|
SCHEDULE OF BENEFITS (RM) |
PLAN (RM) |
| |
AK1
|
AK2
|
AK3
|
|
SECTION A |
|
HOSPITAL BENEFITS |
Hospital Room & Board
(up to 120 days) |
200
|
130
|
90
|
|
Intensive Care Unit |
350
|
250
|
200
|
|
Lodger (up to 120
days) |
50
|
50
|
50
|
|
Malaysian Government
Service Tax (room charges) |
5% Eligible Paid
Express |
|
Operating Theatre |
Full Reimbursement
|
|
Hospital Services &
Supplies |
Full Reimbursement
|
|
PROFESSIONAL FEES &
SERVICES |
|
Pre-Hospital
Diagnostic Tests within 31 days preceding
confinement |
Full Reimbursement
|
|
Pre-Hospital
Specialist consultation within 31 days
preceding confinement |
Full Reimbursement
|
|
Surgeon Fee |
Full Reimbursement |
|
Anaesthetist Fee |
Full Reimbursement |
In-Hospital
Physician's Visit
(1 visit per day and up to 120 days) |
Full Reimbursement
|
Post Hospitalisation
Treatment
(For non-surgical within 31 days from discharge) |
Full Reimbursement
|
|
Ambulance Fee |
Full Reimbursement
|
|
OUT PATIENT/EXTENDED
BENEFITS |
|
Emergency Accidental
Outpatient Treatment (Within 24 hours and
follow-up treatment up to 31 days) |
Full Reimbursement
|
|
Monthly Outpatient
Cancer Treatment |
2,000
|
1,500 |
1,000 |
|
OVERALL
ANNUAL LIMIT |
30,000 |
16,000 |
10,000 |
|
LIFETIME LIMIT -
Only provided in the 3rd year provided
insured has been claims free for the
preceding 2 policy years |
90,000 |
48,000 |
30,000 |
|
SECTION B |
|
Accidental Death
Benefit |
10,000 |
10,000 |
10,000 |
The amount payable will not exceed the actual
costs of the services and the maximum liability of
the company shall not exceed the limits of eligible
expenses based on the Reasonable and Customary and
Medically Necessary charges incurred less deductible
for the account of the Insured.
|
• |
HOSPITAL ROOM AND BOARD
Daily charges for room and board and meals
during confinement as a bedpatient.
|
|
• |
INTENSIVE CARE UNIT
Daily charges as a bedpatient in the
Intensive Care Unit of the hospital.
|
|
• |
LODGER
Fee charged for accompanying the insured
patient during the hospital confinement.
|
|
• |
DAILY-CASH ALLOWANCE AT GOVERNMENT
HOSPITAL
Daily cash allowance for confinement at
Malaysian Government Hospital provided
confined to a Room & Board rate that does
not exceed the limit. No payment will be
made for any transfer to or from any Private
and Malaysian Government Hospital.
|
|
• |
MALAYSIAN GOVERNMENT SERVICE TAX
5% government service tax on eligible Room &
Board charges incurred.
|
|
• |
OPERATING THEATRE
Charges for operating theatre incidental to
the surgical procedure.
|
|
• |
HOSPITAL SERVICES & SUPPLIES
Charges during confinement which shall
include general nursing, prescribed
medicine, dressing, X-rays, laboratory
examinations, electrocardiograms,
physiotherapy, administration of blood and
blood plasma but excluding the cost of blood
and plasma.
|
|
• |
PRE-HOSPITAL DIAGNOSTIC TESTS
Charges for diagnostic tests which are
recommended by a general practitioner within
31 days preceding hospital confinement. No
payment shall be made if upon such
diagnosis, the Insured does not result in
hospital confinement for the treatment of
the medical condition so diagnosed.
Medications and consultation charged by the
general practitioner will not be payable.
|
|
• |
PRE-HOSPITAL SPECIALIST CONSULTATION
Fees charged by the Specialist which are
recommended by a general practitioner in
writing within 31 days preceding hospital
confinement. Payment will not be made for
clinical treatment (including medications
and subsequent consultation) or where the
Insured does not result in hospital
confinement for the treatment of the medical
condition so diagnosed.
|
|
• |
SURGEON FEE
Surgical fees and normal pre and
post-operative care up to 31 days inclusive
both before and after the operation.
|
|
• |
ANAESTHETIST FEE
Fees charged by the Anaesthetist for the
supply and administration of anaesthesia.
|
|
• |
IN-HOSPITAL PHYSICIAN VISIT
Fees charged by the Physician for the
treatment of the Insured Person when
confined for a non-surgical disability.
|
|
• |
POST-HOSPITALISATION TREATMENT
Charges for treatment within 31 days
following discharge from hospital for a
non-surgical confinement administered by the
same Physician.
|
|
• |
AMBULANCE FEE
Charges for ambulance services for
transporting the Insured Person to and from
hospital. Payment is not made if the Insured
Person is not hospitalized.
|
|
• |
EMERGENCY ACCIDENTAL OUTPATIENT TREATMENT
Charges by the hospital or clinic in
connection with the emergency treatment of
bodily injury arising from an accident and
received as an outpatient within 24 hour of
the accidents. Follow-up treatment is up to
31 days by the same Physician.
|
|
• |
MONTHLY OUTPATIENT CANCER TREATMENT
Charges incurred for the alleviation of
neoplastic condition and received at the
outpatient department of a hospital or
registered cancer treatment center following
discharge from hospital.
|
|
• |
OVERALL ANNUAL LIMIT
The maximum annual reimbursement for all
benefits payable subject to the limit as
stated in the Schedule of Benefits.
|
|
• |
LIFETIME LIMIT
The maximum reimbursement for all benefits
payable subject to the limit as stated in
the Schedule of Benefits which is only
provided in the 3rd year provided the
Insured has been claims free for the
preceding 2 policy years.
|
|
• |
ACCIDENT DEATH BENEFIT
Pays lump sum in the event of an accidental
death. |
