Personal Accident Insurance

[bradiston]

2 hours ago, tomster said:

Hi Bradiston,

 

Can I ask what the name of your Allianz policy is?

 

I am looking at their My Health policy and it covers 8 million including illness or accident (I think).

 

Trying to get clarity on this as it seems like your cover with them is limited on the accident side of things.

 

The policy I am looking at is 58k though which is obviously quite expensive.

 

Cheers.

It was Happy Senior 3. I won't renew. It only covers 100,000 of medical expenses. Wouldn't even cover a broken toe.

[bradiston]

On 10/5/2022 at 9:52 PM, bradiston said:

It was Happy Senior 3. I won't renew. It only covers 100,000 of medical expenses. Wouldn't even cover a broken toe.

 

It was suggested, by the insurers themselves, that if I wanted more in medical expenses, I buy 5 low end policies (actually 9k each pa) which pay 100k in medical expenses. I checked with the company and apparently this is permitted. It would cost me 45k THB pa to get 500k medical expenses, plus 5 times the life cover. Maybe worth it? Anyone any experience of this? I think it is a reputable Thai company. But I guess there might be something in the small print that says only one claim per policy(holder). I wonder if there's a catch, but that's now built into my psyche!

 

 

Edited October 12, 2022 by bradiston

[scubascuba3]

49 minutes ago, bradiston said:

 

It was suggested, by the insurers themselves, that if I wanted more in medical expenses, I buy 5 low end policies (actually 9k each pa) which pay 100k in medical expenses. I checked with the company and apparently this is permitted. It would cost me 45k THB pa to get 500k medical expenses, plus 5 times the life cover. Maybe worth it? Anyone any experience of this? I think it is a reputable Thai company. But I guess there might be something in the small print that says only one claim per policy(holder). I wonder if there's a catch, but that's now built into my psyche!

 

 

45k premium for 500k cover sounds really rubbish

[bradiston]

6 minutes ago, scubascuba3 said:

45k premium for 500k cover sounds really rubbish

The 500k is just medical expenses, which is what I was looking for. It would also include 2.5m for motorcycle accident, 5m physical assault or murder (?), 10m public accident (stampede?), 5m for non motorbike related accident. But all the accident cover is linked to life cover, so typically Thai. In other words, accidents resulting in loss of life, limb, sight etc. I'm not sure about the motorcycle cover. SOS included. Maybe broken bones is included. So many questions, and each one needing a separate answer.

[scubascuba3]

14 minutes ago, bradiston said:

The 500k is just medical expenses, which is what I was looking for. It would also include 2.5m for motorcycle accident, 5m physical assault or murder (?), 10m public accident (stampede?), 5m for non motorbike related accident. But all the accident cover is linked to life cover, so typically Thai. In other words, accidents resulting in loss of life, limb, sight etc. I'm not sure about the motorcycle cover. SOS included. Maybe broken bones is included. So many questions, and each one needing a separate answer.

For what you are looking for, health insurance is the way to go, even Pacific Cross 3m type cover is better than the one you're looking at, 500k isn't enough

[bradiston]

6 minutes ago, scubascuba3 said:

For what you are looking for, health insurance is the way to go, even Pacific Cross 3m type cover is better than the one you're looking at, 500k isn't enough

I have health cover but there's a question mark over whether it covers slipping over in the bathroom and cracking my noggin on the washbasin, or something similar. Hip?  Elbow? Wrist? Motorcycle accident? The overlap between health and accident seems a grey area, so cover all bases for the extra is maybe worth it. My health insurers say I'd be covered for in house care after a serious fall, eg hip replacement. But, I don't have it in black and white, written down anywhere I can see. I researched the cost of hip replacement in Thailand. Anything between 300k and heaven knows where. 1.5m? Could be. But you'll not find the latter kind of medical expenses cover anywhere I don't think.

[Etaoin Shrdlu]

13 minutes ago, bradiston said:

I have health cover but there's a question mark over whether it covers slipping over in the bathroom and cracking my noggin on the washbasin, or something similar. Hip?  Elbow? Wrist? Motorcycle accident? The overlap between health and accident seems a grey area, so cover all bases for the extra is maybe worth it. My health insurers say I'd be covered for in house care after a serious fall, eg hip replacement. But, I don't have it in black and white, written down anywhere I can see. I researched the cost of hip replacement in Thailand. Anything between 300k and heaven knows where. 1.5m? Could be. But you'll not find the latter kind of medical expenses cover anywhere I don't think.

