Health Insurance with OPD Cover in Thailand

[Sheryl]

US drug prices are unnaturally inflated. Even the exact same drug, same manufacturer/brand name, costs a great deal less across the border in Canada. And most drugs ahve a generic equivelent produced somewhere in Asia.

[al007]

A word of caution, insurance companies in the UK are regulated on UK business by the financial services ombudsman, that looks after consumer interests, I have a feeling they do not regulate subsidiaries outside the uk

 

If your policy is written in the uk, from a UK office and paid for in the Uk  in sterling I think you are covered

 

However if it were written by an asian subsidiary of a UK company it would probably fall outside the UK ombudsman's jurisdiction, easy to clarify ask your agent to confirm in writing it is covered, also watch the arbitration clause in the event of dispute, it might come into the voluntary part of the scheme

 

The UK financial ombudsman jurisdiction, does not extend to the Isle of Man, or the Channel Islands or Gibraltar, and again UK govt guarentees on bank accounts is also only mainland UK not the islands

 

My mother died at 92 and had paid premiums to Private Patients Plan  ( Equivalent in size to BUPA) for 50 plus years and in the last three years there was a major fight as they kept hiking premiums extortionately,  ( like 30 to 40%) because after a lifetime of payments and few claims she spent a lot of time in hospital, and the insurance company were not happy

 

I am not being doom and gloom just saying be careful, insurance companies are not generally nice people, and are happier not paying 

 

A couple of links, maybe worth perusing, and if in doubt call them and ask are you covered by them in the event of dispute

 

I also believe BUPA Thailand is being sold, again be careful

 

http://www.financial-ombudsman.org.uk/default.htm

 

http://www.financial-ombudsman.org.uk/faq/businesses/vj.html

 

[al007]

I have over the last couple of months been looking at health insurance cover for my wife

 

So far in Thailand I have yet to find one that falls under the UK financial services ombudesman

 

If anyone can give me an insurance company that is regulated accordingly I would be appreciative

 

I even asked the FSA if they were aware of a Thai insurer who would be under their jurisdiction, and they said none so far as they were aware

 

http://www.financial-ombudsman.org.uk/faq/answers/complaints_a11.html

 

complaining to the ombudsman

complaints from people based outside the UK

I'm a UK citizen currently living in Europe. Would I still be covered by the Financial Ombudsman Service if I had a complaint – or would I need to go to a European equivalent?

Whether you could bring the complaint to us would depend on where the business that provided the financial service was based – not on your particular nationality or on where you were living at the time.

Broadly, we cover businesses that provide retail financial products and services in or from the UK. For complaints against businesses based outside the UK, you may be able to get help from an equivalent complaints-handling body.

Look on the website of the European consumer financial complaints network ("FIN-NET") to see if there is an ombudsman scheme (or some other complaints-handling body) dealing with complaints against banking, insurance and/or investment businesses based in the relevant European country.

 

 

 

 

 

 

 

 

 

 

[al007]

Cigna UK have just advised me If i buy direct from them in the UK I would have FSA protection

 

Addendum How my wife would complain to FSA in UK in the event of a problem with me dead is another story, speaks english but can not read or write it, and can not do email !!!

Edited September 14, 2017 by al007

[tonray]

3 hours ago, al007 said:

Cigna UK have just advised me If i buy direct from them in the UK I would have FSA protection

 

Addendum How my wife would complain to FSA in UK in the event of a problem with me dead is another story, speaks english but can not read or write it, and can not do email !!!

How is her Arabic ?

