Health Insurance quotes

[scubascuba3]

13 minutes ago, Sheryl said:

True of many Thai insurers (though not all.)

 

International insurers more often  do full medical underwriting. You know from the start what will and won't be covered as long as you filled out the health history honestly and in full. 

We've got Simon? BM with International insurance  got a claim denied and cancellation of insurance. It will be interesting what the ombudsman concludes, I don't think he agrees with your interpretation of the situation 

[Sheryl]

14 minutes ago, scubascuba3 said:

We've got Simon? BM with International insurance  got a claim denied and cancellation of insurance. It will be interesting what the ombudsman concludes, I don't think he agrees with your interpretation of the situation 

As he acknowledges, he failed to disclose a chronic medical condition on his application which the insurer later found out about.  Not through any deep "digging", it was clearly stated on the hospital forms they received that he had had this condition for a number of years.

 

Had he declared this condition on application, the insurer would certainly have applied an exclusion for prostate problems or else applied a a premium load. Because while it is not a risk factor for prostate cancer, it is a condition which has a high chance of needing hospital treatment in future (as many a thread on this board attests) and which also increases the likelihood of needing a prostate biopsy in future to distinguish it from cancer.

 

There is IMO no possibility the ombudsman would reinstate his policy as the insurer clearly had a legal right to terminate the contract. Any insurer does when it is discovered that a known medical condition known at time of application was not declared, especially one that would have influenced the insurer's decision to issue a policy. 

 

However  the ombudsman  might direct the insurer to refund the unspent (i.e. pro-rated) portion of his premium. Currently the insurer has retained whole premium and the contractual right to do so depends on the omission having been deliberate/intentional and that is hard to prove.  Indeed since he sent the insurer detailed records of his prior lab tests, it could be argued that this showed a  lack of fraudulent intent .

[NanLaew]

18 hours ago, simon43 said:

Therefore, I would strongly suggest that if you do apply for medical insurance, that you disclose every single ailment or condition that you might have had in your life, on the basis that no matter how minor that ailment might have been, your failure to disclose it could be a reason to reject any future claim. 

Furthermore, I would suggest on making sure you know exactly what any government or private hospitals are going to disclose to any prospective insurer to prevent any surprises.

 

Around the time Covid was abating, I acquired new health insurance. Signing up at under 65 years-old, there was no need for a medical, just a personal disclosure "honesty" checklist. Six months later, I needed an emergency procedure: the first time in my life anywhere so I needed to make sure I was covered. In order to fast-track the approval, I signed permissions for the insurer to obtain medical records from the two private hospitals here in Thailand where I had bi-ennial medical examinations for offshore work dating back over 10 years. I had the procedure, it was successful and it was covered. However, a few months later, the insurer drew my attention to a single instance of elevated blood pressure, commensurate with stage 1 hypertension, recorded at Bumrungrad in 2017. None recorded before or since and absolutely nothing to do with the recent emergency.

 

Accordingly, they requested an add-on premium load of 10,000 baht for this act of "non-disclosure." Upon renewal 12 months later, my premiums rose by another 12,000 baht.

 

Needless to say, I will be shopping for a better deal next time around.

 

I would also advise the OP or anyone out doing first-time health insurance shopping is to have a good medical examination including comprehensive lab work done FIRST. Ideally, take onboard any dietary changes or exercise regimens recommended seriously and then get a second medical maybe 6 months later. Then annually. This way YOU get surprised first but more importatntly, you gain a better idea of how rapidly you're falling apart.

Edited March 28, 2023 by NanLaew

[timoti]

10 hours ago, scubascuba3 said:

One of the other issues with insurers is they do little checking when people apply for insurance, but when making a claim there the digging really starts, really you want to know when kicking off insurance exactly what you aren't covered for

 

 

 

 

 

I think it will be hard for them to find out every issue you had unless it can be observed by other doctors and noted.

 

For example let's say you are from Singapore and lived in Italy then in Japan and had a simple procedure. Later you bought an intl cover while living in Thailand, it would be pretty close to impossible for the insurer to find out about the operation in Japan.

 

The only thing they could do is to request full data from the hospital in Thailand that you visited and made the claim.

 

I think one should also ask what the doctor will write in medical certificate so it's within the insurance registration date and not mention anything that could create problems.

[jerrymahoney]

3 hours ago, timoti said:

I think one should also ask what the doctor will write in medical certificate so it's within the insurance registration date and not mention anything that could create problems.

So in plain English, would you be asking the hospital doctor to falsify the pre-admittance evaluation?

