information you need to know about..... MEDICAL/HEALTH
information on the purchase of Medical/Health Insurance (MHI)
Dear Prospective Policy Owner,
You are advised to read through the checklist
below which explains to you the essential features of the MHI policy so that you
are able to make an informed decision before purchasing the policy. If you are
in doubt or where there is ambiguity, please seek clarification from your
insurance intermediary or contact MAA Call Centre Personnel at 1 300 888 622.
You should satisfy yourself that this proposed
plan will best serve your needs and the premium payable under the policy is the
amount you can afford.
The list of important features as contained in a
Medical/Health insurance policy document is as follows:-
- The benefits payable under the policy.
- Significant medical or technical exclusions or
- Limits of benefits (eg. % of costs covered by
the policy, co-payment, ceiling to total claim costs, deductible amounts,
- Nature and extent of the insurer's right to
review and revise the premiums payable, and the notice to be given by the
insurer in the event of any revision.
- Pre-existing conditions, specific illnesses
and qualifying period and the relevant periods applicable.
- Reasonable and customary clause.
- Amount of premiums payable and the payable
- For yearly renewal policies, whether policy
renewal is guaranteed.
- Conditions that would lead to the following
scenarios on policy renewals: a) a policy is renewed with increased premium,
b) a policy is renewed with exclusions, excess amount, etc., and c) a policy
where one or more of the insured members are not being renewed.
- The implications of switching policy from one
insurer to another or transferring from one insurance plan to another that
may cause the Waiting Period, Specific Illness and Pre-existing Conditions
to start afresh or non-acceptance of your proposal.
- The insurer's right to repudiate liability in
the event of your failure to disclose relevant information in the proposal
form that would affect the decision of the insurer to accept or reject the
risk, and on the premiums and terms to be applied to the policy owner.
- A "cooling off period" of 15 days
will be given to review the suitability of the newly purchased policy. If
one was to return the policy to the insurer during this period, premiums
will be refunded after the deduction of expenses, if any.
- The actual terms and conditions will be in the
original policy to be delivered to you once the insurer has underwritten and
approved your proposal.
- Reference on the basics of MHI policies may be
obtained from "The Introduction to Medical and Health Insurance
Products" issued by Bank Negara Malaysia.
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