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Health insurance for expats over 65 in Thailand?


JTXR

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Correct me if I am wrong but aren’t there two Pacific Cross companies? One international and one Local in Thailand, just like Cigna has a company that is international and one that is local.

 

 

Sent from my iPad using Thaivisa Connect

 

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On 3/18/2019 at 12:40 PM, Sheryl said:

 

200K baht will nto even cover a minor surgery in a private hospital.

 

Not owrth having IMO and you can be sure any future government requirement will nto be that low.

 

You should change plans now while you are still without major pre-existing conditions.

 

For those 65 and over, plans to look at include:

 

Cigna Global (silver plan or Close Care)

April My Health International (April global not April Thailand)

Pacific Cross

HCI

BDAE

Globality Health  (Essential Plan)

There are two issues to examine imo. First, an emergency where you have no control. This may result ending up where you don't want to be with a doctor you don't know, with the end result unknown and perhaps an astronomical charge for services. 

 

The second consideration is for minor issues you may know about already and are aware you have to deal with it some time. 

 

Minor issues are far easier to deal with of course because you have full control; choice of doctor, hospital and other issues that may arise. In this situation you may be able to negotiate a lower fee than quoted (private not public). Tap into your Thai network for information you may not have. 

 

Minor surgery does not have to be expensive. I had eye surgery in a relatively new private hospital in Khon Kaen recently. The issue I classify as essential but not urgent. Surgery fee 15,000, overnight stay 1,600. Nurse support, meals and medication brought the final bill to 25,000. 

 

I have a NZ friend with surgery at a different Khon Kaen private hospital, abdominal surgery, ICU one day with five days all up. Bill did not each anywhere near 200k.

 

Point is to look at both scenarios and their requirements, an emergency life threatening situation obviously requires more attention than minor surgery. 

On 3/18/2019 at 12:40 PM, Sheryl said:

 

 

 

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On 3/19/2019 at 10:06 AM, TallGuyJohninBKK said:

No and yes, depending. . .

 

As a general rule, no they dont. Ive had small claims with them in the past and those never triggered any premium change... Others have had larger claims and same.

 

However, from what Ive been told, if you end up having very large claims relative to your total premiums paid over the life of your coverage, they can up yr premium, I believe, their policy says up to 25%.

 

But keep in mind by comparison, PC also hasnt been doing any annual inflationary increases to their premiums in recent years, whereas most of the other insurers have, and often substantial.

 

So Id bet, for other policies, those easily could have totaled 25% over the past 3-4 years. And those hit everyone, not just those with large claims...

 

 

Hi Everyone,

 

Pacific Cross Representative here:

 

I just wanted to make some distinctions and prevent any misinformation out there.

 

Firstly we can accept new applicants up to 75yrs of age and we offer renewal through to 99yrs of age.  People over 65 are required to complete a health exam which can be reimbursed if offer is made and accepted up to 7500 Baht on most of our plans.

 

It is correct that we do not have annual inflationary increases year on year, typically 8-15% with most providers.  We have not adjusted our base premiums since 2015.

 

It is also correct that we reserve the right to increase a premium 25% in the event of a high claims experience.  If the claims versus premium is moderate we would hold rates the following year, and if no claims are lodged we have no claims discounts.  However that does NOT mean we would continue to increase 25% year on year every year if someone has an ongoing condition.  It would be capped after 3 years.  The very worst case is that someone has there premium loaded 25% for 3 years to recover losses on the policy.  We individually experience rate each renewal, where as most companies pool claims and have base premiums increased for everyone. 

 

If a premium has been loaded 25%, if the following year there is no re-occurrence in claims of the accident or illness that loading would be removed at the following renewal.

 

If for example one developed a heart condition, the initial 25% loading would remain ongoing.

 

In some cases we may load a premium for high BMI or a substandard risk, again if at a later date the clients weight improves or a condition has improved we can also remove any associated loading.

 

Ultimately we fully underwrite each plan so there is transparency on the coverage terms before you have reached any decision, most companies will assess a condition at the point of claim, which is not ideal, for example one may have high blood pressure and be on medication, they may think they are covered, though a company that uses moratorium underwriting would be within their right to decline a heart attack as a pre existing condition due to the medication.

