New Conditions Set for COVID Insurance Claims

[snoop1130]

 

BANGKOK, Feb 8 (TNA) – Conditions for COVID-19 insurance claims for in-patient treatment and daily compensation have changed to comply with the new rules of the Public Health Ministry, according to the Office of the Insurance Commission.

 

OIC assistant secretary-general Apakorn Panlert said the Thai Life Assurance Association changed conditions for compensation claims by health insurance policy holders who were infected with COVID-19. The changes would take effect on Feb 15 and comply with the new relevant rules that the Public Health Ministry imposed on Jan 4.

 

Full Story: https://tna.mcot.net/english-news-878685

 

-- © Copyright TNA 2022-02-08

 

- Aetna offers a range of visa-compliant plans that meet the minimum requirement of medical treatment, including COVID-19, up to THB 3m. For more information on all expat health insurance plans click here.

 

- Follow ASEAN NOW on LINE for breaking COVID-19 updates

[kotsak]

Yeap, when you start losing the game, change the rules ????

[SheikYabodyline]

Too many goals? Move the goalposts.

[jonclark]

I think having three legs is the first condition of any successful claim. 

 

Can you imagine if I decided to arbritatrily just change the conditions of my mortgage cause I couldn't afford it. Once again the government shows its true face it is on the side of businesses not the people. Shame on you all 

 

[2long]

I spent 4 days and 4 nights in a shared hospital room, without seeing the doctor at all.

My policy cover was 100,000B and the bill amazingly came to 97,000B ????

[DezLez]

4 minutes ago, 2long said:

I spent 4 days and 4 nights in a shared hospital room, without seeing the doctor at all.

My policy cover was 100,000B and the bill amazingly came to 97,000B ????

Did you give a tip?

[expat1010]

so if I understand correctly: If a tourist comes to Thailand on holidays and tests positive for covid, they will be forced to stay in hospital even if they feel fine and have no symptoms, in addition they will be out of pocket tens of thousands of dollars for the hospital stay because the mandatory insurance won't cover their claim? Is this correct?

[kotsak]

1 hour ago, 2long said:

I spent 4 days and 4 nights in a shared hospital room, without seeing the doctor at all.

My policy cover was 100,000B and the bill amazingly came to 97,000B ????

It's amazing, innit? No wonder because of this milking we suffer premium increases annually. Bloody money suckers. ????

[wprime]

1 hour ago, 2long said:

I spent 4 days and 4 nights in a shared hospital room, without seeing the doctor at all.

My policy cover was 100,000B and the bill amazingly came to 97,000B ????

How did you rack up that bill? Serious symptoms? I had Covid late last year, tested and managed by Bumrungrad, approved for home quarantine and the total bill was about 9000 baht. About 5000 for the PCR test and initial meds, and 4500 for further meds. Got calls throughout the process checking my wellbeing.

[Gold Star]

1 hour ago, expat1010 said:

so if I understand correctly: If a tourist comes to Thailand on holidays and tests positive for covid, they will be forced to stay in hospital even if they feel fine and have no symptoms, in addition they will be out of pocket tens of thousands of dollars for the hospital stay because the mandatory insurance won't cover their claim? Is this correct?

Like my friend recently experienced, you may also be taken to a 10 day hospital incarceration even if you did not test 'Positive'.

 

If your test was performed in a dirty parking lot, by some dude that didn't change his gloves all day from person to person, and vanload to vanload, and it comes back later as not 'Positive, not 'Negative', but 'Trace Detected', you will be taken away.

 

You have no symptoms. Your insurance won't cover it because you don't have Covid. You can't retest. You are trapped with all the others, their screams heard down the halls of the ward for 10 days. There is no internet. At least arrive with a smartphone with a good data package, and have easy access to a few hundred thousand baht to pay your bill to get out. Otherwise, like my friend, you may be threatened on the hospital phone in his room by someone who identified themselves as the immigration police that upon the conclusion of the 10 days , the next move may be to spend some time in jail, then taken to the airport and put on the next plane being blacklisted for life.

 

For tourists, it will most likely be their last trip to Thailand. Ever.

 

For us expats, it is just another inconvenience, indicative of the way we are treated while living here in paradise.

 

 

[StayinThailand2much]

Quote:

 

(...)

According to the new rules of the ministry, COVID-19 treatment is intelligent for patients with body temperatures exceeding 39 degrees Celsius for longer than 24 hours, 

more than 25 breaths per minute for adult patients, oxygen saturation below 94%, changing symptoms for patients with underlying illnesses, doctor' request for close observation and breathing difficulty, fatigue and lower appetite for child patients.

 

 

The COVID-19 cases that are are asymptomatic or have mild symptoms cannot file a COVID-19 insurgance claim for treatment and daily compatibility.

(...)

 

 

39 degrees Celsius for more than 24 hours?

 

No claims for asymptomatic or "mild symptoms" (whatever that means)... - Meaning any such Thai insurance is a waste of money, and as such unreasonable to have in order to enter Thailand.