It would be very unusual for a medical insurance policy to exclude coverage for otherwise legitimate medical expenses because they were the result of an accident. Some may exclude expenses arising from accidents involving hazardous activities, however.

 

Medical policies cover accidents and diseases. Accident policies cover accidents, but don't cover disease. Having said that, there may be rare exceptions, but they would not be mainstream insurance products.

Edited October 12, 2022 by Etaoin Shrdlu

[The Fugitive]

12 minutes ago, Etaoin Shrdlu said:

It would be very unusual for a medical insurance policy to exclude coverage for otherwise legitimate medical expenses because they were the result of an accident. Some may exclude expenses arising from accidents involving hazardous activities, however.

 

Medical policies cover accidents and diseases. Accident policies cover accidents, but don't cover disease. Having said that, there may be rare exceptions, but they would not be mainstream insurance products.

Very clearly explained and helpful. Thanks.

[The Fugitive]

27 minutes ago, bradiston said:

I have health cover but there's a question mark over whether it covers slipping over in the bathroom and cracking my noggin on the washbasin, or something similar. Hip?  Elbow? Wrist? Motorcycle accident? The overlap between health and accident seems a grey area, so cover all bases for the extra is maybe worth it. My health insurers say I'd be covered for in house care after a serious fall, eg hip replacement. But, I don't have it in black and white, written down anywhere I can see. I researched the cost of hip replacement in Thailand. Anything between 300k and heaven knows where. 1.5m? Could be. But you'll not find the latter kind of medical expenses cover anywhere I don't think.

You mention treatment following a moto accident. Would that be as a driver or pillion and/or being a moto taxi passenger? If as a driver wouldn't you need to be covered by your own motor insurance?

[bradiston]

5 minutes ago, The Fugitive said:

You mention treatment following a moto accident. Would that be as a driver or pillion and/or being a moto taxi passenger? If as a driver wouldn't you need to be covered by your own motor insurance?

It covers both

[The Fugitive]

13 minutes ago, bradiston said:

It covers both

Thanks for the clarification. That helps myself and others!

[bradiston]

21 minutes ago, The Fugitive said:

Thanks for the clarification. That helps myself and others!

I posted this rather lengthy reply which may fall under a TLDR heading. I'll add it here, as I was unable to edit my original reply.

 

It covers both, pillion and driver, but it's a good question. There are a million and one pages on the web on the subject of accident v health insurance. Some quote medical policies that have accident cover as an add on, others mention that insurance is mandatory for instance for owning a motor vehicle. In the UK this minimum used to be called 3rd party, fire and theft, meaning by law you had to insure against, amongst other things, injuries to a 3rd party if caused by you. Of course in discussing motor insurance, you need to include vehicle damage so it becomes a completely different beast to health insurance. Plus, some insurers will look at what other policies you have. If you have motor vehicle insurance, a health insurer might say that that is the prime insurance provider if you suffer injuries as a result of an RTA. They might step in if the funds from that policy become exhausted but I'm not in any ways an expert. The whole things a minefield. So I think the suggestion to take out multiple personal accident policies isn't such a crazy idea. Ok, it's an extra 45k THB pa, £1200 maybe, £100 pm, but if it saves you lengthy and costly legal arguments, and gets you patched up and back on your feet, could be it might prove worthwhile. (Note the could be/might be!). But could be, as some very helpful and knowledgeable people have said, superfluous.

[The Fugitive]

23 minutes ago, bradiston said:

I posted this rather lengthy reply which may fall under a TLDR heading. I'll add it here, as I was unable to edit my original reply.

 

It covers both, pillion and driver, but it's a good question. There are a million and one pages on the web on the subject of accident v health insurance. Some quote medical policies that have accident cover as an add on, others mention that insurance is mandatory for instance for owning a motor vehicle. In the UK this minimum used to be called 3rd party, fire and theft, meaning by law you had to insure against, amongst other things, injuries to a 3rd party if caused by you. Of course in discussing motor insurance, you need to include vehicle damage so it becomes a completely different beast to health insurance. Plus, some insurers will look at what other policies you have. If you have motor vehicle insurance, a health insurer might say that that is the prime insurance provider if you suffer injuries as a result of an RTA. They might step in if the funds from that policy become exhausted but I'm not in any ways an expert. The whole things a minefield. So I think the suggestion to take out multiple personal accident policies isn't such a crazy idea. Ok, it's an extra 45k THB pa, £1200 maybe, £100 pm, but if it saves you lengthy and costly legal arguments, and gets you patched up and back on your feet, could be it might prove worthwhile. (Note the could be/might be!). But could be, as some very helpful and knowledgeable people have said, superfluous.