 

I'm happy to answer any questions one may have regarding our product suite or anything related to the above.

 

We have had many people not declare there full history truthfully, and when this occurs and we find out through medical records that the application was not truthful, me may endorse the policy accordingly or terminate the policy.  Its important to declare everything as that is what we base our offer on.  These same people tend to be the people that complain anonymously online or make fake reviews.

 

If a client has been honest on application, we will ALWAYS pay a valid claim.  As we are registered and compliant in Thailand policy holders also have the protection of the OIC.  The same cannot be said of policies sold from offshore.

 

Anyone is welcome to email us directly with any pertinent questions.

 

We have a product suite particularly for Thai Visa readers:

 

https://www.thaivisaprotect.com/about.html

 

[email protected] 

 

Here are some of Pacific Cross’s/Thai Visa Protects core strengths:

·         Worldwide Cover

·         Affordable premiums

·         Fully Staffed English and Thai speaking office

·         24/7 365 emergency assistance and support

·         Annual limits per disability per year rather than combined

·         Cashless Inpatient and Outpatient treatment for treatment in our hospital network of 360+ in Thailand alone.

·         Individual cover ranging from 280,000 THB right through to 50,000,000 THB

·         Full Medical Underwriting – understand your cover from the inception

·         Possibility to cover pre-existing conditions subject to Underwriting approval

·         Family Friendly Pricing

·         No Claims Discounts

·         Excess/deductible options to discount published premiums

·         Medical Evacuations

·         Applicants up to 75yrs of age with lifetime renewal

·         Locally compliant plans with discounts and tax deductible premiums for employer groups

·         Ability to mix and match cover for employer group schemes

·         Ability for members coming from employer groups schemes to retain insurance on individual terms

·         All underwriting and claims processing done ‘inhouse’ and not outsourced to 3rd party administrators

·         The Pacific Cross Group of Companies has Offices in Hong Kong, Philippines, Vietnam, Indonesia, Vietnam

 

 

 

 

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Hi Everyone,
 
Pacific Cross Representative here:
 
I just wanted to make some distinctions and prevent any misinformation out there.
 
Firstly we can accept new applicants up to 75yrs of age and we offer renewal through to 99yrs of age.  People over 65 are required to complete a health exam which can be reimbursed if offer is made and accepted up to 7500 Baht on most of our plans.
 
It is correct that we do not have annual inflationary increases year on year, typically 8-15% with most providers.  We have not adjusted our base premiums since 2015.
 
It is also correct that we reserve the right to increase a premium 25% in the event of a high claims experience.  If the claims versus premium is moderate we would hold rates the following year, and if no claims are lodged we have no claims discounts.  However that does NOT mean we would continue to increase 25% year on year every year if someone has an ongoing condition.  It would be capped after 3 years.  The very worst case is that someone has there premium loaded 25% for 3 years to recover losses on the policy.  We individually experience rate each renewal, where as most companies pool claims and have base premiums increased for everyone. 
 
If a premium has been loaded 25%, if the following year there is no re-occurrence in claims of the accident or illness that loading would be removed at the following renewal.
 
If for example one developed a heart condition, the initial 25% loading would remain ongoing.
 
In some cases we may load a premium for high BMI or a substandard risk, again if at a later date the clients weight improves or a condition has improved we can also remove any associated loading.
 
Ultimately we fully underwrite each plan so there is transparency on the coverage terms before you have reached any decision, most companies will assess a condition at the point of claim, which is not ideal, for example one may have high blood pressure and be on medication, they may think they are covered, though a company that uses moratorium underwriting would be within their right to decline a heart attack as a pre existing condition due to the medication.
 
I'm happy to answer any questions one may have regarding our product suite or anything related to the above.
 
We have had many people not declare there full history truthfully, and when this occurs and we find out through medical records that the application was not truthful, me may endorse the policy accordingly or terminate the policy.  Its important to declare everything as that is what we base our offer on.  These same people tend to be the people that complain anonymously online or make fake reviews.
 
If a client has been honest on application, we will ALWAYS pay a valid claim.  As we are registered and compliant in Thailand policy holders also have the protection of the OIC.  The same cannot be said of policies sold from offshore.
 
Anyone is welcome to email us directly with any pertinent questions.
 