Edited February 8, 2022 by StayinThailand2much

[Etaoin Shrdlu]

2 hours ago, expat1010 said:

so if I understand correctly: If a tourist comes to Thailand on holidays and tests positive for covid, they will be forced to stay in hospital even if they feel fine and have no symptoms, in addition they will be out of pocket tens of thousands of dollars for the hospital stay because the mandatory insurance won't cover their claim? Is this correct?

The insurance mandate requires that a tourist's insurance cover treatment for Covid-19. It does not mandate cover for costs associated with quarantine, isolation or hospitalization for asymptomatic or mildly symptomatic cases that do not require medical treatment. So, yes, it is possible to comply with the requirement for Covid-19 insurance but not have cover for medically-unnecessary hospitalization required by public health policy. This has not been adequately disclosed to incoming travelers or the general public, in my opinion.

 

I believe some insurers have been voluntarily offering optional cover for quarantine and mandatory hospitalization when testing positive. I think these policies are the ones that have been exclusively offered to incoming travelers and can only be purchased in conjunction with travel to Thailand. The OIC's new directive should not prohibit insurers from continuing to offer this cover, if I understand the new regulations correctly.

Edited February 8, 2022 by Etaoin Shrdlu
Punctuation

[connda]

2 hours ago, kotsak said:

Yeap, when you start losing the game, change the rules ????

The "public-private" partnership between government and corporate entities.
So Thai policy holders can now be assured that if Thai insurers every end up on the wrong side of an insurance bet that they underwrote (called a contract), then the government can come along anytime in the future and change the laws in order invalidate the contract at the expense of the policyholders.
That undermines the credibility of both insurance underwriting by Thai insurance companies as well as virtually every contract created in Thailand. 
If a Thai company ever dislikes the terms of a contract they created, all they need to do is lobby the government to change the laws in their favor.  Sweet deal, 'eh?
That should go over great internationally.

[connda]

1 hour ago, expat1010 said:

so if I understand correctly: If a tourist comes to Thailand on holidays and tests positive for covid, they will be forced to stay in hospital even if they feel fine and have no symptoms, in addition they will be out of pocket tens of thousands of dollars for the hospital stay because the mandatory insurance won't cover their claim? Is this correct?

Sweet deal, ain't it?

[StayinThailand2much]

2 hours ago, expat1010 said:

so if I understand correctly: If a tourist comes to Thailand on holidays and tests positive for covid, they will be forced to stay in hospital even if they feel fine and have no symptoms, in addition they will be out of pocket tens of thousands of dollars for the hospital stay because the mandatory insurance won't cover their claim? Is this correct?

Absolutely, as the insurance company can always claim that the symptoms were either 'asymptomatic', or 'mild'...

[connda]

10 minutes ago, StayinThailand2much said:

Quote:

 

(...)

According to the new rules of the ministry, COVID-19 treatment is intelligent for patients with body temperatures exceeding 39 degrees Celsius for longer than 24 hours, 

more than 25 breaths per minute for adult patients, oxygen saturation below 94%, changing symptoms for patients with underlying illnesses, doctor' request for close observation and breathing difficulty, fatigue and lower appetite for child patients.

 

 

The COVID-19 cases that are are asymptomatic or have mild symptoms cannot file a COVID-19 insurgance claim for treatment and daily compatibility.

(...)

 

 

39 degrees Celsius for more than 24 hours?

 

No claims for asymptomatic or "mild symptoms" (whatever that means)... - Meaning any such Thai insurance is a waste of money, and as such unreasonable to have in order to enter Thailand.

More great news to tell my friends back home who used to come to Thailand.
"Unless you're seriously sick your insurance company has been given carte blanche not have to pay out unless you meet a very narrow definition of 'ill' but you'll still be thrown into Covid prison and forced to pay out of pocket even if you thought you were fully covered.  You say you're not coming this year or until this insanity ends?  Can't say I blame you."

[StayinThailand2much]

13 minutes ago, Etaoin Shrdlu said:

I believe some insurers have been voluntarily offering optional cover for quarantine and mandatory hospitalization when testing positive. I think these policies are the ones that have been exclusively offered to incoming travelers and can only be purchased in conjunction with travel to Thailand. The OIC's new directive should not prohibit insurers from continuing to offer this cover, if I understand the new regulations correctly.

So, what will happen now? Will those companies still honour claims for optional cover, or not?

[Moonlover]

Which means that the insurance that I bought from a well known broker here in Thailand (no names, no litigation) is worthless unless I display these symptoms:

 

'body temperatures exceeding 39 degrees Celsius for longer than 24 hours, 

more than 25 breaths per minute for adult patients, oxygen saturation below 94%', 

 

All the more reason now why I shall simply go underground and self isolate if I suspect that I am an asymptomatic Covid victim. 

[Etaoin Shrdlu]

4 minutes ago, StayinThailand2much said:

So, what will happen now? Will those companies still honour claims for optional cover, or not?

I don't think the OIC's new edict, which essentially just countermands the previous one that required insurers to cover unnecessary hospitalization when testing positive for Covid-19 regardless of policy wording, would affect those policies that explicitly state that such expenses are covered.

