Pre-existing Conditions Bupa Thailand

[pen]

I have declared pre-existing conditions as hypertension and kidney stone when i got my individual health insurance made in january 2008. Iin the policy pt. 23 they mention that after 2 years from first commencement date Bupa cannot refuse to pay any claims for pre-existing condtions, unless such pre-existing conditions have been endorsed. Can someone verify that after 2 years, Bupa will pay for these pre-existing conditions, as i feel these 2 conditions cover a great percentage of illness.

[ThaivisaInsurance]

Please read your policy as it will tell you – on the front page ? - which (or both) of the conditions will be taken off after a certain amount of time.

If you still have problems please ask your Broker to explain.

[pen]

Thanks for prompt reply, however they have wrote start from but no end date, that's why i look at pt. 23 in their policy, but now i'm unsure.

Anyway, i have sent you mail regarding quotation for insurance today

[framesolution]

I also have BUPA insurance in Thailand and am not very happy with them. I informed them at the onset on my application that I had a few different minor illnesses that I was treated for over the last few years (nothing serious), and the first time I got sick and needed some tests, they checked my medical records and due to the doctors notes & diagnosis', BUPA came back and slapped several permanent exclusions on my policy. One of them, I had written on the application that I had occasional stomach aches and was treated by a doctor and hospitalized one time overnight, but the doctor wrote the diagnosis was gastritis. I had a endoscopy done this year and there was no ulcer, no H Pylori, no cancer, etc., but because the doctor wrote very minor inflammation on the report, I now have an exclusion forever for an ulcer or gastritis.

Anybody else out there having problems with BUPA Thailand?

[jazzbo]

It is very difficult to give an answer or opinion about any pre-existing condition without seeing EXACTLY what information was provided on the application.

Although others would disagree with me, my interpretation of that BUPA item 23. After 2 years ... cannot refuse to pay clause (and similar clauses from other company's policies) strictly refers to pre-existing conditions of which you were not aware and of which you could not have reasonably been expected to have been aware when the application was submitted. No one here has ever shown any proof to the contrary. It is most certainly not an invitation to submit a fraudulent application.

[peanut]

I declared my gallstones - mistake! After 4 years I still receive a letter warning me that they will not cover anything related to that. I should have just kept quiet.

[jazzbo]

I should have just kept quiet. Fine. And then when you filed a major unrelated claim, if your MD alerted the Insurer to the GI condition, they might have voided the entire policy as you withheld pertinent information on the application.

[peanut]

And why is that? I just happened to know about them. Most people don't, as they are usually asymptomatic. Does that mean that anyone who didn't know about a condition they had, gets their policy voided when it gets discovered?

[jazzbo]

from BUPA (UK) Website : Symptoms of gallstones

Gallstones are very common. Most cause no symptoms at all and

you may not even be aware you have them.

Gallstones that don't cause any symptoms usually don't need any treatment.

Gallstones can irritate the lining of your gallbladder and they can get stuck in your bile duct causing an attack of abdominal (tummy) pain that:

* develops quickly

* is severe

* lasts about one to three hours before fading gradually

* isn't helped by over-the-counter painkillers

So the logic here escapes me: If you showed no symptoms, and you did not seek a professional opinion or professional treatment, how did you happen know about your gallstone condition? The ThaiHealth Application for Individual Health Insurance at Question 4. asks do you have any present 'sickness or abnormal health condition' for which you still have not consulted with or received treatment from a condition? Note: The BUPA Thailand Application is no longer online.

As per Section 23. in the BUPA (Thailand) Policy Terms Handbook, IMHO you would not be excluded for coverage after 2 years for a condition for which you unaware or could not have been expected to be aware. The definition in that same section also says that it IS a pre-exiting condition if you in fact KNEW about it.

[jazzbo]

Edit Paragraph 2: for which you still have not consulted with or received treatment from a PHYSICIAN?

[peanut]

Well exactly - I don't dispute their right to deny treatment for pre-existing conditions, I just feel it's not fair for people who DO declare them. In my case, if I hadn't declared them and just pretended I didn't know about it, by now they would cover it because it's been more than two years.

Or am I completely misunderstanding this? I'm not trying to argue with you - on the contrary, I am happy to hear any convincing arguments that I did the right thing by declaring - I would feel less stupid.

Oh, and I happened to know about them because I am a health conscious individual who takes annual checkups and they showed on the abdominal ultrasound.

[jazzbo]

Kuhn P. -- If you were advised of your GI condition by a Physician who performed or prescribed an abdominal ultrasound -- which I presume he/she would not have done if you had not described some symptoms as an ultrasound would not otherwise be part of a normal annual check-up -- then IMHO you did the proper thing in disclosing the condition on your application as it is part of your Doctor's medical records... Pain in the a-- though it be.

[peanut]

Well, I don't know in what way this is relevant but an upper abdominal ultrasound IS part of regular checkup, at most hospitals (at least for my age - over 30).

So how does it work I wonder? Does BUPA have the right to check my records at ALL hospitals I've ever been to? (The first time I was diagnosed I wasn't even in Thailand)

In any case what's done is done , I'm just curious.

[jazzbo]

What is relevant is that you found out about the GI condition in a medical checkup. Whether the upper abdominal ultrasound is standard procedure or not, it is part of your Doctor's diagnosis and Medical record for you and should be disclosed on any Application... and yes; when you sign the Application, you grant the Insurer the right to request information or copies of any health record you might have from any jurisdiction whether in Thailand or your home or other countries. The Insurer will investigate nothing until you present them with a major claim, and they have claims investigators who just wait for that situation to occur... and the manner in which they investigate will be proportional to the amount and nature of your claim.

Also, should you have major surgery, the hospital and Surgeon will request a complete medical history from you and they will share that information with the Insurer. Withholding information at that point might not be just an Insurance matter but could adversely affect the outcome of your surgery.

[kurnell]

Bupa is absolute rubbish in Thailand. I had an ingrown hair removed from my neck, and Bupa claimed that it was a pre-existing condition (5 years old they said) and would not pay. Coincidentally this was just after I chose not to renew their policy. There are way, way better options out there.

[jazzbo]

I agree there are many other options out there besides BUPA especially when it comes to coverage in the USA. But personally, I have applied to those better options and have been denied acceptance each and every time... and my only major claim experience with BUPA was within months following the 2 year waiting period and they paid for the surgery 100% except for a can of CocaCola.

BTW ACL knee reconstruction equal to roughly 3 years worth of premiums 3rd year into the policy.

Edited December 7, 2009 by jazzbo

[bikerlou47]

I have had then for 3 years and no problems.

I had the occasion to use them one time for serious reaction to bee stings they covered my one night in the hospital 100 per cent.

I also have BUPA insurance in Thailand and am not very happy with them. I informed them at the onset on my application that I had a few different minor illnesses that I was treated for over the last few years (nothing serious), and the first time I got sick and needed some tests, they checked my medical records and due to the doctors notes & diagnosis', BUPA came back and slapped several permanent exclusions on my policy. One of them, I had written on the application that I had occasional stomach aches and was treated by a doctor and hospitalized one time overnight, but the doctor wrote the diagnosis was gastritis. I had a endoscopy done this year and there was no ulcer, no H Pylori, no cancer, etc., but because the doctor wrote very minor inflammation on the report, I now have an exclusion forever for an ulcer or gastritis.

Anybody else out there having problems with BUPA Thailand?