Term insurance or term life, provides protection for your family against uncertainties such as death. Term life insurance is a type of life insurance policy that provides coverage for a certain period, or a specified “term” of years. If the insured dies during the term specified and the policy is active, or “in force,” then a death benefit will be paid.

Otherwise known as critical illness cover or dread disease policy, it is bought to provide additional financial coverage for medical emergencies. Critical illness insurance provides a lump-sum benefit if the insured person is diagnosed with a critical illness covered by the policy. It provides additional coverage for medical emergencies like heart attacks, strokes, or cancer. Because these emergencies or illnesses often incur greater-than-average medical costs, these policies pay out cash to help cover those overruns when traditional health insurance may fall short.

The difference between term and whole life insurance can be boiled down to cost and length. Term Life Insurance is cheaper than whole life and covers you for a set period of time. Whole life insurance typically lasts your entire life and can build cash value, which makes it a more complex and expensive product.

Group medical insurance plan refers to healthcare insurance purchased for a group, usually by employers, business owners, or association executives. This is different from individual health insurance plans, which allow anyone to enroll through an insurance provider. With group healthcare insurance, only certain members or employees of the respective group can get healthcare coverage for themselves and their families. Those who enroll in group healthcare insurance offer many advantages, including low premiums, reasonable deductibles, and comprehensive health coverage.

Group life insurance is an employee benefit that provides a death benefit to the beneficiaries of the insured in the event of their death while they are with the organisation. The goal is to provide financial assistance to the families of these employees during difficult times.

International medical insurance provides medical insurance such as hospitalisation and doctor visits abroad making sure your medical needs are covered when you are on holiday or on business visits. This is different to travel insurance, where you are provided cover for delayed flights, missing luggage, or important documents such as passports. There is medical coverage, however, it is extremely limited or sometimes just emergency cover compared to a standalone medical insurance policy.

We offer continual support for you in claims, hospitalisation, staff enlistment or removal from policy, or questions about your overall policy throughout your policy year. We are here to answer any questions about your policy, making sure you understand every detail of your policy plan.

Our team at PCL Insurance Services is highly specialised in medical and life insurance, making us a reliable source of advice in these areas. While we don’t offer direct advice on other types of insurance, we can connect you with our partner, who specialises in general insurance such as office insurance, business interruption insurance, and director and officer’s insurance.

Throughout the policy year, we prioritise your satisfaction by providing ongoing support and assistance. As your renewal period approaches, we’ll reach out to you 30-45 days in advance to coordinate a policy review and discuss your options for renewal and/or alternative solutions. This is because insurers typically provide us with the renewal quote around this time, and we want to ensure that the process is seamless and hassle-free for you.

We can help you review your current policy and align it with your specific requirements. Our goal is to ensure that you have the coverage you need. We will carefully examine what is covered and what isn’t.

In most policies, you have the freedom to choose any medical doctor and hospital you wish to see. However, some policies may ask you to see only their list of providers, any providers who aren’t on that list will be covered with a co-pay or not covered at all.

You will still be able to purchase medical insurance, however, you will have to disclose this when you complete your medical questionnaire for underwriting purposes. Depending on your condition, it may be covered, covered with a premium loading, or excluded.

However, this is different with Corporate Health Insurance. Depending on the health insurer, if you have a certain number of adults enrolled with the company’s health insurance, you will be entitled to MHD (Medical History Disregarded) underwriting whereby no pre-existing conditions need to be declared and all conditions will be covered.

Unfortunately, no. Most medical insurance policies require you to purchase an inpatient module (hospitalisation) and offer outpatient, maternity, dental and optical modules as optional modules to purchase.

Every year, insurance companies may adjust their premiums to keep up with medical inflation. Other factors that determine an increase are age and claims. Smaller companies are usually under “community-rated” terms which means that renewal rates are based on the entire client portfolio’s performance, not your company’s claims specifically. This means the risks are spread evenly. Under large companies, almost all plans are “experience-rated” which entails that renewal rates are based on your company’s claim ratio. In other words, the more your employees claim and have large claims, the more expensive the premiums at renewal.

