MEDISECURE BOOSTER POLICY (Hospitalisation & Surgical Insurance) POLISI MEDISECURE BOOSTER (Insurans Hospital dan Pembedahan)
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- Calvin Richardson
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1 MEDISECURE BOOSTER POLICY (Hospitalisation & Surgical Insurance) POLISI MEDISECURE BOOSTER (Insurans Hospital dan Pembedahan) FOR CONSUMER INSURANCE CONTRACTS (INSURANCE WHOLLY FOR PURPOSES UNRELATED TO YOUR TRADE, BUSINESS OR PROFESSION) This Policy is issued in consideration of the payment of premium as specified in the Policy Schedule and pursuant to the answers given in your Proposal Form (or when you applied for this insurance) and any other disclosures made by you between the time of submission of your Proposal Form (or when you applied for this insurance) and the time this contract is entered into. The answers and any other disclosures given by you shall form part of this contract of insurance between you and us. However, in the event of any pre-contractual misrepresentation made in relation to your answers or in any disclosures given by you, only the remedies in Schedule 9 of the Financial Services Act 2013 will apply. This Policy reflects the terms and conditions of the contract of insurance as agreed between you and us. BAGI KONTRAK INSURANS PENGGUNA (INSURANS SEPENUHNYA YANG TIDAK BERKAITAN DENGAN PERDAGANGAN, PERNIAGAAN ATAU PROFESION) Polisi dikeluarkan sejajar dengan pembayaran dari premium yang ditentukan dalam Jadual Polisi dan menurut kepada kenyataan yang telah dikemukakan di dalam borang cadangan (atau semasa permohonan insurans ini) dan segala kenyataan yang telah dibuat oleh pihak anda pada atau semasa penyerahan borang cadangan (atau semasa permohonan insurans ini) dan pada masa perjanjian ini ditandatangani. Jawapan dan sebarang pernyataan lain yang anda berikan akan menjadi sebahagian daripada kontrak insurans antara anda dan pihak kami. Walau bagaimanapun, sekiranya terdapat sebarang salah nyata semasa pra-kontrak berhubung dengan jawapan anda atau di mana-mana pernyataan yang diberikan oleh anda, hanya remedi yang terdapat dalam Jadual 9 Akta Perkhidmatan Kewangan 2013 akan diguna pakai. Polisi ini bertindak atas terma-terma dan syarat-syarat kontrak insurans seperti yang telah dipersetujui antara anda dan pihak kami. FOR NON CONSUMER INSURANCE CONTRACTS (INSURANCE FOR PURPOSES RELATED TO YOUR TRADE, BUSINESS OR PROFESSION) This Policy is issued in consideration of the payment of premium as specified in the Policy Schedule and pursuant to the answers given in your Proposal Form (or when you applied for this insurance) and any other disclosures made by you between the time of submission of your Proposal Form (or when you applied for this insurance) and the time this contract is entered into. The answers and any other disclosures given by you shall form part of this contract of insurance between you and us. In the event of any pre-contractual misrepresentation made in relation to