Thanks again for the information! After years of discussions we finally came to the conclusion that my accident risk is minimal, health care plan is now unaffordable and what my wife was most worried about was being able to pay for my funeral. So Life Insurance it is. Pays out 300,000 upon my death so enough to pay for my funeral plus a little left over to tide her over. To be honest it doesn't make financial sense at all but it's what she wanted. 

Edited October 12, 2022 by The Fugitive

[Etaoin Shrdlu]

One area where personal accident coverage may provide benefits that medical insurance does not is in the area of lump sum payments for specific permanent injuries or disabilities arising from an accident such as loss of a limb, loss of eyesight and similar and also a death benefit.

 

Most medical policies will only pay covered expenses for medical treatment and some other related things. A typical medical policy won't pay a lump sum benefit for loss of limbs, eyesight, death, etc. Adding personal accident cover to a medical policy adds these benefits if they are the result of an accident.

Edited October 12, 2022 by Etaoin Shrdlu

[The Fugitive]

22 hours ago, Etaoin Shrdlu said:

One area where personal accident coverage may provide benefits that medical insurance does not is in the area of lump sum payments for specific permanent injuries or disabilities arising from an accident such as loss of a limb, loss of eyesight and similar and also a death benefit.

 

Most medical policies will only pay covered expenses for medical treatment and some other related things. A typical medical policy won't pay a lump sum benefit for loss of limbs, eyesight, death, etc. Adding personal accident cover to a medical policy adds these benefits if they are the result of an accident.

Helpful information thank you. Very recently there was a thread running about Roojai Motor Insurance being unbelievably economical but the consensus of opinion was that the company is OK. With your information in mind, I just checked their criteria for Personal Accident Insurance. Unfortunately, it only goes up to age 65. Their Cancer Insurance is open to new customers up to 60 and renewable until you reach 65.  

[nahkit]

I have personal health insurance with Pacific Cross which has a 40k baht deductible. I top this up with a Chubb PA policy which includes, amongst other coverage, coverage for accidents up to 100,000 baht. 

 

I can confirm that my Chubb policy definitely covers me for broken bones having made two claims, once for a broken thumb and the 2nd time for a broken leg (both of them motorcycle accidents).

 

The Chubb policy costs me just over 5k a year and includes my wife (presumably its calculated on age, I'm in my sixties).

 

Bradiston being quoted 9k for similar coverage seems very excessive.

 

"Plus, some insurers will look at what other policies you have. If you have motor vehicle insurance, a health insurer might say that that is the prime insurance provider if you suffer injuries as a result of an RTA. They might step in if the funds from that policy become exhausted but I'm not in any ways an expert. The whole things a minefield. "

 

When the claim for hospital treatment for the broken leg was submitted to my insurer, nobody asked me if I had motor insurance coverage. I used a combination of the government insurance/Chubb insurance to cover the 40k deductible that I would have otherwise been responsible for, there was some initial confusion on the part of the hospital as to who was covering what but my insurance agent, who speaks reasonable english, dealt with any queries they had.

[Etaoin Shrdlu]

1 hour ago, The Fugitive said:

Helpful information thank you. Very recently there was a thread running about Roojai Motor Insurance being unbelievably economical but the consensus of opinion was that the company is OK. With your information in mind, I just checked their criteria for Personal Accident Insurance. Unfortunately, it only goes up to age 65. Their Cancer Insurance is open to new customers up to 60 and renewable until you reach 65.  

Yes, after a certain age we become economically uninsurable. That's why many countries turn over the oldsters to the government for medical insurance coverage. Even the US, that bastion of capitalism, does this.

[bradiston]

10 minutes ago, nahkit said:

I have personal health insurance with Pacific Cross which has a 40k baht deductible. I top this up with a Chubb PA policy which includes, amongst other coverage, coverage for accidents up to 100,000 baht. 

 

I can confirm that my Chubb policy definitely covers me for broken bones having made two claims, once for a broken thumb and the 2nd time for a broken leg (both of them motorcycle accidents).

 

The Chubb policy costs me just over 5k a year and includes my wife (presumably its calculated on age, I'm in my sixties).

 

Bradiston being quoted 9k for similar coverage seems very excessive.

