allebasi Posted February 7, 2019 Share Posted February 7, 2019 Just a heads up for anyone thinking of signing up with these crooks. Just signed for a second year. No previous claims. Just tried claiming for a finger injury and was told only "semi private room is covered". Where i live all private hospitals are private room only, so complete waste of money...3000b per month. I have medical cover at government hospitals through SS card which is where i eventually got treated. I was never told this but yes...its in the small print. I was miss sold the policy through nowcompare.com. via a very convincing <removed> Yes its my fault...just a warning to anyone thinking of taking out insurance. Link to comment Share on other sites More sharing options...
brewsterbudgen Posted February 7, 2019 Share Posted February 7, 2019 Exactly the same thing happened to my wife. Admitted to our local hospital, Sukhumvit Hospital at Ekkamai, with suspected appendicitis and as they only have "private rooms", they said she was not covered. In the end they paid 70% of the claim. A private room at Sukhumvit Hospital is 1,800 baht. They told us we should go to Bumrungrad in future - a "semi-private" room there is 7,000 baht! We will not be renewing.Sent from my SM-G930F using Thailand Forum - Thaivisa mobile app Link to comment Share on other sites More sharing options...
Sheryl Posted February 7, 2019 Share Posted February 7, 2019 1. They should have covered the room up to the maximum rate allowed for semi private room. 2. Even if room costs were totally disallowed, that should not have precluded payment of the rest of the bill. Room charges are only a very small fraction of a total hospital bill. it sounds to me like the person who processed the claim did not know what they were doing. Appeal this. Check your policy to see what agency is the one designated to resolve any issues, there should be a section which specifies this. (I am not clear where Regency is headquartered nor if there Thai office is considered a Thai company). Or if you cannot find this try the Thai Insurance Commission. http://www.oic.or.th/en/home You can submit a complaint online but will need a Thai speaker to help you do it. Link to comment Share on other sites More sharing options...
Puchaiyank Posted February 7, 2019 Share Posted February 7, 2019 Anyone know of a reasonably priced healthcare insurance package for expats over 70 years? Link to comment Share on other sites More sharing options...
Sheryl Posted February 8, 2019 Share Posted February 8, 2019 17 hours ago, Puchaiyank said: Anyone know of a reasonably priced healthcare insurance package for expats over 70 years? "Reasonably priced" is subjective. Basically it is going to cost you anywhere from USD 3 - 5,000 a year if no deductibles. You can reduce premiums by taking deductibles. Best to work through a broker. AA Insurance Brokers has an office in Pattaya and specialize in healht insurance for expats, they can explain all the options to you. If you belong to the Pattaya Expats Club contact them as they have arrangements with insurers which might represent a savings over what you can get on your own http://pattayaexpatsclub.info/wp/insurance/ Link to comment Share on other sites More sharing options...
brewsterbudgen Posted February 10, 2019 Share Posted February 10, 2019 On 2/7/2019 at 7:02 PM, Sheryl said: 1. They should have covered the room up to the maximum rate allowed for semi private room. 2. Even if room costs were totally disallowed, that should not have precluded payment of the rest of the bill. Room charges are only a very small fraction of a total hospital bill. it sounds to me like the person who processed the claim did not know what they were doing. Appeal this. Check your policy to see what agency is the one designated to resolve any issues, there should be a section which specifies this. (I am not clear where Regency is headquartered nor if there Thai office is considered a Thai company). Or if you cannot find this try the Thai Insurance Commission. http://www.oic.or.th/en/home You can submit a complaint online but will need a Thai speaker to help you do it. In my case Regency agreed to pay 70% of the total bill, but not all of it because my wife stayed in a private room, which is the only type of room the hospital has! Typically, two weeks later my 3 year-old son contracted Influenza A and as we use the same hospital the same situation arose. Again, Regency only covered 70% of the claim because all the children's rooms are "private". When I queried the policy with their Bangkok based rep and their Claims Department, they said this: The plan of your wife is Major Medical and, based on the benefit schedule of this plan, only hospitalizations in a Semi-Private room will be covered. In this case the type of room is not available and per the policy terms and conditions there is no coverage, however, Regency understands the needs of its’ clients and so instead of declining the claim we cover up to 70% of the total bill, a case to case consideration offered by the underwriters. We do cover our clients who go to Sukhumvit Hospital, however for Mrs. *******’s case, this is because of the incorrect use of room type to the chosen plan which is Major Medical. We do understand Mr. ********’s point but this is the standard of the international plan that we offer to our clients around the world. I hope you understand that our claims team needs to adhere to the policy as standard practice with the goal to provide the best assistance and at the same time, practicing the terms and conditions. I would like to advise that Fully Comprehensive Plan covers clients for private room and this might be a more suitable solution for the client to upgrade the plan on renewal to have a full cover for a private room. To be honest, in all other respects I am quite happy with Regency. They are competitively priced, with no excess/co-pay; their Bangkok rep is very efficient, and their Claims team respond quickly. The 70% they agreed to pay was directly billed to the hospital. However, the "semi-private" room restriction is ridiculous as it would appear that they are not prepared to do what Sheryl has suggested in her post, and base the coverage on the cost of the room. I have looked at a competitive policy with Luma which covers all rooms up to a specific price, which would be more than enough to cover a private room at my local hospital (Sukhumvit). Unfortunately, they do not provide refunds so I will have to stick with them until renewal, and then see if they will be more flexible, or upgrade to their "Fully comprehensive" plan (which I won't as it's far more expensive and covers many things I don't need) - or change insurers. I think Regency are international and would imagine their "semi-private" room policy has been legally tested, so I doubt making an official complaint would have much effect. How many other insurers have a "semi-private" room policy? Link to comment Share on other sites More sharing options...
Sheryl Posted February 10, 2019 Share Posted February 10, 2019 Most insurers cover only smei private room but as long as the private room cost is within the amount allowed for a semi-private room it is not a problem. I have never heard of an insurer reducing the entire reimbursment over the type of room. At most they would not cover the room but pay everything else. Again, I urge you to appeal this to the OIC (or other point of appeal as listed in your policy). Link to comment Share on other sites More sharing options...
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