Reimburses the daily charges made by the Hospital for room accommodation and meals incurred by the Insured Person for each day of confinement as a registered bed-paying patient in a Hospital but in no event shall the benefit exceed, for any one day, the rate of Room and Board Benefit as set forth in the Schedule of Benefits but subject to a maximum number of 150 days.

Reimburses professional fees charged by the Anaesthesiologist for the supply and administration of anaesthesia incidental to the performance of a Surgery.

Reimburses daily charges for confinement in an Intensive Care Unit or Cardiac Care Unit where prescribed by the attending Physician or Surgeon but in no event shall the benefit exceed, for any one day, the rate of Intensive Care Unit Benefit set forth in the Schedule of Benefits but subject to a maximum number of 75 days.

Reimburses professional fees and incidental medical expenses charged by a Surgeon, Hospital or Day-care Specialist Centre for a surgical procedure performed in an outpatient setting (without Hospitalisation). Surgical procedure shall include Endoscopy (all types), Intravenous pyelogram (IVP/IVU), Barium studies and Angio-graphic studies and other such diagnostic procedures as deemed Medically Necessary and duly referred by a Physician.

Reimburses charges made by Hospital for the use of an Operating Theatre Room incidental to a surgical procedure.

Reimburses medical expenses for general nursing, prescribed and consumed drugs and medicines, dressings, splints, plaster casts, X-ray, laboratory examinations, electrocardiograms, physiotherapy, rental of appliances, surgical implants, basal metabolism tests, intravenous injections and solutions, administration of blood and blood plasma, oxygen and its administration whilst the Insured Person is confined as a bed-paying patient in a Hospital.

Reimburses charges for ECG, X-ray, laboratory and diagnostic tests which are performed for diagnostic purposes and when in connection with a Disability preceding hospitalisation within sixty (60) days and which are recommended by a Physician. No benefit shall be made if upon such diagnostic services, the Insured Person does not result in Hospitalisation for the treatment of the medical condition diagnosed. Cost incurred for any medications and consultation will not be payable.

Reimburses the professional fees charged for the first time consultation by a Specialist in connection with a Disability within sixty (60) days preceding Hospitalisation and provided that such consultation has been recommended in writing by a Doctor. No benefit shall be made for clinical treatment (including medications and subsequent consultation after the Disability is diagnosed) or where the Insured Person does not result in Hospitalisation for the treatment of the medical condition diagnosed.

Reimburses medical expenses incurred in a Hospital or a registered dental clinic for dental treatment of injury or damage to sound natural teeth as a result of an Accident provided that the dental treatment is received within forty-eight (48) hours of the Accident causing the Injury. Follow-up treatment by the same Dentist will be provided up to thirty-one (31) days from the date of the Accident.

Reimburses medical expenses incurred as a result of a covered bodily injury arising from an Accident for treatment as an outpatient at any registered clinic or Hospital within twenty-four (24) hours of the Accident causing the Injury. Follow-up treatment by the same doctor or same registered clinic or Hospital for the same injury will be provided up to thirty-one (31) days from the date of the Accident.

Reimburses medical charges for follow-up treatment by the same attending Physician and incurred within sixty (60) days immediately following discharge from Hospital for a non-surgical Disability. This shall include medicines prescribed during the follow-up treatment but shall not exceed the supply needed for the said sixty (60) days period.

Reimburses the daily professional fees charged by a legally and medically qualified Physiotherapist for outpatient physiotherapy treatment and incurred within (100) days immediately following discharged from Hospital provided that such service is deemed to be recommended in writing by the same attending Physician/Surgeon who treated the Insured Person during the said confinement.

Reimburses charges incurred for road ambulance services (inclusive of attendant) to and/or from the Hospital of confinement. Payment will not be made if the Insured Person is not Hospitalised.

Reimburses medical charges incurred on transplantation surgery for the Insured Person 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 of an Insured Person whilst the Policy is in force. The costs of acquisition of the organ and all cost incurred by the donors are not covered.

Reimburses the daily expenses for meals and lodging incurred to accompany an insured Child (aged below fifteen (15) years) in the Hospital but not exceeding 150 days.

Pays a daily allowance for each complete day of confinement in a Malaysian Government Hospital up to a maximum number of 150 days, provided that the Insured Person shall confine to a Room and Board rate that does not exceed the Insured benefit limit. No payment will be made for any transfer to or from any non-Malaysian Government Hospital.

