Medical Insurance

Cancer Patient Died Due to Experience Loading

Can you believe what you read here?

Let us explain: We are talking about people who are insured here in the Philippines. The two most important underwriters here are Blue Cross & Pacific Int’l (they are sister companies). Both of them created in their policies an absolute, impossible & unacceptable clause, the “EXPERIENCE LOADING.”

How does this work? What does it mean? What to do about this?

Let us try to explain. How does it work abroad? If an insurance company has a medical portfolio and they make losses (more claims payables the premium income) they will increase the premium for all the members / insured! This sounds logical, right? This is the basis of insurance! One for all and all for one! That is how insurance (they call it TONTINE) was started more than 500 years ago.

But with medical insurances in the Philippines, it does not work like this! The above-mentioned underwriters inserted the experience-loading clause! Apart from the regular periodical increase of premium, based on claims statistics and increase for medical expenses(hospitals/doctors/medicines), the insurer has the right to increase the individual premium of an insured with a high utilization report (claims statistic).

In short, as mentioned as an example in the headline, cancer (recently discovered) patient who was insured already for more than 10 years without any claims, until the time they discovered the illness after maybe 2 years, can be confronted with an individual increase of premium of 200 to 300%.

Because optimum and decent income protection insurance within the Philippines is not available, the insured cannot pay the premium anymore. Therefore, he cannot avail of optimal medical support. For sure then he will die due to the “experience loading”!

For 5 years Ascolin Insurance Consultants & Agency is fighting insurers to eliminate that clause. We strongly believe that because of our persistence this “monster” clause will be history soon!

Leave a Reply

Your email address will not be published. Required fields are marked *