Lmg

[Andy71]

My father took out a health policy with LMG a couple of years ago.

This Feb he was diagnosed with cancer. We submitted a claim, which LMG paid without trouble, he was treated and discharged.

About a month later our broker informed us that his policy was up for renewal the following month. We asked the broker to make enquiries as to whether his current condition and any future 'related' conditions would be covered under the new policy.

Our broker checked and informed us that LMG would cover both, but the premium would go up, the total amount of cover would go down, and we would be liable for 25% of any future claims.

Fair enough.

We asked our broker to check again, which she did and verified the above.

So we signed and paid.

A few weeks later my father had a pulmonary embolism, and was admitted to intensive care at a cost of around 50,000 thb per day. So of course we put in another claim.

LMG refused to pay on the grounds that his embolism was related to his cancer or chemo, even though there is no mention of an exclusion in the contract.

I repeatedly asked for this reason in writing, and I was told time and time again that it had been sent already and they would send another copy etc etc. Still no formal letter from LMG. So I threatened tham with legal action if they did not provide it.

Imagine my surprise when the very next day I got a (recorded delivery) letter from LMG stating that as we HAD NOT PAID OUR PREMIUM!!

within the 30 days grace period, our policy had been cancelled!! Our broker told us that they had been trying to pay LMG but they refused to take payment.

Has anyone experienced anything like this before? Any suggestions? we are talking about a final bill of 1.25 million baht.

I have a Thai lawyer who is very good, however I would feel more comfortable discussing the more technical aspects of this case with someone who is fluent in English........any thoughts?

[Gary A]

I'd take it up with the agent. You should have at least been notified by the agent that there was a problem

[JoePai]

Who is this Broker so we can all stay well clear !

[Andy71]

I'd take it up with the agent. You should have at least been notified by the agent that there was a problem

The agent will not comunicate with me on this matter because there is some doubt as to who I am going to sue over this, the broker, LMG or both of them together.

They previously told me that they have a taped phone conversation with the manager of LMG head office in Bangkok, and an email which proves that LMG were stalling until the grace period for payment had expired. They have refused to show me any of this of course.

Anyway, I think I'll just get them both in the courtroom, then we'll see what really happened.

[Andy71]

Who is this Broker so we can all stay well clear !

It would be unfair of me to say at this point as I still don't know what happened, tempting though it is!

[Andy71]

Does anyone know of a solicitor who specialises in this sort of thing?

[vagabond48]

I got the LMG policy this past year and I am going on 61 so I was wondering how old your Dad is?

Edited October 31, 2009 by vagabond48

[Andy71]

I got the LMG policy this past year and I am going on 61 so I was wondering how old your Dad is?

He was 69 yrs old. He took out the policy with LMG because many insurers wouldn't consider people over 65.

Be very careful with these guys, they have lied to me more than once.

[funlovinkid]

I got the LMG policy this past year and I am going on 61 so I was wondering how old your Dad is?

He was 69 yrs old. He took out the policy with LMG because many insurers wouldn't consider people over 65.

Be very careful with these guys, they have lied to me more than once.

Sorry to hear about your father, and your experience. Just to let you know (in case you haven't been checking), I sent you a couple of private messages (PM) recently, related to this.

[ehs818]

I'm pretty sure you are entitled to go to arbitration on this, at least according to how I read my similar policy. I'm not sure how to file for arbitration, but I recently went thru something similar although different. I had pneumonia and was hospitalized for that. But at the same time I also had something wrong with my epiglottis, a piece of cartilage that food from going into your lungs. I was hospitalized for 2 weeks, although my choking and inability to breath from the condition did stop after about 9 or 10 days. As I was not diagnosed with this condition, simply tested and treated while in the hospital, LMG declined to pay for more than 6 days. The fault is both with the hospital billing department and with LMG. The billing department informed LMG I was checked in, per their contract obligation. They did this via FAX. LMG replied back via email. That was the last time they communicated until LMG was sent my bill on release day. But also the doctors testing and treating me did not write anything in my file about the epiglottis problem as the IV antibiotics used for pneumonia also killed of the bacteria causing the epiglottitis. Crappy! So now I'm in the process of working thru the hospital COO to find out WHY the doctors did not put anything in the file while I was under their care in the hospital. I need them to explain or justify it for me and for LMG. Either way, I never asked, nor was informed that I was in the hospital without insurance coverage, if that is what happened. If anyone has experience going to arbitration here, I'd love to hear about that.

