Medical Insurance 101

With rising healthcare costs, insurance has become an important part of your healthcare plan. Yet, many people are still skeptical about buying medical insurance after hearing stories of people who face difficulties claiming for their money after a surgery or medical treatment.

The problem begins with not understanding enough about medical insurance. The Life Insurance Association of Malaysia (LIAM) sheds some light on this important topic to help you make the best of your medical insurance:

TIP 1: TAKE YOUR TIME

Just like purchasing a car or a house, it is important not rush into buying your insurance plan. There are various plans available in the market with different benefits. So, talk to several insurance agents from different insurance companies before choosing. If you are unclear of the plan or uncertain of something, do not hesitate to ask the insurance agent for further explanations. Having said that, however, it is advisable to buy a plan when you are young and healthy. The older you are, the higher your monthly premiums. Many people now consider buying insurance as an important part of their lives and factor it in together with life milestones such as getting a first job or getting married. Many parents even buy insurance for their babies as soon as they are born.

TIP 2: CHOOSE AN AFFORDABLE PLAN

It’s best to choose a plan that you can afford. Buying a single comprehensive plan is better than buying several different plans with duplicate coverage. Shop wisely as policies differ when it comes to coverage, benefits and costs. Buying a health insurance plan that you can afford will ensure that you can maintain it for a longer time.

TIP 3: KNOW WHOM YOU ARE DEALING WITH

Your insurance agent is an important person who is expected to take care of things when you are down and out, hence it is best is to deal only with licensed insurance companies and a licensed insurance agent. LIAM asserts that a business card does not necessarily mean that the person is an authorised agent, If in doubt, ask the person you are dealing with for proof of his registration and check directly with the insurance company. Ideally you should choose an agent that you can trust and whom you are comfortable with.

TIP 4: BE HONEST

Everyone loves to get the best deal from their insurance. However, lying to the insurance company about your current health condition or age will do you more harm than good. The worse is being discovered when you need it most. Now only will your claims for reimbursement of your expensive medical bill be rejected, you might be charged under the Insurance Act!

TIP 5: READ YOUR POLICY CAREFULLY

Before signing your health insurance contract, be sure to read it carefully. It is important to understand all terms in your insurance agreement before sealing it with your signature. Check to ensure that a copy of the original application is attached to the policy that is completed and accurately reflects your medical information. Also, review the schedule of benefits and make sure that the information is what you are expecting. There should be neither missing pages nor any exclusion in your policy. If any of these problems occur, be sure to notify your insurance agent or company. Do not sign anything if in doubt.

TIP 6: FIND OUT THE BENEFITS

The most important aspect about your health insurance is the benefits, such as what it covers and what doesn’t. Be very clear about this right from the start to avoid feeling cheated when you need to make claims. This is where your insurance agent need to explain very clearly what happens in the event you fall ill or get admitted into hospital unexpectedly.

TIP 7: TYPES OF MEDICAL INSURANCE

Basically, there are four main types of medical and health insurance policies which are offered individually or as a combined package:

  • Hospitalisation and surgical insurance – Provides hospitalisation and surgical coverage when illnesses strike
  • Dread disease or critical illness insurance – Provides you a lump sum of money upon diagnosis of any of the 36 dread diseases or specified illnesses. You can then choose whether to seek treatment or put your affairs in order with that payment.
  • Disability income insurance – Provides you an income stream in the event you are unable to work due to a sickness or injury.
  • Hospital income insurance – Pays you a specified sum of money on a daily basis, subject to an annual limit, in the event you stay in a hospital due to covered illness or injury.

TIP 8: METHOD OF PAYMENT

Avoid making your medical insurance policy payment with cash. Pay with cheques, money order, auto-debit or bank draft, made payable to the insurance company itself and your insurance agent or any other party. Also, remember to request for an official receipt which should state the insurance company’s name, address and phone number.

TIP 9: COMPLETE THE INFORMATION FORM CAREFULLY

Once you have decided to purchase a policy, you must disclose all your personal information. Failure to disclose accurate or complete information can lead to the insurance company refusing the coverage of the medical condition which was not mentioned to them previously. The insurance company also has the right to deny claim for the treatment of a medical condition which was not disclosed and also terminate your medical insurance policy.

TIP 10: GET INFORMATION ON THE AGENT AND INSURANCE COMPANY

It’s important is to note the name of your insurance agent, insurance company, address and contact number and leave the info with your family members or beneficiaries. This information is also useful when upgrading your policy, enquiries or claims. It helps to keep a separate folder solely for your medical insurance documents, together with the agent’s contact details for easy access when needed.

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