Pattaya Health Insurance

[Pattaya57]

Now that I'm on a non-imm O retirement I thought it was about time I got some health insurance.

 

I applied at Pacific Cross as read great reviews and what I think is a good price, 32,019 baht for 1.2 million baht coverage with 20k excess.

 

But I was shocked to find their offer letter included many exclusions that were not excluded in the policy document that I applied for.

 

See below for many items excluded for 3 years with a "will be re-assessed" after so they may never be included. I am 59, in good health and answered 'no' to all their health issue questions in the application

 

Except for accident cover, to me this policy seems worthless with all those exclusions.

 

[Halfaboy]

Try ro get a quote from this compny: https://www.aainsure.net/

 

Good luck !

[Pattaya57]

The worst thing is they exclude all these issues and say they'll be re-assessed after 3 years. They never assessed them in the first place as I answered no to everything. All I can think of is my age at 59 triggered all these exclusions as my 58 year old mate doesn't have them with same company 

[Pattaya57]

17 minutes ago, Halfaboy said:

Try ro get a quote from this compny: https://www.aainsure.net/

 

Good luck !

Thanks, I'll try them. I did go to another broker and they also recommended Pacific Cross policy but I didn't apply with them to see extra exclusions in the offer letter

 

[Pattaya57]

Pacific Cross also gave me a prostate exclusion for 2 years in the offer letter. Again not in policy doc and to be re-assessed after that time so may never be included. Totally useless policy.

 

 

[Pattaya57]

I've just been recommended Macallan brokers. Anyone use them?

[Phantom57]

5 hours ago, Pattaya57 said:

Pacific Cross also gave me a prostate exclusion for 2 years in the offer letter. Again not in policy doc and to be re-assessed after that time so may never be included. Totally useless policy.

 

Also had this with PC, sent PSA test results to them, exclusion lifted. 

[scubascuba3]

Using different brokers gets the same insurers, those exclusions are sensible if lifted after 3 years. They don't want to take people on with hidden pre-existing conditions, known or unknown

[jacko45k]

Also check whether the insurance will pre-pay for treatment, or you are expected to pay yourself and claim back later. Not much help in situations where you may be incapacitated. 

[Pattaya57]

53 minutes ago, scubascuba3 said:

Using different brokers gets the same insurers, those exclusions are sensible if lifted after 3 years. They don't want to take people on with hidden pre-existing conditions, known or unknown

How are all those exclusions sensible? They are not excluded in the policy document, just in the offer letter. There's also so many of them I'm not sure what's left that they do cover.

 

They are also not lifted after 3 years, they are re-assessed. If they are assessed as excluded now for no reason I can see, then why would the re-assessmemt in 3 years be any different and they'll just exclude them again?

 

[scubascuba3]

1 hour ago, Pattaya57 said:

How are all those exclusions sensible? They are not excluded in the policy document, just in the offer letter. There's also so many of them I'm not sure what's left that they do cover.

 

They are also not lifted after 3 years, they are re-assessed. If they are assessed as excluded now for no reason I can see, then why would the re-assessmemt in 3 years be any different and they'll just exclude them again?

 

They will probably check if you've had any treatment in the 3 years if not remove it, but thai insurers aren't very good, they are cheap, coverage is poor, premiums go up with claims and can you rely on a claim being paid, 50/50

[Pattaya57]

I've gone through the application again and the only thing I didn't say 'No' to was do I drink. I said yes with 15-20 drinks of light beer per week (I tried to answer honestly)

 

I'm now wondering if this triggered all the extra exclusions? Drinking 3 days a week having 5-6 light beers is not a lot to me as I only drink Singha 89 which is only 3% alcohol. Insurance may have a different opinion though and treat that the same as if I drank same number of high alchohol spirits?

 

[jippytum]

5 hours ago, jacko45k said:

Also check whether the insurance will pre-pay for treatment, or you are expected to pay yourself and claim back later. Not much help in situations where you may be incapacitated. 

my Thai insurance company pay direct to the hospital. For decades no problem with claims. However  in February this year my insurance agreed terms with hospitial admin prior to operation. However the main hospital in Pattaya requested a deposit of 250,000 baht from me prior to my operation. The amount was repaid after but if a new hospitial policy  defeated the object of having expensive  insurance in the first place. 

[KannikaP]

12 hours ago, Halfaboy said:

Try ro get a quote from this compny: https://www.aainsure.net/

 

Good luck !

They are only Brokers and will even sell you a policy with that company beginning with a W!

[KannikaP]

11 hours ago, Pattaya57 said:

I've just been recommended Macallan brokers. Anyone use them?

Like AA, they are only Brokers who have access to ALL or ANY policies.

They could however advise for or against certain companies from their experience.

The company was named after the Boss's favourite Scotch!  (True, he told me himself)

[Upnotover]

3 hours ago, Pattaya57 said:

I've gone through the application again and the only thing I didn't say 'No' to was do I drink. I said yes with 15-20 drinks of light beer per week (I tried to answer honestly)

 

I'm now wondering if this triggered all the extra exclusions? Drinking 3 days a week having 5-6 light beers is not a lot to me as I only drink Singha 89 which is only 3% alcohol. Insurance may have a different opinion though and treat that the same as if I drank same number of high alchohol spirits?