ERIC

[reason for edit - email removed as per forum rules]

[Gary A]

I have had LMG health insurance for a number of years. Every year the premiums have gone up. The past three years they have increased my premiums substantially. Last year they notified me that I would have to pay the first 20 percent even though I have had no claims. I told them to cancel the 23,000 baht policy. They agreed to drop the 20 percent so I paid the premium. This year the premium has gone up to 28,000 baht because I'm getting older even though I have had the policy for more than 6 years. From 23,000 to 28,000 in one year is TOO much. This time I have canceled. In 5 weeks, I qualify for US Medicare. Now the question is whether to pay for the part B Medicare. I have to return to the US to be able to use it.

[Firefan]

Gary; I presume the 20% they requested extra last year was due to you using the "non cover of expensive areas like USA, EU Etc." discount. I noticed they have removed that discount option now. Cheers!

[Gary A]

That 20 percent meant that I would have to pay the first 20 percent of any claim. Previous to that, they would pay 100 percent. They also raised the premium for last year 3,000 baht. Raising it 3,000 baht last year and wanting to raise it another 5,000 baht this year is just too much. Their greed has cost them this customer.

[vagabond48]

I have had LMG health insurance for a number of years. Every year the premiums have gone up. The past three years they have increased my premiums substantially. Last year they notified me that I would have to pay the first 20 percent even though I have had no claims. I told them to cancel the 23,000 baht policy. They agreed to drop the 20 percent so I paid the premium. This year the premium has gone up to 28,000 baht because I'm getting older even though I have had the policy for more than 6 years. From 23,000 to 28,000 in one year is TOO much. This time I have canceled. In 5 weeks, I qualify for US Medicare. Now the question is whether to pay for the part B Medicare. I have to return to the US to be able to use it.

According to 2 different agents I spoke with before getting my policy last year, LMG has not had an increase for 6 years until this year. I was told that the individual premium can be increased up to a maximum of 20% when a sizable claim is made. The premiums also go up when you go into the next 5 year age group.

This year my renewed policy when up as expected because (1) I went into the next age group and (2) they had an official increase of 5.83%.

[Gary A]

Well, I beg to differ. I think they are bull shitting you. I had no claim and an increase from 23,000 baht to 28,000 baht this year. Last year an increase from 20,000 to 23,000 plus telling me that I would have to pay the first 20 percent of any claim which they finally decided wasn't necessary.

[vagabond48]

Well, I beg to differ. I think they are bull shitting you. I had no claim and an increase from 23,000 baht to 28,000 baht this year. Last year an increase from 20,000 to 23,000 plus telling me that I would have to pay the first 20 percent of any claim which they finally decided wasn't necessary.

Perhaps we have different policies. I have the mega maxi insurance policy. I repeat, the increase that I received was expected and was no surprise. The mega policy doesn't have percentage deductibles but provides premium discount options for 40k ,100k and 200k baht deductible.

[thaiericsweden]

As a professional selling health insurance in Thailand for over 10 years, I have info that will help.

If you have a dispute with an insurance company, you have to go to the Office of Insurance Commission.

The OOIC will assist customers to settle claims if you have been treated unfairly.

If you can show proof of premium payment within the 30 day grace period, the policy should be renewed without dispute.

I hope you can show a bank transfer slip, anything else and the insurance company can wriggle out of this situation.

FYI: LMG does not cap their premium increases at 20% after large claims.

Why isn't the broker revealed?

Seeing this same question repeated several times leads me to believe the broker is hiding.

It also leads me to believe the broker has been in contact with each person to keep them quiet.

Brokers like this, do customers and other brokers a disservice.

If the broker is reading this, contact me, I have more information that you should know about this insurance.