Wednesday, March 9, 2011

Insurance for critical illness

I had actually wanted to write this post for some time.  Insurance cover is indeed very important and essential, particularly in the escalation of costs, and cost of living. Typical medical / health cover in insurance may not be sufficient now, in times when a person is down with some form of critical illness.
Whilst medical and health covers pays most of your hospitalization and treatments per hospital billings, insurance for critical illness actually pays you directly the full sum insured. This is all fine, but then there is a real downside to insurance for critical illness. The policy is very specific and well defined in the small prints. The cue now is that who reads the small print?
I have being reading into insurance for critical illness and also had spoken to several insurance agents about it. My conclusion is that whilst it is good and essential we must always take time to read the small prints and clauses therein.
I quote Malaysia Insurance Portal giving ten reasons for taking up insurance for critical illness:
1              A lump sum CASH payment will be payable.
2              Able to seek immediate treatment in any hospital of your choice.
3            Pay for prescription drugs or treatment not covered by government or private plans.
4            Family able to maintain current standard of living
 (care for your aging parents, children education and your love ones)
5              Protect your mortgages or settle all your loans.
 (Most MRTA policies do not cover critical illnesses)
6            Extra home nursing care during recovery stage.
 (minimise the burden on  your family members)
7            Premium starts from RM 100 a month for a RM 240,000 protection.
 (depending on your age, gender and health condition)
8            Cash back .
 (total cash back value is subject to age and insurer's performance)
9            Many people are diagnosed with Critical Illnesses each year.
 (thanks to medical advances, many survive). But don't let the medical cost be a burden.
10              Peace of mind.

First and foremost we must know and understand the definitions of the standard critical illnesses. They include: (and I specifically highlight definitions into cancers)
1. Heart Attack.
2. Stroke.
3. Coronary Artery Disease Requiring Surgery.
4. Cancer.
Cancer is defined as the uncontrollable growth and spread of malignant cells and the invasion and destruction of normal tissue for which major interventionist treatment or surgery (excluding endoscopic procedures alone) is considered necessary. The cancer must be confirmed by histological evidence of malignancy.

The following conditions are excluded:-
(a) Carcinoma in situ including of the cervix
(b) Ductal Carcinoma in situ of the breast
(c) Papillary Carcinoma of the bladder and Stage 1 Prostate Cancer
(d) All skin cancers except malignant melanoma
(e) Stage I Hodgkinâ’s disease
(f) Tumors manifesting as complications of Acquired Immune Deficiency Syndrome.
5. Kidney Failure.
6. Fulminant Viral Hepatitis.
7. Major Organ Transplant.
8. Paralysis / Paraplegia.
9. Multiple Sclerosis.
10. Primary Pulmonary Arterial Hypertension.
11. Blindness.
12. Heart Valve Replacement.
13. Loss Of Hearing / Deafness.
14. Surgery To Aorta.
15. Loss of Speech.
16. Alzheimerâ’s Disease / Irreversible Organic Degenerative Brain Disorders.
17. Major Burns.
18. Coma.
19. Terminal Illness.
The Life Assured must be suffering from a condition, which in the opinion of an appropriate Medical Practitioner is highly likely to lead to death within 12 months. The Life Assured must no longer be receiving active treatment other than that for pain relief.
20. Motor Neurone Disease.
21. AIDS Due To Blood Transfusion.
22. Parkinsona’s Disease.
23. Chronic Liver Disease.
24. Chronic Lung Disease.
25. Major Head Trauma.
26. Aplastic Anaemia
27. Muscular Dystrophy.
28. Benign Brain Tumor.
A life-threatening, non-cancerous tumor in the brain giving rise to characteristic signs of increased intra-cranial pressure such as papilloedema, mental symptoms, seizures and sensory impairment. The presence of the underlying tumor must be confirmed by imaging studies such as CT Scan or MRI.
Cysts, granulomas, malformations in or of the arteries or veins of the brain, haematomas, tumors in the pituitary gland or spine and tumors of the acoustic nerve are excluded.
29. Encephalitis.
30. Poliomyelitis.
31. Brain Surgery.
32. Bacterial Meningitis.
33. Other Serious Coronary Artery Disease.
34. Apallic Syndrome.
35. AIDS Cover of Medical Staff.
36. Full Blown AIDS.

I herewith include extracts of some typical small prints.
A. There will be no coverage for:
2. Critical Illness
i) disease (s) resulting from acquired Immuno Deficiency Syndrome (AIDS), AIDS – related complex or infection by Human Immuno Deficiency Virus (HIV) unless the condition of the disease or infection arose as a result of blood transfusion in accordance with the critical illness definitions of the policy.
ii) Pre – existing Illness which existed before the Policy Date of Reinstatement of the policy, where pre – existed Illness shall mean disabilities that the Life Insured has reasonable knowledge of. A Life Insured may be considered to have reasonable knowledge of a pre – existing condition where the condition is one for which:-
1.              The Life Insured had received or is receiving treatment; or
2.              Medical advice, diagnosis, care or treatment has been recommended; or
3.              Clear and distinct symptoms are or were evident; or
4.              Its existence would have been apparent to a reasonable person in the circumstances.
iii)Angioplasty, cancer, coronary artherectomy, heart attack, other serious coronary artery disease and/or surgery for coronary arterial disease occurring within sixty (60) days after the Policy Date or Date of Reinstatement of the Policy.
iv) Diseases other than those specified in 2 (iii) above occurring within thirty (30) days after the Policy Date of Reinstatement of the Policy.
v) Critical Illness claim/s resulting directly or indirectly from any Congenital Conditions for lives with age of entry of two (2) years or less where such disorder is known to the Policy Owner. Congenital Conditions shall mean any medical or physical abnormalities existing at the time of birth as well as neo – natal physical abnormalities developing within 6 months from the time of birth. They will include hernias of all types and epilepsy except when caused by a trauma which occurred after the date that the insured was continuously covered under this Policy.
vi) Critical Illness resulting from all or any self – inflicted injury while sane or insane.
C. Sum Insured for child below the age of four (4) years is reduced upon death, TPD or diagnosis of any of the Critical Illness or actual undergoing of Surgery covered by this policy of the child. The sum insured payable will be according to a scheduled table.
 Take care 
Allen Lai

No comments:

Post a Comment