So according to your numbers 10% profit + 38% = 48% of your premiums is profit for the insurance company.

[internationalism]

Yes, but still some those detected fraudulent claims are payed, because too difficult to prove them false. That was a tone my friend gave me. Many more % are undetected. 

So I put that figure in calculation. 

Sometimes ago I have searched google for scale of fraud in insurance, but I haven’t come across any estimates. 

There are whole gangs specializing in insurance scam, constantly developing their techniques 

[fridog]

I read all the topic as I am particularly interested (unfortunately). I am in my early 50s and worried at the perspective of getting old and sick without adequate health coverage in Thailand.

 

I have a friend who recently underwent a relatively simple surgery. Faced with the expenses claim, his insurance company run a deep search of all his medical records and eventually found something that could somehow be related. Apparently, he had failed to report it before starting the policy.

 

My question is: How deep can insurance companies go into checking your medical records here? Can they easily check all your records across all hospitals in Thailand ever since you stepped into the country with the click of a button?

 

Is it really that simple? So do you have to worry that they find any trace of preexisting or undeclared health problems or it's more a matter of chance?

 

[scubascuba3]

6 minutes ago, fridog said:

I read all the topic as I am particularly interested (unfortunately). I am in my early 50s and worried at the perspective of getting old and sick without adequate health coverage in Thailand.

 

I have a friend who recently underwent a relatively simple surgery. Faced with the expenses claim, his insurance company run a deep search of all his medical records and eventually found something that could somehow be related. Apparently, he had failed to report it before starting the policy.

 

My question is: How deep can insurance companies go into checking your medical records here? Can they easily check all your records across all hospitals in Thailand ever since you stepped into the country with the click of a button?

 

Is it really that simple? So do you have to worry that they find any trace of preexisting or undeclared health problems or it's more a matter of chance?

 

they've probably got a seemless process in place to dig deep with all the hospitals, they do it everytime. Getting info from farangland is difficult but they can ask for you to contact GP and get records. Personally i think if they might decline a claim or exclude stuff then you might as well save your money up for when you need it

[Sheryl]

3 hours ago, fridog said:

I read all the topic as I am particularly interested (unfortunately). I am in my early 50s and worried at the perspective of getting old and sick without adequate health coverage in Thailand.

 

I have a friend who recently underwent a relatively simple surgery. Faced with the expenses claim, his insurance company run a deep search of all his medical records and eventually found something that could somehow be related. Apparently, he had failed to report it before starting the policy.

 

My question is: How deep can insurance companies go into checking your medical records here? Can they easily check all your records across all hospitals in Thailand ever since you stepped into the country with the click of a button?

 

Is it really that simple? So do you have to worry that they find any trace of preexisting or undeclared health problems or it's more a matter of chance?

 

Thai insurers can readily check your records at hospitals here.

 

With any insurance, you should not withhold relevant information or lie on your application -- that would invalidate the entire policy.

 

Western based insurers tend to do full medical underwriting based on detailed (and clear) application forms. They are unlikely to reject a claim later as pre-existing if they did not apply an exclusion at the time the policy was issued.

 

The behavior you describe - digging at the time of a claim for anything in past records that might justify not paying it - is unfortunately typical of Thai insurers who, even if they claim to do full medical underwriting, often do a very slipshod job of it. It is  not at all typical of western based insurers. They are very unlikely to do any "digging" unless something about the nature of the claim rings alarm bells.

 

In which regard - any insurer will give extra scrutiny to claims in the first year and especially if for something that, by its nature, was likely to have been present for a while.

 

 

[timoti]

Hi,

 

So I contacted AA brokers and they referenced this page:

https://www.aainsure.net/april-international/

 

Is this the April Global plan? I will read through some of the documents meanwhile.

[Sheryl]

1 hour ago, timoti said:

Hi,

 

So I contacted AA brokers and they referenced this page:

https://www.aainsure.net/april-international/

 

Is this the April Global plan? I will read through some of the documents meanwhile.

 

Yes, it is the global plan, the application goes to April France.

 

This is the insurance I have and I have been happy with it. I have the Essential Plan with a USD $500 deductible (excess) per year.

[brewsterbudgen]

I see AA Insurance Brokers are now offering WRLife as a policy option.

[timoti]

On 1/25/2022 at 6:35 PM, Sheryl said:

 

Yes, it is the global plan, the application goes to April France.

 

This is the insurance I have and I have been happy with it. I have the Essential Plan with a USD $500 deductible (excess) per year.

Thanks you are right this one is much cheaper, I am pretty surprised. But if you add OP, with age the premiums become astronomical. Without OP, it's very good indeed.

[timoti]

Btw I ended up getting the April Global plan, and seeing how they are with the claims now.

 

Anyone can share their experiences? @Sheryl

 

Because I wanted to claim an inpatient op, and they told me I have to mail the physical bills if it's over certain amount. That seems awfully inefficient.

 

Also I noticed even their top 2 plans for IP only allow 30 to 60 days of pre/post op coverage. 30 days is very little and 60 is just meh. I see some insurances that offer 6 months, but of course then I see them cutting corners in other things so there is that.

 

It's just that anything before, but mostly after an op can take a lot of time and money too. So that's something to factor.

