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   INFORMATION SUMMARY OF MEDICAGEN 200 

NOTE: This information provides a summary of the main features of MedicaGen 200 for illustration purposes and does not constitute a contract of insurance. Policy owners are advised to refer to the actual policy document for full details of the product terms and conditions, including those outlined below.

(A) TERMS OF ISSUE

1) This is a Hospital & Surgical (H & S) Policy until age 75. It is a Conditional Renewable Policy which means, is renewable at the option of POLICYHOLDER until the occurrence of any of the following:-

  1. non payment of premium or premium not made on time

  2. fraud or misrepresentation of material fact during application

  3. the policy is cancelled at the request of the policyholder

  4. total claims of the policy have reached the lifetime limit specified or on the death of the policyholder

  5. the policyholder attains the coverage age limit specified

  6. 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

  7. Insured Person falls within an occupational class which is not insurable under the Policy

The renewal premium payable for the H & S Policy is NOT Guaranteed:

  1. The Company can revise the premium at the time of renewal according to the Company's risk assessment and it shall be applicable to all policyholders of MedicaGen 200.

  2. The premium rate is age-banded and is payable according to each Policyholder's attained age on each Policy year anniversary.

  3. The premium will be adjusted if the policyholder changes occupation from Class 1 or 2 to Class 3.

2) Co-payment and/or deductible maybe imposed by the Company, depending on underwriting considerations. Even if such Co-payment and/or deductible is imposed, the policyholder shall only be liable up to RM3,000. Not withstanding this, if the policyholder utilises a Room & Board rate, which is more than his/her entitlement, then he/she shall also be subjected to the Upgraded Room & Board 20% Co-payment clause.

3) If the proposal or declaration of the policyholder is untrue or misrepresented or mistated in any respect, then this policy shall be void.

4) Cooling-Off period may apply if this Policy shall have been issued and for any reason whatsoever the Insured Person shall decide not to take up the Policy, the Insured Person may return the Policy to the Company for cancellation provided such request is delivered by the Insured Person to the Company within fifteen (15) days from the date of delivery of Policy. The Insured Person is entitled to the return of the full premium paid less deduction of medical expenses incurred by the Company, if any, in the issue of the Policy.

(B) MAJOR BENEFITS AND INDICATIVE PREMIUM RATES*

PLAN 1

(RM)

PLAN 2

(RM)

PLAN 3

(RM)

PLAN 4

(RM)

Hospital Room & Board (max 365 days per annum)

110 160 210 360
Overall Annual limit on benefits payable 35,000 50,000 70,000 120,000
Lifetime Limit - during first two (2) policy years 35,000 50,000 70,000 120,000
Lifetime Limit thereafter, provided insured has been claims free for the preceding two (2) policy years 105,000 150,000 210,000 360,000
Indicative premium for standard risks aged 35 (H & S premium, class 1 occupation) 284 367 465 680
Indicative premium for standard risks aged 45 (H & S premium, class 1 occupation) 393 505 646 920

(C) SOME MAJOR BENEFITS LIMITATIONS*

This product DOES NOT cover:

  1. All Pre-existing illnesses

  2. All Specified Illnesses (first 120 days):- Hypertension, Diabetes mellitus, Cardiovascular disease, Tumours, Cancers, Cysts, Nodules, Polyps, Stones of the urinary and biliary systems, Ear, Nose (including sinuses) and Throat conditions, Hernias, Haemorrhoids, Fistulae, Hydrocele, Varicocele, Endometriosis including diseases of the reproduction system, Vertebro-spinal disorders (including disc) and Knee conditions

  3. Illness that commenced within the Waiting Period of thirty (30) days except for accidental injuries

  4. Pregnancy, infertility and all complications arising therefrom

  5. Routine Physical examinations, medical check-ups, Dental conditions, Plastic/Cosmetic Surgery

  6. Congenital conditions, Circumcision, Organ donation

  7. Drugs and Alcohol abuse, Suicide, Attempted Suicide, Psychiatric conditions

  8. HIV, AIDS or any HIV/AIDS related conditions, Sexually Transmitted Diseases

  9. Sleep disorders, Hormone replacement therapy, Alternative treatment

  10. Hazardous sports, private flying

  11. Any attempt of violation of the law or resistance to lawful arrest

  12. Participation in riots and active duty in Armed Forces

  13. Any Person who resides outside Malaysia for more than 90 consecutive days while the policy is in force

* where appropriate, cross-references maybe made to relevant clauses in the policy contract.

 

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