WRLife medical insurance - experiences?

[KannikaP]

12 hours ago, bradiston said:

One member here (see Monday on page 2), and an acquaintance I have who says he's had 1.5m THB of treatment and has been with them for 3 years. Showed me his original cover note. He has had radiation treatment at Bangkok hospital Pattaya and elsewhere.

The guy who's number Mr Lorentz gave me says he also had millions paid out by WrLife last year. Never hear from those who didn't get paid.

However with this new rule, anyone over 65 with pre-existing conditions six months ago, WILL BE PAID. 

Does that work in all other branches of insurance?  555

[jerrymahoney]

The current WrLife Policy available online states:

 

3. For aged 65 and over: 2 choices

 

3.1 Health checkup required prior to coverage to determine pre-existing conditions. (or)

 

3.2 A six month waiting period prior to coverage for specific diseases. Specific diseases: Hypertension & Cardiovascular Disease, All Tumors, Polyp or Cyst, Hernias, Hemorrhoids, Prostate Disease, Diabetes, Cancer, Cholecystitis, Cholelithiasis, Calculi of the Urinary Organs.

 

So not every condition is covered.

 

The rationale -- strictly as I infer -- is that if someone age 65 or over declares a pre-existing condition upon application, and there is no (inpatient) treatment required for that condition for 6 months, the company believes that there is an acceptable risk to them as to any further treatment required.

[brewsterbudgen]

3 minutes ago, jerrymahoney said:

The current WrLife Policy available online states:

 

3. For aged 65 and over: 2 choices

 

3.1 Health checkup required prior to coverage to determine pre-existing conditions. (or)

 

3.2 A six month waiting period prior to coverage for specific diseases. Specific diseases: Hypertension & Cardiovascular Disease, All Tumors, Polyp or Cyst, Hernias, Hemorrhoids, Prostate Disease, Diabetes, Cancer, Cholecystitis, Cholelithiasis, Calculi of the Urinary Organs.

 

So not every condition is covered.

 

The rationale -- strictly as I infer -- is that if someone age 65 or over declares a pre-existing condition upon application, and there is no (inpatient) treatment required for that condition for 6 months, the company believes that there is an acceptable risk to them as to any further treatment required.

Seems fair enough.  No Insurer would still be in business if there were no pre-existing conditions exclusions.

 

As a WRLife policy holder I'm still nervously waiting for the horror stories about them not paying claims or any other issues, but so far it seems to be legit.  I have to decide whether to renew in October, or change again!

[KannikaP]

17 minutes ago, jerrymahoney said:

The current WrLife Policy available online states:

 

3. For aged 65 and over: 2 choices

 

3.1 Health checkup required prior to coverage to determine pre-existing conditions. (or)

 

3.2 A six month waiting period prior to coverage for specific diseases. Specific diseases: Hypertension & Cardiovascular Disease, All Tumors, Polyp or Cyst, Hernias, Hemorrhoids, Prostate Disease, Diabetes, Cancer, Cholecystitis, Cholelithiasis, Calculi of the Urinary Organs.

 

So not every condition is covered.

 

The rationale -- strictly as I infer -- is that if someone age 65 or over declares a pre-existing condition upon application, and there is no (inpatient) treatment required for that condition for 6 months, the company believes that there is an acceptable risk to them as to any further treatment required.

Sounds reasonable, but if someone is prescribed blood pressure or BHP meds in that six months, then the cover is cancelled, no?

[brewsterbudgen]

9 minutes ago, KannikaP said:

Sounds reasonable, but if someone is prescribed blood pressure or BHP meds in that six months, then the cover is cancelled, no?

My broker "assured" me that the fact that I've been taking BP medication for mild hypertension and statins for slightly raised cholesterol for many years, did not need to be mentioned....

[KannikaP]

Just now, brewsterbudgen said:

My broker "assured" me that the fact that I've been taking BP medication for mild hypertension and statins for slightly raised cholesterol for many years, did not need to be mentioned....

Until you make a claim for something connected, WrLife will do a bit of investigating, and there goes your claim.

If that happens, will your broker foot the bill?

[jerrymahoney]

The above hypothetical is that someone age 65 or over did not need prescribed blood pressure or BHP before applying for the coverage and, now within 6 months of coverage, he does?

[Etaoin Shrdlu]

52 minutes ago, brewsterbudgen said:

My broker "assured" me that the fact that I've been taking BP medication for mild hypertension and statins for slightly raised cholesterol for many years, did not need to be mentioned....

My suggestion would be to ask the broker to get that in writing from someone in a position of authority at the insurance company.  Otherwise you may find that it is an issue when you have a claim. 

[bradiston]

2 hours ago, KannikaP said:

Benny at AA Pattaya actually suggested WrLife to me, which policy to take. Someone else said the same.

