When does it become time to put money aside in a separate account and self insure?

[scubascuba3]

33 minutes ago, jerrymahoney said:

Is that the same 800K that some have in their Bangkok Bank account via their agent for microseconds?

no it's the real 800k

[jerrymahoney]

2 minutes ago, scubascuba3 said:

no it's the real 800k

Oh.

[scubascuba3]

1 minute ago, jerrymahoney said:

Oh.

Presumably you're self insuring also? you know insurer with little track record of paying claims, best to be on the safe side

[jerrymahoney]

4 minutes ago, scubascuba3 said:

Presumably you're self insuring also? you know insurer with little track record of paying claims, best to be on the safe side

You know best.

[scubascuba3]

4 minutes ago, jerrymahoney said:

You know best.

Usually yes, gets tiring after a while

[jerrymahoney]

You wrote earlier this topic:

 

'Those insured should also be self insured as a "claim denied" is likely and common.' *

 

As you asked before on this topic about some detail for the 5M baht self-insurance  account , how about some detail on your 'likely' reference above:

 

Likelihood of an outcome or result:

 

"Virtually certain" means greater than a 99 percent probability of occurrence.
"Extremely likely" means greater than 95 percent.
"Very likely" means greater than 90 percent.
"Likely" means greater than 66 percent.
"More likely than not" means greater than 50 percent.
"About as likely as not" means 33 to 66 percent.
"Unlikely" means less than 33 percent.

https://www.ipcc.ch/site/assets/uploads/2017/08/AR5_Uncertainty_Guidance_Note.pdf

 

* https://aseannow.com/topic/1299265-when-does-it-become-time-to-put-money-aside-in-a-separate-account-and-self-insure/?do=findComment&comment=18172290

 

 

[scubascuba3]

7 minutes ago, jerrymahoney said:

You wrote earlier this topic:

 

'Those insured should also be self insured as a "claim denied" is likely and common.' *

 

As you asked before on this topic about some detail for the 5M baht self-insurance  account , how about some detail on your 'likely' reference above:

 

Likelihood of an outcome or result:

 

"Virtually certain" means greater than a 99 percent probability of occurrence.
"Extremely likely" means greater than 95 percent.
"Very likely" means greater than 90 percent.
"Likely" means greater than 66 percent.
"More likely than not" means greater than 50 percent.
"About as likely as not" means 33 to 66 percent.
"Unlikely" means less than 33 percent.

https://www.ipcc.ch/site/assets/uploads/2017/08/AR5_Uncertainty_Guidance_Note.pdf

 

* https://aseannow.com/topic/1299265-when-does-it-become-time-to-put-money-aside-in-a-separate-account-and-self-insure/?do=findComment&comment=18172290

 

 

how likely depends on insurer and those insured depending on how honest they were at application time, any visits to hospital that can be tracked.

 

I was just made aware of a recent court case where there was a claim denied resulted in a cancelled policy etc etc, the outcome makes me think a court case may be worthwhile 

[Scouse123]

1 hour ago, FruitPudding said:

Out of interest, where do you get the check up?

I use Bangkok hospital in Khonkaen.

[Yellowtail]

2 minutes ago, scubascuba3 said:

how likely depends on insurer and those insured depending on how honest they were at application time, any visits to hospital that can be tracked.

 

I was just made aware of a recent court case where there was a claim denied resulted in a cancelled policy etc etc, the outcome makes me think a court case may be worthwhile 

It has been my experience, that my insurance (Health Net, Cingna and BCBS) would often pay claims they did not have to when resubmitted. In the over twenty years I was covered, I never had a legitimate claim refused. 

[Scouse123]

On 7/2/2023 at 6:21 AM, tomacht8 said:

At 61 you can easily get private Thai health insurance. The most important thing is to check that there will be no age limit for health insurance to kick you out in the future. Most health insurance policies are valid globally, with the exception of the United States. You can start with a basic health insurance without dentist and out patient service. Only for the case of a serious illness that requiring hospitalization. In order to find the best solution for you, you cannot avoid reading the fine print carefully.

I have private health insurance and always have had. My current insurer is Thai based Pacific Cross but members have said they can be very difficult to get them to pay for a claim, hence me looking around, not that I am ill in any way, I am not.

 

I have three years no claims with them and an excess of 40K THB

 

When I contacted my broker, she said it was true that they rigorously check the patients history, but in the event that pre existing conditions have been declared and nothing hidden or omitted, they pay out.

 

I have also checked out Wr Life but I am advised that not enough is known about them as they are a relative newcomer to the market.

