Life, critical illness and accident cover: 19 common questions

Life, critical illness and accident insurance answer one question: what happens to my family if I die, fall seriously ill or have an accident? Each answer comes first, then the reasoning.

19 questions

Life, critical illness & accident

How much life insurance do I need? How many times my annual income?

A common guide is about 10 times your annual income, but it is more accurate to work out the gap: housing loan and other debts, plus your family’s living costs for the years they need support and your children’s education, minus savings, EPF and existing cover. The difference is the cover you need.

Is term life or whole life right for me?

If your budget is limited and you have a housing loan and young children, term life gives high cover at a low premium during the years you need it most. If you want lifelong cover, cash value or legacy planning, whole life fits. Many families combine both.

I’m single with no dependants. Do I need life insurance?

If no one relies on your income and no one would inherit your debts, life cover is not the first priority; a medical card and critical illness cover matter more. But if you have a housing loan, support your parents or plan to start a family, a term plan bought while young and healthy is cheap.

What does critical illness insurance cover? Is early-stage cancer covered?

Malaysian critical illness plans generally cover a standard list of serious illnesses, such as cancer, heart attack, stroke and kidney failure, commonly 36 or more conditions. Early-stage cancer is only covered if the plan includes early-stage benefits. A plan that only covers severe stages may not pay for early cancer.

What is the difference between early, intermediate and severe-stage critical illness?

These are levels of severity for the same illness. Multi-stage plans pay part of the sum assured at an early stage and the rest at the severe stage. Plans that only cover the severe stage pay once the illness meets the severe definition. Multi-stage cover costs more but pays earlier.

After one critical illness claim, does the policy end? Can I claim more than once?

It depends on the plan. Many traditional critical illness benefits end after paying the full amount. Some plans offer multiple claims, for example for different illness groups or cancer recurrence, usually with waiting intervals. Check before you buy.

I have a medical card. Why do I need critical illness cover too?

A medical card pays hospital bills. Critical illness cover pays you a lump sum on diagnosis. Recovery from a serious illness can take months, with no income while the loan, household bills and uncovered costs continue. The lump sum is for those.

What is the difference between personal accident insurance and an accident rider on a life policy?

Standalone personal accident (PA) insurance is usually cheaper, covers accidental death and disability, sometimes accident medical costs and hospital income, and renews yearly. An accident rider is attached to your life policy and pays extra on accidental death. They complement each other.

Does personal accident insurance cover motorcycle accidents?

Most PA policies cover motorcycle accidents, but some pay a lower amount for them or restrict certain jobs such as delivery riders, and a valid licence is usually required. Tell the insurer you ride a motorcycle when you apply.

Is accident insurance more expensive for high-risk jobs such as construction, lorry driving or delivery?

Yes. Insurers price by occupation class, so high-risk jobs pay more, some benefits may be limited, and a few occupations may not be accepted. Because the risk is higher, the cover matters more. Declare your job accurately or claims may be affected.

Is suicide covered?

Life policies generally don’t pay the sum assured for suicide within one year of the policy starting or being reinstated, and only refund premiums paid, depending on the terms. After one year, the policy generally pays as normal.

What happens to life insurance if someone goes missing?

A life claim needs proof of death. If someone goes missing, the family generally has to wait for a legal presumption of death (under Malaysian evidence law, usually after seven years) or apply to court for an order presuming death. Keep paying premiums meanwhile so the policy doesn’t lapse.

How is total and permanent disability (TPD) defined?

TPD generally means being totally and permanently unable to work for income because of illness or accident, usually confirmed after a continuous period such as 6 months, or specified cases such as total blindness or loss of two limbs. Definitions and age limits (for example before 65 or 70) differ between policies.

What is waiver of premium, and should I add it?

Waiver of premium means future premiums are waived if the life assured or the payor suffers a critical illness, TPD or death, and the policy continues. It is especially worth adding a payor waiver to a policy parents buy for a child, so the child’s cover doesn’t stop.

Can I stop paying premiums? How much do I get back if I surrender?

You can, but the result depends on the policy. Term life simply ends with no refund. Policies with cash value can be surrendered for that value, or converted to reduced paid-up (no more premiums, lower cover). Check the cash value table first, and consider whether you could buy the same cover again.

I paid for 10 years. Why is my surrender value so low?

Part of each premium has paid for 10 years of protection, commissions and administration, and investment-linked plans also depend on fund performance. Early cash values are usually low and rise closer to maturity, which is why surrendering savings or investment plans early is costly.

Can I borrow against my policy? What is the interest rate?

Traditional policies with cash value usually allow a policy loan up to a percentage of the cash value. The interest rate is set by the insurer and can change. Unpaid loans and interest are deducted from claims or surrender values, and if the debt exceeds the cash value, the policy may lapse.

Should I keep my old policy or switch to a new one? What are the risks?

Generally keep the old policy and top up the cover it lacks. Switching risks new waiting periods, higher premiums at your current age, exclusions for conditions that appeared since, and losses from surrendering the old plan.

Someone is telling me to switch policies because the new one is better. Should I believe it?

Don’t cancel anything yet. Ask for a written comparison of cover, premiums, waiting periods and exclusions for both policies; agents are required to explain the risks when recommending a replacement. Send both to Lulu for an objective comparison, and only deal with the old policy after the new one is approved.

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