your answers or in any disclosures made by you, it may result in avoidance of your contract of insurance, refusal or reduction of your claim(s), change of terms or termination of your contract of insurance. This Policy reflects the terms and conditions of the contract of insurance as agreed between you and us. WHEREAS the Policyholder named in the Policy Schedule has applied to Lonpac Insurance Bhd (hereinafter called 'the Company') for the insurance herein described and has paid or agreed to pay the premium stated in the Policy Schedule as consideration for the insurance hereinafter contained. NOW THIS POLICY WITNESSES that if the Insured Person is confined to a hospital for treatment or is surgically treated as a day case during the Period of Insurance stated in the Policy Schedule, the Company will pay to the Policyholder or his legal personal representative the sum or sums stated in Policy Schedule. Payment is subject to reasonable and customary charges and will only be made upon receipt and approval of proofs of expenses incurred. THIS POLICY is an excess major medical insurance policy and will only pay after the Insured Person has exhausted all other avenues of compensation from other basic or major medical insurances and is subject to provisions, conditions and limitations as contained herein or as may be endorsed hereon. BAGI KONTRAK INSURANS KOMERSIAL (INSURANS BAGI TUJUAN PERDAGANGAN, PERNIAGAAN ATAU PROFESION) Polisi dikeluarkan sejajar dengan pembayaran dari premium yang ditentukan dalam Jadual Polisi dan menurut kepada kenyataan yang telah dikemukakan di dalam borang cadangan (atau semasa permohonan insurans ini) dan segala kenyataan yang telah dibuat oleh pihak anda pada atau semasa penyerahan borang cadangan (atau semasa permohonan insurans ini) dan pada masa perjanjian ini ditandatangani. Jawapan dan sebarang pernyataan lain yang anda berikan akan menjadi sebahagian daripada kontrak insurans antara anda dan pihak kami. Sekiranya terdapat sebarang salah nyata pada pra-kontrak berhubung dengan jawapan anda atau di mana-mana pernyataan yang diberikan oleh anda, ia mungkin mengakibatkan pembatalan kontrak insurans, keengganan atau pengurangan gantirugi, perubahan terma atau penamatan kontrak insurans anda. Polisi ini bertindak atas terma-terma dan syarat-syarat kontrak insurans seperti yang telah dipersetujui antara anda dan pihak kami. BAHAWASANYA Pemegang Polisi yang dinamakan di dalam Jadual Polisi telah memohon kepada Lonpac Insurance Bhd (selepas dari ini dirujuk sebagai 'Syarikat') untuk insurans yang dinyatakan dan telah membayar atau bersetuju untuk membayar premium yang dinyatakan di dalam Jadual Polisi sebagai pertimbangan untuk insurans yang terkandung. DENGAN INI POLISI INI MENYAKSIKAN jika sekiranya semasa Tempoh Insurans, Orang Yang Diinsuranskan dimasukkan ke hospital untuk rawatan atau menjalani pembedahan sebagai kes hari, Syarikat akan bayar kepada Pemegang Polisi atau kepada wakil diri sah di sisi undang-undang Pemegang