 

Another poster suggested Mister Prakan on here and they have responded that Pacific Cross is best in the current market.

 

 

[Scouse123]

20 minutes ago, Yellowtail said:

It has been my experience, that my insurance (Health Net, Cingna and BCBS) would often pay claims they did not have to when resubmitted. In the over twenty years I was covered, I never had a legitimate claim refused. 

Cigna are double the price of Pacific Cross and will only cover me for Thailand and the UK at this fee of 96K THB.

 

I often travel to Vietnam, Cambodia and Laos as well as other countries in the region, so that won't do for me.

[Scouse123]

31 minutes ago, scubascuba3 said:

how likely depends on insurer and those insured depending on how honest they were at application time, any visits to hospital that can be tracked.

 

I was just made aware of a recent court case where there was a claim denied resulted in a cancelled policy etc etc, the outcome makes me think a court case may be worthwhile 

What was the outcome?

 

Also, my contact at Pacific Prime broker said the main cause of disputed claims from the insurer was non disclosure or pre existing conditions and not declaring health issues they knew they had.

[jerrymahoney]

40 minutes ago, scubascuba3 said:

how likely depends

You said "likely" with no "it depends" qualifier.

[scubascuba3]

21 minutes ago, Scouse123 said:

What was the outcome?

 

Also, my contact at Pacific Prime broker said the main cause of disputed claims from the insurer was non disclosure or pre existing conditions and not declaring health issues they knew they had.

i can't say the outcome but, non disclosure of preexisting can be claimed by insurer (we know they love that) but may not be right

[scubascuba3]

17 minutes ago, jerrymahoney said:

You said "likely" with no "it depends" qualifier.

obviously i can't cover the 1000s of policy holders separately,so there is some generalisation 

[Sheryl]

7 hours ago, Scouse123 said:

Cigna are double the price of Pacific Cross and will only cover me for Thailand and the UK at this fee of 96K THB.

 

I often travel to Vietnam, Cambodia and Laos as well as other countries in the region, so that won't do for me.

It sounds like you refer to Cigna Thailand not Cignal Global. Or have you not taken into accojnt hhe cover for emergency care when travelling? 

 

Cigna offers both deductible and copay options which reduce premiums. And their premiums at older ages do not rise as dramatically as PC. Be sure to look at premiums for the age bands above yours. And remember the additional 25% increases after large claims in addition to age rtlated increases. 

 

  In the long run this policy will cost you far more and in addition -- and this to me is a clincher --  will not cover you for any chronic illness you develop beyond the initial years claim (and in the case of cancer, cover you even at first claim only up up 100k which in your case is 0 cover since less than your deductible). At which point you are also unabld to get a different policy. 

 

Since you are planning to live out your old age  in Thailand you may well (in fact probably will) end up with a policy that has become completely unaffordable and does not cover your health conditions (cancer, heart disease, kidney disease, stroke  to name just a few things that would be excluded aferr first year of claims and have a high chance of occurring in old age). This is all clearly spelled out in the policy terms. These are not policies suitable for growing old in Thailand. Better for younger people here temporarily. 

[mania]

4 hours ago, Sheryl said:

Since you are planning to live out your old age  in Thailand you may well (in fact probably will) end up with a policy that has become completely unaffordable and does not cover your health conditions (cancer, heart disease, kidney disease, stroke  to name just a few things that would be excluded after first year of claims and have a high chance of occurring in old age). This is all clearly spelled out in the policy terms. These are not policies suitable for growing old in Thailand. Better for younger people here temporarily. 

To be clear...You are saying this only about the Thai based policies correct? You feel the International based policies will be stable.. ie: not priced out or 25% increases after big claims etc that you mentioned

[Sheryl]

4 hours ago, mania said:

To be clear...You are saying this only about the Thai based policies correct? You feel the International based policies will be stable.. ie: not priced out or 25% increases after big claims etc that you mentioned

Yes. Thai policies only, and specifically the Pacific Cross policy OP is considering renewing.

 

Insurers based in Western countries are not allowed to increase premiums based on claims history. Nor are they allowed to newly exclude a condition  that developed after the policy was issued.  Haven't seen any that singled out cancer for a much  lower level of reimbursement either. 

[mania]

Thanks Sheryl glad to hear that!

[NanLaew]

On 6/29/2023 at 6:57 PM, Neeranam said:

50 is a good age to start saving for health insurance

 

It's also a good age to start self-funded annual medical examinations so you don't get blindsided by the perlious "I'm healthy for my age" self-assessments.

