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Home l Products & Services l Medical Insurance l Foreign Worker Hospitalization & Surgical Insurance Scheme (SKHPPA)
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Intensive Care Unit (ICU) (Maximum up to 15 days)
In-Hospital Physician Visits (Maximum up to 30 days)
Reimburses the fees for the supply and administration of anaesthesia
 

   
  Foreign Worker Hospitalization & Surgical Insurance Scheme (SKHPPA) is a yearly renewable hospital and surgical insurance scheme designed to reduce the financial burden of the employer of foreign workers in the event of hospital admission of their foreign workers to a Non-Corporatised Malaysian Government Hospital due to an accident or illness.

Eligible persons for insurance under this policy are those present and future full-time foreign worker employees of policyholder, from the age of eighteen (18) to fifty-nine (59), who are actively engaged at their usual work on the date the persons are eligible to join this policy.

To Prospective PolicyHolder
This page contains important information about your Insurance. You should read all the information carefully to make sure that you fully understand it and that it meets your needs. You are advised to read through the checklist below which explains the essential features of the SKHPPA so that you are able to make an informed decision before purchasing the policy. If you have any inquiries, please seek clarification from your insurance intermediary or any of Tokio Marine Insurans (Malaysia) Berhad (hereinafter called “TMIM”) branch office.
1.
The benefits payable under the policy are highlighted in the "Description of Benefits/Coverage."
2.
This is a yearly renewable plan, whereby the premiums and benefits are subject to review from time to time. Any changes to benefits and premium can only be imposed by TMIM on policy anniversary with 90 days written notice based on the emerging claims experience of the portfolio.
3.
Cover ceases from the time your foreign worker leaves Malaysia and resumes upon his/her return to Malaysia.
 
•
 The SKHPPA proposal forms are available at any of TMIM branch office.
•

 The Employer must complete the proposal form and submit the completed proposal form together with premium to any TMIM office.
• Coverage is effective upon receipt of payment of premium.
• The Policy will be sent to the employer within 21 working days.
•

 If the policy has not been received within the stipulated period, kindly contact the TMIM branch office.

The Policy shall become effective as of the date stated in the Schedule. The Policy Anniversary shall be one (1) year after the effective date and annually thereafter. On each such anniversary, the Policy is renewable at the premium rates in effect at that time as notified by the Company.		  

  • PRE-EXISTING ILLNESS shall be limited to disabilities which existed before the effective date of cover and for which the Insured Person should have reasonably been aware of. An Insured Person may be considered to have reasonable knowledge of a pre-existing condition where the condition is one for which :
    (i) the Insured Person had received or is receiving treatment;
    (ii) medical advice, diagnosis, care or treatment has been recommended;
    (iii) clear and distinct symptoms are or were evident; or
    (iv)

    		 its existence would have been apparent to a reasonable person in the circumstances.

    SPECIFIED ILLNESSES     shall mean the following disabilities and its related complications, occurring within the first one hundred and twenty (120) days of Insurance of the Insured Person :
    (a) Cardiovascular disease
    (b) All cancers
 
   
This Scheme does not cover any hospitalization, surgery or charges caused directly or indirectly, wholly or partly, by any one (1) of the following occurrences:

1.
Pre-existing illness. However, this exclusion is waived in the event the Insured Person passes the medical examination as confirmed by Fomema Sdn. Bhd. (FOMEMA) within 30 days from the Insured Person’s arrival to Malaysia.
 
2.
  • Specified Illnesses occurring during the first one hundred and twenty (120) days of continuous cover.
 
3.
Plastic/Cosmetic surgery, circumcision, eye examination, glasses and refraction or surgical correction of nearsightedness (Radial Keratotomy) and the use or acquisition of external prosthetic appliances or devices such as artificial limbs, hearing aids, implanted pacemakers and prescriptions thereof.
 
4.
Dental conditions including dental treatment or oral surgery except as necessitated by Accidental Injuries to sound natural teeth occurring wholly during the Period of Insurance.
 
5.
Private nursing, rest cures or sanitaria care, illegal drugs, intoxication, sterilization, venereal disease and its sequelae, AIDS (Acquired Immune Deficiency Syndrome) or ARC(AIDS Related Complex) and HIV related diseases, and any communicable diseases requiring quarantine by law.
 
6.
Any treatment or surgical operation for congenital abnormalities or deformities including hereditary conditions.
 
7.
Pregnancy, child birth (including surgical delivery), miscarriage, abortion and prenatal or postnatal care and surgical, mechanical or chemical contraceptive methods of birth control or treatment pertaining to infertility. Erectile dysfunction and tests or treatment related to impotence or sterilization.
 