[ClaySmc]

I don't think I've seen this asked:
How do insurance companies find out you had a test or condition that you did not list in an application? Especially now that you are in Thailand, and any of this took place years ago in the West?

 

By the way, here is a link regarding how one insurance company processes some claims:
How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them (msn.com)

 

[jerrymahoney]

1 hour ago, ClaySmc said:

I don't think I've seen this asked:
How do insurance companies find out you had a test or condition that you did not list in an application? Especially now that you are in Thailand, and any of this took place years ago in the West?

At least in Thailand, most expats carry only insurance for inpatient procedures which requires an evaluation by the hospital medical staff before the insurer approves.

 

Some things will be obvious to the doctor whether directly related to the claim requested or not.

 

I always get something like this as to a last year chest X-ray:

 

Old fracture at right clavicle, fixed by plate and screws.

 

from 25 years before.

 

As to the "I don't think I've seen this asked" put the following into Google search and you will get lots of hits:

 

aseannow.com how does an insurer know medical history

Edited March 29, 2023 by jerrymahoney

[scubascuba3]

5 hours ago, ClaySmc said:

I don't think I've seen this asked:
How do insurance companies find out you had a test or condition that you did not list in an application? Especially now that you are in Thailand, and any of this took place years ago in the West?

 

By the way, here is a link regarding how one insurance company processes some claims:
How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them (msn.com)

 

When I completed a quote questionnaire a few years ago they wanted to see my GP records in the UK. I guess if you couldn't find any just more likely a claim denied down the line. As for medical records in Thailand they contact the hospitals, there's a good chance there's a secret database insurers can access

[ClaySmc]

4 hours ago, scubascuba3 said:

they wanted to see my GP records in the UK.

Thanks. That would be hard tracking down, so I guess another reason to not go down that road.

[scubascuba3]

2 minutes ago, ClaySmc said:

Thanks. That would be hard tracking down, so I guess another reason to not go down that road.

My GP easily printed a couple A4 sheets for me

[timoti]

12 hours ago, jerrymahoney said:

So in plain English, would you be asking the hospital doctor to falsify the pre-admittance evaluation?

If I had pre-existing, I don't see any issues. Many doctors are willing to help the patients but some doctors could be overzealous to try to write down everything without any diagnosis. For example you might mention pain in one of your hand bones, and the doctor could write arthritis which could cause issues on your claims, despite not having it.

 

So you have to be on top of what the doctor is writing down. It's up to the individual.

[Paddy 696]

On 3/28/2023 at 12:16 PM, jonesthepost said:

If you return to UK yes you will get free treatment but you will join the large waiting list on the NHS, also a wait to get an appionment with  a GP.

Are you sure you don't need to be resident in UK 6 MONTHS B4 FREE TREATMENT 

[jerrymahoney]

16 hours ago, timoti said:

For example let's say you are from Singapore and lived in Italy then in Japan and had a simple procedure. Later you bought an intl cover while living in Thailand, it would be pretty close to impossible for the insurer to find out about the operation in Japan.

... except for the scar.

[timoti]

3 hours ago, jerrymahoney said:

... except for the scar.

Not all operations will leave scar. I had people tell me they had all kinds of operation through their genital organs.

[PJ71]

On 3/28/2023 at 10:32 AM, Sheryl said:

True of many Thai insurers (though not all.)

 

International insurers more often  do full medical underwriting. You know from the start what will and won't be covered as long as you filled out the health history honestly and in full. 

I had to fill out exactly nothing for my medical insurance, nada.

 

I've had a claim in recently and it was explained to me that there's nothing required before signing up, they do what they call back end checking, ie asking hospitals for medical records once you've an issue.

 

I assume this is to get your money first!

[timoti]

32 minutes ago, PJ71 said:

 

What do you guys think about vumi vs cigna vs bupa vs april?

 

I checked their preimums before but they were way more expensive.

 

I think bupa was 3x april and cigna was 2x. Vumi was similar but they don't cover some countries like Singapore if i am not wrong.

 

Cigna doesn't have pre post op coverage unless you buy OP module which doubles the price.

 

Bupa had many clauses in their brochure and still way more expensive.

Edited March 29, 2023 by timoti

[jerrymahoney]

5 hours ago, timoti said:

Not all operations will leave scar. I had people tell me they had all kinds of operation through their genital organs.

Yes. Not all. 

 

On the application, it is just a matter of what is asked. Some ask for medical history only up to 5 years prior.  But all it seems have you sign a statement that you have provided complete medical history as requested subject to cancellation if later proven otherwise.