Unfortunately, you can’t. Changes only occur at renewal. This will need to be notified before your renewal date with plenty of time for your changes to occur.

There are two types of premiums calculated by insurers – Community Rated and Experience Rated.

Community or Pool Rated premiums are based on the medical claims of everyone within a community or risk pool, whereas Experience Rated premiums are calculated using each individual’s claims history. Upon renewal, rates will increase based on either of these two strategies.

Initially, Community Rated premiums tend to be more expensive, but the yearly premium increase is predictable and can be budgeted for. Medical inflation in Southeast Asia has been around 9-12% in recent years, and Community Rated providers typically raise their rates between 5-10% annually.

In contrast, Experience Rated premiums are typically cheaper at the outset, but more of the premium is converted into profits for the insurer. If an insurer pays out a lot for a client’s claims in a given year, they will find a way to recoup that money in later years by increasing premiums.

Experience Rated providers often impose a “loading” at renewal if a client is diagnosed with a chronic illness or an injury requiring long-term care and subsequently leading to high claims. This loading can result in a renewal premium that is much higher, up to two to five times the current premium, or the client may not be offered a renewal if their liability to the provider is too high. Community Rated policies do not have these issues.

Typically, there are four distinct types of underwriting procedures: Full Medical Underwriting, Medical History Disregarded, CPME Underwriting and Moratorium.

Full Medical Underwriting (FMU)

FMU is a common medical underwriting process in Hong Kong. FMU has a basic medical questionnaire you must fill out. With most medical insurance application forms, you must disclose everything such as any pre-existing conditions. Any disclosed conditions could be either accepted, accepted with a premium loading, or excluded. If you don’t disclose a condition, it may result in the cancellation of your policy

 

Medical History Disregarded (MHD)

MHD is typically offered to group medical policies with a certain number of employees. There is no health declaration form and any pre-existing conditions you might have will be ignored and covered under the policy. Please note, insurers have their own general exclusions which will not be covered under MHD.

 

CPME Underwriting

CPME underwriting works by allowing you to transition the same terms you had with your other insurer to your new insurer. This works very well with existing policyholders as they will not need any further medical underwriting. Typically, the new insurer will ask you to fill out an application form and provide them with your existing benefits schedule to see if they are able to transfer you to one of their medical policies.

Usually, the transfer between two insurers will need to be approved by both insurers.

 

Moratorium

Moratorium underwriting includes an application form whereby you must state all pre-existing conditions which have occurred within a specific period. This can range from the previous five years to two years depending on the insurer. These pre-existing conditions will then be put on the insurers waiting period, where they will be excluded from your coverage for a specific period. Your pre-existing condition could be included in your coverage after at least two years of cover. However, this depends on the insurer and their waiting period policy.

There are various ways a health insurance policy can be adjusted to fit your budget. Here are some examples –

• Co-insurance – A co-insurance is an amount payable towards eligible inpatient or outpatient costs each time you claim.
• Deductible – A deductible is a single amount that each member will pay out-of-pocket towards your eligible medical costs each year, before the insurance “kicks in” for the rest of the policy year.
• Choosing a Semi-Private Room instead of a Private Room – It means that Hospitalisation and Day-care in the entire area of cover will be covered up to Semi-Private room, and should you end up having treatment in a Private Room, you will be liable to pay the difference: room charges, surgeon charges, anaesthetist charges etc.
• Choosing smaller area of cover for your group health insurance like Worldwide Excluding US instead of Worldwide can bring down the cost considerably
• Avoiding the extras – When it comes to health insurance, you have the option to include or exclude certain benefits such as dental, maternity, and wellness. While these may come at an added cost, it’s important to consider the advantages and disadvantages before making a decision.