[NanLaew]

<cloudflared>

[Yellowtail]

19 minutes ago, NanLaew said:

It's also a good age to start self-funded annual medical examinations so you don't get blindsided by the perlious "I'm healthy for my age" self-assessments.

And to be clear, annual examinations are important whether your self-funding on not. 

 

 

[scubascuba3]

4 hours ago, NanLaew said:

It's also a good age to start self-funded annual medical examinations so you don't get blindsided by the perlious "I'm healthy for my age" self-assessments.

Probably better if these are anonymous otherwise Insurers might find out and find a preexisting condition

[Phulublub]

On 6/29/2023 at 11:53 AM, Etaoin Shrdlu said:

If you only set aside an amount equal to what you would pay in premiums each year, you would be seriously underfunded.

Possibly. 

 

The Insurance companies have overheads and make a profit from underwriting, so it is not a zero sum game.

 

If everyone self-insured then some would be underfunded, some would be just right, and some would be overfunded....but overall, the population would be better off.

 

PH

[Phulublub]

On 7/2/2023 at 12:15 PM, Mikkihiiri said:

If you put aside the same yearly amount you would pay to an insurance company you will not be covered enough if something serious will happen. I am 65 yo and have a 5,000,000 THB coverage insurance with PACIFIC CROSS. The premium is around 52,000 THB per year with no coverage below 50,000 THB of hospital bill. You get a 10% on the yearly premium if you did not use the insurance the previous year.

But if one hundred of you clubbed together, without the insurance company, to pay any claim up to $5M, then you would all be $2000 a year better off.....on average....but the $2000 is what you pay to ensure that if the worst happens to YOU then you are covered.

 

PH

[howerde]

23 hours ago, Scouse123 said:

What was the outcome?

 

Also, my contact at Pacific Prime broker said the main cause of disputed claims from the insurer was non disclosure or pre existing conditions and not declaring health issues they knew they had.

Remember your contact will be a sales person, they will not be the ones going through any claim you make. 

[Scouse123]

10 minutes ago, howerde said:

Remember your contact will be a sales person, they will not be the ones going through any claim you make. 

Yes,

 

That message is coming across to be loud and clear from what I pick up in the telephone conversations with them.

[Scouse123]

5 hours ago, NanLaew said:

It's also a good age to start self-funded annual medical examinations so you don't get blindsided by the perlious "I'm healthy for my age" self-assessments.

I do that every year religiously and will be going again later this month..

 

Totally agree, we must be proactive in looking after ourselves.

[VirgoSG]

I've been scanning through this thread again, and see that many people have expressed an interest in what companies / policies one should look at.  So, I thought I would re-post what I had to say a couple of weeks ago (with a couple of additions) as it may help people who are reconsidering their coverage options:--

<Take a look at AXA International health insurance (based in the UK, not the local AXA branch in Thailand)  [ Search for "axa global healthcare" ].  I have been with them for many years, and had an excellent claims experience (including cataract surgery, removal of potentially cancerous skin growths, expensive hospitalisation/treatment while traveling to HK).  Doesn't matter where you live in the world, they will cover you wherever you happen to be, and you can also choose where you get treatment (e.g. if I elect to go to Singapore for treatment, no problem). 

Contrary to what many people say, reputable (and likely non-Thai) insurers do not jack up the premium based on your personal claims record.  AXA increase their premiums based on the company's total claims experience and medical-related inflation.  In some years my premium has increased as little as 2%, in others up to 17%.  

They certainly insure Thais as well as expats, because we recently switched my partner's insurer to AXA International -- her own policy, not added onto mine.  Her premium aged 39 is about THB40,000 -- roughly the same as the appalling Thai insurance policy she had before, and vastly superior coverage.

With a GBP2,000 (voluntary) deductible, aged 75, my annual (worldwide excluding USA) premium this year is GBP5,300 (about THB230,000).  And that includes emergency evacuation and repatriation cover.  Once you are insured, there is no age limit that I am aware of (although I don't know if they have an upper age limit for new policies). And there should be no problem getting cover at your young 61 years!  They also have an exceptionally reasonable policy regarding pre-existing conditions.  

If you are interested after reading their website, I would suggest calling their health advisers or their sales team.  Their staff are really well-trained (sales people not pushy at all, and customer advisors are superb), personable and helpful.  

[save the frogs]

16 minutes ago, VirgoSG said:

premium this year is GBP5,300 (about THB230,000). 

What I'm getting from this thread ...

 

Having no insurance or bad insurance will bankrupt you.

 

And paying for proper insurance eliminates the lower cost of living in Thailand.