 

As for a pre-admission evaluation provided to an insurer by the hospital, I have never had a doctor ask: What would you like to to write?

Edited March 29, 2023 by jerrymahoney

[PJ71]

11 hours ago, timoti said:

What do you guys think about vumi vs cigna vs bupa vs april?

 

I checked their preimums before but they were way more expensive.

 

I think bupa was 3x april and cigna was 2x. Vumi was similar but they don't cover some countries like Singapore if i am not wrong.

 

Cigna doesn't have pre post op coverage unless you buy OP module which doubles the price.

 

Bupa had many clauses in their brochure and still way more expensive.

I use Regency intl, cost is 170K baht for me and the wife, we're both under 50. This is with a 40K baht excess.

 

One claim to date, no issues but a lot of digging looking for an excuse not to pay out IMO.

[simon43]

15 hours ago, Paddy 696 said:

Are you sure you don't need to be resident in UK 6 MONTHS B4 FREE TREATMENT 

No... see my previous posts on this subject.

[BritManToo]

On 3/28/2023 at 6:26 PM, NanLaew said:

Furthermore, I would suggest on making sure you know exactly what any government or private hospitals are going to disclose to any prospective insurer to prevent any surprises.

 

Around the time Covid was abating, I acquired new health insurance. Signing up at under 65 years-old, there was no need for a medical, just a personal disclosure "honesty" checklist. Six months later, I needed an emergency procedure: the first time in my life anywhere so I needed to make sure I was covered. In order to fast-track the approval, I signed permissions for the insurer to obtain medical records from the two private hospitals here in Thailand where I had bi-ennial medical examinations for offshore work dating back over 10 years. I had the procedure, it was successful and it was covered. However, a few months later, the insurer drew my attention to a single instance of elevated blood pressure, commensurate with stage 1 hypertension, recorded at Bumrungrad in 2017. None recorded before or since and absolutely nothing to do with the recent emergency.

 

Accordingly, they requested an add-on premium load of 10,000 baht for this act of "non-disclosure." Upon renewal 12 months later, my premiums rose by another 12,000 baht.

 

Needless to say, I will be shopping for a better deal next time around.

 

I would also advise the OP or anyone out doing first-time health insurance shopping is to have a good medical examination including comprehensive lab work done FIRST. Ideally, take onboard any dietary changes or exercise regimens recommended seriously and then get a second medical maybe 6 months later. Then annually. This way YOU get surprised first but more importatntly, you gain a better idea of how rapidly you're falling apart.

I would advise everyone to avoid medical tests and check-ups.

The more items of interest they note, the more exclusions and higher price you will pay for insurance.

Best to have no medical history of any kind.

[scubascuba3]

52 minutes ago, BritManToo said:

I would advise everyone to avoid medical tests and check-ups.

The more items of interest they note, the more exclusions and higher price you will pay for insurance.

Best to have no medical history of any kind.

You have a point there, could go to labs anonymously 

[jayboy]

Interesting thread. A common theme is the increasing cost of heath insurance premiums though in my experience over many years is that these have always easily exceeded the inflation rate.These increases apply to everybody not just the older customers.What I'm not sure of, and perhaps someone could advise, is whether - because obviously claims are more frequent in older people - there is an extra increase simply because the customer is old. My other query is whether in health insurance there is any element of non claim bonus - though I don't think there is.

Edited March 30, 2023 by jayboy

[Sheryl]

35 minutes ago, jayboy said:

Interesting thread. A common theme is the increasing cost of heath insurance premiums though in my experience over many years is that these have always easily exceeded the inflation rate.These increases apply to everybody not just the older customers.What I'm not sure of, and perhaps someone could advise, is whether - because obviously claims are more frequent in older people - there is an extra increase simply because the customer is old. My other query is whether in health insurance there is any element of non claim bonus - though I don't think there is.

All health insurance policies increase premiums with age. Some annually and some in 5 year age bands. 

 

In adfition there are sometimes inflationary increases across the board. This has especially been so post COVID

 

And most Thai issued policies will, on top of all this, raise an individual premium based on claims history....as much as 25% each year in which there was a claim and  this is over and above age related increases and inflationary adjustments. As a result many people get priced out as they age or after developing a chronic condition. Which is exactly why I recommend against Thsi issued poluc8es edlspecially for those who plan to live here into old age. 

[Sheryl]

2 hours ago, BritManToo said:

I would advise everyone to avoid medical tests and check-ups.

The more items of interest they note, the more exclusions and higher price you will pay for insurance.

Best to have no medical history of any kind.

Or start your health insurance while still young and healthy.