BUPA Thailand - Warning

[pomozki]

I am having a nightmare with these people. They distort the truth and then change their stance without any apology. Please allow me to summarise. I’d love some advice.

I joined Bupa 2 years ago, shortly after having an episode of Transverse Myelitis. A lesion (inflamed spot) was detected by an MRI on the spine.
At that stage there are 2 possibilities – tumour or TM lesion. Doctors treated it with anti-lesion drug (prednisolone) but warned me that if the drug hadn’t worked, they’d have recommended a biopsy to see if it was a tumour. Luckily, the drug worked, it disappeared. If it never returns it is called CIS (Clinically Isolated Syndrome). Doctors also did MRI of the brain and it was clear. Phew.

If it happens again the diagnosis is Multiple Sclerosis. The longer you last without a repeat, the better your chance of it not recurring. So far it’s nearly 3 years.

Obviously when I joined Bupa I declared this and they rightly attached an exclusion for spinal disorders of this type, including multiple sclerosis.

Last year I had an entirely different illness, excruciating pain in the head and shoulders, followed my numbness in the shoulders. I went to hospital and intravenous painkillers eventually made the pain go away. This time I had a CT of the brain – again, it was clear. Bupa at first refused to cover it, claiming it was linked to the previous incident but after fighting with them for 4 months or so they eventually coughed up (about 65,000 baht) for my 6-day stay in hospital.. Yes, it took a long time.

I didn’t feel good for them, having to pay me 2 years’ premiums so soon after I joined but hey, I told the truth, and they made me fight like hell for it.

I was just about to renew my policy when I noticed they had added another exclusion … for strokes. I queried it. They said the original brain MRI for the lesion was not clear (as the doctors had told me) – and in fact had indicated the possibility of a prior stroke, a possible prior brain tumour, plus a high risk of a stroke in the future.

I protested. I’ said I'd had THREE neurologists examine the brain MRI and all said the brain was fine. I’d also had a 2016 brain CT for the unconnected illness – again, it showed the brain was fine.

 

I had the hospital send them all my test records again to give them a chance to review their opinion. They stuck to their guns.
I kept protesting. Suddenly, and without any apology, they have finally admitted there was no evidence after all of a problem in the brain but still insisted on the exclusion. I asked why. The lady declared they had changed their opinion from a tumour in the brain to a tumour in the spine “and after all, you have always admitted you had a tumour in the spine”.
What!!! I flipped. I told her I had never ever ever admitted I’d had a tumour. It was quite the opposite. The docs had told me that since the prednisolone worked, it had been Transverse Myelitis as the original neuro suspected. I was never treated for a tumour and nobody has ever told me I had one.

If I were younger I’d switch insurance companies. Trouble is, I’m 61 – not only is it harder to get covered but when a friend suggested I try Pacific Cross and declared the TM incident they refused to cover me, even with an exclusion for multiple sclerosis, saying I was at risk of further illness. I wasn’t happy but I appreciated their honesty.

I just resent Bupa Thailand’s medical advisers being able to come up with nonsense. The fact they’ve suddenly changed their mind and still got it wrong tells me they are playing fast and loose with the truth – they are either incompetent or deliberately distorting this to wash their hands of me. They must feel untouchable. Accepting an exclusion based on "a tumour of the spine" would make it very hard to claim for anything serious in future. Should I just accept that? Can they be allowed to distort the truth without being accountable? I know this is Thailand but really! Frankly, I've almost given up hope of being to trust them again but I still want them to be held accountable.

So sorry for this long rant. I felt I needed to explain it all. If you’ve read this far thanks very much – if you have a (helpful) opinion I’d be really grateful. Cheers.

[Sheryl]

I am not at all sure BUPA uses true medical experts at all. They seem to use people with little medical knowledge who work off charts of symptoms and possible associated conditions. I have known them to come up with some pretty far fetched things as a result.