We have a product suite particularly for Thai Visa readers:
 
https://www.thaivisaprotect.com/about.html
 
[email protected] 
 
Here are some of Pacific Cross’s/Thai Visa Protects core strengths:
·         Worldwide Cover
·         Affordable premiums
·         Fully Staffed English and Thai speaking office
·         24/7 365 emergency assistance and support
·         Annual limits per disability per year rather than combined
·         Cashless Inpatient and Outpatient treatment for treatment in our hospital network of 360+ in Thailand alone.
·         Individual cover ranging from 280,000 THB right through to 50,000,000 THB
·         Full Medical Underwriting – understand your cover from the inception
·         Possibility to cover pre-existing conditions subject to Underwriting approval
·         Family Friendly Pricing
·         No Claims Discounts
·         Excess/deductible options to discount published premiums
·         Medical Evacuations
·         Applicants up to 75yrs of age with lifetime renewal
·         Locally compliant plans with discounts and tax deductible premiums for employer groups
·         Ability to mix and match cover for employer group schemes
·         Ability for members coming from employer groups schemes to retain insurance on individual terms
·         All underwriting and claims processing done ‘inhouse’ and not outsourced to 3rd party administrators
·         The Pacific Cross Group of Companies has Offices in Hong Kong, Philippines, Vietnam, Indonesia, Vietnam
 
 
 
 
How far do you go back for pre-existing conditions? another company asks "have you ever had", european companies often go back 5 years only
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14 minutes ago, scubascuba3 said:
28 minutes ago, Pacific Cross Rep said:
Hi Everyone,
 
Pacific Cross Representative here:
 
I just wanted to make some distinctions and prevent any misinformation out there.
 
Firstly we can accept new applicants up to 75yrs of age and we offer renewal through to 99yrs of age.  People over 65 are required to complete a health exam which can be reimbursed if offer is made and accepted up to 7500 Baht on most of our plans.
 
It is correct that we do not have annual inflationary increases year on year, typically 8-15% with most providers.  We have not adjusted our base premiums since 2015.
 
It is also correct that we reserve the right to increase a premium 25% in the event of a high claims experience.  If the claims versus premium is moderate we would hold rates the following year, and if no claims are lodged we have no claims discounts.  However that does NOT mean we would continue to increase 25% year on year every year if someone has an ongoing condition.  It would be capped after 3 years.  The very worst case is that someone has there premium loaded 25% for 3 years to recover losses on the policy.  We individually experience rate each renewal, where as most companies pool claims and have base premiums increased for everyone. 
 
If a premium has been loaded 25%, if the following year there is no re-occurrence in claims of the accident or illness that loading would be removed at the following renewal.
 
If for example one developed a heart condition, the initial 25% loading would remain ongoing.
 
In some cases we may load a premium for high BMI or a substandard risk, again if at a later date the clients weight improves or a condition has improved we can also remove any associated loading.
 
Ultimately we fully underwrite each plan so there is transparency on the coverage terms before you have reached any decision, most companies will assess a condition at the point of claim, which is not ideal, for example one may have high blood pressure and be on medication, they may think they are covered, though a company that uses moratorium underwriting would be within their right to decline a heart attack as a pre existing condition due to the medication.
 
I'm happy to answer any questions one may have regarding our product suite or anything related to the above.
 
We have had many people not declare there full history truthfully, and when this occurs and we find out through medical records that the application was not truthful, me may endorse the policy accordingly or terminate the policy.  Its important to declare everything as that is what we base our offer on.  These same people tend to be the people that complain anonymously online or make fake reviews.
 
If a client has been honest on application, we will ALWAYS pay a valid claim.  As we are registered and compliant in Thailand policy holders also have the protection of the OIC.  The same cannot be said of policies sold from offshore.
 
Anyone is welcome to email us directly with any pertinent questions.
 
