HOSPITALISATION & SURGICAL POLICY

This insurance reimburses the actual medically necessary expenses incurred by the insured person as a consequence of hospitalisation or surgery due to accident or illness, subject to the terms, conditions and exclusions of the Policy.

BENEFITS

PERSONS ELIGIBLE

Persons eligble for covered under the policy are:-

• Anyone between the ages of 15 days and 60 years and renewable up to age 70
• Persons who reside in Malaysia only

Age limit :
Eligible persons between 15 days to 60 years, renewable up to 70 years.

Condition:
Premium payable will increase with age by the relevant age band for the plan purchased.

Family Discount:
A family discount of 10% is allowed on the total premium for the family with three (3) members or more.

No Claim Discount:
15% (on renewal of policy only)

EXCLUSIONS

PRE-EXISTING ILLNESS mean disabilities that existed before the Effective Date of Insurance of an Insured Person and for which the Insured is receiving treatment or showing manifestations/symptoms irrespective of whether the Insured was aware or should have been reasonably aware.

Consultation with a medical doctor for any sign or pain or discomfort shall constitute a manifestation of symptom of disability.

CONGENITAL CONDITION shall mean any medical or physical abnormalities existing at the time of birth, as well as neo-natal physical abnormalities developing within 6 months from the time of birth, whether known or unknown to the insured. They will include hernias of all types and epilepsy except when caused by a trauma which occurred after the date that the Insured was continuously covered under this policy.

SPECIFIC ILLNESSES shall mean the following disabilities and its related complications, occurring within the first 120 days of Insurance of the Insured Person, irrespective of whether the Insured Person was aware of the disability or not:

This policy shall not cover :-

1. Pre-exiting illness.
2. Specified Illnesses occurring during the first 120 days of continuous cover.
3. Any medical or physical conditions arising within the first 30 days of the Insured Person's cover or date reinstatement whichever is latest except for accidental injuries.
4. Plastic/Cosmetic surgery, circumcision, eye examination, glasses and refraction or surgical correction of nearsightedness (Radial Keratotomy or Lasik) and the use or acquisition of external prosthetic appliances or devices such as artificial limbs, hearing aids, implanted pacemakers and prescriptions thereof.
5. Dental conditions including dental treatment or oral surgery except as necessitated by Accidental Injuries to sound natural teeth occuring wholly during the Period of Insurance.
6. Private nursing, rest cures for sanitarium care, illegal drugs, intoxication, sterilization, venereal disease and its sequalae, AIDS (Acquired Immune Deficiency Syndrome) or ARC (AIDS Related Complex) and HIV related diseases, and any communicable disease required quarantine by law.
7. Any treatment or surgical operation for congenial abnormalities or deformities including hereditary conditions.
8. Pregnancy, child birth (including surgical delivery), miscarriage, abortion prenatal or postnatal care , surgical, mechanical or chemical contraceptive methods of birth control or treatment pertaining to infertility. Erectile dysfunction and tests or treatment related to impotence or sterilization.
9. 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.
10. Suicide, attempted suicide or intentionally self-inflicted injury while sane or insane.
11. 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.
12. Ionising radiation or contamination by any radioactivity from any nuclear fuel or nuclear waste from the process of nuclear fission or from any nuclear weapons material.
13. Expenses incurred for donation of any body organ by Insured Person and costs of acquisition of the organ including all costs incurred by the donor during organ transplant and its complications.
14. Investigation and treatment of sleep and snoring disorders, hormone replacement therapy and alternative therapy such as treatment, medical service or supplies, including but limited to chiropratic services, acupuncture, acupressure, reflexology, bonesetting, herbalist treatment, massage or aroma therapy or other alternative treatment.
15. Care or treatment for which payment is not required or to the extent which is payable by any other insurance or indemnitiy covering the insured and disabilities arising out of duties of employment or profession that is covered under a Workman's Compensation Insurance Contract.
16. Psychotic, mental or nervous disorders, (including any neuroses and their physiological or psychosomatic manifestations).
17. Cost/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.
18. 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 and illegal activities.
19. Private flying other than as a fare-paying passenger in any commercial scheduled airlines licensed to carry passengers over established routes.
20. Expenses incurred for sex changes.

For further information about this product, please contact our nearest branch and our customer service staff will gladly assist you.