2012年5月25日金曜日

HEALTH INSURANCE MALAYSIA


ALL APPROVED MM2H APPLICANTS Below 60 years old have to purchase a Malaysian Medical & Health Insurance, International Heath Insurance Policy is also acceptable. Our Insurance Brokers represent a few Malaysian Health Insurance Plans and given below is Healthplan from a renown worldwide insurance company - Alliance Insurance ( www.allianz.com.my )  - Check out the terms & conditions below & the premium chargeable. (International Healthcare Plans also available).
Annual Premium for Cashless Plan* ( NO UPFRONT PAYMENT BY YOU ON HOSPITALISATION )

Age Band
Plan 1
Plan 2
Plan 3
Plan 4
30 days � 5 years
        738
        617
        530
        392
6 years � 21 years
        638
        534
        394
        341
22 years � 29 years
        838
        700
        600
        443
30 years � 39 years
        1,039
        866
        741
        544
40 years � 49 years
     1,239
        1,032
        882
        646
50 years � 54 years
     1,790
     1,488
     1,269
        925
55 years � 59 years
     2,091
     1,737
     1,481
        1,077
60 years � 64 years
     2,692
     2,235
     1,903
     1,382
65 years � 69 years
     3,143
     2,608
     2,220
     1,610

*Premiums are inclusive of MCO Fees of RM28.00 per person
Allianz Care Individual
With Allianz Care - Individual, you need not worry about funding for your healthcare costs or it being a burden on yourself and your loved ones.  All you have to do is to select from a choice of 4 plans that suits your needs.
Benefits
Allianz medical card guarantees hospital admission at panel hospitals.  All hospital bills will be settled automatically upon discharge.
International Medical Assistance Program (Optional Benefit)
Emergency medical evacuation and repatriation of mortal remains, medical assistance and travel information.
Domestic Medical Assistance Program (Optional Benefit)
Emergency medical evacuation, repatriation and medical assistance.
Choice Of Plan
Allianz Care - Individual offers you a choice of four (4) attractive plans designed to suit your budget and healthcare needs.
Conditional Renewable
This Policy will be renewable subject to the terms and conditions the Policy.  Allianz reserves the right to revise the premium rate applicable at the time of renewal.  Such changes, if any shall be applicable to all policyholders irrespective of their claim experience according to the Company抯 risk assessment.
Conditional Renewal will be applicable after two (2) years of Policy inception provided that there is no claim incurred in the previous two (2) years.  Subsequently, if there are claims incurred in the later years, the Insurer will not impose any exclusion upon the Insured Person.  If there is claims incurred within the first two (2) years of Policy inception, the Insured Person would still be qualify for the guaranteed renewal, subject to exclusions.
The Injured Person shall give immediate notice in writing to the Company on any injury, disease, physical defect or infirmity of which the Injured Person has become aware or been affected within the first two years of Policy inception.
Premiums
Premiums would be based on age band.  The minimum age entry is thirty (30) days and the maximum age is sixty nine (69) based on next birthday.
Specified Illnesses shall mean the following disabilities and its related complications, occurring within the first 120 days of Insurance of the Insured Person:
  • Hypertension, diabetes mellitus and cardiovascular disease;
  • All tumours, cancers, cysts, nodules, polyps, stones of the urinary system and biliary system;
  • All ear, nose (including sinuses) and throat conditions;
  • Hernias, haemorrhoids, fistulae, hydrocele, varicocele;
  • Endometriosis including disease of the reproduction system;
  • Vertebro-spinal disorders(including disc) and knee conditions.
Note
There will be a waiting period of thirty (30) days from the commencement date of insurance for sickness benefits. No benefits will be payable if hospitalization and/or illness commences within this period. Coverage for accidental bodily injuries will, however, be effective upon the commencement of insurance.
Application for change of benefits to a higher plan can only be made on Policy Anniversary Date and is subject to acceptance by Allianz.
If you are not satisfied with this policy for whatever reasons, you may return it to us within fifteen (15) days from the date of delivery.  We will cancel the policy and refund to you all premiums paid provided there no any medical expenses incurred.
This policy is renewable at the option of Policyholder until the occurrence of any of the following:
  • non payment of premium or premium not made on time;
  • fraud or misrepresentation of material fact during application;
  • the Policy is cancelled at the request of the Policyholder;
  • total claims of the Policy have reached the lifetime limit specified and/or on the death of the Insured Person;
  • the Insured Person ceases to qualify as a dependant based on the definition of the policy;
  • the Insured Person attains the coverage age limit specified;
  • termination of coverage for all Policies in a certain market and the Company withdraws this Policy completely from the market in accordance with the Portfolio Withdrawal Condition.
Exclusions
This contract does not cover any hospitalization, surgery or charges caused directly or indirectly, wholly or partly, by any one of the following occurrences:
  • Pre-existing illness.
  • Specified Illness occurring during the first 120 days of continuous cover.
  • Any medical or physical conditions arising within the first 30 days of the Insured Person抯 cover or date reinstatement whichever is latest except for Accidental Injuries.
  • Plastic/cosmetic surgery, circumcision, eye examination, glasses and refraction or surgical correction of nearsightedness (Radial Keratotomy or Lasik) and the use of acquisition of external prosthetic appliances or devices such as artificial limbs, hearing aids, implanted pacemakers and prescriptions thereof.
  • Dental conditions including dental treatment or oral surgery except as necessitated by Accidental Injuries to sound natural teeth occurring wholly during the Period of Insurance.
  • Private nursing, rest cures or sanitaria care, illegal drugs, intoxication, sterilization, venereal disease and its sequelae, AIDS (Acquired Immune Deficiency Syndrome) or ARC (Aids Related Complex) and HIV related diseases, and any communicable diseases required quarantine by law.
  • Any treatment or surgical operation for congenital abnormalities or deformities including hereditary conditions and degenerative disorders.
  • Pregnancy, child birth (including surgical delivery), miscarriage, abortion and prenatal or postnatal care and surgical, mechanical or chemical contraceptive methods or birth control or treatment pertaining to infertility. Erectile dysfunction and tests or treatment related to impotence or sterilization.
  • Hospitalization primarily for investigatory purposes, diagnosis, x-ray examination, general physical or medical examinations, not incidental to treatment or diagnosis of a covered Disability or any treatment which is not Medically Necessary and any preventive treatments, preventive medicines or examinations carried out by a Physician, and treatments specifically for weight reduction or gain.
  • Suicide, attempted suicide or intentionally self-inflicted injury while sane or insane.
  • War or any act of war, declared or undeclared, criminal or terrorist activities, active duty in any armed forces, direct participation in strikes, riots and civil commotion or insurrection.
  • Ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission of from any nuclear weapons material.
  • Expenses incurred for donation of any body organ by an Insured Person and costs of acquisition of the organ including all costs incurred by the donor during organ transplant and its complication.
  • Investigation and treatment of sleep and snoring disorders, hormone replacement therapy and alternative therapy such as treatment, medical service or supplies, including but not limited to chiropractic services, acupuncture, acupressure, reflexology, bonesetting, herbalist treatment, massage or aroma therapy or other alternative treatment,
  • Care or treatment for which payment is not required or to the extent which is payable by any other insurance or indemnity covering the Insured and Disabilities arising out of duties of employment or profession that is covered under a Workman抯 Compensation Insurance Contract.
  • Psychotic, mental or nervous disorders, (including any neuroses and their physiological or psychosomatic manifestations).
  • Costs/expenses of services of a non-medical nature, such as television, telephones, telex services, radios or similar facilities, admission kit/pack and other ineligible non-medical items.
  • Sickness or Injury arising from racing of any kind (except foot racing), hazardous spots such as but not limited to skydiving, water skiing, underwater activities requiring breathing apparatus, winter sports, professional sports and illegal activities.
  • Private flying other than as a fare-paying passenger in any commercial scheduled airlines licensed to carry passengers over established routes.
  • Expenses incurred for sex changes.
  • Terrorism.

