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BANGKOK 17 February 2019 05:09
Sheryl

Health Insurance - what to watch out for

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I have brought up these same issues and for now maintain my local BUPA policy but soon (when start to draw pension and SS) will likely switch to an international insurer. As we age the expense is just part of what we need to do to stay covered for likely events and infirmity.

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From Tilleke & Gibbins:

Regulations

Insurance companies are subject to extensive regulation in terms of capital adequacy, permitted investments, handling of claims, marketing activities, dispute resolution, and others. Policy wording may only be used following approval of the OIC. In addition, all advertising images and solicitation documents are regarded as part of the relevant insurance policy. If the meaning of any advertised wording or image is contrary to that written in the policy, such meaning is to be interpreted in favor of the insured or the beneficiary (as the case may be).

http://www.tilleke.com/resources/compliance-complete-insurance-country-guide-thailand

 

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I've just switched to an International policy too.  However!  Once you do that you are at the whims of that insurance company's under-writing department for probably at least 2 years, i.e., within a period of time ranging between 2 to 5 years any chronic illness will be considered a pre-existing condition and simply not covered.  This is the way insurance companies operate.  There is no real way of getting around it. 

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Since  -- according to the MSH Int's website --  "The medical evacuation coverage of Asia Care is provided & managed by Mondial Assistance (Allianz Group)" there may be restrictions imposed by Allianz as to in what (stable?) medical condition one must be in prior to their authorizing evacuation from Myanmar to Thailand that is one might be necessitated to be treated in Myanmar for a period of time before one is in condition to be evacuated to Thailand for further treatment.

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I am in the same process of changing insurers as I still have a rather inexpensive but most probably not adequate Expat-insurance from a company of my home country.

Talked about this to my excellent and experienced Doc at Bumrungrad last week, and he warned me of signing up for an insurance from a Thai based company (though I was rather looking into an international company that covers the entire ASEAN region in case the current PM thinks he does not want me here any longer).

The main point indeed is the "pre-existing conditions" thing. I will only sign a new contract somewhere else if those conditions are clearly listed in the policy, and the way they can raise the premium or exclude chronic illnesses as well.

Saw two reputable insurance agents already and went through a lot of brochures, but so far haven't found anything that would me want to sign with the respective company. That the insurers r reluctant to provide you with the exact policy wording is certainly concerning

Edited by siam2007
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The easiest way to get around any pre-existing condition complications is to have had the underwritten policy for 10 or so years before you start to make any major claims. If you start your major claim regime shortly after signing up for the insurance, they certainly are going to look to see that all medical history was properly disclosed when the policy was started.

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Nothing unusual.  All companies adjust your monthly cost after you have been sick or let's say smashed your car etc.

But if it says it cover up to 2 million in costs then that's what you'll get. After that your price goes up.

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Generally, the insurance industry in Thailand is a joke.  Check out the analysis of insurance of any sort offered by Thai-based companies and be prepared for a shock on the siamfirm interlaws website.  The principal of Siam Firm Inter Laws (who has run the same law firm for more than 30 years- somsak chopaka) describes the Thai insurance industry as a "swamp full of crocodiles". There are many articles from Somsak Chopaka on the website discussing legal issues of vital interest to farang residents, covering business (how to stay safe), various scams targeting foreigners, how to deal with the police, family law matters divorce, child custody, keeping your assets safe, company law, the real philosophies/beliefs behind Thai law and how it applies to foreigners etc.  It will clarify a lot of concerns and misconceptions TVF posters seem to suffer from.  Save yourself a lot of heartache by getting basic answers from the articles.

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There was a posting in TV recently relating to a story of someone being stone-walled when making a claim from BUPA, and one hears many similar tales.  Cigna oversell extensively, but I have not heard any specific rejection of a claim by them.  There's the usual confusion between health, accident and travel insurances.  It is a minefield and none of them want to pay out on a claim unless they can see an endgame where you either recover completely, or pop your clogs. They dread the long, drawn-out medical conditions.

 

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Yes, of course they do, but they have set the premium increases for  age with that in mind. A decent policy/company understands that insurance is based on risk-sharing and in that system there will be those who end up costing the company very little and those who end up costing them a lot - and that they have to pay out for the latter group, like it or not.

 

I too haven't heard of Cigna being unreasonable about this or jacking up rates (beyond their normal schedule) even with serious chronic conditions like cancer.

 

But the local insurers can and many will.

 

 

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