Polisi jumlah atau sejumlah wang seperti yang dinyatakan di dalam Jadual Insurans. Pembayaran akan tertakluk kepada bayaran munasabah dan biasa diamalkan dan hanya akan dibayar selepas bukti perbelanjaan diterima dan diluluskan. POLISI INI adalah insurans perubatan major ekses dan hanya akan membayar selepas Orang Yang Diinsuranskan telah kehabisan semua kemudahan pampasan lain dari insurans perubatan asas atau insurans perubatan major lain dan tertakluk kepada peruntukan, syarat dan batasan seperti yang terkandung di sini atau sebagaimana yang diendorskan di sini. Page 1 of 30
2 SCHEDULE OF BENEFITS Section Description of Benefits (as at 01 January 2018) Plan 1 (RM) Plan 2 (RM) Plan 3 (RM) Plan 4 (RM) Plan 5 (RM) Plan 6 (RM) A HOSPITALISATION AND SURGICAL EXPENSES 1. Before the patient is admitted to hospital or surgically treated in a hospital a. Pre-Surgical Consultation & Diagnosis b. Pre-Hospital Specialist Consultation c. Pre-Hospital Diagnostic Tests 2. When the patient is being treated as a bed-paying patient in a hospital or is surgically treated a. Intensive Care Unit b. Hospital Supplies & Services c. Surgical Fees (including Anaesthetist & Operating Theatre Fees) d. In-Hospital Physician Visit not exceeding two visits a day 3. After the patient is discharged from hospital for a non-surgical treatment a. Post Hospitalisation Treatment 4. If the patient needs to be moved by road ambulance to an appropriate location for treatment or diagnosis a. Ambulance Fees As Charged, subject to reasonable, customary and necessary expenses which is incurred within 31 days prior to hospital admission or surgery As Charged, subject to reasonable, customary and necessary expenses which is incurred during the policy period As Charged, subject to reasonable, customary and necessary expenses which is incurred up to 60 days from the date of discharge from the hospital As Charged, subject to reasonable, customary and necessary expenses which is incurred during the policy period 5. Other Benefits As Charged, subject to reasonable, customary and necessary expenses which is a. Organ Transplant b. Goods and Services Tax c. Medical Report Fee d. Nursing at Home incurred during the policy period B SPECIFIC OUTPATIENT TREATMENTS (Sub-Limit included in the Per Disability Limit) 1. Outpatient Cancer Treatment, per annum (inclusive in the Per Disability Limit) 2. Outpatient Kidney Dialysis, per annum (inclusive in the Per Disability Limit) 300, , , , , , , , , , , ,000 LIMITS OF COVERAGE (Section A & B) a. Room & Board, per day limit (incurred during the policy period) 1,000 1, b. Deductible Per Disability (Top-Up Basis) 15, ,000 10, ,000 7,500 75,000 c. Per Disability Limit 1,000,000 1,000, , , , ,000 d. Overall Annual Limit 2,000,000 2,000,000 1,500,000 1,500,000 1,000,000 1,000,000 Important Note: The Room and Board Limit, Per Disability Limit, Sub-Limit and Overall Annual Limit will increase every five years as stipulated in the Schedule of Limits, subject to the following