When it comes to acquiring health insurance, pre-existing conditions are only a problem if an agent tells you they are, right?
Wrong! As Colleen Thornton discovers…
An insurance broker’s job is to sell insurance policies. To achieve that, they must attract people like you and me. Most agents are very good at this, but that doesn’t mean they’re honest or acting in your best interests.
Some agents are only interested in increasing their sales quota, and they’re ruthless about it. They’ll overlook, disregard, or simply omit critical information. Others are guided by ethics. They’re informed, clear, and forthcoming with their clients.
How can you tell the difference? The questions they ask give a lot of insight, and I know from own recent journey in securing expat health insurance.
Ask me no questions, I’ll tell you no lies
The road to acquiring a reputable health insurance policy that actually deliver when disaster strikes isn’t as smooth as most people think––or as some insurance agents will have you believe. According to Andy Williams, who runs the most established expat insurance company in Chiang Mai (CNX-Insure), pre-existing conditions can cause major problems for people and the validity of their policy.
Why on earth would we divulge a history of hypertension, high cholesterol, or the presence of a heart stent?
This is particularly true if your pre-existing conditions are not established and stated clearly at the start of the insurance cover.
I sat down with Andy to discuss the problem of pre-existing conditions in securing an insurance policy. As an expert in the industry who’s also fluent in Thai, Andy has a keen sense of where things go wrong for honest people who want simple, cost-effective health cover in Chiang Mai.
The big business behind things left unsaid
Researching health cover is an issue for many people, primarily because they don’t do adequate research, namely ask the right questions. We all want that peace of mind nearly every agent and broker promises their health insurance policies will provide. The problem is that we don’t all want to do the investigative work required to secure one that actually covers us. The cost of a policy is usually an issue, but it’s not always the main barrier.
So, what is?
Full disclosure. If no one is asking––and better yet, your medical history is deemed “irrelevant”––why on earth would we divulge a history of hypertension, high cholesterol, or the presence of a heart stint?
To illustrate this, I’ll share my own story, which came up during the interview.
Back in December 2020, which marked the end of a long and challenging year for most of us, I received a call from an online company that compares insurance policies. They connected me to a broker that handles insurance policies for expats.
Many insurance agents, particularly the small fry, would claim to cover me
Normally, insurance isn’t really my “thing”––let’s just put it that way. For the better part of eight years, I’d been hopping around Southeast Asia completely uninsured. I drive a scooter and ride a bicycle every day. I’ve been ziplining (in Laos, no less), paragliding, rock climbing, abseiling, and various other risky activities enjoyed by many a nomad.
But last year I had an accident. It was minor, but it shook me. Then, I had another accident a few months later. Shortly after, I wondered if buying health insurance would be a wise move at that point in my life. I’d been spared major injuries twice already; was there a #3 in my future?
After all, life has taught me (and most people) that anything can happen to anyone at any time. I could have a proper accident that lands me in hospital. I could get dengue fever. I could visit with a doctor for a routine health exam and discover that I have high cholesterol or a heart arrhythmia. Then what? No insurance agent is going to cover me then, right?
Well, according to Andy, many insurance agents, particularly the small fry, would claim to cover me. Not despite those conditions, but rather in chosen ignorance to them.
“If disaster strikes, your health history gets assessed on the operating table, and that emergency heart surgery meets a big, fat CLAIM DENIED.”Andy Williams
What often happens with insurance policies is something insurance brokers refer to as “medical history disregarded.” Indeed, part of their pitch is to make your medical history irrelevant to your signing on the dotted line. The problem then is one of assumptions. People will presume that any pre-existing condition is irrelevant, and an agent won’t tell them otherwise. They may also believe that because their condition is controlled, it’s not really a condition.
The reality is that any pre-existing condition is only irrelevant to some of these shady insurance agents at two key times: when you pay for the policy and the period afterward in which nothing bad happens to you––phew.
But––as Andy explains–– “if disaster strikes, your health history gets assessed on the operating table, and that emergency heart surgery meets a big, fat CLAIM DENIED.”
In my case, that phone call I received took all of 10 minutes. The agency representative asked me important questions like my name, date of birth, nationality, and current place of residence. However, they did not ask me about my medical history, and I offered nothing. According to Andy, if I had a troublesome health history, then I’m likely not covered under my insurance policy for any costs related to my health issues. Ouch!
What is a pre-existing condition anyways?
Insurance policies are loaded with confusing clauses, caveats, and downright jaw-breaker terms. Such gobbledygook flies right over the heads of many people, and we’re not always willing to afford the time and effort required to understand a policy properly.
But it’s not the health insurance vernacular that should worry us as much as those seemingly simple, common phrases that we assume we understand. So, when an agent dangles that “medical history disregarded” carrot before us, throws us a reasonable enough price, it’s easy to take the bait and sign.
Forty-five percent of adults in the United States have hypertension or are taking medication for hypertension
I asked Andy, “some health issues are fuzzy, so how do you know if you have a pre-existing condition?”
“I’ll always ask if they have pre-existing conditions. Many say no, so I ask them if they take medication, and they say, ‘yeah, I take medication for blood pressure, but everyone takes medication for blood pressure. I don’t consider it a condition because it’s controlled.’ But then what happens if they stop taking the medication? Their blood pressure spikes and they’re in danger of having a heart attack.”
Forty-five percent of adults in the United States have hypertension or are taking medication for hypertension, making it seem the norm (source). But according to Andy, any health issue that makes you dependent on medication is considered a pre-existing condition, regardless of its pervasiveness.
Don’t disregard your medical history
Choosing not to divulge our medical history to an insurance agent is our choice and right to privacy, right? Absolutely, and if you’re prepared to deal with the consequences of that omission, and no one is pushing you for information, then all is well––sign on the dotted line.
But know full well that you are just as responsible as the agent for ensuring the terms of your coverage. If you have any heart condition, or you’re taking medication for a heart-related health issue, transparency is critical, even if an agent doesn’t ask. It’ll save you a costly surprise later and prevent you from spending loads on a premium for health cover not worth the paper it’s printed on.