i really dont use it at all (never submit any claims). This is only for visa application.
As most medical insurance in asia, they have alot of exception for claims, ie any pre-existing conditions or related issie will not be covered. Say if you are on blood pressure pills than most heart related issue will not be covered. And the medical care here is reasonable priced so i can afford it (knock on wood).
Same here, i did a 90 online report the same day i left Thailand, 2 days later received email advising 90 reporting rejected reason being applicant left the country.
Also i purchased new medical insurance before i left and immigration give me another entry stamp for 1 more year until the expiration of the new insurance.