 

For example the localized April plans i.e. April Singapore offer 180 days for this, albeit 2x the premium and other issues.

 

On pacific prime website it shows that even the top most expensive Cigna plan doesn't offer this kind of pre/post op coverage. That was shocking to me.

 

I also saw Tokio Marine insurance there, not sure if that's any good. No benefits document that I could find.

[Sheryl]

11 hours ago, timoti said:

Btw I ended up getting the April Global plan, and seeing how they are with the claims now.

 

Anyone can share their experiences? @Sheryl

 

Because I wanted to claim an inpatient op, and they told me I have to mail the physical bills if it's over certain amount. That seems awfully inefficient.

 

Also I noticed even their top 2 plans for IP only allow 30 to 60 days of pre/post op coverage. 30 days is very little and 60 is just meh. I see some insurances that offer 6 months, but of course then I see them cutting corners in other things so there is that.

 

It's just that anything before, but mostly after an op can take a lot of time and money too. So that's something to factor.

 

For example the localized April plans i.e. April Singapore offer 180 days for this, albeit 2x the premium and other issues.

 

On pacific prime website it shows that even the top most expensive Cigna plan doesn't offer this kind of pre/post op coverage. That was shocking to me.

 

I also saw Tokio Marine insurance there, not sure if that's any good. No benefits document that I could find.

First of all please clarify if your plan is issued by Aoril in France or April Thailand. Many people end up getting MyHealth Thailand and mistakenly think it is April Global.

 

You need pre-approval for hospitalization unless the total cost is under US $2,000 (likely only with day surgeries). With that obtained, they will pay the hospital directly. Most private hospitals will arrange all this for you. Allow a week to 10 days for it unless it is an emergency admission. In case of emergency  the hospital needs to notify April at once and they will process a Guarantee of Payment that same day.  Depending on the hospital and what immediate treatment is needed, you might be asked to give a refundable credit card deposit until it arrives.

 

When they pay the hospital directly the only things excluded are your deductible (if you have one) and the cost of discharge medication. For discharge medication as well as post op outpatient care you have to submit receipts. If you went through a broker, they may handle all this for you, mine does.

 

As for me I have had 3 claims in the 4 years of my policy:

 

1. Emergency admission after an accident which required 2 surgeries and about 2 weeks in hospital. Hospital called April while I was still in the ER. This was a Sunday morning. Guarantee of Payment came through in about 4 hours. As I needed immediate surgery the hospital requested, and I gave, a credit card payment of about  US $4,000. This was refunded that same day when the GOP came in. Total hospital bill came to US $25 000 (this was in Cambodia so priced in USD) and everything except my $500 deductible was paid by April to the hospital. I then had an additional $3, 000- 4,000 or so in outpatient follow up. These I paid first and April fully reimbursed.

 

2. Epidural injection for lumbar spine problem as well as pre and post care (including MRI) were paid as it was considered a day surgery. I did not get pre-approval as the procedure cost was under the threshold, and I was in a lot of pain and did not want to wait. Since I did not have pre-approval I had to pay first and get reimbursed after. About 36k baht for the procedure and another 30-40k in pre and post care (including Xray and MRI). Fully reimbursed except for the deductible. I could have avoided the prepayment of the 36k had I gotten pre-approval but as not an emergency would have taken about a week.

 

3. Decompression surgery on lumbar spine -- got pre-approval and hospital was paid directly. About 350k baht. After care as outpatient was maybe 5-10k more reimbursed based on receipts

 

 

 

[timoti]

Thanks a lot @Sheryl. Yes it's April Global I bought from AA based on your recommendation. In the IP op I also asked for GOP but didn't want to wait. But I had a work insurance that came first to pay most of it, so that's why.

 

So now I submitted the rest to April but AA told me I have to mail in actual bills.

 

Also she said every bill no matter what has to include a medical report. Do you know anything about this? Because it muddies the waters a bit. Because the hospital is saying medical report or medical certificate, etc which AA is using interchangebly.

 

So now I am trying to get the hospital to issue that for each follow up visit to accompany each bill. It proves a bit difficult. They said full MR would cost $300 to issue as it details everything but I said that's not what they want. It would be silly to ask for that each time I visit for follow up.

[Sheryl]

52 minutes ago, timoti said:

Thanks a lot @Sheryl. Yes it's April Global I bought from AA based on your recommendation. In the IP op I also asked for GOP but didn't want to wait. But I had a work insurance that came first to pay most of it, so that's why.

 

So now I submitted the rest to April but AA told me I have to mail in actual bills.

 

Also she said every bill no matter what has to include a medical report. Do you know anything about this? Because it muddies the waters a bit. Because the hospital is saying medical report or medical certificate, etc which AA is using interchangebly.

 

So now I am trying to get the hospital to issue that for each follow up visit to accompany each bill. It proves a bit difficult. They said full MR would cost $300 to issue as it details everything but I said that's not what they want. It would be silly to ask for that each time I visit for follow up.

Yes you do have to mail them the original Bill's. Make copies for yourself.

 

Medical certificate (usually 1 or 2 pages max) is sufficient and hospitals usually provide for free. Just something signed by doctor stating diagnosis and treatment given.