Comprehensive Hospitalization And Surgical Coverage

Table of Benefits
Plan 1
RM
Plan 2
RM
Plan 3
RM
Plan 4
RM
Hospitalization & Surgical Expenses
350
230
160
110
(a)Ordinary Room
Intensive Care Unit
350
350
350
350
(daily maximum up to 60 days for any one disability)
(b)Surgical Fees
As charged
(includes day-care surgery)
(c)Hospital Supplies & Services
(Includes service tax)
(d)Pre-Hospital Diagnostic Test
(includes fees incurred for consultation within 31 days prior to hospital admission)
(e)Daily-Cash Allowance at Government Hospital
200
180
150
120
(lump sum payment per disability)
Out of Hospital

As charged
  (a)Emergency Accidental Outpatient Treatment
(includes follow-up treatment up  to 31 days from the date of accident)
(b)Outpatient Cancer Treatment
(c)Outpatient Kidney Dialysis Treatment
(d)Post Hospitalisation Treatment
(valid within 60 days from the date of discharge from hospital)
(e)Home Nursing Care
3,000
2,000
1,000
500
(limit per disability)
Overall Annual Limit
125,000
95,000
65,000
35,000
Lifetime Limit
375,000
285,000
195,000
105,000
Deductible
100
100
100
100

The Insured Person need only pay a deductible amount of RM100.  This amount is applicable per hospital admission/day-care surgery and the same amount applies for Plans 1, 2, 3, and 4.
If the Insured Person is hospitalized at a Room & Board rate which is higher than his/her eligible benefit, the Insured Person shall bear 20% of the other eligible benefits described in the Schedule of Benefits. 