 

"Plus, some insurers will look at what other policies you have. If you have motor vehicle insurance, a health insurer might say that that is the prime insurance provider if you suffer injuries as a result of an RTA. They might step in if the funds from that policy become exhausted but I'm not in any ways an expert. The whole things a minefield. "

 

When the claim for hospital treatment for the broken leg was submitted to my insurer, nobody asked me if I had motor insurance coverage. I used a combination of the government insurance/Chubb insurance to cover the 40k deductible that I would have otherwise been responsible for, there was some initial confusion on the part of the hospital as to who was covering what but my insurance agent, who speaks reasonable english, dealt with any queries they had.

It's possible we're not comparing like for like. You say you have "coverage for accidents for 100k". Is that for medical expenses? I'm 72. I fit into a much higher premium bracket than a 6x year old. There are much cheaper policies available with the same insurer, starting at 2,900 pa, then 4,500 pa, but which carry only 20k and 50k medical expenses cover respectively for my age and occupation group. The 9k I'm being quoted drops to 6.5k and 7.8k for the 61-65 and 66-70 age groups respectively. I think the cover for accidents is adequate - 7 figures, except motorbikes, at 500k.

 

Yes, your PA policy covers broken bones, but the 100k you mention covers what, exactly? Were all expenses covered by your PA insurance? You say you used "government insurance". Not sure where that comes into a discussion of PA and private medical insurance. I certainly don't have it.

[Etaoin Shrdlu]

7 minutes ago, nahkit said:

 

 

"Plus, some insurers will look at what other policies you have. If you have motor vehicle insurance, a health insurer might say that that is the prime insurance provider if you suffer injuries as a result of an RTA. They might step in if the funds from that policy become exhausted but I'm not in any ways an expert. The whole things a minefield. "

 

When the claim for hospital treatment for the broken leg was submitted to my insurer, nobody asked me if I had motor insurance coverage. I used a combination of the government insurance/Chubb insurance to cover the 40k deductible that I would have otherwise been responsible for, there was some initial confusion on the part of the hospital as to who was covering what but my insurance agent, who speaks reasonable english, dealt with any queries they had.

If two or more policies are covering the same loss, there are a couple of things that would need to be looked into. First is whether one policy states that it is primary coverage, if it is silent, or states that it only pays if all other insurance has been exhausted. If it is primary, it should pay first. If two policies state that they are primary or are both silent, then one needs to look to see if one is a more specific type of policy. A motor policy with PA benefits would probably be considered to be more specific for a motor-related claim than a standard PA policy covering all types of accidents. 

 

There are other scenarios such as when two or more policies pay on a contributory basis.  It is usually best to avoid situations where policies pay on a contributory basis, because it may cause gaps and shortfalls if the policies are not almost identical, although there may be times when contributory policies are desirable.

 

The above does not apply to accidental death or dismemberment benefits under PA policies where multiple policies may pay these types of benefits without violating the principle of indemnity.

[bradiston]

2 minutes ago, Etaoin Shrdlu said:

If two or more policies are covering the same loss, there are a couple of things that would need to be looked into. First is whether one policy states that it is primary coverage, if it is silent, or states that it only pays if all other insurance has been exhausted. If it is primary, it should pay first. If two policies state that they are primary or are both silent, then one needs to look to see if one is a more specific type of policy. A motor policy with PA benefits would probably be considered to be more specific for a motor-related claim than a standard PA policy covering all types of accidents. 

 

There are other scenarios such as when two or more policies pay on a contributory basis.  It is usually best to avoid situations where policies pay on a contributory basis, because it may cause gaps and shortfalls if the policies are not almost identical, although there may be times when contributory policies are desirable.

 

The above does not apply to accidental death or dismemberment benefits under PA policies where multiple policies may pay these types of benefits without violating the principle of indemnity.

I'm wondering whether the suggestion by my insurer to take out multiple policies in order to beef up a particular aspect of the cover, eg medical expenses, is actually viable. It suggests claiming on all 5 policies every time you had legitimate cause to claim on just one of them is a possibility. Hmmm. Yet more questions. So all claims could be increased by a factor of 5.

[Etaoin Shrdlu]

To go a bit deeper into the issue with contributory insurance, there can be problems when more than one policy is arranged to try to "stack" limits if the policies are not written in a manner that allows this.

 

Let's say I arranged five PA policies with identical wording each covering medical expenses for a limit of 100,000 and I had an accident and I incurred 300,000 in covered medical expenses.

 

Each insurer could take the position that their policy will contribute proportionally towards the claim. Each insurer would agree to pay 20% of the limit of liability under their policy since each insurer is one of five covering the same risk. Since each insurer has a limit of liability of 100,000, each would pay 20,000 towards the claim. In this scenario, the limits were not stackable and each insurer participated on a proportionate contributory basis based upon their limit of liability, not the amount of expense incurred. One would then only collect 100,000 towards their 300,000 claim in spite of having arranged five policies each with 100,000 in limits.

