POLICY EXCLUSIONS

This contract does not cover any hospitalization, surgery or charges cause directly or indirectly, wholly or partly, by any one (1) of the following occurrences :

1) 30 days “Waiting Period”

  • Any treatment/admission in any Hospital occurring during the first 30 days period from the policy commencement date or registration date is not covered by the Plan except for treatment/admission due to accidental cases only. This clause shall not be applicable after the first year of cover. However, if there is a break in between the takaful/insurance cover from one period to another, the Waiting Period shall apply again.

2) 120 days Specific Illness

  • Any admission in any hospital occurring during the first 120 days period from policy commencement date or registration date due to Specific Illnesses are not covered.
  • Specific Illness means the disabilities occurring within the first 120 days of this takaful/insurance contract or from policy commencement date or from student registration date, irrespective of whether the covered person/student was aware of the disability or not. The specific illness specified in the policy contract are as follows :-
      • Endometriosis/Adenomyosis
      • Hernia / Hemorohoids / Fistulae
      • Tumour/ Cysts/ Nodules/ Polyps / Lumps of all kinds
      • Stones in the Urinary / Biliary Systems
      • Gastric / Duodenal Ulcers
      • Cataracts
      • Cholecystitis/ Cholelithiasis/ Calculi of the Urinary Organ
      • Spinal Disorders requiring surgery
      • Diabetes Melitus
      • Nasal Conditions requiring surgery
      • Tonsils requiring surgery
      • Hypertension or Cardio-vascular Deceases

3) Pre-existing Illness Condition

  • Any treatment / admission in any hospital due to pre-existing illness are not covered for 1st one (1) year coverage period.
  • Pre-existing Illness Condition means the disability existed or have developed symptoms or there exist manifestation of illness before the effective date of cover in respect to a covered person of which the covered person was aware or should reasonable have been aware, or based on normal medically accepted pathological development of the illness or illnesses.
  • Consultation with a medical doctor for any sign or pain or discomfort shall constitute a manifestation or symptom of a disability.
  • The status of pre-existing illness will be confirmed by the doctor who treated the patient prior to admission or before requesting for a guarantee letter.

4) Plastic/Cosmetic surgery, circumcision, eye examination, glasses and refraction or surgical correction of nearsightedness (Radial Keratotomy or Lasik) and the use or acquisition of external pros thetic appliances or devices such as artificial limbs, hearing aids, implanted pacemakers and prescriptions thereof.

5) Dental conditions including dental treatment or oral surgery except as necessitated by Accidental injuries to sound natural teeth occur ring wholly during the Period of Insurance.

6) 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 required quarantine by law.

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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