 

Highly likely to be the reason.

[metisdead]

A post with a photo of a bottle of a beverage containing alcohol has been removed:

• You will not advertise, display, promote, review or endorse, directly or indirectly, the name or trademark of any alcoholic beverage. Such actions are potentially in contravention of Section 32 of the Alcoholic Beverage Control Act (2008).

 

 

[topt]

6 hours ago, Pattaya57 said:

They are not excluded in the policy document, just in the offer letter.

I recently renewed with April Int but looked very closely at moving to Pacific Cross due to the premiums.

I had a long discussion with a guy at AA Insure looking at different companies including PC about which he warned me of the initial  exclusion period and then he sent me the Ts and Cs which clearly showed the exclusions/waiting periods (and more as I am older) you mention. I never got as far as completing an application or receiving an offer letter. 

Moral of the tale - do more research first 

[Pattaya57]

1 hour ago, Upnotover said:

Highly likely to be the reason.

So I guess that means we need to not drink to get decent insurance cover in Thailand (or lie on the application and say only 7 drinks a week).

 

I just have one wine with dinner I swear... 😉

[bradiston]

I came across the Monty Python sketch recently, where the agent is explaining  the policy the customer bought is the "Never Pay Out" policy. Hilarious.

 

https://youtu.be/2n3M-0JDTCI?si=SuOukA8wb5-JU0VF

[Pattaya57]

32 minutes ago, topt said:

I recently renewed with April Int but looked very closely at moving to Pacific Cross due to the premiums.

I had a long discussion with a guy at AA Insure looking at different companies including PC about which he warned me of the initial  exclusion period and then he sent me the Ts and Cs which clearly showed the exclusions/waiting periods (and more as I am older) you mention. I never got as far as completing an application or receiving an offer letter. 

Moral of the tale - do more research first 

No, I reviewed the T&C's thoroughly and these 3 year exclusions are not there (the 2 year prostate exclusion was there). I talked to a broker and he was shocked by the exclusions I received, until I said that I told them I had 15-20 light beers a week.

 

Big mistake on my part as the 15 light beers are probably only 10 'standard drinks' anyway as only 3% alcohol 

 

[bradiston]

3 minutes ago, Pattaya57 said:

No, I reviewed the T&C's thoroughly and these 3 year exclusions are not there (the 2 year prostate exclusion was there). I talked to a broker and he was shocked by the exclusions I received, until I said that I told them I had 15-20 light beers a week.

I have afib (irregular heartbeat) and wrlife put a 2 year moratorium on it. Right now, I'm completely covered. Age 74.

[scubascuba3]

8 minutes ago, bradiston said:

I have afib (irregular heartbeat) and wrlife put a 2 year moratorium on it. Right now, I'm completely covered. Age 74.

Maybe 🤞

[bradiston]

2 minutes ago, scubascuba3 said:

Maybe 🤞

Yes, as you say, maybe. It's a risky business, insurance!

[TheFishman1]

When these companies after three years they’ll reevaluate the situation that’s total BS that will stay on there permanently and then if you go to the hospital for a claim they say it was pre-existing or due to a pre-existing condition I’ve return out of London and the company always been very fair with me And when I needed any major operational hospital stay they were preapproved it and they paid the hospital directly I’ve never had a problem with them very careful with Insurance here read everything two times over before you sign it I’ll try to trick you TIT 

[Upnotover]

1 hour ago, Pattaya57 said:

No, I reviewed the T&C's thoroughly and these 3 year exclusions are not there (the 2 year prostate exclusion was there). I talked to a broker and he was shocked by the exclusions I received, until I said that I told them I had 15-20 light beers a week.

 

Big mistake on my part as the 15 light beers are probably only 10 'standard drinks' anyway as only 3% alcohol 

 

UK guidance, for example, is maximum 6 pints of 4% beer per week. So your 20 x 3% x 330ml beers exceeds that was far as total alcohol is concerned. Plus the fact that anyone saying 15-20 will likely be considered to be 20-30.

[topt]

2 hours ago, Pattaya57 said:

No, I reviewed the T&C's thoroughly and these 3 year exclusions are not there

Yes sorry you are correct. I just reread your OP again and it does look like they may have excluded due to the reasons you mention.

 

For anybody else a little more senior here is a link to their general exclusions and standard provisions which raised red flags for me -

https://www.aainsure.net/pacific-cross/Pacific Cross 8 General Exclusions and Standard Provisions.pdf

[Canadian Snowbird]

Many insurance companies have a list of exclusions that is far more comprehensive than their list of inclusions. And you have to fight for any claims as you end up dealing with an adjuster who gets paid a commission for everything he saves on a claim. Insurance ... the  biggest scam ever invented. 

[PattayaParent]

22 hours ago, Pattaya57 said:

I've just been recommended Macallan brokers. Anyone use them?

 

Been using Jack as my insurance broker for 30 years.

[PattayaParent]

10 hours ago, KannikaP said:

The company was named after the Boss's favourite Scotch!  (True, he told me himself)

 

So was his son!