 

I'm not saying that this is how Thai insurers always approach such a scenario, but I would suggest that a prospective policyholder consult with his or her insurance broker to make sure that their policies won't do this. Some policies may specifically prohibit stacking limits. 

 

 

 

 

[Etaoin Shrdlu]

19 minutes ago, bradiston said:

I'm wondering whether the suggestion by my insurer to take out multiple policies in order to beef up a particular aspect of the cover, eg medical expenses, is actually viable. It suggests claiming on all 5 policies every time you had legitimate cause to claim on just one of them is a possibility. Hmmm. Yet more questions. So all claims could be increased by a factor of 5.

Sometimes sales staff (and especially agents) are not very aware of how the claims department will actually pay claims. Ask the agent to provide you written confirmation that you can stack the limits of multiple policies to achieve what you want. Ask the agent to get that written confirmation from the underwriter.

[scubascuba3]

10 minutes ago, Etaoin Shrdlu said:

Ask the agent to get that written confirmation from the underwriter.

I suspect the agent won't respond after that request

[Etaoin Shrdlu]

1 minute ago, scubascuba3 said:

I suspect the agent won't respond after that request

Quite possible, in which case it would be best to find a competent broker to seek to arrange suitable cover. I really wouldn't recommend trying to do things like this on one's own or through an insurer's agent.

[Etaoin Shrdlu]

8 hours ago, Etaoin Shrdlu said:

To go a bit deeper into the issue with contributory insurance, there can be problems when more than one policy is arranged to try to "stack" limits if the policies are not written in a manner that allows this.

 

Let's say I arranged five PA policies with identical wording each covering medical expenses for a limit of 100,000 and I had an accident and I incurred 300,000 in covered medical expenses.

 

Each insurer could take the position that their policy will contribute proportionally towards the claim. Each insurer would agree to pay 20% of the limit of liability under their policy since each insurer is one of five covering the same risk. Since each insurer has a limit of liability of 100,000, each would pay 20,000 towards the claim. In this scenario, the limits were not stackable and each insurer participated on a proportionate contributory basis based upon their limit of liability, not the amount of expense incurred. One would then only collect 100,000 towards their 300,000 claim in spite of having arranged five policies each with 100,000 in limits.

 

I'm not saying that this is how Thai insurers always approach such a scenario, but I would suggest that a prospective policyholder consult with his or her insurance broker to make sure that their policies won't do this. Some policies may specifically prohibit stacking limits. 

 

 

 

 

Upon further reflection, I don't think this scenario is likely to occur. Instead each policy would probably contribute up to its limit of liability and not result in a shortfall. But that does not mean there aren't potential issues with having multiple policies covering the same risk. 

[scubascuba3]

This is my Axa policy, I've had it a few years, apply to 65, renewable to 74, about the best around. I've actually got the 6,900 premium, 250k medical cover, it's an old policy but they keep me on it, current policy available is below

 

https://www.axa.co.th/en/AXA-PA-Sabuyjai-My-Exclusive

 

 

Edited October 13, 2022 by scubascuba3

[The Fugitive]

3 hours ago, scubascuba3 said:

This is my Axa policy, I've had it a few years, apply to 65, renewable to 74, about the best around. I've actually got the 6,900 premium, 250k medical cover, it's an old policy but they keep me on it, current policy available is below

 

https://www.axa.co.th/en/AXA-PA-Sabuyjai-My-Exclusive

 

 

Agree it's very good!

[Adumbration]

I have AXA car insurance.  I have just emailed them about this policy.  I do not have work permit...non-o visa retired.  

 

Will let you know how I go.

[scubascuba3]

28 minutes ago, Adumbration said:

I have AXA car insurance.  I have just emailed them about this policy.  I do not have work permit...non-o visa retired.  

 

Will let you know how I go.

It's fine for retired people, non imm O

[nahkit]

20 hours ago, bradiston said:

You say you used "government insurance". Not sure where that comes into a discussion of PA and private medical insurance. I certainly don't have it.

The government insurance is included when you pay your vehicle road tax and covers medical expenses up to 30k in the case of a motorcycle accident. So no, if you don't have a legally taxed vehicle in Thailand then you won't have it.

 

My response "comes into the discussion" because you yourself mentioned other sources of insurance in the event of a traffic accident.