I came into the meeting with a quotation of a higher basic sum assured but with an average medical plan, the SM200. The number "200" indicates that the insurance company will bear up to RM200 for each stay in a hospital room per night. If the client chooses to upgrade to a more expensive room, he/she will have to pay the price difference between the room and RM200. On top of that the client will have to bear 20% of the total medical cost, limited to RM3000 during his/her stay there. For example, if the client subscribed to SM200 and upgraded to a RM260/night room for 5 nights and the total medical cost is RM6,000, he/she has to pay:
5x[260-200] + [6,000x20%] = RM1,500
On the other hand, if the total medical cost is RM20,000 (remember that the co-payment for the medical cost is limited to RM3000):
5x[260-200] + [20,000x20%] = RM4,300
Medical cost limited to RM3000, co-payment is reduced to: RM500
In the event that the client chooses to stay within the limit of his room cost, he/she only has to pay for the 10% of the medical cost, limited to RM500. For example, if the client subscribed to SM200, stayed in a RM180/night room for 7 nights, and with a total medical cost of RM15,000, he/she has to pay:
[20,000x10%] = RM2,000
Medical cost limited to RM500, co-payment is reduced to: RM3,300
After explaining to the client as to how the reimbursements for the rooms come into play, the clients immediately decided that he wanted the SM300 as opposed to SM200. If he were hospitalized, he wanted to stay in a single room where his family can camp out to give him moral support. I made up the last part, but his arguments are valid. The cost for hospital rooms is increasing over the years, and single rooms in accredited hospitals in Selangor cost from RM198 and all the way to RM298. This means that if a client subscribes to SM200 and he is admitted to the hospital with the cheapest single room of RM298, he/she has to either downgrade to a double-bedded room or pay the price difference for each night of his stay and commit to a 20% co-payment of the total medical cost.
In truth however, the term client is a misnomer. He is not my client until he has subscribed to an insurance policy. At the end of the meeting, he expressed great interest in subscribing to one, but had to do a little research before making the decision. It was a smart move as subscribing to a policy is a long-term commitment, and not one that can be decided in just one night. I am counting on this prospect and am looking forward to hear from him soon.
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