We have a product suite particularly for Thai Visa readers:
 
https://www.thaivisaprotect.com/about.html
 
[email protected] 
 
Here are some of Pacific Cross’s/Thai Visa Protects core strengths:
·         Worldwide Cover
·         Affordable premiums
·         Fully Staffed English and Thai speaking office
·         24/7 365 emergency assistance and support
·         Annual limits per disability per year rather than combined
·         Cashless Inpatient and Outpatient treatment for treatment in our hospital network of 360+ in Thailand alone.
·         Individual cover ranging from 280,000 THB right through to 50,000,000 THB
·         Full Medical Underwriting – understand your cover from the inception
·         Possibility to cover pre-existing conditions subject to Underwriting approval
·         Family Friendly Pricing
·         No Claims Discounts
·         Excess/deductible options to discount published premiums
·         Medical Evacuations
·         Applicants up to 75yrs of age with lifetime renewal
·         Locally compliant plans with discounts and tax deductible premiums for employer groups
·         Ability to mix and match cover for employer group schemes
·         Ability for members coming from employer groups schemes to retain insurance on individual terms
·         All underwriting and claims processing done ‘inhouse’ and not outsourced to 3rd party administrators
·         The Pacific Cross Group of Companies has Offices in Hong Kong, Philippines, Vietnam, Indonesia, Vietnam
 
 
 
 

How far do you go back for pre-existing conditions? another company asks "have you ever had", european companies often go back 5 years only

We ask for 10 years on the application, but also if any additional operations and conditions previously.

 

We will most likely exclude previous surgeries.  We may load premium to accommodate substandard risks.

 

A key additional point with us is even if you have hypertension or hyperlipidemia although we may exclude the maintenance (medication doctor visits etc) we will cover the outcomes such as strokes or heart attacks, that is a huge plus and not common in the market.  Again the offer will be transparent before any decision reached by client.

 

 

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2 hours ago, Thaivisa Health Protect said:

Hi Everyone,

 

Pacific Cross Representative here:

 

Thanks for the clarifications posted above, and contributing to the thread...  A couple of questions....

 

1. Re the ThaiVisa product you mention above, if someone is already a PC policyholder with you, and wanted to switch to the ThaiVisa policy, would that require re-underwriting with eval of all medical treatment up to present time, or an be done simply as a simple policy transfer?

 

2. There's some question in this thread about your Maxima policy and its former 5M and 20M annual/per episode and lifetime policy claim limits. My agent told me that you no longer have the 5M limit and it no longer shows up on my annual policy statements, just the 20M lifetime amount recently.  But when I looked  at your website today for Maxima, I still saw both the 5M and 20M limit amounts listed.

 

3. What level of cooperation/interoperability exists between your different country operations? In other words, if someone has a policy with you here in Thailand and then decides to relocate to the Philippines, could they simply move/transfer their existing policy to PH seamlessly. Or they'd have to start over from scratch with new underwriting and evaluation by the PH operation?

 

Thanks very much!

 

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When I punched in numbers on the TV-Health site, I got a price of 67,292, or 5608 baht month= $175USD a month. This is for GOLD plan, 10,000,000 baht , inpatient only, no dental and 20,000 baht deductible.

 

David Shield International Plan is $173USD a month, 1.2MIL USD, no deductible or copay, inpatient only, no dental or vision.

 

I am 63. At 65 DS goes up to $211. Following is quoted from a DS rep e-mail to me---For those already in the plan, the price will increase at age 65 or renewal to $211.  This is based on 2019 rates.  Every 5 years there is an increase in premium due to age group transition.

 

There may also be increases due to medical trend in the market.

 

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3 hours ago, claynlr said:

David Shield International Plan

 

I'd never heard of that insurer before....

 

Are they primarily a company that deals with Israeli citizens?  And from what I was told, they'll only write new health insurance cover for people up to age 64, not any older.... But at least, they don't cancel at any particular age.

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I'd never heard of that insurer before....

 

Are they primarily a company that deals with Israeli citizens?  And from what I was told, they'll only write new health insurance cover for people up to age 64, not any older.... But at least, they don't cancel at any particular age.

They are an Israeli company that has branched out into global expatriate insurance. Will insure expats of any nationality.

 

 

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

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Just now, Sheryl said:

They are an Israeli company that has branched out into global expatriate insurance.

 

I saw mention about the expat stuff on their website... But when I chatted with them online just now, the person answering online told me he thought I would not be eligible for cover as I'm not an Israeli citizen.... But after some back and forth on that point, he finally offered to have their sales staff call me on Monday when they return, to confirm one way or another.

