Room (bed) and meals. It does not include lodger, telephone and television.

You will be responsible for the 20% of the other eligible benefits described in the Schedule of Benefit but subject to a maximum limit of RM3,000 per disability for plans with Overall Annual Limit not exceeding RM100,000 or subject to a maximum limit of RM5,000 per disability for plans with Overall Annual Limit exceeding RM100,000. So, choose a plan that best suits your need and a premium you could afford.

It covers pre-surgical assessment, Specialist's visits and all post-surgical care up to thirty-one days from the date of surgery but within the maximum indicated in the Schedule of Benefit.

Is out-patient or day surgery covered?

As long as there is a surgical procedures carried out for the covered diagnosis, this is covered under Surgical Fees where an overnight stay is not required.

Is sex change operation covered?

No, operation or any treatment related to sex change are not covered.

Pre-Hospital Diagnostic Tests cover the charges for medically necessary ECG, x-ray and laboratory test, which are recommended by a qualified medical practitioner and performed for diagnostic purposes on account of an injury or illness in connection with a disability preceding hospitalization. Medications and consultation charged by the medical practitioner will not be payable. Pre-Hospital Specialist Consultation covers the first consultation fees charged by a specialist. Medication and subsequent consultation after the illness is diagnosed will not be covered. This benefit is payable only if you are resulted in hospitalization and expenses 31 days prior to admission would be covered.

Yes, it will be covered under Hospital Supplies and Services. However if the admission is purely for diagnostic / investigation purpose, it is not covered.

No, this is not covered under the policy.

It covers the fees charged by the attending physician for visiting an in-paying patient while confined for a non-surgical disability and subject to a maximum of one visit per day.

Post-Hospitalization Treatment is for follow up treatment for non-surgical confinement incurred within 60 days following discharge.

It includes the charges made by the hospital for medically necessary general nursing, dressings, splints, plaster casts, x-ray, laboratory examinations, electrocardiograms, physiotherapy, basal metabolism tests, intravenous injections and solutions, administration of blood and blood plasma but excluding the cost of blood and plasma during hospitalization.

It covers medicines that are dispensed by a physician, a registered pharmacist or a hospital and with prescription by a physician or specialist in respect of treatment for a covered disability during in-patient and within 60 days following discharge.

It covers expenses incurred as a result of a bodily injury / injury to sound natural teeth arising from an accident where you seek out-patient treatment at any registered clinic or hospital within 24 hours of accident. This includes follow up treatment within 31 days by the same doctor or same registered clinic or Hospital.

No, dental checkup is not covered. This benefit covers expenses for Medical Necessary treatment due to accidental injuries to sound natural teeth. Treatment has to be seek in any registered dental clinic or hospital within 24 hours of the Accident on out-patient basis.

In such case, the claim may be considered if it is from the same clinic or hospital.

Normally a medical report will be required. We will only waive the medical report on case to case basis provided the bill is with clear details of the injury.

No, the claim will not be payable as the coverage of the policy has not been commenced.

No, you are unable to claim for this benefit for any transfer to or from any private hospital and government hospital, as in accordance to the Persatuan Insurans Am Malaysia (PIAM) guideline.

Yes, the ambulance fees for this transfer will be payable up to the benefit limit.

It covers kidney dialysis performed at a legally registered dialysis center.

Dialysis centres have to be registered with the Health Ministry. Registered dialysis centre will display a license by the Health Ministry at their premise.

You are required to submit the original bills and original receipts to the branch either weekly or monthly to make a claim.

It covers the actual charges incurred for the treatment of cancer performed at a legally registered cancer treatment center.

No, it covers the charges incurred on transplantation surgery for you being the recipient of the transplant of a kidney, heart, lung, liver or bone marrow. Payment for this Benefit is applicable only once per lifetime whilst the Policy is in force and shall be subject to the limit as set forth in the Schedule of Benefit. The costs of acquisition of the organs and all costs incurred by the donors are not covered.

KIMB will reimburse for one organ transplant only. You will have to bear the expenses for the transplant of another organ.

No, if the diagnosis / treatment is for organ transplant, then the maximum amount payable is for Organ Transplant benefit indicated in the Schedule of Benefit.

It is to reimburse the expenses for meals and lodging incurred to accompany an Insured Person in the hospital. Please note the specific product provided for this benefit and the eligibility age defined.

No, the cause of AIDS will not affect the claim eligibility. Upon the diagnosis of AIDS, the benefit shall be paid.

As the maximum amount has been paid in full sum, the subsequent admission which is a complication of the AIDS will not be covered. Bear in mind, this benefit is only paid once during Insured lifetime. The policy is renewable subject to "Period of Cover and Renewal" clause.

It covers the charges for home nursing care plan established and periodically reviewed by a registered medical practitioner and is only payable after a minimum of 3 days hospitalization beginning within 7 days of hospital discharge. The maximum period payable is 20 weeks.

This will be decided by the attending Medical Practitioner. Only nursing care provided under a plan recommended by a registered Medical Practitioner is covered.

In the event of accidental injury while you are at oversea, the monetary limit for hospital related benefit will be doubled for Inner Limit plan. Overall Annual Limit remains the same.

It covers the consultation fees charged by a second specialist to determine whether a surgical operation is necessary and / or required in view of your medical condition.

No, this benefit covers only the first time consultation fee with a second specialist. Charges for diagnostic test, medication and subsequent consultation are not covered.

Personal Accident Benefits (i.e. Accidental Death, Permanent Total Disablement, Bereavement Benefit and Evacuation and Repatriation Fees) are not subject to Overall Annual Limit and Lifetime Limit.

It is optional for you to fill up the Nomination form. If no Nomination form is filled up, the benefit will be payable to the legal representative or next of kin of the deceased insured under the policy.

i) At Panel Clinic: You will be required to show your medical card at the registration counter of KIMB panel clinic. You may proceed to seek for consultation and treatment without having to make payment for a covered condition except to pay for co-payment RM5 per visit. Co-payment is waived for accidental injury only.
ii) At Non-Panel Clinic: You will be required to pay first after the consultation and reimburse from KIMB for a covered condition. You will be reimbursed up to 80% of the actual charges or maximum RM20 per visit, and it is subject to emergency basis only.

Charges incurred for specialist consultation is claimable if the consultation is referred by KIMB panel doctors. Co-payment of RM5 will apply per visit and is claimable up to RM100 per visit (inclusive of co-payment). However, co-payment shall be waived for Accidental Injury only.

There is a limit of one General Practitioner (GP) and one Specialist visit per day. However, there is no limitation on the number of visit in a year. This benefit is subject to Out-patient Annual Limit and Out-patient Lifetime Limit as stated in the Schedule of Benefit.

No, there is no restriction of clinic. However, visitation to non-panel clinic is strictly for emergency situation and on reimbursement basis.

No, there are no Pre-existing Illness, Waiting Period and Specified Illnesses exclusion for Out-patient Clinical benefits.

'Normal clinical hours' refers to the operating hours of a clinic.

No, a house call consultation is not reimbursable. This benefit only covered if treatment is at the doctor's clinic or office.

No, you will be receiving one (1) medical card. There will be a note: "Including Out-patient Clinical" printed on the medical card if you take up Out-patient Clinical benefit.

It covers charges for annual pap smear or prostate specific antigen test.

No, only preventive screening carried out at panel clinic is claimable and it is limited to one screening per year.

You will have to notify KIMB within 30 days and submit all original bills, receipts, referral letter (for out-patient specialist care), medical report and doctor's summary of the cost of treatment including medicines and services rendered.