Claim case sharing
How to select a suitable medical insurance plan
According to the Insurance Claims Complaints Bureau, the number of complaints regarding hospitalisation and medical insurance products has doubled from 60 cases in 2004 to 120 cases in 2005. In most cases, complaints arose out of the application of policy terms and policyholders not declaring their medical records when purchasing insurance. We all look for thorough medical insurance protection, but what in particular should we be paying attention to? What benefits should be included in a general medical insurance plan and how does one decide how much cover is right for their needs?
Medical insurance usually covers a policyholder’s medical expenses, which is further divided into outpatient services and hospital services (inpatient services). While outpatient service protection covers the consultation fee of general and specialist practitioners and prescribed medication expenses, hospital service protection (inpatient service protection) covers a policyholder’s expenses during hospitalisation, including room & board, charges for doctor’s visits and surgical fees. As instances of critical illness are on the rise, it is also recommended that one should consider purchasing additional benefits to protect against critical illnesses, such as cancer, kidney failure, stroke, heart attack etc. Unless specified in the policy, most medical insurance plans do not cover dental treatment and cosmetic surgery. Therefore, the policyholder should be certain of their requirements when purchasing a specific plan.
Although most insurance plans have maximum benefits payable for each protected item, the policyholder should decide on the sum insured based on their own medical needs. In order to select an adequate amount of sum insured, the policyholder should first consider the types of medical benefits they would require, such as outpatient, hospitalisation (inpatient) and critical illness protection. They should then also take into consideration the cost of the medical service that they prefer. For example, the medical expenses would be higher if a patient wants to undergo treatment in a private hospital. As the premium increases with a broader scope of protection, one should carefully select an affordable medical insurance plan. If a policyholder is part of a group medical cover provided by their employer, one could consult the insurance company to purchase an additional personal medical insurance for more comprehensive protection. In this case, some insurance companies now provide medical insurance plans with a “top-up” feature, which allows customers to supplement their existing coverage with a more economical premium. For example, MSIG’s MediSure Plus Top-Up Plan allows customers to choose an annual deductible on top of their current medical insurance coverage with an insurance premium discount.
Unless a pre-existing condition is disclosed and accepted by the insurance company, it will be excluded in most medical insurance plans; hence, policyholders must declare their medical record. One should also pay attention to waiting periods. This means that any medical expenses claimed during a certain period after the medical plan was activated would not be covered by the insurance. In short, it is recommended that policyholders read through the terms & conditions of their policy thoroughly.
Terms and conditions at a glance
Is it better to purchase medical insurance at an early age?