 

If you purchased a policy that specifically covers this risk, you should still be ok. If you have a normal medical insurance policy with industry standard wording, such expenses likely won't be covered going forward. 

 

[Etaoin Shrdlu]

31 minutes ago, connda said:

The "public-private" partnership between government and corporate entities.
So Thai policy holders can now be assured that if Thai insurers every end up on the wrong side of an insurance bet that they underwrote (called a contract), then the government can come along anytime in the future and change the laws in order invalidate the contract at the expense of the policyholders.
That undermines the credibility of both insurance underwriting by Thai insurance companies as well as virtually every contract created in Thailand. 
If a Thai company ever dislikes the terms of a contract they created, all they need to do is lobby the government to change the laws in their favor.  Sweet deal, 'eh?
That should go over great internationally.

It was the OIC that required insurers to pay for medically-unnecessary hospitalization when the policies in question clearly excluded these expenses from the outset. Foreign medical insurance policies also routinely exclude medically-unnecessary expenses, so this exclusion isn't a Thai thing. Holders of Thai medical insurance policies actually enjoyed a coverage that would not have been available under almost all foreign medical insurance policies while the OIC's previous directive was in place.

 

Basically, the government forced insurers to pay for expenses related to public health policy and not medical expenses, something insurers never contemplated when they issued the policies. Insurers are correct in lobbying the OIC for relief from this requirement. I suspect that the OIC would not prohibit insurers from voluntarily offering such cover, however.

 

[connda]

1 hour ago, wprime said:

How did you rack up that bill? Serious symptoms? I had Covid late last year, tested and managed by Bumrungrad, approved for home quarantine and the total bill was about 9000 baht. About 5000 for the PCR test and initial meds, and 4500 for further meds. Got calls throughout the process checking my wellbeing.

How did they rack up that bill and you didn't?
You just said it:  You were allowed to quarantine and recover at home.
A lot of foreigners are not given that option.  Their only option is a police escort to a private hospital and the hefty price-tag attached to that forced hospitalization.

[Moonlover]

7 minutes ago, connda said:

How did they rack up that bill and you didn't?
You just said it:  You were allowed to quarantine and recover at home.
A lot of foreigners are not given that option.  Their only option is a police escort to a private hospital and the hefty price-tag attached to that forced hospitalization.

Do you have any real hard evidence that that is what has been happening?

[Moonlover]

32 minutes ago, Etaoin Shrdlu said:

I don't think the OIC's new edict, which essentially just countermands the previous one that required insurers to cover unnecessary hospitalization when testing positive for Covid-19 regardless of policy wording, would affect those policies that explicitly state that such expenses are covered.

 

If you purchased a policy that specifically covers this risk, you should still be ok. If you have a normal medical insurance policy with industry standard wording, such expenses likely won't be covered going forward. 

 

Are you a qualified expert on such matters, or is this just an opinion?

[Etaoin Shrdlu]

6 minutes ago, Moonlover said:

Are you a qualified expert on such matters, or is this just an opinion?

40 years in the insurance industry, including almost two decades in Thailand. Other than that, no.

Edited February 8, 2022 by Etaoin Shrdlu

[dj230]

Another reason to not cheap out on travel insurance, get from a reputable company and have no issues. 

[Moonlover]

10 minutes ago, dj230 said:

Another reason to not cheap out on travel insurance, get from a reputable company and have no issues. 

Well is that true or not?

 

Should I rely on the locally purchased, Covid specific policy bought though a well known broker here in Thailand? It could make a very big difference to how I would respond were I to suspect that I may have contracted the disease.

 

There seems to be a whole dose of ambiguity going round at the moment and this penultimate paragraph from the full article has me very concerned.

 

'The COVID-19 cases that are asymptomatic or have mild symptoms cannot file a COVID-19 insurance claim for treatment and daily compensation'.

[daveAustin]

Say again, if this is put in place then government should step in and pay for any unnecessary treatment. Fair enough positives paying for incarceration, if that is their policy, but being scammed by being obligatory drugged ain’t right now is it. 

[Sticky Rice Balls]

Thainess 101.....The lesson is repeated until it is learned....

[dj230]

1 hour ago, Moonlover said:

Well is that true or not?

 

Should I rely on the locally purchased, Covid specific policy bought though a well known broker here in Thailand? It could make a very big difference to how I would respond were I to suspect that I may have contracted the disease.

 

There seems to be a whole dose of ambiguity going round at the moment and this penultimate paragraph from the full article has me very concerned.

 

'The COVID-19 cases that are asymptomatic or have mild symptoms cannot file a COVID-19 insurance claim for treatment and daily compensation'.

I was completely covered, if you buy dodgy travel insurance just to qualify to enter Thailand, you get dodgy coverage as well. 

With insurance, most of the time you get what you pay for. 

[internationalism]

6 hours ago, 2long said:

I spent 4 days and 4 nights in a shared hospital room, without seeing the doctor at all.

My policy cover was 100,000B and the bill amazingly came to 97,000B ????

What hospital name and town?

How many patients in the room?

what medicines and how many pills of each you got?

97k is about rigt, if you got all those inflated price medicines