I suggest you switch to Cigna Global. They are far more sophisticated in their medical understanding and as a result much more reasonable in how they handle preexisting conditions. If you accept a deductible and/or copay the premium will be about the same for a much higher level of cover.

[pomozki]

thanks so much for your reply Sheryl. Quite an eye opener.
I thought I was going mad for a while - surely, a reputable company like Bupa (even the Thai version) couldn't keep getting such basic things wrong. Then  I realised they really didn't know what they were talking about when they suddenly changed their verdict from pre-existing brain tumour to spinal tumour, neither of which I've ever had. The neurologist didn't seem bothered by their errors - he just congratulated me on feeling well and having not had a recurrence of my original episode.
BUT - I'm still furious. For a start I'm nearly 62 and fear future insurance companies may either refuse to take me (as Pacific Cross did) or offer me a terrible policy. In short I want to know if Bupa/insurance companies are at all answerable. I want Bupa held to account for worrying the hell out of me and brazenly accusing me of having terrible pre-existing conditions. In short they're either totally incompetent or trying to find an excuse not to keep me on. One reason I opted for them in the first place was cos if I ever leave Thailand they pass on my track record to Bupa international., Very good incentive.
Didn't you once mention a group that monitors insurance companies here in Thailand? I want them to learn their behaviour has not only eben shocking but unacceptable.

[richard_smith237]

I too had an issue with BUPA (International) when I first added my Wife.

When applying and when asked if my Wife had had a stay in hospital in the past 5 years I'd included that she'd had hospital stay as a result of a UTI (Urinary tract infection - not uncommon).

 

Upon receiving the Policy I noticed that BUPA had excluded a number of 'Abdominal issues'... I argued with BUPA that having once had a broken leg does not increase the risk of another broken leg, or a dislocated knee etc... and with a non symptomatic UTI there exists no chance of a related recurrence.  

 

BUPA finally agreed to remove the UTI and 'abdominal issues' (the specifics of which I fail to remember) from the Policy after a series irritating communication - Sheryl's explanation above would make sense in that I felt I was dealing with someone without any medical knowledge only referencing a 'risk matrix'....  

 

My whole family are now with a different insurer after BUPA's premiums increased at a rate I considering unreasonable when compared with their competition. 

[pomozki]

Thanks Richard - actually my nightmare has been with Bupa Thailand - I'd expect this sort of amateurish sloppiness from them. I'm quite surprised your similar experience was with Bupa International. I thought they were among the best going.
out of interest who are you with now? I might see if they (or Cigna as Sheryl suggested) can offer me something decent. I suspect I might have less chance than you cos to this day Bupa have insisted on keeping in exclusions which are totally unwarranted and I'll have to explain that to the new people. I therefore let the policy lapse and am now uninsured. very unhappy with Bupa over that. At least you could truthfully say you were only changing companies to look for a better deal.

 

even if I can't get a better policy, it's quite uplifting to see that other people have had similar experiences and that even insurance companies don't know what they're talking about sometimes.

when you're told you may well have had a stroke and/or brain tumour and are at a high risk of another stroke it's only natural to become anxious, even if you don't believe it's true

[richard_smith237]

2 minutes ago, pomozki said:

Thanks Richard - actually my nightmare has been with Bupa Thailand - I'd expect this sort of amateurish sloppiness from them. I'm quite surprised your similar experience was with Bupa International. I thought they were among the best going.
out of interest who are you with now? I might see if they (or Cigna as Sheryl suggested) can offer me something decent. I suspect I might have less chance than you cos to this day Bupa have insisted on keeping in exclusions which are totally unwarranted and I'll have to explain that to the new people. I therefore let the policy lapse and am now uninsured. very unhappy with Bupa over that. At least you could truthfully say you were only changing companies to look for a better deal.

 

even if I can't get a better policy, it's quite uplifting to see that other people have had similar experiences and that even insurance companies don't know what they're talking about sometimes.

when you're told you may well have had a stroke and/or brain tumour and are at a high risk of another stroke it's only natural to become anxious, even if you don't believe it's true

 

My Wife, Son and I are now with MSH Asia Care (Worldwide Except US cover).