but the Deductible Per Disability remains unchanged during the increase in limits:- a. The respective new limits will only apply to new policies issued or policies renewed on or after the effective date of the respective increase in limits. b. The limits applicable for the respective claims shall be the limits applicable to the policy during the first intimation of the respective claim and the increased limits will not be applicable to claims already reported. Page 2 of 30
3 JADUAL MANFAAT Seksyen Keterangan Manfaat (pada 01 Januari 2018) Pelan 1 (RM) Pelan 2 (RM) Pelan 3 (RM) Pelan 4 (RM) Pelan 5 (RM) Pelan 6 (RM) A PERBELANJAAN HOSPITAL DAN PEMBEDAHAN 1. Sebelum pesakit dimasukkan ke hospital atau menjalani pembedahan di hospital a. Rundingan Pakar dan Ujian Diagnostik Pra-pembedahan b. Rundingan Pakar Pra-hospital c. Ujian Diagnostik Pra-hospital 2. Apabila pesakit sedang dirawat sebagai pesakit dalam di hospital atau menjalani pembedahan a. Unit Rawatan Rapi b. Bekalan dan Khidmat Hospital c. Bayaran Pembedahan (termasuk Bayaran Pakar Bius dan Bayaran Bilik Bedah) d. Lawatan Pakar Perubatan Dalam Hospital, tidak melebihi dua lawatan sehari 3. Selepas pesakit keluar dari hospital untuk rawatan bukan pembedahan a. Rawatan selepas penghospitalan 4. Jika pesakit perlu dipindahkan oleh ambulans darat ke lokasi yang sesuai untuk rawatan atau diagnosis a. Bayaran Ambulans Seperti yang Dicajkan, tertakluk kepada perbelanjaan munasabah, biasa dan perlu yang dilakukan dalam masa 31 hari sebelum kemasukan atau pembedahan hospital Seperti yang Dicajkan, tertakluk kepada perbelanjaan munasabah, biasa dan perlu yang dilakukan semasa tempoh polisi Seperti yang Dicajkan, tertakluk kepada perbelanjaan munasabah, biasa dan perlu yang ditanggung sehingga 60 hari dari tarikh selepas keluar dari hospital Seperti yang Dikenakan, tertakluk kepada perbelanjaan munasabah, biasa dan perlu yang dilakukan semasa tempoh polisi 5. Manfaat Lain Seperti yang Dikenakan, tertakluk kepada perbelanjaan munasabah, biasa dan a. Transplan Organ b. Cukai Barang dan Perkhidmatan c. Bayaran Laporan Perubatan d. Jagaan Jururawat Di Rumah perlu yang dilakukan semasa tempoh polisi B RAWATAN PESAKIT LUAR YANG TERTENTU (Had yang termasuk dalam Had Setiap Hilang Upaya) 1. Rawatan Kanser Pesakit Luar, setiap tahun (termasuk dalam Had Setiap Hilang Upaya) 2. Dialisis Buah Pinggang Pesakit Luar, setiap tahun (termasuk dalam Had Setiap Hilang Upaya) 300, , , , , , , , , , , ,000 HAD PERLINDUNGAN (Seksyen A & B) a. Bilik Hospital dan Makan, had harian yang dikenakan semasa tempoh polisi b. Deduktibel Setiap Hilang Upaya (berasaskan perlindungan tambahan) 1,000 1, , ,000 10, ,000 7,500 75,000 c. Had Setiap Hilang Upaya 1,000,000 1,000, , , , ,000 d. Had Tahunan Keseluruhan 2,000,000 2,000,000 1,500,000 1,500,000 1,000,000 1,000,000 Nota Penting: Had Harian Bilik Hospital dan Makan, Had Setiap Hilang Upaya dan Had Tahunan Keseluruhan akan meningkat setiap lima tahun seperti yang dinyatakan di dalam