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MHI UNDERWRITING GUIDELINES. MHI UNDERWRITING GUIDELINES.

Relevant highlights from the Medical and Health Insurance Underwriting Guide :-

  • Criteria for Individual/Family/Riders of Life Policy (page 3)
    • Premium charged to be Age-band for at least 5 bands.
    • The premium rate and description of the benefit/exclusion clauses must be clearly published on the brochure to the proposer.
    • Apply reasonable and customary charges and Co-payment clause for "As Charged/Full Reimbursement" policy.
    • "As Charged/Full Reimbursement" policy shall be subject to an Overall Annual Limit and not on per disability basis.
    • Apply Cooling-Off Period Clause.
  • Weight to Height Ratio (page 6)
    • The weight to height ratio is a method of measuring whether a person is overweight.
    • Grossly overweight people have a high tendency of suffering from hypertension, and Cardiovascular Diseases.
  • Effective Date of Coverage (page 7)
    • The Effective Date of coverage for the Insured Person(s) shall be the date in which the Insurer has accepted his/her application and has paid or agreed to pay the appropriate premium. No issuance of covernote be exercised pending approval of acceptance.
  • Occupation
    • The occupation of a person subjects the person to accidental as well as health hazards. As such the occupation of the person is an important consideration in underwriting.
  • Medical Underwriting (page 10)
    • It is normally not adequate to impose premium loading only for declared medical conditions or past medical history. This is because there is no amount of loading is adequate to cover a possible recurrence arising from certain disabilities. As such, it would be more appropriate to exclude the treatment for the condition whilst the policy will still cover others. For example, the condition like "Diabetes Mellitus" is a condition that will never be recovered. It can only be under control but not cured. As such if an applicant declares to suffer from this condition, it is advisable to exclude it for treatment permanently provided it is well controled and managed.
  • Uniform Policy Model (page 19)
    • Insurer is at liberty to develop products of varying benefits and coverage but to comply with the standardised wordings for the industry in respect of underwriting medical expenses insurance as set forth in the Glossary of Terms for Policy if the particular benefit, definitions, conditions and exclusion are used.
  • "Take-Over Policies" condition is defined as... (page 29)
    • "If this policy shall have commenced immediately upon termination of a preceeding policy and if an Insured shall have been afflicted with a medical disability at the time this policy started (and benefits under the preceeding policy would have been available to him), such Insured shall continue to be covered for the existing disability, but not to exceed the limits of the previous policy or limits of this policy whichever shall be lesser on condition the Company has secured a copy of the preceeding policy."

More information will be updated here from time to time.



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