|
Policy Coverage & Plans |
 |
B-Rawat Individual
Plans
|
SCHEDULE OF BENEFITS (RM) |
PLAN (RM) |
| |
RW1
|
RW2
|
RW3
|
Hospital Room & Board
(up to 120 days) |
200
|
130
|
90
|
|
Intensive Care Unit
(up to 20 days) |
350
|
250
|
200
|
|
Daily cash allowance
at Government Hospital (up to 120
days) |
50
|
50
|
50
|
|
Malaysian Government
Service Tax (Room & Board charges) |
5% Eligible Paid
Express |
|
SURGICAL ADMISSION
(for item (a) to (e) |
15,000
|
10,000
|
5,000
|
|
a) Surgeon's Fee |
Full Reimbursement
subject to reasonable and customary charges |
|
b) Anaesthetist's Fee |
|
c) Operating theatre |
|
d) Hospital Services &
Supplies |
e) Pre-Hospital
Diagnostic Test
(Within 31 days preceding confinement) |
|
NON-SURGICAL
ADMISSION (for item (f) to (i) |
15,000
|
10,000
|
5,000
|
f) In-Hospital
Physician's Visits
(1 visit per day and up to 120 days) |
Full Reimbursement
subject to reasonable and customary charges |
|
g) Hospital Services &
Supplies |
h) Pre-Hospital
Diagnostic Test
(Within 31 days preceding confinement) |
i) Pre-Hospitalisation
Treatment
(for non-surgical within 31 days from
discharge) |
|
Ambulance Fee |
200
|
200
|
200
|
|
Medical Report |
50
|
50
|
50
|
|
OVERALL
ANNUAL LIMIT |
30,000 |
20,000 |
15,000 |
|
LIFETIME LIMIT -
Only provided in the 3rd year provided
insured has been claims free for the
preceding 2 policy years |
90,000 |
60,000 |
45,000 |
|
ANNUAL PREMIUM ON
NEXT BIRTHDAY(RM) |
RW1
|
RW2
|
RW3
|
|
AGE |
|
|
1 - 18 years |
280
|
235
|
190
|
|
19 - 30 years |
330
|
280
|
230
|
|
31 - 40 years |
410
|
350
|
290
|
|
41 - 50 years |
530
|
450
|
370
|
|
51 - 55 years |
595
|
490
|
420
|
|
56 - 60 years |
730
|
600
|
500
|
|
61 - 65 years |
930
|
760
|
630
|
|
66 - 70 years |
1,160
|
960
|
800
|
|
SUPPLEMENTARY
BENEFITS (RM) |
Max Limit
|
Additional
Premium (RM)
|
|
1) Pre-Certification
Admission Services to Panel Hospital |
|
100
|
|
2) Monthly Outpatient
Cancer Treatment |
1,000
|
35
|
|
3) Monthly Outpatient
Kidney Dialysis Treatment |
1,000
|
35
|
|
4) Outpatient
Physiotherapy Treatment (Within 90 days from
discharge) |
1,000
|
35
|
|
5) Emergency Accident
Outpatient Treatment (Within 24 hours and
follow-up treatment up to 31 days) |
1,000
|
35
|
Note :
|
• |
Class 3 will have a 15%
loading on overall total premium
|
 
Description Of Benefits
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.
|
|
• |
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.
|
|
• |
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.
|
|
• |
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.
|
|
• |
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.
|
|
• |
MEDICAL REPORT
Fees charged by doctor for completion of
medical report.
|
|
• |
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.
|
For detailed description of the covered benefits,
please refer to the Policy Contract.
|