 

Before chatting, I couldn't find anything on their website saying they only write policies for Israelis.... so who knows.... Of course, I also didn't find anything on their website that says they'll only write new cover for folks up to age 64.... And their chat staff was very definite about that detail.

 

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I looked into April International (Thailand not France), although lower priced premiums their exclusions go back to birth. Such as have you ever had asthma, migraines and all sorts of stuff and then they exclude anything connected to it, which is vague.

 

April France go back 5 years on most things, I'll follow up with them at some point

 

 

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17 hours ago, TallGuyJohninBKK said:

 

I saw mention about the expat stuff on their website... But when I chatted with them online just now, the person answering online told me he thought I would not be eligible for cover as I'm not an Israeli citizen.... But after some back and forth on that point, he finally offered to have their sales staff call me on Monday when they return, to confirm one way or another.

 

Before chatting, I couldn't find anything on their website saying they only write policies for Israelis.... so who knows.... Of course, I also didn't find anything on their website that says they'll only write new cover for folks up to age 64.... And their chat staff was very definite about that detail.

 

They are not limited to Israelis. They will enroll up to 64 years, 364 days. Verified with a rep. AA Ins. will quote them. Same price as direct.

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Question to the DS rep--

Thanks so much Natalie. One question--When you say " After age 64 we do not accept new applicants. " does this mean after a person turns 64 (as in on their 64th B-Day)? I am thinking I will start retirement in SEP 2019, at which time I would be 64 years 2 months.

Her answer--

You will be okay, up until your 65th birthday (64 and 364 days J).

 

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On 4/26/2019 at 6:28 PM, TallGuyJohninBKK said:

2. There's some question in this thread about your Maxima policy and its former 5M and 20M annual/per episode and lifetime policy claim limits. My agent told me that you no longer have the 5M limit and it no longer shows up on my annual policy statements, just the 20M lifetime amount recently.  But when I looked  at your website today for Maxima, I still saw both the 5M and 20M limit amounts listed.

 

Sorry, I misspoke on this post/comment above regarding Pacific Cross....

 

For their Maxima policy and others as well, in the last couple years, they seem to have eliminated what previously had been a LIFETIME total claims limit on their policies... Mine, for example, had previously been 20M baht, but that limit no longer exists.

 

The broad limit they DO still have is the per disability/per year limit, which for the Maxima policy is capped at 5M baht.

 

Unfortunately, one negative about their policies, and perhaps other insurers here too, is that their PER NIGHT inpatient room coverage amounts have remained fixed and unchanged for all the years I've had the policy with them (no inflationary adjustment).

 

So, my 8,000 baht per night room charge limit was perfectly OK when I took out the policy more than a decade ago... But a lot of private hospital room rates in BKK have skyrocketed over that period, and now the 8K limit is on the low end of typical room charges at the more prominent privates in BKK.

 

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33 minutes ago, TallGuyJohninBKK said:

 

Sorry, I misspoke on this post/comment above regarding Pacific Cross....

 

For their Maxima policy and others as well, in the last couple years, they seem to have eliminated what previously had been a LIFETIME total claims limit on their policies... Mine, for example, had previously been 20M baht, but that limit no longer exists.

 

The broad limit they DO still have is the per disability/per year limit, which for the Maxima policy is capped at 5M baht.

 

Unfortunately, one negative about their policies, and perhaps other insurers here too, is that their PER NIGHT inpatient room coverage amounts have remained fixed and unchanged for all the years I've had the policy with them (no inflationary adjustment).

 

So, my 8,000 baht per night room charge limit was perfectly OK when I took out the policy more than a decade ago... But a lot of private hospital room rates in BKK have skyrocketed over that period, and now the 8K limit is on the low end of typical room charges at the more prominent privates in BKK.

 

Maxima plus policy has a limit of 10m Baht.

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3 minutes ago, alfieconn said:

Maxima plus policy has a limit of 10m Baht.

 Yes, Pacific Cross has a whole variety of different named policies with different benefit limits and payout caps. In several instances, they have a regular version and then a different PLUS version policy, such as the separate and different Maxima and Maxima Plus policies. The plus versions have higher premiums and higher coverage/benefit limits.