No, I meant the notice in bold red? I thought I'd seen it somewhere but can't remember where. It seems to have disappeared now, and Benny says he has no knowledge of it.

 

Sorry for the confusion.

[Etaoin Shrdlu]

2 hours ago, jerrymahoney said:

The current WrLife Policy available online states:

 

3. For aged 65 and over: 2 choices

 

3.1 Health checkup required prior to coverage to determine pre-existing conditions. (or)

 

3.2 A six month waiting period prior to coverage for specific diseases. Specific diseases: Hypertension & Cardiovascular Disease, All Tumors, Polyp or Cyst, Hernias, Hemorrhoids, Prostate Disease, Diabetes, Cancer, Cholecystitis, Cholelithiasis, Calculi of the Urinary Organs.

 

So not every condition is covered.

 

The rationale -- strictly as I infer -- is that if someone age 65 or over declares a pre-existing condition upon application, and there is no (inpatient) treatment required for that condition for 6 months, the company believes that there is an acceptable risk to them as to any further treatment required.

My guess is that the carve-back of cover for those specific conditions would only apply if they were first diagnosed or discovered after the policy had been in force for six months. If any of these conditions were declared on the proposal form or found during the physical exam, they may be excluded full stop, depending upon the company's underwriting guidelines and the circumstances of the condition.

 

I think the underwriter is taking the position that if these conditions had not been previously diagnosed or suspected at the time of proposal and did not surface until after six months into the policy period, they will presume that the proposer was not exercising adverse selection against the insurer by obtaining cover when there was knowledge or suspicion that something was amiss.

 

This is only my opinion and WRLife would need to explain their definition of pre-existing condition and how this carve-back would work.

 

 

 

 

 

 

[bradiston]

52 minutes ago, Etaoin Shrdlu said:

My guess is that the carve-back of cover for those specific conditions would only apply if they were first diagnosed or discovered after the policy had been in force for six months. If any of these conditions were declared on the proposal form or found during the physical exam, they may be excluded full stop, depending upon the company's underwriting guidelines and the circumstances of the condition.

 

I think the underwriter is taking the position that if these conditions had not been previously diagnosed or suspected at the time of proposal and did not surface until after six months into the policy period, they will presume that the proposer was not exercising adverse selection against the insurer by obtaining cover when there was knowledge or suspicion that something was amiss.

 

This is only my opinion and WRLife would need to explain their definition of pre-existing condition and how this carve-back would work.

 

 

 

 

 

 

Yes, there is confusion over the wording. I checked with an agent today, and it seems if you declare pre-existing, as I did, then the insurer will set conditions  eg a moratorium. If you have "nothing to declare", then if you develop a listed condition within 6 months it will be excluded, or otherwise uncovered, but I'm not sure how long for or what happens thereafter. If you develop a condition after 6 months, then you're covered.

 

This is only my understanding to date. It doesn't constitute advice, just my point of view.

[scubascuba3]

4 hours ago, brewsterbudgen said:

My broker "assured" me that the fact that I've been taking BP medication for mild hypertension and statins for slightly raised cholesterol for many years, did not need to be mentioned....

having seen the detail of a court case coming up involving a health insurance claim with another company the broker seems to be taking on the role of the scarlet pimpernel, you can't rely on what brokers say, you need it in black and white

[scubascuba3]

36 minutes ago, bradiston said:

Yes, there is confusion over the wording. I checked with an agent today, and it seems if you declare pre-existing, as I did, then the insurer will set conditions  eg a moratorium. If you have "nothing to declare", then if you develop a listed condition within 6 months it will be excluded, or otherwise uncovered, but I'm not sure how long for or what happens thereafter. If you develop a condition after 6 months, then you're covered.

 

This is only my understanding to date. It doesn't constitute advice, just my point of view.

Strange their preexisting policy, thai companies will often go back many years even to birth 

[bradiston]

1 hour ago, scubascuba3 said:

Strange their preexisting policy, thai companies will often go back many years even to birth 

But it's not strictly speaking a Thai company. I think it best if I bow out of this thread. I'm not qualified to answer any questions regarding policies etc etc. I can only pass on my experiences. 

[Etaoin Shrdlu]

2 hours ago, bradiston said:

Yes, there is confusion over the wording. I checked with an agent today, and it seems if you declare pre-existing, as I did, then the insurer will set conditions  eg a moratorium. If you have "nothing to declare", then if you develop a listed condition within 6 months it will be excluded, or otherwise uncovered, but I'm not sure how long for or what happens thereafter. If you develop a condition after 6 months, then you're covered.

 

This is only my understanding to date. It doesn't constitute advice, just my point of view.

