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<Prudent Strategies in Taking Out Medical Insurance> pdf (Chinese Version only)
Smart Tips |
No harm done to provide more details When filling the proposal form, take the advice of the insurance agent and judge for yourself what information or medical history should be provided. There are a number of questions concerning your medical history and record in the application form. It helps if the applicant considers relevant and provides additional information other than that asked in the form. Reasons for reporting facts “Facts” include personal information, drinking and smoking habits, record of medical history,etc. This information will enable the insurance company to decide whether to accept or rejectyour application, or to decide the premium rate, policy terms and conditions. (Policy application forms will generally ask a lot of questions on medical record. It helps to report them even if there is no such provision in policy application forms.) |
Disclosing Medical History is a Must When Taking out Medical Insurance
The first step in effecting medical insurance is to fully disclose all facts on the application form, since this information can affect the validity of the policy.
Claim rejected due to non disclosure of medical history
Mrs Wong had a gall stone removal surgery in hospital a few months ago. She submitted a claim form to the insurance company after discharge from hospital. The insurance company subsequently rejected her claim for she did not disclose her history of hepatitis B in the proposal form. The reason of rejection was non-disclosure. Mrs Wong said: “I still don’t understand what a gall stone has to do with hepatitis B. Aren’t they two separate things?”
Disclose your medical history to avoid dispute
A number of insurance professionals have been consulted on the above case. They unanimously view that the decision to reject this claim by insurance company is reasonable since it is the essential responsibility of an applicant to disclose the information when applying for medical insurance cover. This is because the insurance company does not know the applicant and the health status of each applicant varies. Only the applicant knows his own health status. As such, if an applicant provides inaccurate or incomplete information, the insurance company will not be able to based on the information provided, assess and underwrite the risk accurately, as well as to apply appropriatel terms and fix the premium. As a result, the protection under such policy cannot be established.
Besides, insurance professionals remind us that there is a “waiting period” for some kinds of coverage. During this period (usually ranges from fourteen days to one year from the effective date of the policy), only injury resulting from accident requiring treatment will be covered; medical expenses incurred due to restricted illness will be excluded. Policyholders should pay extra attention to this.