Anyone who has ever applied for health insurance will be familiar with the long application forms which insurance companies make us complete where you are required to disclose your medical history. While it may seem a nuisance, there is no way of escaping this process. It’s an essential part of getting health insurance in Thailand in place.
Questions vary on an insurer to insurer basis, but the aim of these questions has a common objective. It allows the insurer to build up a picture of your ‘risk profile’. Are you worth taking on?
Questions can include asking about past surgeries, how much you drink, whether or not you smoke, and if you take any medication. The person who assesses applications at an insurance company is called an underwriter. They assess risk and decide on if to make an offer of insurance, and if so, under what terms. They will look at a number of factors to come to this decision.
For people with pre-existing medical conditions there may be a temptation not to disclose your medical history at point of application, and hope that the insurance company will cover your condition. Here we look at some reasons why this is not the way to go!
- It’s illegal. When you sign up to a health insurance policy in Thailand you sign a declaration that says you have declared any information which could effect an insurance company’s decision on whether to accept you onto a plan. This information is known as ‘material facts’. If you knowingly fail to disclose such information, an insurance company can refuse to pay claims later down the line or they can declare the policy void from inception. To stop this from happening, all you need to do is to keep your side of the deal and be honest. For more information on Insurance Law in Thailand, check out the OIC website.
- Insurers check your history. An insurance company will not just rely upon your declaration when big claims arise. They will examine your medical history to see if the condition is pre-existing. This applies for people who have a plan with direct billing arrangements also.
- Understand your exclusions. If exclusions are going to be placed on you, then it’s best to know from the beginning of the policy than leaving it to when your claim is refused. By declaring conditions fully at the front end, you can be confident that you are not going to be refused cover later down the line.
- Doctors reports can be damning. Doctors write reports on all aspects of your consultation/surgery. If previous surgery or illness is uncovered then insurers are sure to find out about it, potentially leaving your claim un-payable.
- Conditions may not be excluded. Declaring conditions does not mean that all will be excluded. There are examples of conditions which will either not be excluded, or will be excluded only for a set period of time.
- Don’t slow down the process - If an insurer suspects that you have not fully disclosed your history, then they will likely request your whole medical history from a set time period. This can take a while to get together. In the meantime you will need to pay ‘out of pocket’ while you wait for them to decide if you are covered or not.
- Don’t get stuck with no insurance. For people who are over 60 years old, the number of insurers who will accept you onto cover decreases. If you are on cover, and the policy is later cancelled due to your dishonesty, you could find yourself uninsurable.
If you need any help with the application process, please feel free to get in touch with Seek2Insure today.