Some insurers put no time or other limitation on their ability to invoke the pre-existing exclusion clause. In such cases, anything that the insurer believes existed at the time of proposal would be excluded, regardless of how long after policy inception or subsequent renewals it was discovered.  It may not matter whether the insured was ever previously aware of or suspected they had a condition. If it was likely to have existed at the time of proposal or inception of cover, the insurer may seek to exclude cover.

 

Others insurers may agree to insure some conditions after a waiting period, however the passage of the waiting period does not negate an insurer's ability to deny a claim or entirely void a policy based upon non-disclosure on the proposal form.

[BigStar]

On 8/10/2022 at 5:13 PM, scubascuba3 said:

should get @BigStar on the case he can investigate them and come back with a 4 page analysis

One of the advantages of foresight: get Thai SS health insurance. I'm done worrying about private insurance.????

[jerrymahoney]

On 8/11/2022 at 1:44 PM, scubascuba3 said:

having seen the detail of a court case coming up involving a health insurance claim with another company the broker seems to be taking on the role of the scarlet pimpernel, you can't rely on what brokers say, you need it in black and white

So just from the above info, the case may involve a claim denied by the insurer, while the broker assured the policy holder the claim, for that type occurrence, would be covered. 

[scubascuba3]

28 minutes ago, jerrymahoney said:

So just from the above info, the case may involve a claim denied by the insurer, while the broker assured the policy holder the claim, for that type occurrence, would be covered. 

Not only denied the claim but wants previous unrelated claims refunded due to an undisclosed pre-existing condition which was mentioned to the broker but not on the application form. This isn't Wrlife but shows could happen when application forms are badly worded, form didn't ask for the information 

[brewsterbudgen]

On 8/11/2022 at 9:35 AM, KannikaP said:

Until you make a claim for something connected, WrLife will do a bit of investigating, and there goes your claim.

If that happens, will your broker foot the bill?

No, of course not, but it's too late now, I've had the policy for almost a year.  

[jerrymahoney]

2 hours ago, scubascuba3 said:

Not only denied the claim but wants previous unrelated claims refunded due to an undisclosed pre-existing condition which was mentioned to the broker but not on the application form. This isn't Wrlife but shows could happen when application forms are badly worded, form didn't ask for the information 

Well presuming this is a case in a Thai court, this is the standard on a Thai insurer application:

WARNING: Office of Insurance Commission (OIC.)
The applicant should disclose all the facts you know. Any nondisclosure shall make the policy issued hereunder voidable.
The Company has the right to void the contract according the Civil Commercial Code Section 865.

 

So just from the above, the insurance company could say you knew about such pre-exiting conditions. You just chose not to disclose ALL of them.

 

But since this is a WrLife topic, their application form states:

 

MEDICAL PREEXISTING CONDITIONS (IF ANY):
past or present sickness, past surgery,
medicine taken:

 

NB: with no time reference i.e. last 5 or 10 years

 

Personally, I had no problem with the above from WrLife as I had just completed a life insurance application at age 70 (accepted) where I provided a medical history going back to arthroscopic knee surgery in 1998.

[bradiston]

6 hours ago, jerrymahoney said:

Well presuming this is a case in a Thai court, this is the standard on a Thai insurer application:

WARNING: Office of Insurance Commission (OIC.)
The applicant should disclose all the facts you know. Any nondisclosure shall make the policy issued hereunder voidable.
The Company has the right to void the contract according the Civil Commercial Code Section 865.

 

So just from the above, the insurance company could say you knew about such pre-exiting conditions. You just chose not to disclose ALL of them.

 

But since this is a WrLife topic, their application form states:

 

MEDICAL PREEXISTING CONDITIONS (IF ANY):
past or present sickness, past surgery,
medicine taken:

 

NB: with no time reference i.e. last 5 or 10 years

 

Personally, I had no problem with the above from WrLife as I had just completed a life insurance application at age 70 (accepted) where I provided a medical history going back to arthroscopic knee surgery in 1998.

What I find slightly questionable is that, although I offered a medical, previous medical records and a blood test, they weren't interested. So having disclosed my Afib as my only known (to me) preexisting condition, they might argue in the event of a claim that I had others, even though I wasn't aware of them. 

 

I've been warned Pattaya is full of scams, but hopefully this is not one of them. I mean, enough people know about this apparently legit company now to bring derision on themselves in the event of no cover. Right??? Hmmm.

[jerrymahoney]

29 minutes ago, bradiston said:

What I find slightly questionable is that, although I offered a medical, previous medical records and a blood test, they weren't interested. So having disclosed my Afib as my only known (to me) preexisting condition, they might argue in the event of a claim that I had others, even though I wasn't aware of them. 