Jadual Had dan tertakluk kepada berikut tetapi Deduktibel Setiap Hilang Upaya tidak akan berubah pada masa had perlindungan meningkat:- a. Had baru masing-masing hanya akan terpakai kepada polisi baru yang dikeluarkan atau polisi yang diperbaharui pada atau selepas tarikh berkuat kuasa peningkatan had tersebut. b. Had Perlindungan yang dikenakan untuk tuntutan masing-masing adalah had yang dikenakan terhadap polisi pada hari pertama tuntutan masing-masing dibuat dan peningkatan Had Perlindungan tidak akan terpakai kepada tuntutan yang telah dilaporkan. Page 3 of 30
4 Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan SCHEDULE OF LIMITS JADUAL HAD Schedule of Limits Plan 1 (Ringgit Malaysia) Jadual Had Pelan 1 (Ringgit Malaysia) 1/1/2018 1,000 1,000,000 15, , ,000 2,000,000 1/1/2068 2,000 2,000,000 15, , ,000 4,000,000 1/1/2019 1,000 1,000,000 15, , ,000 2,000,000 1/1/2069 2,000 2,000,000 15, , ,000 4,000,000 1/1/2020 1,000 1,000,000 15, , ,000 2,000,000 1/1/2070 2,000 2,000,000 15, , ,000 4,000,000 1/1/2021 1,000 1,000,000 15, , ,000 2,000,000 1/1/2071 2,000 2,000,000 15, , ,000 4,000,000 1/1/2022 1,000 1,000,000 15, , ,000 2,000,000 1/1/2072 2,000 2,000,000 15, , ,000 4,000,000 1/1/2023 1,100 1,100,000 15, , ,000 2,200,000 1/1/2073 2,100 2,100,000 15, , ,000 4,200,000 1/1/2024 1,100 1,100,000 15, , ,000 2,200,000 1/1/2074 2,100 2,100,000 15, , ,000 4,200,000 1/1/2025 1,100 1,100,000 15, , ,000 2,200,000 1/1/2075 2,100 2,100,000 15, , ,000 4,200,000 1/1/2026 1,100 1,100,000 15, , ,000 2,200,000 1/1/2076 2,100 2,100,000 15, , ,000 4,200,000 1/1/2027 1,100 1,100,000 15, , ,000 2,200,000 1/1/2077 2,100 2,100,000 15, , ,000 4,200,000 1/1/2028 1,200 1,200,000 15, , ,000 2,400,000 1/1/2078 2,200 2,200,000 15, , ,000 4,400,000 1/1/2029 1,200 1,200,000 15, , ,000 2,400,000 1/1/2079 2,200 2,200,000 15, , ,000 4,400,000 1/1/2030 1,200 1,200,000 15, , ,000 2,400,000 1/1/2080 2,200 2,200,000 15, , ,000 4,400,000 1/1/2031 1,200 1,200,000 15, , ,000 2,400,000 1/1/2081 2,200 2,200,000 15, , ,000 4,400,000 1/1/2032 1,200 1,200,000 15, , ,000 2,400,000 1/1/2082 2,200 2,200,000 15, , ,000 4,400,000 1/1/2033 1,300 1,300,000 15, , ,000 2,600,000 1/1/2083 2,300 2,300,000 15, , ,000 4,600,000 1/1/2034 1,300 1,300,000 15, , ,000 2,600,000 1/1/2084 2,300 2,300,000 15, , ,000 4,600,000 1/1/2035 1,300 1,300,000 15, , ,000 2,600,000 1/1/2085 2,300 2,300,000 15, , ,000 4,600,000 1/1/2036 1,300 1,300,000 15, , ,000 2,600,000 1/1/2086 2,300 2,300,000 15, , ,000 4,600,000 1/1/2037 1,300 1,300,000 15, , ,000 2,600,000 1/1/2087 2,300 2,300,000 15, , ,000 4,600,000 1/1/2038 1,400 1,400,000 15, , ,000 2,800,000 1/1/2088 2,400 2,400,000 15, , ,000 4,800,000 1/1/2039 1,400 1,400,000 15, , ,000 2,800,000 1/1/2089 2,400 2,400,000 15, , ,000 4,800,000 1/1/2040 1,400 1,400,000 15, , ,000 2,800,000 1/1/2090 2,400 2,400,000 15, , ,000 4,800,000 1/1/2041 1,400 1,400,000 15, , ,000 2,800,000 1/1/2091 2,400 2,400,000 15, , ,000 4,800,000 1/1/2042 1,400 1,400,000 15, , ,000 2,800,000 1/1/2092 