 

There are some minor limitations such as Max room charge 5440 Baht (after which we pay), the policy otherwise matches BUPA international, has a 32,000,000 baht per year ceiling (vs 5,000,000 baht with BUPA Thailand - Platinum cover).

 

Only my Wife has made a claim for a 3 night stay last year (Gastroenteritis) - she said there were no issues with direct settlement at all. 

[HampiK]

Hello,

 

I am very interested to hear more about health insurance as well.

I am right now checking different insurance companies (April, cigna, FWD, MSH, Pacific cross, ....)

 

The problem is... if people don't have problems with the insurance company they probably never will write anything about it...only if a problem exists.

So if you hear some bad things, but the insurance has about 20 million members this mean maybe it's still a good company... on the other side a small one with maybe only 50'000 members who also have some bad experiences mean maybe much worse, because of the percentages....

[churchill]

My experience with BUPA Thailand .. briefly 

 

I joined just under a year ago ..

 

Recently noticed my heart rate was 135 and not adjusting .. after 3 days went to Bangkok Hospital Samui and they admitted me to ICU straight away for medication to reduce the rate and monitor .. After 1 night discharged . I claimed on my BUPA but was not too hopeful as I have an exclusion for hypertension .. sure enough they rejected .

 

However I then thought about the possible cause and decided that it was over exercise .. I joined a Crossfit class just over a year ago and had noticed the week prior to this episode loss of stamina and shortness of breath during exercise ... so I asked BUPA to reconsider .. although the Dr report from Samui Hospital stated underlying hypertension they did not say this was the cause . BUPA initially rejected my appeal but being quite persistent someone at BUPA Thailand decided to send my claim to BUPA UK head office who agreed with me and so my claim was authorised .

 

Since that time I had atrial fibrillation and after some time the Dr recommended a catheter ablation operation which I had done at Piyavate Hospital Bangkok . Knowing BUPA I asked the hospital to get preauthorisation .... When I arrived at the hospital for the operation I heard that BUPA had rejected my preauthorisation claim ...which once they had accepted the initial claim for fast heart beat  seemed to me ridiculous that they would then reject the claim to sort out that problem .

 

So again a flurry of emails and they eventually agreed and paid in full on checkout after 1 night ( 160,000 baht ) .

 

It seems BUPA have a policy of initially rejecting any claim with any possible link to any exclusions in their policy ... I expect Hypertension could be linked to many problems but not necessarily be the cause .....

 

So I think be prepared to appeal and push .

[Pilotman]

On 28/07/2017 at 0:48 AM, Sheryl said:

I am not at all sure BUPA uses true medical experts at all. They seem to use people with little medical knowledge who work off charts of symptoms and possible associated conditions. I have known them to come up with some pretty far fetched things as a result.

I suggest you switch to Cigna Global. They are far more sophisticated in their medical understanding and as a result much more reasonable in how they handle preexisting conditions. If you accept a deductible and/or copay the premium will be about the same for a much higher level of cover.

Sorry to butt in and i'm not a medical expert, but this is not a medical issue, its an actuarial issue, which unfortunately, you won't win with medical logic.  BUPA, like all insurance based services, runs on probabilities and actuarial algorithms.  They have deemed you a bad financial risk  and I very much doubt they will change their minds on that. Change suppliers and you may get a different algorithm applied, but I some how doubt it. A very good friend of mine in g the UK cannot get travel insurance at any price due to two heart attacks.  Despite being now fully fit after a triple heart bypass, they won't take the insurance risk. Same issue, not medical, but actuarial. 

[impulse]

I wish we'd get more discussions like this when the true nature of an insurance company and their behavior in the wake of a claim becomes evident.  So often, all we hear is the ease of signing up, the premiums, and (maybe) the black and white exclusions.  

