Page 58 - MEDICAL AND HEALTH INSURANCE

MEDICAL AND HEALTH INSURANCE

 Workers handling explosives and other toxic materials.

Occupational classifications help to determine the premium and the type

and amount of coverage to be offered. Higher premium and stricter terms

and limits may be imposed on the more hazardous class. A loading factor

would normally be applied on the occupational class, depending on the
insurer's risk appetite.

HOSPITAL BANDING AND CHARGES

The relative luxury of the hospital services and environment has a bearing

to its charges for the services rendered. In other words, high-end private

hospital pricing will differ from a medium-

ranged private hospital and a public hospital. No doubt, the surgeon fees

has been contained by the 13th Schedule of the Private Healthcare
Facilities and Services (Private Hospitals and Other Private Health Care

Facilities) (Amendment) Order 2013 but the main bulk of the hospital

supplies and services are controlled by the respective hospital

management, which may differ in costing.

So, if the insurance product caters for a five-star panel private hospital for
the customer, it would be priced for it as the resultant claim cost would be

related to the services and facilities offered.

The rationale for hospital banding pricing differentiation is that the pricing

difference may vary from 10% to 20% or more for the same disability

within the same locality when comparing like to like in terms of medical
treatment.

AGE AND GENDER RELATED (BANDING AND AGE-SPECIFIC) RATING

The gender of a person also has an effect on the person's probable

morbidity rate. In general females tend to have a higher morbidity rate

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