The Waiting Period for Specified Illness is 120 days. Do refer to the Exclusion list for the details of what is not covered for the first 120 days when starting the medical card.
Let it be known that there is also an Incontestibility Period of up to 2 years.
There is a difference between these two.
If there are any claim which falls under the Specified Illness within the waiting period of 120 days, the said claim will be duly rejected.
However if a major claim (that has a close relation to a Critical illness) were to happen within the 2 years from starting of the policy, the insurer may at its discretion use the Incontestibility Period clause.
This means that the insured will have to pay for the hospital bill and then file the claim to the insurer for reimbursement.
The insurer will then investigate as to whether the insured had seek any consultation with regards (to the illness being claim) to determine if a non declaration of material fact had occur during the policy inception.
For example, mild stroke before the 2 years of Incontestibility period.
If admitted due to a mild fever or accident, then most likely there won't be any investigation be triggered.
If the result of the investigation for the non disclosure of material fact is sided on the insured (meaning there is no record in hospital or clinic) then the claims will be duly paid back to the insured.
However if the result of the investigation shows that there was indeed elements of non disclosure of material fact, eg health status (have record in hospital or clinics of the illness eg lumps or tumor or cancer marker high), occupation (lorry driver declared as office worker) , smoking status (smoker declared as non smoker), then the policy will be re-underwrite by the Underwriters.
Should the insured ia not agreeable to the new term (due to the non disclosure) then the policy will be considered as null and void. All premiums paid minus the claims (if any) will be refunded to the insured.
This is why it is very critical to get insured when we are healthy with no records in the hospital.
It is also very important to answer the health questionaires properly.
Let it be known that there is also an Incontestibility Period of up to 2 years.
There is a difference between these two.
If there are any claim which falls under the Specified Illness within the waiting period of 120 days, the said claim will be duly rejected.
However if a major claim (that has a close relation to a Critical illness) were to happen within the 2 years from starting of the policy, the insurer may at its discretion use the Incontestibility Period clause.
This means that the insured will have to pay for the hospital bill and then file the claim to the insurer for reimbursement.
The insurer will then investigate as to whether the insured had seek any consultation with regards (to the illness being claim) to determine if a non declaration of material fact had occur during the policy inception.
For example, mild stroke before the 2 years of Incontestibility period.
If admitted due to a mild fever or accident, then most likely there won't be any investigation be triggered.
If the result of the investigation for the non disclosure of material fact is sided on the insured (meaning there is no record in hospital or clinic) then the claims will be duly paid back to the insured.
However if the result of the investigation shows that there was indeed elements of non disclosure of material fact, eg health status (have record in hospital or clinics of the illness eg lumps or tumor or cancer marker high), occupation (lorry driver declared as office worker) , smoking status (smoker declared as non smoker), then the policy will be re-underwrite by the Underwriters.
Should the insured ia not agreeable to the new term (due to the non disclosure) then the policy will be considered as null and void. All premiums paid minus the claims (if any) will be refunded to the insured.
This is why it is very critical to get insured when we are healthy with no records in the hospital.
It is also very important to answer the health questionaires properly.
No comments:
Post a Comment