[Sheryl]

An unrelated post has been moved to its own topic

[Thanyaburi Mac]

Several good comments on the issue of medical insurance in this long thread under Thai News, here's just page 39:

 

https://www.thaivisa.com/forum/topic/986427-report-all-foreign-tourists-will-soon-need-insurance-in-order-to-enter-thailand/?page=39

 

Mac

[al007]

I want to elaborate a little more re UK regulation of insurance, financial services banking etc, after the Financial Services Ombudesman contacted me today and we had a long telephone conversation, they were very helpful, and user friendly, and I also became better informed

 

A lot of comments have been made on this thread re this matter, some may be correct some maybe not

 

There are two applicable regulatory bodies

 

The major one is the Financial Conduct Authority (FCA)in London, tel no  44207 066 1000, who regulate the companies

If in doubt whether or not you are covered by Uk regulations contact them and give them the full legal name of the insurer and their place of business, and they will advise if they regulate this specific body, they regulate and can impose fines for breach of rules, they also regulate who can be sold products, for instance a non resident UK person can not use a UK stockbroker, I also can not use a Gibraltar pensions adviser if I am an American resident, despite being a UK citizen

 

It is all exceedingly complicated, and difficult to interpret

 

The second is the Financial Ombudsman Service,  tel +44 20 7964 0500. and they only deal with complaints and have no power to regulate  or fine the companies

 

It very much appears if your policy is not directly written and sold from the UK you will not be covered by UK regulations and safeguards, even although a fully owned subsidiary, incorporated in say Thailand

 

However if you check with the FCA and your company, who wrote the policy is under their jurisdiction you are safe, and this is easy to do, by telephone or email

 

I believe there are a large number of people who simply do not know the answer, you can not trust a Thai broker to give a correct answer

 

At least you will know

[Sheryl]

Policies written/issued in Thailand will be under the Office of the Insurance Commission (OIC).  However, the Thai regulatory framework is much looser than that of the UK as regards health insurance -- insurers are, for example, allowed to raise rates on an individual basis if that person's health condition has deteroriated, provided of course that the policy language allows this, (which the Thai-based policies I have read -- BUPA and MSH -- do).  Any issue with a Thai insurer which appears to contravene policy terms can, however, be appealed to the OIC. http://www.oic.or.th/en

 

Policies issued out of France will come under French Insurance Law and have recourse to the French insurance ombudsman  ( "La Médiation del'Assurance"). I expect there would be a similar provision for policies issued out of other western European countries as well as New Zealand/Oz.

[al007]

28 minutes ago, Sheryl said:

Policies written/issued in Thailand will be under the Office of the Insurance Commission (OIC).  However, the Thai regulatory framework is much looser than that of the UK as regards health insurance -- insurers are, for example, allowed to raise rates on an individual basis if that person's health condition has deteroriated, provided of course that the policy language allows this, (which the Thai-based policies I have read -- BUPA and MSH -- do).  Any issue with a Thai insurer which appears to contravene policy terms can, however, be appealed to the OIC. http://www.oic.or.th/en

 

Policies issued out of France will come under French Insurance Law and have recourse to the French insurance ombudsman  ( "La Médiation del'Assurance"). I expect there would be a similar provision for policies issued out of other western European countries as well as New Zealand/Oz.

All seems to be pointing the same way if possible buy from uk  and have Uk cover and protection 

[al007]

 

It would appear the risks of being self insured as I am; are increasing, and as we get older we need to be very cognisant of these factors, and if you are lucky enough to come from a country like the UK where the government will look after you regardless as you get older maybe retreat and go home before it gets too late, if you are returning permanently the system will pick you up regardless

I choose to stay here but could if push came to shove cover maybe 5.0M bhatt  plus of bills and maybe a bit more: otherwise be very careful, dying with no money is even more painful than dying with some, I personally have maybe some terminal illnesses but am still alive and kicking and not dead yet, I expect to have another night of pain

 

      I am very grateful for what I have I am approaching 73 and but for the most caring loving wife should be back home in the UK

 

 

 

      We went out and had a very beautiful quiet dinner tonight

 

 

 

       I choose to stay and accept the consequences but it is at least knowing the downside

http://www.internationalinvestment.net/products/pensions/fca-calls-action-ageing-population/

FCA calls for action over ‘ageing population’

By: Eugene Costello | 21 Sep 2017 

 

 

The Financial Conduct Authority today called for government action to protect the interests of older consumers who are becoming a bigger group, with an ageing population thanks to extended life expectancy and medical advances.