 

Ya never really know until you file a claim.  A whopper.

 

[geriatrickid]

How about stepping back and approaching this from a disinterested neutral position?

What is an insurance policy? 

In plain language it is a  risk transfer product. You are saying to another party, please let me transfer my risk to you. The other party, says ok, we'll take the risk transfer, but here are our conditions for the transaction, and here is the cost.

 

Why would the person  wishing to transfer the risk, expect to be able to dictate the terms and cost of the transaction?  If the risk is that good, then  keep the risk. Obviously if the person wishes to purchase the risk transfer instrument, the risk is evident. No one is forcing a consumer to purchase the BUPA product. There are other financial institutions.

 

And now, to the medical  condition at hand. All health policies have a pre-existing exclusion. Sometimes it's absolute and sometimes there is a stability  condition. For example, heart conditions are typically subject to a minimum 6 month to 2 year stability condition from the time of the last drug change. For example, a change in the Ace inhibitor or Beta blocker medication activates the pre-existing condition exclusion clause in many policies, especially travel health insurance.  Sadly, there are many who are unaware of this and find out when they have a health crisis.   In the OP's case, he has had two events in just under 3 years. This is a red flag for any health insurer. The fact that one wishes to add a very specific exclusion and declare it does not make it any worse than the health insurer who won't have the specific exclusion, but will instead rely upon an omnibus stability condition exclusion.

 

The OP has had two serious events. This is sufficient to cause the underwriting assessment to add a condition or to exclude outright  the  application for coverage. The fact that the   OP is able to obtain any coverage from BUPA speaks to the goodwill of the carrier as they could have just as easily said to go pound sand.

 

And one last point. Actuarial tables showing cost of illness and death are the same for all  health insurers. They are computed from the same population data base.  This means that the insurers will  charge fairly similar premiums for the same risk. Where the premium variance comes in is on the costs of underwriting including the commission paid to the agent and the investment  income generated from premium. This is why it is prudent to compare. However, an insured isn't in the position of dictating terms and pricing to the entity accepting the risk transfer.

 

 

[lopburi3]

4 minutes ago, geriatrickid said:

All health policies have a pre-existing exclusion.

Not currently true in USA under ACA or some older group policies.  Unfortunately that does not help most Thailand residents.

[Morch]

I think what people are upset with is the marketing angle vs. delivering in time of need. Easier to accept an outright rejection to insure then dealing with such refusal to cover when the person is the midst of a medical event. Not the best circumstances to deal with financial matters. Now, of course - customers need to shop around, that goes without saying. But when you buy something that's supposed to provide ease of mind and get a bag of hassle instead, reactions are understandable.

[tomwct]

I would go to BUPA International and have them sort out your problems here especially if you plan to continue your coverage with them.

[Mover1]

On 28/07/2017 at 0:48 AM, Sheryl said:

I am not at all sure BUPA uses true medical experts at all. They seem to use people with little medical knowledge who work off charts of symptoms and possible associated conditions. I have known them to come up with some pretty far fetched things as a result.

I suggest you switch to Cigna Global. They are far more sophisticated in their medical understanding and as a result much more reasonable in how they handle preexisting conditions. If you accept a deductible and/or copay the premium will be about the same for a much higher level of cover.

Wow i just tried Cigna for a quote and their cheapest was 70,000 baht. Is that the normal price for a 44 year old uk expat in thailand? Seems excessive

[Sheryl]

13 hours ago, lopburi3 said:

Not currently true in USA under ACA or some older group policies.  Unfortunately that does not help most Thailand residents.

Also policies differ greatly in how they handle pre-existing conditions and it is not always a flat exclusion. Cigna Global, for example, will not impost exclusions for certain pre-existing conditions (e.g. hypertension) if they are stable and well controlled at the time of enrollment., Other policies may exclude only for a specified period of time and then cover the condition if there were no exacerbations during that period.

