Insurance - Health Insurance / Medical Insurance

Health / Medical Insurance: includes a variety of plans offering world-wide protection, 24-hours a day, including in-patient benefits (operations, medicine, surgeons fees), out-patient benefits (clinic visits, general consultation, prescribed drugs and dressings), emergency medical repatriation / evacuation, maternity cover, physiotherapy, psychiatric illnesses, dental work and traditional medicine, amongst others.

In-Patient Benefits: a health insurance contract covering all or part of the cost of hospital treatment and care.

Out-Patient Benefits: a health insurance contract covering all or part of the cost of medical treatment and care provided on an out-patient basis.

Emergency Evacuation Plan: covers costs incurred in moving an insured person from the place of incident to the nearest appropriate medical facility, as determined by the attending medical practitioner or specialist and in conjunction with the insurer’s medical advisors.

Maternity Cover: covers all or part of the cost of giving birth. If you are planning to start or expand your family it is important to be aware that insurance companies in many cases do in fact offer maternity benefits, but that these benefits are generally subject to waiting periods and limits. Very few plans offer full cover for the birth of a child, instead providing partial cover that you can put towards the total cost of having a baby, which can be substantial in some of the leading urban centres in Asia, particularly cities like Hong Kong and Singapore.

Dental Cover: a segment of a medical or health insurance contract that covers all or part of the cost of dental treatment.

Cashless Billing offers users the ability to present their insurance card at a hospital or clinic, whereby the insurer will settle the cost of your medical care direct with the provider of medical care. Many insurers have panel doctors and networks of clinics and hospitals that they deal with directly for the settling of insurance claims. This is certainly convenient for the user or patient, but it is not necessarily without its pitfalls as users may often be guided towards treatments or prescriptions that are dictated by the limitations of their insurance cover or certain agreements that may exist between provider and insurance company.

Deductible / Excess: cashless billing will generally be a feature of just a certain portion of insurance policies. In a bid to reduce the level of premium that one is subject to, customers may take up the option of a deductible or excess on their insurance policy. In such cases the individual will bear the cost of treatment up to an agreed level- that of the deductible or excess – at which point the insurer will then start to bear the cost of the medical treatment. The terms and levels of excess and deductible vary from insurer to insurer. For example an excess may be applied by an insurance company per medical condition on claims made by an individual during their period of cover. Meanwhile a deductible may be applied to all claims made by an individual on her or his cover per policy year. That is anything up to an agreed level is paid for by the individual, and anything over that number is handled by the insurer. Swiss-Sure is able to offer guidance on the ins and outs of deductibles and excesses and what could work best for you based on your requirements.

the medical history of an applicant is taken into account by an insurer on receipt of their application to assess whether that individual has any pre-existing conditions that should be taken into account with reference to their application. The presence of a pre-existing condition may in turn have an impact on the underwriting process that insurers undertake when assessing an application. There are a number of different ways in which insurers approach pre-existing conditions and we at Swiss-Sure can assist you in finding the right one for your particular circumstances.

While some insurance companies may reject applications or exclude pre-existing conditions from the terms of cover of a policy, it is vitally important for an individual to be truthful on an application. This is because if an insurer finds out at a later date that certain facts were knowingly omitted from an application, which should have been included, then a policy can be immediately cancelled leaving an individual with zero cover- a far from ideal situation.

Therefore, while some companies will simply exclude pre-existing conditions and those conditions that later arise which may be related to the initial existing condition, there are those that take a slightly different approach. Some companies may implement a loading to the listed premium. This means that the applicant will be able to see that condition covered at an additional cost on top of the listed or original premium.

Another approach is that an insurance company may implement a moratorium on that pre-existing condition. A medical insurer-imposed moratorium on a pre-existing condition is generally a period of two years. If, during this period, there are no recurrences of illness related to the pre-existing condition the insurer will then look at including the condition under the terms of your policy. It is important to note that when making medical or health insurance offers to companies or groups, that insurers will often include a medical history disregarded (MHD) clause as an incentive to secure the business.

Areas of cover that are often causes of confusion and can sometimes lead to conflict with insurers include extensions for chronic conditions, routine and major restorative dental, extended home nursing, maternity cover and USA elective treatment, not to forget USA exclusions. The key with seeking cover for these very specific requirements is that you fully understand the small-print and exclusions when you enter into a policy contract.

This is where Swiss-Sure prides itself in offering a level of service a step above the rest: a ‘no holds barred’ explanation of the pros and cons of different policies. We help you to make sense out of the small print, saving you time and confusion in those moments when you come to rely on your cover. At Swiss-Sure, unlike with many other companies, our relationship with you only begins when we assist you to identify the right policy for you, your family or your organisation.

When an individual secures medical insurance through Swiss-Sure, because of the size of our client base and our 25+ years of track record in the industry, they are able to reap a number of the benefits that are typically enjoyed by groups or companies when such organisations participate in collective insurance schemes.

This is important for a number of reasons: Insurers can go out of business, withdraw from certain markets or jurisdictions, cancel policies or cease products. These situations are not day-to-day occurrences, but they do happen.

If this happens to an individual that is relying on a policy’s coverage it can have a devastating impact on a person or indeed a group of individuals. In such a scenario, Swiss-Sure, with its substantial quantum of business and long-established relationships with insurers, can assist in seeking to secure replacement cover with the goal that any transfer will be conducted based on the same or better terms.

Swiss-Sure would also use its position to seek new cover with no new medical underwriting and or the waiting period potentially waived. The Company is able to pursue these solutions based upon our track record in the industry and solid relationships with insurance providers.

Swiss-Sure is able to properly represent our clients in these types of circumstance as we can negotiate with insurers based on the size of our client base, our 25+ years in the industry in Asia and because we are an independent broker and not an insurer or an agent affiliated with any particular insurance company.

Medical / health insurance can be purchased by an individual or indeed by an association, organisation or company for its employees or members (i.e. a Group Medical scheme).

Swiss-Sure’s Group Medical Insurance portfolio and client base has grown steadily over the last 25+ years driven and supported by a commitment to our individual clients. In many cases our individual clients, being senior executives and company leaders, have referred Swiss-Sure to act as medical and general insurance advisors to their companies. We have provided intermediary and advisory services to some of our group clients for in excess of 20 years, securing them just a few years following our company establishment in 1988.

The Company currently counts private banks, wealth management firms, global infrastructure groups and international schools across Asia amongst our valued group clients.

The services that we offer to our individual clients are very similar to those that we offer to our group clients; independent insurance advisory and intermediary services, supported by our pledge to put our clients first, always.

With insurance costs and premiums under continued upward pressure, driven by the rising cost of medical treatment, particularly in key metropolitan centres, we at Swiss-Sure fully understand the challenges that companies and HR professionals face on a daily basis; balancing employee expectations with financial limitations.

At Swiss-Sure we seek to provide innovative insurance advisory services to enable companies to offer their employees quality health insurance cover within the parameters set by company management. We work hand-in-hand with Company management and dedicated HR teams to arrive at health insurance solutions that work for the whole organisation, including company management and employees.