 

I've been warned Pattaya is full of scams, but hopefully this is not one of them. I mean, enough people know about this apparently legit company now to bring derision on themselves in the event of no cover. Right??? Hmmm.

From the English policy document on the wrlife.net website:

 

Definitions:

Pre-existing condition: A medical illness or injury that you have before you start a new health care plan may be considered a "a pre-existing condition".

 

 

[bradiston]

22 minutes ago, jerrymahoney said:

From the English policy document on the wrlife.net website:

 

Definitions:

Pre-existing condition: A medical illness or injury that you have before you start a new health care plan may be considered a "a pre-existing condition".

 

 

Yes, but I'm not a surgeon or a doctor. How do I know if a tumour isn't growing somewhere inside of me? And why aren't they interested in finding out through a simple medical procedure? Seems crazy to accept that risk and the potential huge outlay for want of a simple medical test. Risk assessment is what insurance is all about. They're taking on incalculable risk with no apparent qualms.

[jerrymahoney]

Verbatim from English language policy on wrlife.net website:

 

The Main Insured must, when joining, complete and sign online on the web site: www.wrlife.net the application form can include a medical questionnaire validated by the Insurer. An additional medical examination, paid by the Insured, may be requested.

 

The Insurer reserves the right to make acceptance conditional upon the production of any additional information it considers necessary.

 

1. For any pre-existing, chronic conditions and injury before the start date of the policy, the condition has to be studied and can either been covered with or without moratorium, or loading, or excluded.

 

2. For aged under 65: Health checkup is not required: there is a three month waiting period for specific diseases.

 

3. For aged 65 and over: 2 choices
3.1 Health checkup required prior to coverage to determine pre-existing conditions. (or)
3.2 A six month waiting period prior to coverage for specific diseases.
Specific diseases: Hypertension & Cardiovascular Disease, All Tumors, Polyp or Cyst, Hernias, Hemorrhoids, Prostate Disease, Diabetes, Cancer, Cholecystitis, Cholelithiasis, Calculi of the Urinary Organs.

______________

 

BTW 3.2 was what was in the RED BREAKING NEWS notice a few days back.

[scubascuba3]

31 minutes ago, bradiston said:

Seems crazy to accept that risk and the potential huge outlay for want of a simple medical test. Risk assessment is what insurance is all about. They're taking on incalculable risk with no apparent qualms.

Maybe they don't see it as a risk because they just won't pay out if they haven't got the funding

[jerrymahoney]

38 minutes ago, scubascuba3 said:

Maybe they don't see it as a risk because they just won't pay out if they haven't got the funding

Maybe. Thank you.

 

When i worked with US oil companies, they used to lend money to the banks overnight.

[bradiston]

5 hours ago, scubascuba3 said:

Maybe they don't see it as a risk because they just won't pay out if they haven't got the funding

It's possible. Then the whole thing is completely fraudulent.

[bradiston]

5 hours ago, jerrymahoney said:

Verbatim from English language policy on wrlife.net website:

 

The Main Insured must, when joining, complete and sign online on the web site: www.wrlife.net the application form can include a medical questionnaire validated by the Insurer. An additional medical examination, paid by the Insured, may be requested.

 

The Insurer reserves the right to make acceptance conditional upon the production of any additional information it considers necessary.

 

1. For any pre-existing, chronic conditions and injury before the start date of the policy, the condition has to be studied and can either been covered with or without moratorium, or loading, or excluded.

 

2. For aged under 65: Health checkup is not required: there is a three month waiting period for specific diseases.

 

3. For aged 65 and over: 2 choices
3.1 Health checkup required prior to coverage to determine pre-existing conditions. (or)
3.2 A six month waiting period prior to coverage for specific diseases.
Specific diseases: Hypertension & Cardiovascular Disease, All Tumors, Polyp or Cyst, Hernias, Hemorrhoids, Prostate Disease, Diabetes, Cancer, Cholecystitis, Cholelithiasis, Calculi of the Urinary Organs.

______________

 

BTW 3.2 was what was in the RED BREAKING NEWS notice a few days back.

Actually, we've been over this ground already. I took it up with AA. I believe the explanation was, if, in the first 6 months, you develop any of the listed conditions, you won't be covered, but whether this is for an indefinite period I've no idea. If, however, you declare a pre-existing, then the insurers will decide on the level of cover, if any.

 

The red breaking news "quote", was taken out of its context. I believe it was put up by a broker elsewhere in Thailand as clickbait, if you like. It was poor practice.

[jerrymahoney]

This is from the WrLife English language Policy document:

 

ANY INSURANCE FROM AN INTERNAL BROKER
We are also licensed broker and we can find covers from any provider even from competitors. The WrLife global architecture also owns brokerage companies. One is in France for example and has the insurance broker license for all Europe.

[Dart12]

question already answered in following pages.