INSURANCE PLAN

TABLE OF BENEFITS / SCOPE OF COVERAGE

Plan 1

Plan 2

                 

CATEGORY 1 : PERSONAL ACCIDENT & DEATH 

 

 RM

 RM

  GROUP TERM LIFE ("GTL") AND GROUP PERSONAL ACCIDENT ("GPA")      
  1. Death (Natural Cause/ Sickness)       RM20,000.00 RM30,000.00
    Death (Accidental Cause)       RM20,000.00 RM30,000.00
  2 Total Permanent Disablement (Natural Cause/ Sickness)   RM20,000.00 RM30,000.00
    Total Permanent Disablement due to accidental cause   RM20,000.00 RM30,000.00
    inclusive of all types of physical injury- as per table of benefits      
  3 Partial Permanent Disablement due to accidental cause Max. RM20,000.00 RM30,000.00
    inclusive of all types of physical injury cause by accident- as per table of benefit    
                 
 

CATEGORY 2 : IN-PATIENT SERVICES (CASHLESS)

RM

RM

  GROUP HOSPITAL AND SURGICAL ("GHS")        
  Third Party Adminstrator/Medical Card Provider : Mediexpress Sdn Bhd      
  Hospital Benefit, Fees and Services          
  1 Room & Board per day          
    Ordinary ( up to 120 days in Private Hospital / Government Hospital)   RM120.00 RM150.00
  2 Insentive Care Unit (daily maximum up to 30 days)     RM350.00 RM380.00
  3 Hospital Miscellaneous Services       as charged as charged
  4 Surgical Fees         as charged as charged
  5 Anaesthetic Fees         as charged as charged
  6 Operating Theatre Fees       as charged as charged
  7 In-Hospital Physician (daily maximum up to 120 days)   as charged as charged
  8 Pre-Surgical / Medical Diagnostic Services (Follow-up within 60 days prior to admission) as charged as charged
  9 Pre-Surgical/ Medical Specialist Consultation (Follow-up within 60 days prior to admission) as charged as charged
  10 Second Surgical Opinion       as charged as charged
  11 Post Hospitalisation Treatment (within 60 days of discharge)   as charged as charged
  12 Ambulance Services Fees (Private ambulance or Inhouse ambulance)   RM250.00 RM250.00
  13 Claim/Reimbursement Medical Report Fee     RM50.00 RM80.00
  14 Government Hospital Cash Benefit Allowance (up to a maximum of 120 days)   RM30.00 RM45.00
  15 Reimbursement of Government Service Tax     6% 6%
  16 Day Surgery Benefit / Day Care - > 6 hours     as charged as charged
                 
 

CATEGORY 3 : EMERGENCY OUT-PATIENT SERVICES 

RM

RM

  1 Emergency Outpatient Accidental Treatment (maximum per case)   RM2,000.00 RM2,500.00
    (Follow-up within 14 days of first treatment)        
  2 Emergency Outpatient Dental Treatment     as charged as charged
  3 Emergency Outpatient Sickness Treatment - (between 12.00 midnight to 6.00 am only) as charged as charged
  OVERALL ANNUAL LIMIT FOR CATEGORY 2 & 3     RM15,000.00 RM20,000.00
                 

CATEGORY 4 - GP OUT-PATIENT SERVICES

RM

RM

                 
  1 Outpatient for Sickness Treatment     - as charged - - as charged -
    i) Routine Consultation, Medication, Injection     subject to annual limit subject to annual limit
    ii) Diagnostic Lab/X-Ray Procedure     of RM350.00 of RM500.00
    iii) Out-patient Surgical Procedures    

Panel Clinic - cashless UM Student's Clinic (KKPUM)

Excess : Nil

Panel Clinic - cashless UM Student's Clinic (KKPUM)

Excess : Nil

   

Cronic illness (including pre-existing illness)

Additional Terms

  1. Outpatient GP treatment annual limit is RM350 (Plan 1) and RM500 (Plan 2) per students
  2. Non Panel Clinics bills will be on "Pay and Claim Basis" (Reimbursement Claim)
  3. Maximum Limit claimable amount per visit is RM150 (Plan 1) and RM200 (plan 2)
  4. OP treatment at PPUM/UMMC is covered on pay and claim basis
    The above OP Benefits does not cover outpatient specialist visit
       
   

 

IMPORTANT NOTES (applicable for Category 4 only) :

COVERED

  • Outpatient treatment at KKPUM (UM Clinic) is covered and on "cashless basis" subject to availability limit, standard terms, conditions and exclusions.
  • Outpatient treatment at any GP clinics outside UM are covered on "Pay and Claim Basis" (reimbursement)
  • Outpatient treatment at PPUM (UM Hospital-Government wing) is covered  on "Pay and Claim Basis" (reimbursement)

(For ii and iii above, please submit  the original medical receipt and fill-up OP form at our Etiqa Agency’s office @ UM)


NOT COVERED

  • Outpatient treatment at any specialist hospital are not covered EXCEPT for
    • Emergency Accidental and Sickness Treatment (Covered under category 3 above)
    • Sixty (60) days pre admission date and sixty (60) days post discharge date (Covered under category 2 above)
  • As per Standard Policy Exclusions.

 

                 
  2 Outpatient for Accidental Treatment - pay and claim basis (GP Clinic and Specialist Visit)   - as charged - - as charged -
    i) Routine Consultation, Medication, Injection     subject to annual limit subject to annual limit
    ii) Other related expenses       of RM1,000.00 of RM2,000.00
                 
 

CATEGORY 5 : FUNERAL / REPATRIATON

RM

RM

                 
  1 Funeral Expenses / Repatriation Expenses     RM10,000.00 RM15,000.00
    Funeral Expenses is inclusive of other necessary cost incurred such as      
    a) Repatriation Allowance          
    b) Place of Interment          
    c) Cremation or Funeral Ceremony in Malaysia        
    d) Transportation          
                 

OVERALL ANNUAL CONTRIBUTION RATE
(ALL-IN COST PER STUDENT)

 RM

 RM

  STUDENT ONLY - PER ANNUM (INCLUSIVE 6% GST)
      RM370.00 RM530.00

NOTE:

1) 6% GST is imposed to the premium charge to the student with effect from 2016/2017 policy renewal.
2) The actual premium rate inclusive GST is RM370.00 (plan 1) and RM530 (plan 2).

Contact & Support

FOR HOSPITAL ADMISSION AND DISCHAGRED

Please contact our 24 HOURS ETIQA HEALTHCARE CALL CENTRE at 1 800 88 9998 or email to etiqahealthcare@etiqa.com.myfor the following services :-

  • Hospital Admission/Discharged Matters
  • Requisition/Follow-up of  Guarantee Letterfor Hospital Admission
  • Membership Status and Emergency Cases
  • Latest list of Panel Hospital Nationwide

FOR OTHER SERVICES as per below :-

  • Claims Submission
  • Outpatient Matters
  • Follow-up claim status
  • Other Takaful/Insurance Products/Plan – Travel PA, PA, Motor Insurance
  • Private Car Road Tax Renewal
  • Others

Please contact/email or drop by our Agency Office :-
ETIQA TAKAFUL AGENCY OFFICE,
NZ Network Management Services SdnBhd
Ground Floor, Block E, Perdanasiswa Complex
University of Malaya
50603 Kuala Lumpur
(Near to ISC office)

Tel No :03-7956 9688 / 019-6025970
Email :info-etiqa@myumtakafulplan.com or hanisah434@gmail.com

Any Complaint, please email to mzaidimsaad@gmail.com/fadhilah.s@etiqa.com.my

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