2,400 2,400,000 15, , ,000 4,800,000 1/1/2043 1,500 1,500,000 15, , ,000 3,000,000 1/1/2093 2,500 2,500,000 15, , ,000 5,000,000 1/1/2044 1,500 1,500,000 15, , ,000 3,000,000 1/1/2094 2,500 2,500,000 15, , ,000 5,000,000 1/1/2045 1,500 1,500,000 15, , ,000 3,000,000 1/1/2095 2,500 2,500,000 15, , ,000 5,000,000 1/1/2046 1,500 1,500,000 15, , ,000 3,000,000 1/1/2096 2,500 2,500,000 15, , ,000 5,000,000 1/1/2047 1,500 1,500,000 15, , ,000 3,000,000 1/1/2097 2,500 2,500,000 15, , ,000 5,000,000 1/1/2048 1,600 1,600,000 15, , ,000 3,200,000 1/1/2098 2,600 2,600,000 15, , ,000 5,200,000 1/1/2049 1,600 1,600,000 15, , ,000 3,200,000 1/1/2099 2,600 2,600,000 15, , ,000 5,200,000 1/1/2050 1,600 1,600,000 15, , ,000 3,200,000 1/1/2100 2,600 2,600,000 15, , ,000 5,200,000 1/1/2051 1,600 1,600,000 15, , ,000 3,200,000 1/1/2101 2,600 2,600,000 15, , ,000 5,200,000 1/1/2052 1,600 1,600,000 15, , ,000 3,200,000 1/1/2102 2,600 2,600,000 15, , ,000 5,200,000 1/1/2053 1,700 1,700,000 15, , ,000 3,400,000 1/1/2103 2,700 2,700,000 15, , ,000 5,400,000 1/1/2054 1,700 1,700,000 15, , ,000 3,400,000 1/1/2104 2,700 2,700,000 15, , ,000 5,400,000 1/1/2055 1,700 1,700,000 15, , ,000 3,400,000 1/1/2105 2,700 2,700,000 15, , ,000 5,400,000 1/1/2056 1,700 1,700,000 15, , ,000 3,400,000 1/1/2106 2,700 2,700,000 15, , ,000 5,400,000 1/1/2057 1,700 1,700,000 15, , ,000 3,400,000 1/1/2107 2,700 2,700,000 15, , ,000 5,400,000 1/1/2058 1,800 1,800,000 15, , ,000 3,600,000 1/1/2108 2,800 2,800,000 15, , ,000 5,600,000 1/1/2059 1,800 1,800,000 15, , ,000 3,600,000 1/1/2109 2,800 2,800,000 15, , ,000 5,600,000 1/1/2060 1,800 1,800,000 15, , ,000 3,600,000 1/1/2110 2,800 2,800,000 15, , ,000 5,600,000 1/1/2061 1,800 1,800,000 15, , ,000 3,600,000 1/1/2111 2,800 2,800,000 15, , ,000 5,600,000 1/1/2062 1,800 1,800,000 15, , ,000 3,600,000 1/1/2112 2,800 2,800,000 15, , ,000 5,600,000 1/1/2063 1,900 1,900,000 15, , ,000 3,800,000 1/1/2113 2,900 2,900,000 15, , ,000 5,800,000 1/1/2064 1,900 1,900,000 15, , ,000 3,800,000 1/1/2114 2,900 2,900,000 15, , ,000 5,800,000 1/1/2065 1,900 1,900,000 15, , ,000 3,800,000 1/1/2115 2,900 2,900,000 15, , ,000 5,800,000 1/1/2066 1,900 1,900,000 15, , ,000 3,800,000 1/1/2116 2,900 2,900,000 15, , ,000 5,800,000 1/1/2067 1,900 1,900,000 15, , ,000 3,800,000 1/1/2117 2,900 2,900,000 15, , ,000 5,800,000 Page 4 of 30
5 Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Schedule of Limits Plan 2 (Ringgit Malaysia) Jadual Had Pelan 2 (Ringgit Malaysia) 1/1/2018 1,000 1,000, , , ,000 2,000,000 1/1/2068 2,000 2,000, , , ,000 4,000,000 1/1/2019 1,000 1,000, , , ,000 2,000,000 1/1/2069 2,000 2,000, , , ,000 4,000,000 1/1/2020 1,000 1,000, , , ,000 2,000,000 1/1/2070 2,000 2,000, , , ,000 4,000,000 1/1/2021 1,000 1,000, , , ,000 2,000,000 1/1/2071 2,000 2,000, , , ,000 4,000,000 1/1/2022 1,000 1,000, , , ,000 2,000,000 1/1/2072 2,000 2,000, , , ,000 4,000,000 1/1/2023 1,100 1,100, , , ,000 2,200,000 1/1/2073 2,100 2,100, , , ,000 4,200,000 1/1/2024 1,100 1,100, , , ,000 