 

And, when they do exclude, companies vary greatly in how broad the exclusion is. Some will be narrowly limited to the actual condition whereas others (e.g. BUPA Thailand) will throw in everything but the kitchen sink.

 

Etc etc.

[Sheryl]

On 8/3/2017 at 11:06 PM, pomozki said:

Didn't you once mention a group that monitors insurance companies here in Thailand? I want them to learn their behaviour has not only eben shocking but unacceptable.

That would be the Office of the Insurance Commission

http://www.oic.or.th/en

 

It is indeed possible to lodge complaints with them but as your claim was ultimately paid I doubt they will take much interest.

[Sheryl]

13 hours ago, geriatrickid said:

How about stepping back and approaching this from a disinterested neutral position?

What is an insurance policy? 

In plain language it is a  risk transfer product. You are saying to another party, please let me transfer my risk to you. The other party, says ok, we'll take the risk transfer, but here are our conditions for the transaction, and here is the cost.

 

Why would the person  wishing to transfer the risk, expect to be able to dictate the terms and cost of the transaction?  If the risk is that good, then  keep the risk. Obviously if the person wishes to purchase the risk transfer instrument, the risk is evident. No one is forcing a consumer to purchase the BUPA product. There are other financial institutions.

 

And now, to the medical  condition at hand. All health policies have a pre-existing exclusion. Sometimes it's absolute and sometimes there is a stability  condition. For example, heart conditions are typically subject to a minimum 6 month to 2 year stability condition from the time of the last drug change. For example, a change in the Ace inhibitor or Beta blocker medication activates the pre-existing condition exclusion clause in many policies, especially travel health insurance.  Sadly, there are many who are unaware of this and find out when they have a health crisis.   In the OP's case, he has had two events in just under 3 years. This is a red flag for any health insurer. The fact that one wishes to add a very specific exclusion and declare it does not make it any worse than the health insurer who won't have the specific exclusion, but will instead rely upon an omnibus stability condition exclusion.

 

The OP has had two serious events. This is sufficient to cause the underwriting assessment to add a condition or to exclude outright  the  application for coverage. The fact that the   OP is able to obtain any coverage from BUPA speaks to the goodwill of the carrier as they could have just as easily said to go pound sand.

 

And one last point. Actuarial tables showing cost of illness and death are the same for all  health insurers. They are computed from the same population data base.  This means that the insurers will  charge fairly similar premiums for the same risk. Where the premium variance comes in is on the costs of underwriting including the commission paid to the agent and the investment  income generated from premium. This is why it is prudent to compare. However, an insured isn't in the position of dictating terms and pricing to the entity accepting the risk transfer.

 

 

I have to disagree slightly. The actuarial tables are the same but in going from a specific medical history or past claim to a specific condition on an actuarial table there is a process that requires medical knowledge/understanding.  What I have seen happen with BUPA Thailand many, many times is incorrect interpretation of medical information leading to application of a condition the insured or applicant does not have and never had, because a medically untrained person is reading ff charts and misinterpreting information.

 

Example: someone who answered yes to a question of whether they had ever experienced heartburn (who hasn't?), but who never had any GI condition, was given an exclusion for hiatal hernia (which he did not have) and subsequently had a claim related to heart attack disallowed on grounds it was related to the (non-existing) hiatal hernia. Somebody looked at a chart which listed hiatal hernia as a possible cause of heartburn and then increased risk of heart attack as a possible complication of the (non-existing) h.h. Another example is the OP of this thread. And I have seen countless more. I do not see this with internationally based insurers.

 

 

[scubascuba3]

In the UK my mum has had 3 hip replacements and a heart valve replacement on Bupa. The important thing is you need to get in before preexisting conditions exclusions kick in, plus be prepared for big monthly premiums

[KittenKong]

On 28/07/2017 at 0:48 AM, Sheryl said:

I suggest you switch to Cigna Global.

 

A Google search brings up several seemingly different companies and websites with similar names.

