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You are here: Skip Navigation LinksHome > Insurance > Products > Product Gallery > Medical Frequently Asked Questions
MEDICAL FREQUENTLY ASKED QUESTIONS
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mediGUARD FAQ



- General
- Upgrade / Conversion / Take-Over Policies
- Guaranteed Admission
- Reimbursement
- Benefits
- Specific Exclusions
- Mediguard Junior
 
- Mediguard Grads
- Mediguard Biz
- Mediguard Family
- Mediguard Senior
- Mediguard Lady
- Recurring Payment Using Credit Card - Monthly Instalment


 
GENERAL
 
1.
Do I need to undergo medical check up prior to application?
 
No.
   
2.
Upon submission of the proposal form, when does the cover begin?
 
The cover shall be effective from the day the proposal form is approved by Kurnia Insurans (Malaysia) Berhad (KIMB) and with premium paid.
   
3. Are the premiums guaranteed?
 
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.
   
4.
What happens if I did not pay the premiums on the premium due date?
 
The policy will not be effective or not renewed.
   
5.
Is there a grace period for the new medical policy?
  Yes, the grace period is 14 days.
   
6. Is there any no claim discount for medical policy?
  No.
   
7. What happens if I want to restart my lapsed policy?
 
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.
   
8.
Can I include any dependant (spouse or child) during policy period or on renewal?
 
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.
   
9. Does Kurnia Medical Insurance cover foreigners?
  Yes, as long as they domicile in Malaysia for at least one year.
   
10. Can minors buy standalone policy?
 
Yes they can, provided policyholder is either the father / mother and minor is the insured.
   
11. Can self-employed buy this medical insurance?
  Yes, they can.
   
12. Is the coverage worldwide?
 
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.
   
13.
If the foreigner (Insured) has a medical policy and goes back to his/her home country for holiday, is the Insured covered?
 
The Oversea Treatment clause and Residence Overseas clause will apply in this case.
   
14.
If I travel to Singapore or other countries for treatment, am I entitled for a claim?
 
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.
   
15.
Can KIMB tailor-made the Individual plan as per my request?
 
No, the benefit schedule of the Individuals plan is standard and as such cannot be tailor-made.
   
16.
Is there a limit to the number of claim that I can make during the 12 months cover?
 
No, as long as the claim is still within the Overall Annual Limit.
   
17.
What is the maximum lifetime limit for each plan?
 
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.
   
18.
Does it cover if I am admitted to Government Hospital?
 
Yes, it is full reimbursement up to the overall annual limit.
   
19. Is traditional treatment covered?
  No.
   
20. Do I need to notify KIMB every time I change job?
 
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.
   
21. How to renew the policy?
 
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.
   
22.
Will I get any refund of premium for an annual premium payment made if I cancel the policy?
 
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:
   
 
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
   
23 What is "Medically Necessary"?
  A "Medically Necessary" shall mean a medical service, which is:
 
i.
Consistent with the diagnosis and customary medical treatment for a covered disability,
ii.
In accordance with standards of good medical practice, consistent with current standard of professional medical care, and of proven medical benefits,
iii.
Not for the convenience of the Insured or the Physician, and unable to be reasonably rendered out of hospital,
iv.
Not of an experimental, investigational or research nature, preventive or screening nature,
v.
And for which the charges are fair and reasonable and customary for the disability.
   
24. What is "Waiting Period"?
 
"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.
   
25. What is a "Cooling-Off Period"?
 
"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.
   
  General Rules
   

26.

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.
  No, mixture of products in a policy is not allowed.
   
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.
 
Yes, variation of plans in a policy is allowed as long as all plans are under the same product.
   
28.
Is variation of option with medical card and no medical card (reimbursement) allowed?
 
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.
   
29. Can an Insured take up Out-Patient Clinical Benefit only?
 
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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