If an Insured Person is diagnosed with Cancer or Kidney Failure as defined herein, the Company will reimburse medical charges incurred for the treatment of Cancer or Kidney Failure provided such treatment (radiotherapy &/or chemotherapy for Cancer and Dialysis for Kidney failure but excluding costs for consultation, examination tests, take home drugs) is received at the outpatient department of a Hospital or a legally registered Cancer Treatment center or Kidney Dialysis center immediately following discharge from Hospital confinement or surgery subject to the monthly limit as stated in the Schedule of Benefits.

Reimburses the daily professional fees for the services rendered by a medically qualified and licensed Nurse in the Insured Person’s home and incurred within sixty (60) days immediately following discharged from Hospital provided that such services is deemed to be Medically Necessary by the attending Physician in writing. The plan and schedule of the treatment for this Home Nursing Care must be established and prescribed in writing by the attending Physician. No payment will be made for custodial care, meal, general housekeeping services. companion, rest cure or personal comfort items.

Pays the Insured or the legal representative of the Insured the stated lump sum benefit in the event of Accidental death of an Insured Person if death occurs within six (6) months from the date of the Accident.

It means Medically Necessary expenses incurred by an Insured Person due to a covered Disability and provided that the expenses incurred fall within the ’Description of Benefits’ and benefit limits of the Insured Benefits Plan.

It means Disability that the Insured Person has reasonable knowledge of on or before the effective date of insurance of the Insured Person. An Insured Person may be considered to have reasonable knowledge of a Pre-existing Condition where the condition is one for which:

It means charges for medical care which is Medically Necessary shall be considered reasonable and customary to the extent that it does not exceed the general level of charges being made by others of similar standing in the locality where the charge is incurred, when furnishing like or comparable treatment, services or supplies to individual of the same sex and of comparable age for a similar Disability and in accordance with accepted medical standards and practice could not have been omitted without adversely affecting the Insured Person’s medical condition.

If an Insured Person seeks treatment overseas, benefits in respect of the treatment shall be covered subject to the exclusions, limitations and conditions specified in this Policy and all benefits will be payable based on the official exchange rate ruling on the last day of the Period of Confinement and shall exclude the cost of transport to the place of treatment provided:

If an Insured Person is hospitalized at a published Room & Board rate which is higher than his/her eligible benefit, the Insured shall bear 20% of the other eligible benefits described in the Schedule of Benefits.

This Policy does not cover any costs, expenses or consequences caused directly or indirectly, wholly or partly, by any one of the followings:

Any Pre-existing Condition, except Disabilities that are declared to the Company in the Proposal form and which the Company may decide not to exclude or impose conditions on will be covered after the Insured Person has been covered under this Policy for more than twelve (12) consecutive months.

Specified Illnesses occurring during the first one hundred and twenty (120) days of continuous cover of an Insured Person.

Any medical or physical conditions arising within the Waiting Period of the Insured Person’s cover or date reinstatement whichever is latest except for Accidental Injury.

Cosmetic/plastic surgery, cosmetic treatment, eye refraction and its correction by any means except as necessitated by Injuries occurring wholly during the Period of Insurance, and the use or acquisition of external prosthetic appliances or devices such as artificial limbs, hearing aids, implanted pacemaker and prescriptions thereof.

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.

Rest cures or sanitaria care, venereal disease and its sequelae, AIDS (Acquired Immune Deficiency Syndrome) or ARC (AIDS Related Complex), and HIV (Human Immune-deficiency Virus) related diseases, treatment of alcohol dependence syndrome and illegal drugs.

Pregnancy, childbirth (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, sexual dysfunction, sterilization or sex changes.

Psychotic, mental or nervous disorders, (including any neuroses and their physiological or psychosomatic manifestations), self-inflicted injury or attempted suicide.

Hospitalisation primarily for investigatory purposes, diagnosis, X-ray examination, general physical or medical examinations, or any diagnostic test 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, and treatments pertaining to weight control.

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.

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, bonesetting, herbalist treatment, massage or aroma therapy or other alternative treatment.

Care or treatment for which payment is not required or to the extent which is payable by any other insurance or indemnity.

War or any act of war, declared or undeclared, terrorist activities, active duty in any armed force, direct participation in strikes, riots and civil commotion or insurrection.

Ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapons material.