Walter van der Wal

What about high blood pressure?

Always be 'up front' with your health insurer about high blood pressure


When submitting an application for the purchase of health insurance, many applicants avoid mentioning that they once had a high reading when they had their blood pressure checked. When eventually caught and confronted about this, they express surprise that mentioning it was really that important.

Their rationale for not mentioning it was that it happened rarely, or happened only once, and that anyone would get a high reading in a similar situation. Therefore, they didn't really feel that it was necessary to mention it. Unfortunately, health insurance companies strongly disagree with them on this..

Last year we had a couple of fairly recent applicants get hospitalized. Their hospitalization had something to do with their history of hypertension (high blood pressure), among other things, which they neglected to mention when filling out their health applications. The insurance company was quite upset. They refused to pay their claims and promptly cancelled their policies. They did refund their premiums, though.

A couple of other insureds who had their insurance for nearly two years sought treatment for something unrelated to hypertension. But, while they were being treated, the insurance company discovered that they had also had a history of hypertension which they had failed to mention when they applied for the insurance. Although they had had the insurance for nearly 2 years, the insurance company made them each complete a new application and resubmit it for reevaluation. The start date for their coverage would be the date that they resubmitted their corrected application.

One client explained that his "fear of doctors" was the only reason that his blood pressure ever increased. The reading only got higher than normal when it was checked at a medical facility by a medical practitioner. When he checked it himself, at home, the reading was never higher than normal. That is why he never mentioned the reading in the doctor's office. He felt that this high reading is normal for anyone who is nervous about visiting doctors. He doesn't feel that it has anything to do with him having a blood pressure problem.

To some extent, he is right. While surfing the Internet looking for the "causes of hypertension", I discovered a form of hypertension called "white-coat" (or office) hypertension. It refers to blood pressure that rises above its usual level when it is measured in a clinic setting, such as a doctor's office, where a nurse or doctor may be wearing a white lab coat. If a number of blood pressure checks are made during the visit, the blood pressure readings start going down and may even reach "normal."

High blood is broken down into two forms. These are described as "essential (or primary) hypertension" and "secondary hypertension". Essential hypertension is a far more common condition and accounts for 95% of hypertension. The cause of essential hypertension is multi-factorial, that is, there are several factors whose combined effects produce hypertension. In secondary hypertension, which accounts for 5% of hypertension, the high blood pressure is secondary to (caused by) a specific abnormality in one of the organs or systems of the body. White-coat hypertension falls under the category of secondary hypertension.

All well and good; but, what actually causes hypertension and how can it be cured? The truth is that medical science really doesn't know. All they really know is how to control it. And, they know that if it gets out of control it can destroy vital parts of your body, particularly your heart, and it can kill you.

In secondary-hypertension there are triggers that activate the cause of hypertension. These triggers don't activate hypertension in most people and only a select few have this problem. For most people, fear of doctors doesn't cause their blood pressure to increase when they have it checked by a medical professional. Cigarette smoking can also activate hypertension in some smokers, but not in most smokers.

Many people just experience "borderline" hypertension where the reading is just a little above normal.

In any case, the health insurance companies want to know about this because, if you don't keep your blood pressure under control, it will very probably become a serious problem for you in the future as you get older. And, your problem will become your health insurer's problem.

Yes, health insurance companies will exclude coverage for testing, medication and treatment of hypertension if you mention any higher than normal blood pressure readings. But that really shouldn't matter if you keep your blood pressure under control. Outpatient monitoring isn't costly, especially if you use a government hospital.


For more information on healthcare and medical insurance in Thailand, please feel free to reach out to Pacific Prime Thailand Insurance Brokers, or email Walter directly at walter@pacificprime.com




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