| GENERAL |
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| 1. |
Do I need to undergo medical
check up prior to application?
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No.
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| 2. |
Upon submission of the proposal
form, when does the cover begin?
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The cover shall be effective from
the day the proposal form is approved by Kurnia Insurans
(Malaysia) Berhad (KIMB) and with premium paid.
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| 3. |
Are the premiums guaranteed? |
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We may change the premiums in the
future, as the premium rates are not guaranteed. The
change of premium will be based on KIMB overall experience
in underwriting this class of insurance.
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| 4. |
What happens if I did not pay
the premiums on the premium due date?
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The policy will not be effective
or not renewed.
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| 5. |
Is there a grace period for the
new medical policy?
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Yes, the grace period is 14 days. |
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| 6. |
Is there any no claim discount for medical policy? |
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No. |
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| 7. |
What happens if I want to restart my lapsed policy? |
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You will be subjected to the usual
exclusions on Pre-existing Illness, Specified Illnesses
and Waiting Period of 30 days all over again. Hence
we encourage you not to lapse your medical insurance
policy.
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| 8. |
Can I include any dependant (spouse
or child) during policy period or on renewal?
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Yes, you can. You will have to complete
a new proposal form to declare on the new member health
and other information for KIMB assessment.
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| 9. |
Does Kurnia Medical Insurance cover foreigners? |
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Yes, as long as they domicile in Malaysia for at least
one year. |
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| 10. |
Can minors buy standalone policy? |
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Yes they can, provided policyholder
is either the father / mother and minor is the insured.
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| 11. |
Can self-employed buy this medical insurance? |
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Yes, they can. |
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| 12. |
Is the coverage worldwide? |
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Yes, this policy is applicable worldwide
for twenty-four (24) hours a day and you are covered
up to 90 days from the day you leave Malaysia. The
benefits payable will be subjected to the reasonable
and customary charges on the basis that the costs for
the said treatment would be reasonably charged by a
Hospital/ Physician in Malaysia.
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| 13. |
If the foreigner (Insured) has
a medical policy and goes back to his/her home country
for holiday, is the Insured covered?
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The Oversea Treatment clause and
Residence Overseas clause will apply in this case.
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| 14. |
If I travel to Singapore or
other countries for treatment, am I entitled for
a claim?
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You are entitled to make a claim
if the nature of treatment is not available in Malaysia
and the treatment is upon recommendation of a Physician.
The claim will be subjected to reasonable and customary
charges.
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| 15. |
Can KIMB tailor-made the Individual
plan as per my request?
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No, the benefit schedule of the
Individuals plan is standard and as such cannot be
tailor-made.
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| 16. |
Is there a limit to the number
of claim that I can make during the 12 months cover?
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No, as long as the claim is still
within the Overall Annual Limit.
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| 17. |
What is the maximum lifetime
limit for each plan?
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Lifetime limit is the maximum
amount of claim that you can claim for the lifetime.
The maximum Lifetime Limit is double of the Overall
Annual Limit for MediGuard
Value. For MediGuard Premier, MediGuard Junior, MediGuard
Grads, MediGuard Biz, MediGuard Family, MediGuard Lady
and MediGuard Senior, the maximum Lifetime Limit is
three times of the Overall Annual Limit.
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| 18. |
Does it cover if I am admitted
to Government Hospital?
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Yes, it is full reimbursement
up to the overall annual limit.
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| 19. |
Is traditional treatment covered? |
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No. |
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| 20. |
Do I need to notify KIMB every time I change job? |
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Yes, under the policy you will
need to notify KIMB on any material change in your
occupation or business under the 'Change In Risk' clause.
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| 21. |
How to renew the policy? |
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In order to renew the policy,
you will need to notify the company and make payment
of the premium within 14 days from the date of expiry.
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| 22. |
Will I get any refund of premium
for an annual premium payment made if I cancel the
policy?
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Policy may be cancelled by the
policyholder at any time by giving a written notice
to the company; and provided that no claims have been
made during the current policy year. The policyholder
shall be entitled to a refund of the premium as follows:
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| Period
Not Exceeding |
Refund
of Annual Premium |
| 15 days |
90% (Applicable to renewal only) |
| 1 month |
80% |
| 2 months |
70% |
| 3 months |
60% |
| 4 months |
50% |
| 5 months |
40% |
| 6 months |
30% |
| 7 months |
25% |
| 8 months |
20% |
| 9 months |
15% |
| 10 months |
10% |
| 11 months |
5% |
| Period exceeding 11 months |
No refund |
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| 23 |
What is "Medically Necessary"? |
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A "Medically Necessary" shall mean a medical
service, which is: |
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| i. |
Consistent with the diagnosis
and customary medical treatment for a covered
disability,
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| ii. |
In accordance with standards
of good medical practice, consistent with current
standard of professional medical care, and of
proven medical benefits,
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| iii. |
Not for the convenience of
the Insured or the Physician, and unable to be
reasonably rendered out of hospital,
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| iv. |
Not of an experimental, investigational
or research nature, preventive or screening nature,
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| v. |
And for which the charges
are fair and reasonable and customary for the
disability.
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| 24. |
What is "Waiting Period"? |
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"Waiting Period" means
any claim falls within the 30 days from the effective
date of the policy will not be covered unless it is
due to an accident. However, this waiting period is
not applicable to renewal policy.
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| 25. |
What is a "Cooling-Off Period"? |
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"Cooling-Off Period" means
if policy has been issued and you decide not to take
up the policy, you may return the policy to the company
for cancellation within fifteen (15) days from the
date of delivery of the policy. You are entitled to
the return of the full premium paid less deduction
of medical expenses incurred by KIMB in the issue of
the policy.
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General Rules |
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26.
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Is mixture of products in a
policy allowed? For example, in a family of four
members, the father might take up mediGuard Biz,
the mother taking up mediGuard Lady and the children
enroll in mediGuard Junior.
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No, mixture of products in a policy is not allowed. |
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| 27. |
Is variation of plans in a
policy allowed? For example, a family of four members
wishes to take up mediGuard Family. However, the
parent enrolls in plan with Room & Board of RM
250 while the children in plan with Room & Board
rate of RM 150.
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Yes, variation of plans in a policy
is allowed as long as all plans are under the same
product.
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| 28. |
Is variation of option with
medical card and no medical card (reimbursement)
allowed?
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No. If one of the family members
wants to take up medical card option, then all members
must also be covered under medical card option.
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| 29. |
Can an Insured take up Out-Patient Clinical Benefit
only? |
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No, Insured cannot take up Out-Patient
Clinical Benefit only. It is compulsory to enroll in
In-Patient Hospitalization & Surgical insurance
if they want to have Out-Patient Clinical coverage.
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