 

Are they all the same company? Is there any significant difference between the multiple entities? Which, if any, offers the best service and value for UK expats living in Thailand?

[Sheryl]

https://www.cignaglobal.com/

[homeseeker]

I have just learnt that BUPA Thailand is taken over, so wonder what changes, if any, will arise?

 

See:

 

 

http://www.nationmultimedia.com/detail/Corporate/30321765

 

[tonray]

13 minutes ago, homeseeker said:

I have just learnt that BUPA Thailand is taken over, so wonder what changes, if any, will arise?

 

See:

 

 

http://www.nationmultimedia.com/detail/Corporate/30321765

 

Oh Christ, last thing I need is an American insurer in Thailand... They know all the tricks of how not to pay off. 

[teddog]

13 minutes ago, tonray said:

Oh Christ, last thing I need is an American insurer in Thailand... They know all the tricks of how not to pay off. 

Too true,  if youngish in good health medical insurance is relatively cheap,those ever increasing years, old age ,too many minor claims etc.threatens,then its kaput for medical insurance unless of course a sharp intake of breath every month when it comes to coughing up another large slice of income for peace of mind

  Of course things may happen,but im not insuring through the nose,not here in Thailand

[tonray]

1 minute ago, teddog said:

Too true,  if youngish in good health medical insurance is relatively cheap,those ever increasing years, old age ,too many minor claims etc.threatens,then its kaput for medical insurance unless of course a sharp intake of breath every month when it comes to coughing up another large slice of income for peace of mind

  Of course things may happen,but im not insuring through the nose,not here in Thailand

I'm old so no real choice. Have Bupa now but will likely switch to Cigna Global. Double the premium but much better coverage. Can't risk everything at my age 59

[teddog]

Just now, tonray said:

I'm old so no real choice. Have Bupa now but will likely switch to Cigna Global. Double the premium but much better coverage. Can't risk everything at my age 59

1. Well IM 71 (almost)   s'pose in rude health, all I need is emergency e visa for India, AA flight ,if bedridden AI flight,and fixed up pronto.  Govt. hospitals here are that bad,for stability then 2 hour flight,done it before in emergency..all fine and dandy

[tonray]

13 minutes ago, teddog said:

1. Well IM 71 (almost)   s'pose in rude health, all I need is emergency e visa for India, AA flight ,if bedridden AI flight,and fixed up pronto.  Govt. hospitals here are that bad,for stability then 2 hour flight,done it before in emergency..all fine and dandy

not really a sound plan but one can make their own choices in life.

[teddog]

12 minutes ago, tonray said:

not really a sound plan but one can make their own choices in life.

..and the sound plan would be letting the white coated shysters in private hospitals laying into you?.  Yes Yes Yes coerced and frightened into laying out ever more money into 'peace of mind'medical insurance here in' rip off El Centro.'  Im lucky anyhow, past employment would scoop me up and mediflight back 'ome,without that  I still would not be coerced into fees the medical issuers were after   no damned way

[churchill]

just had this from BUPA .. 

 

Have to wait and see ...

 

 

'Thank you for your mail. Bupa Thailand was acquired by Atena on 25^th Julay 2017

 

There will be no change to the current policy between you, as our customer, and Bupa Thailand as your health insurer. All corresponding terms and conditions within your contract remain the same

 

There will be no change to the service we provide to customers, we remain committed to continuing to deliver excellent standard of customer service '

[tonray]

5 minutes ago, churchill said:

just had this from BUPA .. 

 

Have to wait and see ...

 

 

'Thank you for your mail. Bupa Thailand was acquired by Atena on 25^th Julay 2017

 

There will be no change to the current policy between you, as our customer, and Bupa Thailand as your health insurer. All corresponding terms and conditions within your contract remain the same

 

There will be no change to the service we provide to customers, we remain committed to continuing to deliver excellent standard of customer service '

Now I'm not laughing at you...but....ha ha ha ha ha ha. yeah, right.