In a paper published today titled ‘Ageing Population and Financial Services’, the FCA said that it had outlined a number of areas of concern that had implications for the financial services industry.

It pointed to the cost of long-term care for older members of society, with long-term care costs averaging £28,000 a year, though this figure reaches £38,700 if nursing care is needed.

‘Hardship and poor outcomes for the elderly’

It pointed out that these costs are likely to rise, and that many will experience hardship and “poor outcomes” if they have not made financial provision for such costs associated with increased ageing.

The FCA said: “In light of this uncertain landscape, and lack of consumer demand, we recognise that there is limited appetite for the financial markets to intervene to create products and services to support the funding of long term care.

“Given the wide ramifications of policy in this area, we believe these are properly issues for government and parliament to address rather than the FCA.

“What the FCA can do is continue to look at the financial services parts of this market and whether consumer harm is arising.

“Where we see detriment, we will flag this to government and parliament where appropriate.”

The “limited appetite” to serve this market was, it said, partly due to a feeling among financial services providers that policy in this area is likely to change, creating uncertain market conditions in which to trade.

‘Additional problems with mortgages for older borrowers’

There were additional problems with mortgages for older borrowers, said the FCA, with lending criteria being “opaque” and a lack of consistency as to upper-age limits for borrowers.

“Firms may be unnecessarily limiting themselves, and older borrowers, by having rigid policies or systems and controls that are unable to consider individual circumstances, potentially resulting in unintended exclusion of credit-worthy consumers in the target market,” the report said.

The report follows yesterday’s announcement, as reported, by the Work and Pensions Committee that it is to carry out a far-reaching examination of the pensions industry amid fears that the public is receiving poor financial advice or even falling prey to ‘scams’ and fraudsters when it comes to their savings and retirement incomes.

 

 

Edited September 21, 2017 by al007

[oMega69]

On 2017-03-09 at 2:15 PM, Sheryl said:

I have yet to see a policy for thsi part of the world (or international expat policy) where OPD cover was worth it, given what OPD costs are in Thailand.

 

Vastly increases the premium, by far more than you would ever be likely to spend out of pocket.

 

Stick to IPD is my advice. These usually cover day surgeries and many aso cover rpocedures like CT, MRI etc.

 

MSH or Cigna Global would be my recommendations,. If you are planning to grow old here, be aware that MSH and all other Thai-issued policies reserve the right to adjust premiums based on your "risk profile" (state of health, prior claims) which means that even though they guarantee lifetime cover, they can price you out if they want to. This won;t be an issue if you have claims that are clearly one-off sort of things but should you develop a long-term chronic condition, it could be.

 

Cigna costs more but will not do that - they can't, as they are governed by UK insurance regs.

 

"What’s more, no matter what your age, you’ll be able to renew your policy at the same rate as others in your age group, regardless of how many claims you’ve made in the previous year."  

https://www.lumahealth.com/products/asia-care-plus/

[Sheryl]

Yes, that is exactly the language one wants. I am however unable to find it in the actual policy documents.

 

LUMA apparently is new name for MSH.

 

I had considered insuring with them and did not precisely because I could not get, from their office, any assurrance on this point. In fact had great difficulty getting them to respond to any questions.

 

Which is not to say it is not a good policy. It appears to be the best of the locally issued ones and if indeed they guarnatee not to adjust premiums based on prior claims then as good as internatlly issued policies.

[oMega69]

21 hours ago, Sheryl said:

Yes, that is exactly the language one wants. I am however unable to find it in the actual policy documents.

 

LUMA apparently is new name for MSH.

 

I had considered insuring with them and did not precisely because I could not get, from their office, any assurrance on this point. In fact had great difficulty getting them to respond to any questions.

 

Which is not to say it is not a good policy. It appears to be the best of the locally issued ones and if indeed they guarnatee not to adjust premiums based on prior claims then as good as internatlly issued policies.

I have contact with them... what do u want to know ?