Bupa Insurance -- A New Catch

[Sheryl]

It is time to renew my policy and I decided to upgrade my coverage from Emerald to Diamond. I'm perfectly healthy, 54 years old, had the policy for around 6 years with only one small minor claim for a carpal tunnel; decompression 2 years ago.

After I sent the forms in, they called to say that I could upgrade but only with the exclusion that for any future carpal tunnel problems which would remain covered at the previous, lower level.

In other words once you have made a claim you cannot get increased level of coverage applicable to the same sort of problem, even if it is not a chronic condition.

For me it is no big deal -- the surgery was successful, I no longer have the problem and hopefully it won't recur, and if it does, it involves only outpatient surgery and the old level of coverage will do. But if my previous claim had been for something else, it might e a problem.

Like many people I always debated what level of coverage to get. Had I known about the limitations on upgrading once you've had a claim I would have opted for a higher level to begin with.

As to why I stay with BUPA -- it's because they guarantee lifetime coverage if you enroll before a certain age (I think 60), I don't know of other insurers who do so.

Anyhow: if you have or are getting BUPA coverage, I suggest you start with the highest level coverage you think you will ever want....as you may be limited in your ability to upgrade later.

[sometime]

It is time to renew my policy and I decided to upgrade my coverage from Emerald to Diamond. I'm perfectly healthy, 54 years old, had the policy for around 6 years with only one small minor claim for a carpal tunnel; decompression 2 years ago.

After I sent the forms in, they called to say that I could upgrade but only with the exclusion that for any future carpal tunnel problems which would remain covered at the previous, lower level.

In other words once you have made a claim you cannot get increased level of coverage applicable to the same sort of problem, even if it is not a chronic condition.

For me it is no big deal -- the surgery was successful, I no longer have the problem and hopefully it won't recur, and if it does, it involves only outpatient surgery and the old level of coverage will do. But if my previous claim had been for something else, it might e a problem.

Like many people I always debated what level of coverage to get. Had I known about the limitations on upgrading once you've had a claim I would have opted for a higher level to begin with.

As to why I stay with BUPA -- it's because they guarantee lifetime coverage if you enroll before a certain age (I think 60), I don't know of other insurers who do so.

Anyhow: if you have or are getting BUPA coverage, I suggest you start with the highest level coverage you think you will ever want....as you may be limited in your ability to upgrade later.

The only thing guaranteed in this world is that you will die. If Bupa think that you are going to be a drain on the company because of a terminal illness they can refuse to renew you’re policy, in the US & in the UK by law insurance companies have to renew your policy, but in Thailand!!! Need I say more?

If I am wrong in this statement someone will say so.

[backflip]

"in the US & in the UK by law insurance companies have to renew your policy...If I am wrong in this statement someone will say so."

You are wrong. Insurance companies in the US do not have to renew your policy.

[NedKelly]

Yeah.....insurance companies......cant live with them cant live without them......but dont they become the devil if they want to ?!!! Sort of like make up the rules as you go along.

I would suggest to anyone who is dealing in any leaglly binding matter to record (audio) your interview with employees, have written statements signed and checked by them and include your own clause saying that when asked what information has 'not' been dislcosed..........then they have to sign it and tell all or nothing. This is the only way you can have any claim on them at all because they will deny it all the way to the bank.

[sfokevin]

Curious... How much is your annual premium for Diamond coverage?.. Their website has no premium schedule

[sbk]

exclusion based on a pre-existing condition is extremely common for most insurance companies, Thai or not.

From about.com :

Insurance companies try to discourage people from waiting until they get sick in order to purchase health insurance. One way in which they do this is to impose pre-existing condition exclusion periods. This means that if you have a medical problem which exists at the time you enroll in or purchase your health insurance, the insurance company will deny all claims pertaining to this medical problem for a certain period of time.

If you have job-based coverage, the pre-existing condition exclusion period is limited to 12 months (18 months if you are a late enrollee) and only applies to conditions for which you sought treatment in the 6 months leading up to enrollment. You may be able to apply creditable coverage to offset your pre-existing condition exclusion period. For example, if you were on an individual policy before enrolling in your job-based coverage, you may be able to subtract the amount of time you were covered on your individual policy from the pre-existing condition exclusion period.

The rules governing pre-existing condition exclusion periods in individual policies vary widely from state to state. As a general rule, they are very different from the rules limiting pre-existing condition exclusion periods in job-based coverage. Check out these consumer guides which contain state-specific information about pre-existing condition exclusion periods in individual policies.

[Sheryl]

Yesd I know about exclusion of pre-existing conditions but this was a renewal of a long standing policy, not new enrollment.

Also arguably it is not a pre-existing condition as I do not have it now, it is fully resolved.

re rates, it depends on your age and sex. They'll send you an info packet on request.

[C5VETTE]

Curious... How much is your annual premium for Diamond coverage?.. Their website has no premium schedule

It depends on your age.

For example without outpatient coverage :

36-40 is 18192 Baht/year

46-50 is 23358 Baht/year

56-60 is 31286 Baht/year

etc, etc

[Dakhar]

I have a story for you...

Back in the USA a grew up at sea level. I move to a higher elavation, and now I have high blood pressure. I see numerous doctors, they run a bunch of needless diagnostic tests. One of which is a thyroid sonar scan. The scan states some possiblle small mass found, or possibly "artifact." That same day a Thyroid uptake test is done... results negative.

I move to Thaialand suddenly the High PB is gone... doc here in Thailand says the answer is simple, you are now at sea level!!!! Dang that is awesome.... meanwhile I have a medical history of High BP, and of a thyroid condition both of which do not exsist.

ING insurance in Thailand sticks a high risk label on me and charges me double what I should be insured. They also told me that I had to have a Thyroid byopsy done before they would agree to insure me. I did so... (painful) and it was also negative.

So now ING says... "OK we will insure you, but we will not cover any thyroid conditions in the future....."

What a scam.

[sbk]

I agree, insurance is a scam and they will find any excuse not to pay for something. They will cite reason after reason until you finally give up.

Sheryl, although they are citing pre existing condition you should dig up your policy and see if you can appeal this. Sometimes it works.

OK, usually not, but at least you will have tried

[Ijustwannateach]

Economic pressure can also help. A coworker of mine (also under BUPA) got covered over the limit stipulated by his policy because our boss called and asked for a special exception for him, and we have a lot of policies with them. So even though it shouldn't matter, if you're part of a group policy you can sometimes expect better service because as a group you're paying more money.

"Steven"

[Sheryl]

It is no big problem for me in this instance, as I mentioned the excluded condition is both resolved and minor, and should it recur can easily be dealt with under the lower level of coverage. If however it had been heart disease or cancer, this would be a big problem. My point in posting was to let people know that when selecting a level of coverage you cannot assume the ability to increrase it at a later date, something I was unaware of and which would obviously factor into the choice. If I had known I would have opted for the maximum level of hospital coverage to begin with.

[Tywais]

If I had known I would have opted for the maximum level of hospital coverage to begin with.

You have a good point and am glad you brought it up. I currently have both University (government) and BUPA (belts (braces) and suspenders approach) and will re-evaluate my Bupa coverage before I hit a cutoff age for changing. It's because it's not clear to me if my Uni coverage can be continued if I retire, so keeping Bupa around in case.