Take Health Insurance When Healthy, If Not Claim Easily Rejected
You should take health insurance when you are healthy. Why ? even when registering healthy, including passing medical checks, but because you already have a disease before, most likely the insurance company will refuse your health insurance application.
We once received a reader's vent telling us that the health insurance company rejected her ill claims despite her paying the premium on time and being a member long enough.
Inquired had a search, the insurance company refused because the disease claimed to have suffered participants before becoming an insurance policyholder.
"Why, is not I already pass the medical check-up when filing?" Asked this reader further. He seemed to not believe the explanation and felt lied to.
We need to understand the provisions in health insurance. This provision will determine whether or not a claim submission is accepted.
# 1 Pre-Existing Condition
This provision briefly stipulates that claims for pre-existing illness prior to becoming an insurance policy holder will not be replaced or covered.
For example, before becoming a policyholder, you already have high blood disease. Thus, the claim of high blood treatment will not be replaced and so on.
In one health insurance policy, we find this provision as follows:
Pre-Existing Condition
Any type of Illness, Conditions, Injury, or Inability:
existing or existing; or
where the cause exists or has existed; or
where the Insured and / or Dependent has known, there have been signs or symptoms or illness; or
as indicated by the results of laboratory tests or other investigations indicating the possibility of certain conditions or illnesses; before the Policy Issuance Date or the date of change (Addendum), whichever is most recent.
We can see that the scope is wide enough. In essence, the insurer will not reimburse the cost of the disease claim that has been suffered by the previous policyholder.
# 2 Waiting Period 30 Days All Diseases
When you become a health insurance participant, you can not necessarily make a claim. There is a 30 day waiting period.
During the waiting period, participants are not allowed to make a claim. After 30 days from the issuance of the health insurance policy, new participants may file a health claim.
# 3 Waiting Period 12 Months Special Illness
Not all diseases can claim participants after 30 days of health insurance membership. Because insurance companies set a number of diseases that the waiting period reaches 1 year.
Here are 17 special diseases that have a 12 month waiting period, namely: (1) All types of Hernia; (2) All types of tumors / lumps / cysts / Cancer; (3) Tuberculosis; (4) Endometriosis; (5) Hemorrhoids; (6) Diseases of the tonsils or adenoids; (7) Abnormal conditions of the nasal cavity, nasal septum or nasal shell (konka), including sinuses; (8) Thyroid gland disease; (9) Hysterectomy (with or without salpingo - oophorectomy); (10) Heart and vascular (cardiovascular) disease including all strokes; (11) Hemorrhoids and fistulas in the anus; (12) The stones in the bile duct system; (13) Kidney stones, urinary tract or bladder; (14) Cataracts; (15) Gastric or duodenal ulcers; (16) All types of reproductive system disorders, including fibroids / myomas in the womb; (17) Intervertebral disc prolapse;
# 4 Important Convey Honest Information
In the policy, the insurance company stipulates that:
"In the case of giving a statement, statement or explanation in the Letter of Life Insurance / Health Request and / or Insurance Request Form for Data of the Insured Candidate and / or its change submitted by the Policyholder, there is an element of fraud and / or forgery then the Insurer has the right to disprove the truth Policy at any time so as to be entitled to cancel the Insured. "
This provision essentially states that false statements will cause the claim reimbursement not to be made. So if ever or feel the disease should reveal with honest and sejurjurnya.
Because if not honest, the consequences will be incriminating the participants. For example, it has been paying premiums on time, but when the participant filed a claim was rejected because the insurer found dishonest information during the disease investigation.
Conclusion
You can see that if a health insurance filing is made after suffering illness, then the claim is likely to be rejected. This is primarily for illnesses that have already suffered before becoming a health insurance participant.
Pre-existing conditions are the standard in the insurance world because insurance companies do not want to bear the participants who clearly already have the disease.
Insurance companies want to receive healthy participants. If later sick (after becoming a participant), it is a risk received by the insurance company.
So, you strongly suggested to volunteer and family to be a participant of health insurance as early as possible when the health condition is all still excellent.