 

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Anyone on here have an existing Thai Policy, that they have successfully claimed on without any hassle please ?

Forget what promises you may have in your policy etc, someone who has actually used and claimed without any issue ? (above 100k)

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If you mean a policy issued in Thailand, I had BUPA in the past (since bought out by Aetna Thailand) and paid several times over the years but all  these claims were under 100k. The largest I think was around 50k. 3-4 claims over a number of years, no problems. But should add I add had the policy several years before first claim.

 

I now have April International, policy issued out of France but office in Bangkok helps handle claims. They just paid about 250k to hospital with no problem, got the Guarantee of Payment in a matter of a few hours after arrival in hospital (emergency admission)

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I used to have a BUPA Thailand policy a few years ago.  Went to Phuket Siriroj Hospital with bad dengue, 60,000 baht treatment (3 night stay, IVs, bedbaths by pretty nurses...).  BUPA paid the hospital directly.

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One note about pre-existing exclusions.  I was with BUPA for 10 years (now with Aetna) and had an exclusion related to surgery I had ages ago.  I said that I was going to move my policy as I thought an exclusion due to successful surgery 30 years ago seemed wrong to me, especially as I'd had no recurring issues for the last 30 years and not even claimed for anything in the lsst 8 years.

 

They asked for a medical check plus X-rays, and then removed the exclusion.

 

So there can be some sensible flexibility.

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You both didn't go with the deductible/excess? If they pay direct I wonder how they deal with the deductible? you have to hand over a credit card for the first x baht or something?
I had no deductible with BUPA. I do have a 500 US deductible with April but for some reason the GOP came through as 100% payment. I expect the 500 will get deducted when I claim reimbursement of follow up care (they cover outpatient care related to the hospitalization for up to 30 days) or else they'll bill me.

What usually happens is that the GOP states the deductible and you pay that to the hospital.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

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  • 2 weeks later...
On 5/2/2019 at 2:01 PM, Sheryl said:

I had no deductible with BUPA. I do have a 500 US deductible with April but for some reason the GOP came through as 100% payment. I expect the 500 will get deducted when I claim reimbursement of follow up care (they cover outpatient care related to the hospitalization for up to 30 days) or else they'll bill me.

What usually happens is that the GOP states the deductible and you pay that to the hospital.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app
 

 

Sheryl, for the April insurance out of France, who are the point or points of contact for someone here in Thailand who wants to find out about the details of their policies, get a quote, etc etc?

 

Do they have an English language website that provides that kind of info?

 

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Sheryl, for the April insurance out of France, who are the point or points of contact for someone here in Thailand who wants to find out about the details of their policies, get a quote, etc etc?
 
Do they have an English language website that provides that kind of info?
 
AA Insurance brokers in Pattaya or Hua Hin will help with the paperwork
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4 minutes ago, scubascuba3 said:
33 minutes ago, TallGuyJohninBKK said:
 
Sheryl, for the April insurance out of France, who are the point or points of contact for someone here in Thailand who wants to find out about the details of their policies, get a quote, etc etc?
 
Do they have an English language website that provides that kind of info?
 

AA Insurance brokers in Pattaya or Hua Hin will help with the paperwork

 

Does that mean, they can provide policy brochure info, rate sheets, etc etc?

 

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Does that mean, they can provide policy brochure info, rate sheets, etc etc?
 
Yes, they emailed it to me with a comparison. They provided the April Thailand initially so i had to email back for the France stuff. The April Thailand one is a lot cheaper and bigger deductibles but their medical history questions goes back further.

Email them they should reply withing a few hours
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3 hours ago, TallGuyJohninBKK said:

 

Sheryl, for the April insurance out of France, who are the point or points of contact for someone here in Thailand who wants to find out about the details of their policies, get a quote, etc etc?

 

Do they have an English language website that provides that kind of info?

 

They do but AA Insurance brokers will also get all that info for you as well as comparative info for other policies. Most important they will help liase with the insurance if and as necessary afterwards if you have a claim. Jenny there has been an absolute angel during my recent accident, going over and beyond the call of duty to help me out in all aspects. I am very, very happy with both the insurance and the broker.  Not so happy to have been struck by a motorcycle, but at least in the difficult aftermath I had no barrier to accessing the best care and no financial worries.

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