Scope of Benefits
Hospital Room & Board
Reasonable and Customary Charges for daily room accommodation and meals during the confinement as an in-patient.
Intensive Care Unit
Reasonable and Customary Charges for daily room and board as an in-patient in the Intensive Care Unit of the hospital.
Hospital Supplies and Services
Reasonable and Customary Charges incurred during a hospital confinement, which shall include general nursing, prescribed and consumed drugs and medicines, 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.
Operating Theatre
Reasonable and Customary Charges for usage of operating theatre incidental to the surgical procedure.
Surgical Fees
Reasonable and Customary Charges for surgery performed and normal operative care up to 31 days before and after the operation.
Anaesthetist Fee
Reasonable and Customary Charges by the Anaesthetist for the supply and administration of anaesthesia.
In-Hospital Physician Visit
Reasonable and Customary Charges by the Physician for the treatment of the Insured Person when confine for a non-surgical disability subject to maximum of two (2) visits per day.
Organ Transplant
Reasonable and Customary Charges and professional fees for the surgical transplantation of the kidney, heart, lung, liver or bone marrow performed in a hospital. Payment is limited to one event per lifetime.
Pre-Hospital Diagnostic Tests
Reasonable and Customary Charges for diagnostic tests, which are recommended by a Specialist within 60 days preceding hospital confinement. No payment will be made if upon such diagnosis, the insured Person does not result in hospital confinement for the treatment of the medical condition diagnosed.
Pre-Hospital Specialist Consultation
Reasonable and Customary Charges by the Specialist for the first-time consultation, which are recommended by a general practitioner in writing within 60 days preceding hospital confinement. Payment will not be made for clinical treatment (including medication and subsequent consultation after the illness is diagnosed), or where the Insured does not result in hospital confinement for the treatment of the medical condition diagnosed.
Post-Hospitalisation Treatment
Reasonable and Customary Charges for treatment by the same physician within 60 days following discharge from hospital for a non-surgical confinement.
Emergency Accidental Outpatient Treatment
Reasonable and Customary Charges for services and medical supplies provided by the hospital or clinic for emergency treatment of bodily injury as a result of a covered accident and received as an outpatient within 24 hours of the accident. Follow-up treatment is up to 14 days of the accident administered by the same Physician.
Ambulance Fees
Reasonable and Customary Charges for domestic ambulance services for transporting the Insured Person to and/ or from hospital. Payment will not be made if the Insured Person is not hospitalised.
Daily-Cash Allowance
For each full day of hospital confinement at a Malaysian Government Hospital.
Malaysian Government Service Tax
On eligible paid expenses.
Overall Annual Limit
It is the maximum annual reimbursement for benefits payable in respect of expenses incurred for treatment provided to the Insured Person during the period of insurance as stated in the Schedule of Benefits.
