Problem Claims? Understand the Pre-Existing Conditions

Jakarta, – Never heard of or read about pre-existing condition in insurance? The provisions regarding these conditions are important to know so that you don’t experience problems or difficulties when submitting a claim.

What is meant by pre-existing condition in insurance is a condition in which all kinds of illness, injury, or disability whose signs or symptoms are known or unknown to you, whether or not you have been diagnosed/received treatment/medication/advice/consultation by a doctor, which occurred before the policy was issued, or Recovery Which policy is the latest in accordance with the provisions of the policy.

easy, pre-existing condition is a condition where you have been diagnosed or have a history of certain diseases when you sign up for insurance. So, if you are honest about your health condition from the start of registering as an insurance customer, the claim process in the future will be smoother and easier.

As an illustration, imagine that you own a vehicle that was burned or flooded. Of course, the insurance company will not immediately be willing to provide protection for your vehicle because the risks borne will be very large.

It is very important for prospective customers to inform about pre-existing condition actually to the insurer. Because, if at a later date the insurer discovers the fact that the information provided is about pre-existing condition If it is not true, then the insurance company can cancel the policy and refuse to submit a claim.

But calm, does not mean to have pre-existing condition cannot be covered by insurance. Prospective customers with pre-existing condition still get insurance coverage.

Some insurance companies can still accept prospective customers with pre-existing conditions if they are old customers. With conditions, the prospective customer has never filed a claim related to the disease he is suffering from, and has never undergone medical treatment for the disease within a certain time.

Prospective customers can also become policyholders with exceptions, for example being a customer of a policyholder but an illness is included pre-existing condition will not be borne.

Another option is that the insurance company can also accept prospective customers on condition that they pay a premium at a higher rate. The premium increase is made because of the risk pre-existing condition tends to be higher.

Pre-Existing Conditions Are Often the Reason for Problem Insurance Claims

Pre-existing conditions also not infrequently it becomes a reason for disputes and even becomes an insurance problem between customers who cry out for losses and insurance companies because of a lack of understanding about this.

In order not to experience rejection of insurance claims which can result in customer complaints, prospective customers must be transparent. You should be open with insurance companies about your medical history. There is no need to cover up congenital or birth defects.

Some insurance companies may refuse insurance applications with conditions pre-existing condition to avoid customers shouting losses against disappointing claims. But there are also those who accept it with special terms and conditions depending on the policies of each insurance company.

Are you clear about pre-existing conditions? So make sure you always fill out SPAJ (Life Insurance Application Letter) or SPAK (Health Insurance Application Application) honestly, so that there are no problems with refusal of claims in the future.

Prudential has been loyal to accompany and protect the financial security of customers and their families for 175 years in the world, including 100 years in Asia and more than 27 years in Indonesia. From time to time we have overcome various challenges, and to this day Prudential Indonesia continues to stand firmly and always realize its commitment to protect the Indonesian people, one of which is reflected in the payment of claims of more than IDR 16 trillion during 2022.

This is possible thanks to the trust given by customers and good corporate governance to maintain the trust that has been given, and our focus is on supporting them so they can #SurelyStep into the future and get the best in life.

[Gambas:Video CNBC]

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