Annual Premium for Non Cashless Plan (PAY FIRST & CLAIM PAYMENT FROM INSURANCE COMPANY)

Age Band
Plan 1
Plan 2
Plan 3
Plan 4
30 days � 5 years
        527
        457
        388
        280
6 years � 21 years
        473
        392
        333
        240
22 years � 29 years
        631
        522
        443
        320
30 years � 39 years
        789
        653
        554
        400
40 years � 49 years
        946
        783
        665
        479
50 years � 54 years
      1,380
     1,142
        970
        699
55 years � 59 years
      1,617
     1,338
     1,136
        819
60 years � 64 years
      2,090
     1,730
     1,469
        1,059
65 years � 69 years
      2,445
     2,023
     1,718
     1,239


Annual Premium for Cashless Plan* ( NO UPFRONT PAYMENT BY YOU ON HOSPITALISATION )

Age Band
Plan 1
Plan 2
Plan 3
Plan 4
30 days � 5 years
        738
        617
        530
        392
6 years � 21 years
        638
        534
        394
        341
22 years � 29 years
        838
        700
        600
        443
30 years � 39 years
        1,039
        866
        741
        544
40 years � 49 years
     1,239
        1,032
        882
        646
50 years � 54 years
     1,790
     1,488
     1,269
        925
55 years � 59 years
     2,091
     1,737
     1,481
        1,077
60 years � 64 years
     2,692
     2,235
     1,903
     1,382
65 years � 69 years
     3,143
     2,608
     2,220
     1,610

*Premiums are inclusive of MCO Fees of RM28.00 per person
Portfolio Withdrawal Condition
The Company reserves the right to cancel the portfolio as a whole if it decides to discontinue underwriting this insurance product.
Cancellation of the portfolio as a whole shall be given by written notice to the policyholder and the Company will run off all policies to expiry of the period of cover within the portfolio.
Important Notice
Thank you for your interest in the Individual Healthcare product offered by Allianz General Insurance Malaysia Berhad (揂llianz�).
Firstly, before purchasing any Medical and Health Insurance (MHI) product, you should ensure that you understand the basic and important features of the product; and that the important information has been disclosed to you.  Our managers/intermediary partners are available to help you with the following questions:
  • What are the basic and salient features of Medical and Health Insurance in general?
  • What are the basic and salient features of the product proposed to my company?
  • Do I have all the information needed to make an informed decision?
  • Am I satisfied that the product proposed best suits the needs of my company and employees?

>Below is a checklist of items that can serve as a guide to you, so that you may make an informed decision before purchasing this product.
Information Checklist
  • Ascertain if there are any pre-existing conditions, specified illnesses and qualifying period and how long will the period be applicable.
  • Comprehend and realize if there are any limitation of benefits (e.g. % of costs covered by the Policy, co-payment, ceiling to total claim costs and deductible amounts).
  • Comprehend the nature and extent of Allianz抯 right to review and revise the premiums payable. If you are agreeable and understand how and when notification of the revision will be made.
  • Comprehend the nature and extent of Allianz抯 right to repudiate liability in the event that you have failed to disclose relevant information that would have affected Allianz抯 decision to accept or reject the risk, and on the premiums and terms to be applied to you.
  • Find out whether there are other avenues (e.g. any insurer抯 website) where details of the important features of the product can be obtained.
  • Refer to the Proposals, Policy Contract for details of important Policy features.
  • Understand the benefits that are payable under this Policy.
  • Understand the significant medical or technical exclusions or restrictions applicable.
  • You may refer to 擳he Introduction to Medical and Health Insurance Products� issued by Bank Negara Malaysia for more information on Medical and Health Insurance products in general.
  • Understand the possible conditions that would lead to the following scenarios on the Policy renewal:
-Policy is renewed with a level premium;
-Policy is renewed with an increased premium; or
-Policy is not renewed.
  • Understand the implications of switching Policies from one Insurer to another.
Important Notice To Prospective Policy Owners
  • In the event of any inconsistency in this brochure, the English version of this brochure shall prevail over all other versions.
  • It may not be advantageous to switch from one health Policy to another, as you may be subjected to new underwriting requirements for waiting period/exclusion of specified illness/pre-existing conditions of the new Policy.
  • Please note that if an Insured Person has received other medical insurance or government plans, the Insurer shall bear no charges unless benefits received do not fully cover incurred charges, which are covered under the Policy.
  • Please note that the exclusions, limitations, terms and conditions as stated in this proposal are not exhaustive. Please refer to the actual Policy Contract for detailed benefits, exclusions, limitations, terms and conditions.
  • The information enclosed is accurate as at the date of print.
  • You are to ascertain that this product will best serve your needs and that you are agreeable to the premium payable under the Policy.
You should ensure that important information regarding the Policy is disclosed to you and that you understand the information disclosed. Where there is ambiguity, you should seek clarification from the Insurer.

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