8.
  • Hospitalization primarily for investigatory purposes, diagnosis, X-ray examination, general physical or medical examinations, not incidental to treatment or diagnosis of a covered Disability or any treatment which is not Medically Necessary and any preventive treatments, preventive medicines or examinations carried out by a Physician, and treatments specifically for weight reduction or gain.
 
9.
Suicide, attempted suicide or intentionally self-inflicted injury while sane or insane.
   
 
10.
War or any act of war, declared or undeclared, criminal or terrorist activities, active duty in any armed forces, direct participation in strikes, riots and civil commotion or insurrection.
 
11.
Ionizing radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapons material.
 
12.
Expenses incurred for donation of any body organ by an Insured Person and costs of acquisition of the organ including all costs incurred by the donor during organ transplant and its complications.
 
13.
Investigation and treatment of sleep and snoring disorders, hormone replacement therapy and alternative therapy such as treatment, medical service or supplies , including but not limited to chiropractic services, acupuncture, acupressure, reflexology, bone setting, herbalist treatment, massage or aroma therapy or other alternative treatment.
 
14.
Care or treatment for which payment is not required or to the extent which is payable by any other insurance or indemnity covering the Insured and Disabilities arising out of duties of employment or profession that is covered under a Workman's Compensation Insurance Contract.
 
15.
Psychotic, mental or nervous disorders, (including any neuroses and their physiological or psychosomatic manifestations).
 
16.
Costs/expenses of services of a non-medical nature, such as television, telephones, telex services, radios or similar facilities, admission kit/pack and other ineligible non-medical items.
 
17.
Sickness or Injury arising from racing of any kind (except foot racing), hazardous sports such as but not limited to skydiving, water skiing, underwater activities requiring breathing apparatus, winter sports, professional sports and illegal activities.
 
18.
  • Private flying other than as a fare-paying passenger in any commercial scheduled airlines licensed to carry passengers over established routes.
   
19. Expenses incurred for sex changes.
 
BENEFITS (ANY ONE DISABILITY)
AMOUNT (RM)
 
 
1(a). Daily Hospital Room & Board (Maximum up to 30 days)          
1(b). Intensive Care Unit (ICU) (Maximum up to 15 days)  
2. Hospital Supplies and Services
As charged in accordance to
3. Operating Theatre
charges consistent with Third (3rd) Class Room
4. Surgical Fees (Exclude Organ Transplantation)
and Board to a maximum of RM60.00 per day
5. Anesthetist Fees
in a Non-Corporatised Malaysian Government Hospital
6. In-Hospital Physician Visits (Maximum up to 30 days)
in conformance to the charges specified under
7. In-Hospital Specialist Consultation Visits (Maximum up to 30 days)
Fees Act 1951, Fees (Medical) Order  1982.
8. Ambulance Fees/Medical Report Fees  
9. Service Tax (6%)  
Maximum Overall Annual Limit (Item 1 to 8) per Insured Person     RM10,000.00    
ANNUAL PREMIUM : RM120.00 per Insured Person          
The duration of cover is for one year. You need to renew your cover annually.          
           
Important note:          
The description on the available cover is only a brief summary for quick and easy reference. The precise terms and conditions that apply are stated in the policy contract.
 
     
 
   
1. What does the SKHPPA cover?
  It covers hospitalization & surgical charges incurred by the foreign worker in the event of hospital admission to a Non-Corporatised Malaysian Government Hospital due to an Accident or Illness.
   
2. Is the SKHPPA a compulsory scheme?
  Yes
   
3.


 My foreign workers are insured under the foreign workers compensation shceme (FWCS), do they need to be insured under SKHPPA?
  Yes. The SKHPPA and the FWCS are two different schemes and both are compulsory.
   
4. Can the premium be deducted from the foreign workers salary?
  Yes, the employer can advance the payment for the required premium and then subsequently deduct the same from the foreign worker's salary.
 
5. How much is the premium and when will coverage take effect?
  The annual premium is RM120.00 per worker per annum and coverage will take effect upon registration with premium duly paid.
   
6. Is medical check-up required?
  Not necessary as long as the foreign workers are legally working in Malaysia and have passed the medical examination administered by Fomema Sdn. Bhd. (FOMEMA).
   
7. Any restriction to hospital admission?
  Yes, admission to Non-Corporatised Malaysian Government Hospital only.
 
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