I wrote about my shooting-through-the roof insurance premium in 2024. The saga sadly continues.

In July, my insurance company sent out emails asking if I, its customer, wanted to save on insurance premiums. I said, yes. How? Deductibles, it said.

The email, paraphrased, read as follows. ‘The higher the deductible the more you can save. A higher deductible helps you to reduce your premium due to lower insurance charges. The new medical plans offered come with multiple co-payment options to suit your needs. You can get a RM250 cash reward if you upgrade and/or sign up for a new policy.’

The cash reward didn’t apply to existing policies. Fair enough. However, the new deductibles did. In asterisk, ‘Terms and Conditions’ apply, naturally. Our agent suggested my husband and I sign up for a new policy, although it offered no additional benefits to us. Hmm.

Currently, I have a deductible or a Med Saver of RM300. The deductible amount has been status quo since 2019, despite the two heart-stopping increases last year. What a deductible means is I pay the designated RM300 for treatment sought. The insurer pays the balance if/when my medical bill exceeds RM300.

The new higher deductibles are RM1k, RM3k, RM5k and RM10k. The discounts are based on age, premium and policy type, and they range somewhere between 10% and 30%. Anything to save money on escalating premiums was worth considering. Yes? Hmm.

As I said the emails arrived in July this year. And, the toing and froing began with our agent. First to clarify what it meant by a deductible per disability. I already understood that I had to pay upfront up to RM10k, for example, if necessary, to treat my fractured wrist. Beyond RM10k, the insurer paid.

The question we had was how disability applied to cancer, which would very likely require intensive and longer periods of treatments. Hence, what if an insured needed more than 12 months of immunotherapy and chemotherapy? Does one disability cover treatments for however many years?

We received unsatisfactory and contradictory answers from the agent, and from his online customer service colleagues. Plus, the FAQs on the website, which we were referred to, didn’t add any clarity.

The definition for ‘Any One Disability’ in the policy is:

‘Refers to the single Disability and its complications that result in the Life Assured being Confined to a Hospital one or more times, or seeking Outpatient treatment. Ok

All Confinement to a Hospital and/or Outpatient shall be considered to be from the same Disability if the Life Assured has not completely recovered and is still under treatment for that Disability and its complications. Ok

Life Assured’s Confinement to a Hospital and/or Outpatient shall be considered to be from a new Disability if the Life Assured has fully recovered and does not require any more treatment for the Disability for a period of more than ninety (90) days following the date of discharge from the last Confinement to a Hospital or from the date of last Outpatient treatment for the same Disability.’ Ok except …

The word ‘and’ was the contention. My husband explained that in law, the word ‘and’ means that both conditions must be met, i.e. the Life assured must have fully recovered AND does not require treatment for more than 90 days. Even if treatment is not required for more than 90 days but the Life Assured has not fully recovered then it’s not considered a new disability. If the cancer remains (i.e. not fully recovered) but no treatment is required for more than 90 days, it’s not a new disability. Hmm. So how? Still waiting…

The second query was why I, not my husband, was required to sign an Offer of Conditional Acceptance (OCA) to increase my deductible. Why indeed? Screenshots of text exchanges between my agent and his colleagues explained that it was to remind me that I had an exclusion i.e. I cannot make a claim for any treatment related to arthritis. And, another eight, yes, eight conditions were listed under a Terms and Conditions section.

The arthritis exclusion and the eight conditions in one form or other are already present in my 2019 policy. I pointed this out to my agent, who said it was a standard thing. Really? What am I missing here?

Sad to say, I’ve little confidence in what my agent or his colleagues have communicated thus far. They seem to regurgitate standard-template responses rather than make an effort to understand the actual questions. Annoyingly, insurance agents are more interested in introducing and selling new policies, even when they’re not needed or relevant.

I’m wondering aloud about the real benefits offered in convoluted insurance policies, the quality of services provided by agents/companies, and the incongruity between the still rising premiums and the still profit-making players in the local insurance industry. Hmm.