Frequently Asked Questions

FAQs – Individuals and their families

  • Will my premium increase if I make a claim?

    No, our policies are community-rated – this means that risk is shared across the global pool of all policy holders and our premiums are set accordingly. We do not believe that individuals should be penalized for making claims but all premiums will typically increase to some degree each year to account for the inflation of healthcare costs. Your premium will also increase if you move into a higher age-band or if you lose a no-claims discount.

  • I currently have a medical condition, would I be covered for this?

    No, our individual policies are underwritten on a 24-month moratorium basis. This means that any condition you have had, or have experienced symptoms of, within 24 months prior to the commencement date of your policy will not be covered. This is a rolling moratorium, so once you have had 2 years of continuous cover, a 24-month period free of symptoms and recurrence is not forseeable, you may be covered for that condition.

    However, individuals with pre-existing conditions do have the option of applying for FMU – Full Medical Underwriting – whereby coverage for some or all of these conditions may be provided. This requires completion of a more extensive medical declaration which will be assessed by our underwriting team. If your application is accepted, your premium will typically be subject to a surcharge to account for the additional risk assumed by NZI Healthcare.

  • Am I covered outside of Thailand?

    Yes, coverage is worldwide excluding USA. However, all plans except Standard do include some degree of US cover for life-threatening medical emergencies. If you travel to the US we recommend taking a travel insurance add-on which provides full cover in USA up to a plan limit of THB136 million.

  • Will NZI Healthcare settle my bills directly with the hospital?

    For in-patient treatment, we operate a direct-billing facility at any of our contracted hospitals. Costs for treatment at hospitals with which we do not have a billing agreement will be dealt with on a case-by-case basis but typically require a letter of guarantee which we will provide for any hospital worldwide. Out-patient medical costs are dealt with on a pay-and-claim basis: the patient pays directly to the hospital, submits a claim form, and we reimburse the costs within 15 business days unless more information is required for claims assessment.

    Check out our list of contracted hospitals in Thailand.

  • What happens if I relocate to a different country?

    We will transfer your policy free of charge to the most suitable option for the specific country you are moving to. This could be an international plan denominated in US$, GBP or Euros or a locally licensed plan via one of our local offices.

  • Can I pay my premium in installments?

    Yes. You can pay your premium annually, quarterly or monthly. There are additional charges for the latter two options.

  • The premium is a little out of my budget, is there any way I can reduce this?

    Yes. We offer the option of taking a larger voluntary excess that will reduce your premium by 5% to 40%. An excess is the level of healthcare costs that the policy-holder agrees to cover him/herself before making a claim. For example: You have a bill of B90,000 and an excess of B34,000 on your policy. You would pay B34,000 of this cost, NZI Healthcare would cover the remaining B56,000. Excesses operate on a per-condition, per-plan-year basis.

  • Are there any conditions or types of treatment that are permanently excluded?

    Yes. Examples include congenital birth defects, infertility treatment and sleep apnea. Please contact us for a full list of policy exclusions. Or download a copy of our policy documents.

     

FAQs – Corporate Groups

  • What kind of medical insurance policy premiums are considered an expense which we can offset against our income, thus reducing our tax liability in Thailand?

    Premiums paid for employee medical insurance only under a policy that is licensed in-country by the Thailand Office of Insurance Commission (OIC). NZI Healthcarehealth insurance plans are fully licenced with the OIC and are fully tax-deductible in Thailand.

    Any premium paid to a provider outside of Thailand, and/or for a policy that is not licensed in-country, cannot be offset against tax liability under Thai law.

  • Will our premiums increase if I make a claim?

    All group premiums are assessed based on a number of criteria including claims history, so may increase upon renewal, subject to our underwriter’s assessment. We always endeavor to make any claims-based increase reasonable. All premiums will typically increase to some degree each year to account for the inflation of healthcare costs.

  • One of our employees has a medical condition, would he be covered for this?

    If your plan is underwritten with MHD (Medical History Disregarded) terms, yes, the employee would be covered within the plan remit. MHD underwriting is available for groups of 10 or more employees at a 25% surcharge. For groups of 50 or more, NZI Healthcare will waive the additional charge.

    If your plan is underwritten with moratorium terms he would not be covered at policy commencement. The moratorium means that any condition a member hassuffered, have experienced symptoms of, or sought treatment for, within 24 months prior to the commencement date of your policy, will not be covered. This is a rolling moratorium, so once a member has had 2 years of continuous cover, anda 24-month period free of symptoms or treatment, and recurrence is not deemed foreseeable, he/she may be covered for that condition.

  • Are we covered outside of Thailand?

    Yes, coverage is worldwide excluding USA. All plans except Standard include a limited amount of cover in the USA for life-threatening emergencies. However, if you do travel to the US we recommend taking a travel insurance add-on which provides full cover in USA up to a plan limit of THB136 million.

  • Can we pay our premium in installments?

    Yes. You can pay your premium annually, bi-annually or quarterly. There are additional charges for the latter two options.

  • Will NZI Healthcare settle our bills directly with the hospital?

    If your policy is subject to MHD underwriting, the direct billing facility is indeed available for in- and out-patient treatment at contracted hospitals. For policies subject to moratorium underwriting, the direct billing facility will apply to in-patient treatment only. Out-patient medical costs are dealt with on a pay-and-claim basis for moratorium policies: the patient pays directly to the hospital, submits a claim form, and we reimburse the costs within 15 business days.

    Costs for treatment at hospitals with which we do not have a billing agreement will be dealt with on a case-by-case basis but typically require a letter of guarantee, which we will provide,prior to patient check-out,for any hospital worldwide.

    Check out our list of contracted hospitals in Thailand.

  • Are we eligible for MHD underwriting and is there an extra charge for this?

    Groups of 10 or more employees are eligible for MHD underwriting subject to an additional charge based on the size of the group. MHD underwriting is provided free of charge for groups of 50 or more employees.

  • Are there any conditions or types of treatment that are permanently excluded?

    Yes. Examples include birth defects, conditions resulting from alcohol or drug abuse, infertility treatment and sleep apnea. Please contact us for a full list of policy exclusions, or download a complete policy wording to study at your convenience.

  • What do NZI Healthcare need from us in order to provide a quotation?

    *Census – member names, dates of birth and an indication of whether members are employees or dependents

    *Details of job role and duties for any members not employed in a typical office role. Especially relevant for those working offshore or in a high risk environment.

    Claims history

    Details of your existing policy

    Your priorities and budget

     

    *Mandatory