• Hospital Room & Board
Reimburses the daily charges made by the Hospital for room accommodation and meals incurred by the Insured Person for each day of confinement as a registered bed–paying patient in a Hospital.
• Intensive Care Unit
Reimburses daily charges for confinement in an Intensive Care Unit or Cardiac Care Unit where prescribed by the attending Physician or Surgeon
• Surgeon Fees
Reimburses professional fees charged by the Surgeon for a Surgery performed. This includes Surgeon’s ward visits, pre–surgical assessment and all normal post–surgical care up to sixty (60) days before and after the operation.
Surgeon Fees shall also include professional fees charged by a second Physician or Surgeon who may be consulted prior to Hospitalisation of Insured Person for a surgical operation.
• Anaesthetist Fees
Reimburses professional fees charged by the Anaesthesiologist for the supply and administration of anaesthesia incidental to the performance of a Surgery.
• Operating Theatre Fees
Reimburses Operating Room charges incidental to the performance of a Surgery.
• In–Hospital Physician Visits
Reimburses professional fees charged by a Physician for visiting a bed–paying patient while confined for a non–surgical Disability subject to a maximum of one (1) visit per day up to maximum number of 150 days.
• Hospital Services & Supplies
Reimburses charges for general nursing, prescribed and consumed drugs and medicines, dressings, splints, plaster casts, X–ray, diagnostic tests, laboratory examinations, electrocardiograms, physiotherapy, rental of appliances, surgical implants, basal metabolism tests, intravenous injections and solutions, administration of blood and blood plasma, oxygen and its administration, and eligible Government Service Tax whilst the Insured Person is confined as a bed–paying patient in a Hospital.
• Pre–hospital Diagnostic Tests
Reimburses charges for ECG, X–ray, laboratory and diagnostic tests which are performed for diagnostic purposes and when in connection with a Disability preceding Hospitalisation within Thirty-one (31) days and which are recommended by a Physician. No benefit shall be made if upon such diagnostic services, the Insured Person does not result in Hospitalisation for the treatment of the medical condition diagnosed. Cost incurred for any medications and consultation will not be payable under this benefit item.
• Pre–hospital Specialist Consultation
Reimburses the professional fees charged for the first time consultation by a Specialist in connection with a Disability within Thirty–one (31) days preceding Hospitalisation and provided that such consultation has been recommended in writing by a Doctor. No benefit shall be made for any clinical treatment (including medications and subsequent consultation) or where the Insured Person does not result in Hospitalisation for the treatment of the medical condition diagnosed.
• Post–Hospitalisation Treatment
Reimburses medical charges for follow–up treatment by the same attending Physician and incurred within sixty (60) days immediately upon discharge from Hospital for a non–surgical Disability. This shall include medicines prescribed during the follow–up treatment but shall not exceed the supply needed for the said sixty (60) days period.
• Outpatient Physiotherapy Treatment
Reimburses the daily professional fees charged by a legally and medically qualified Physiotherapist for outpatient physiotherapy treatment and incurred within sixty (60) days upon discharge from Hospital provided that such service is deemed to be Medically Necessary by the attending Physician in writing.
• Emergency Accidental Outpatient Treatment
Reimburses medical expenses incurred as a result of a covered bodily injury arising from an Accident for treatment as an outpatient at any registered clinic or Hospital within twenty–four (24) hours of the Accident causing the Injury. Follow–up treatment by the same Doctor or same registered clinic or Hospital for the same Injury will be provided up to Thirty–one (31) days from the date of the Accident.
• Emergency Accidental Dental Treatment
Reimburses medical expenses incurred in a Hospital or a registered dental clinic for dental treatment of injury or damage to sound natural teeth as a result of an Accident Provided that the dental treatment is received within forty–eight (48) hours of the Accident causing the Injury. Follow–up treatment by the same Dentist will be provided up to Thirty–one (31) days from the date of the Accident.
• Ambulance Fee
Reimburses charges incurred for road ambulance services (inclusive of attendant) to and/or from the Hospital of confinement. Payment will not be made if the Insured Person is not Hospitalised.
• Government Service Tax
Reimburses the 5% Government Service Tax on the eligible Hospital Room and Board charges.
• Lodger Benefit
Reimburses the daily expenses for meals and lodging incurred to accompany an insured Child (aged below fifteen (15) years) in the Hospital but not exceeding sixty (60) days.
• Traditional Medical Treatment
Reimburses medical expenses incurred for treatment of a covered Accidental Injury on outpatient basis and treated by a registered Traditional Medical Practitioner within twenty–four (24) hours after the Accident.
• Medical Report
Reimburses charges made by Hospital/Physician for completion of medical report of a covered Disability.
• Home Nursing Care
Reimburses the daily professional fees for the services rendered by a medically qualified and licensed Nurse in the Insured Person’s home and incurred within one–hundred (100) days immediately upon discharge from Hospital. The plan and schedule of the treatment for this Home Nursing Care must be established and prescribed in writing by the attending Physician. No payment will be made for custodial care, meal, general housekeeping services, companion, rest cure or personal comfort items.
• Daily Cash Allowance At Government Hospital
Pays a daily allowance for each complete day of confinement in a Malaysian Government Hospital up to a maximum number of 150 days. No payment will be made for any transfer to or from any non–Malaysian Government Hospital.
• Organ Transplant
Reimburses the medical charges incurred for transplantation surgery for the Insured Person being the recipient of the transplant of Kidney, Heart, Lung, Liver or Bone Marrow. No benefit is allowable under this policy other that this particular benefit item (Organ Transplant) and payment for this Benefit is applicable only once per Lifetime of an Insured Person whilst the Policy is in force. The costs of acquisition of the organ and all costs incurred by the donors are not covered.
• Funeral Benefit
Pays the Insured or the legal representative of the Insured the stated lump sum benefit on the occurrence of ONE of the following events:
a)
Accidental death of an Insured Person if death occurs within six (6) months from the date of the Accident. OR
b)
Death of Insured Person during the period of confinement in the Hospital or within 30 days upon discharge from the hospital provided only if at the date of his/her death, his/her age falls between 19 years and 60 years inclusive.
• Outpatient Cancer Treatment
If an Insured Person is diagnosed with Cancer as defined herein, the Company will reimburse medical charges incurred for the treatment of Cancer provided such treatment of radiotherapy &/or chemotherapy (but excluding costs for consultation, examination test, take home drugs) is received at the outpatient department of a Hospital or a legally registered Cancer treatment center immediately following discharge from Hospital confinement or surgery.
• Outpatient Kidney Dialysis Treatment
If an Insured Person is diagnosed with Kidney Failure as defined herein, the Company will reimburse the medical charges incurred for Kidney dialysis performed at the outpatient department of a Hospital or a legally registered Kidney Dialysis center immediately following discharge from Hospital confinement or surgery. (The costs for consultation, examination tests, take home drugs are excluded).
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