2,200,000 1/1/2074 2,100 2,100, , , ,000 4,200,000 1/1/2025 1,100 1,100, , , ,000 2,200,000 1/1/2075 2,100 2,100, , , ,000 4,200,000 1/1/2026 1,100 1,100, , , ,000 2,200,000 1/1/2076 2,100 2,100, , , ,000 4,200,000 1/1/2027 1,100 1,100, , , ,000 2,200,000 1/1/2077 2,100 2,100, , , ,000 4,200,000 1/1/2028 1,200 1,200, , , ,000 2,400,000 1/1/2078 2,200 2,200, , , ,000 4,400,000 1/1/2029 1,200 1,200, , , ,000 2,400,000 1/1/2079 2,200 2,200, , , ,000 4,400,000 1/1/2030 1,200 1,200, , , ,000 2,400,000 1/1/2080 2,200 2,200, , , ,000 4,400,000 1/1/2031 1,200 1,200, , , ,000 2,400,000 1/1/2081 2,200 2,200, , , ,000 4,400,000 1/1/2032 1,200 1,200, , , ,000 2,400,000 1/1/2082 2,200 2,200, , , ,000 4,400,000 1/1/2033 1,300 1,300, , , ,000 2,600,000 1/1/2083 2,300 2,300, , , ,000 4,600,000 1/1/2034 1,300 1,300, , , ,000 2,600,000 1/1/2084 2,300 2,300, , , ,000 4,600,000 1/1/2035 1,300 1,300, , , ,000 2,600,000 1/1/2085 2,300 2,300, , , ,000 4,600,000 1/1/2036 1,300 1,300, , , ,000 2,600,000 1/1/2086 2,300 2,300, , , ,000 4,600,000 1/1/2037 1,300 1,300, , , ,000 2,600,000 1/1/2087 2,300 2,300, , , ,000 4,600,000 1/1/2038 1,400 1,400, , , ,000 2,800,000 1/1/2088 2,400 2,400, , , ,000 4,800,000 1/1/2039 1,400 1,400, , , ,000 2,800,000 1/1/2089 2,400 2,400, , , ,000 4,800,000 1/1/2040 1,400 1,400, , , ,000 2,800,000 1/1/2090 2,400 2,400, , , ,000 4,800,000 1/1/2041 1,400 1,400, , , ,000 2,800,000 1/1/2091 2,400 2,400, , , ,000 4,800,000 1/1/2042 1,400 1,400, , , ,000 2,800,000 1/1/2092 2,400 2,400, , , ,000 4,800,000 1/1/2043 1,500 1,500, , , ,000 3,000,000 1/1/2093 2,500 2,500, , , ,000 5,000,000 1/1/2044 1,500 1,500, , , ,000 3,000,000 1/1/2094 2,500 2,500, , , ,000 5,000,000 1/1/2045 1,500 1,500, , , ,000 3,000,000 1/1/2095 2,500 2,500, , , ,000 5,000,000 1/1/2046 1,500 1,500, , , ,000 3,000,000 1/1/2096 2,500 2,500, , , ,000 5,000,000 1/1/2047 1,500 1,500, , , ,000 3,000,000 1/1/2097 2,500 2,500, , , ,000 5,000,000 1/1/2048 1,600 1,600, , , ,000 3,200,000 1/1/2098 2,600 2,600, , , ,000 5,200,000 1/1/2049 1,600 1,600, , , ,000 3,200,000 1/1/2099 2,600 2,600, , , ,000 5,200,000 1/1/2050 1,600 1,600, , , ,000 3,200,000 1/1/2100 2,600 2,600, , , ,000 5,200,000 1/1/2051 1,600 1,600, , , ,000 3,200,000 1/1/2101 2,600 2,600, , , ,000 5,200,000 1/1/2052 1,600 1,600, , , ,000 3,200,000 1/1/2102 2,600 2,600, , , ,000 5,200,000 1/1/2053 1,700 1,700, , , ,000 3,400,000 1/1/2103 2,700 2,700, , , ,000 5,400,000 1/1/2054 1,700 1,700, , , ,000 3,400,000 1/1/2104 2,700 2,700, , , ,000 5,400,000 1/1/2055 1,700 1,700, , , ,000 3,400,000 1/1/2105 2,700 2,700, , , ,000 5,400,000 1/1/2056 1,700 1,700, , , ,000 3,400,000 1/1/2106 2,700 2,700, , , ,000 5,400,000 1/1/2057 1,700 1,700, , , ,000 3,400,000 1/1/2107 2,700 2,700, , , ,000 5,400,000 1/1/2058 1,800 1,800, , , ,000 3,600,000 1/1/2108 2,800 2,800, , , ,000 5,600,000 1/1/2059 1,800 1,800, , , ,000 3,600,000 1/1/2109 2,800 2,800, , , ,000 5,600,000 1/1/2060 1,800 1,800, , , ,000 3,600,000 1/1/2110 2,800 2,800, , , ,000 5,600,000 1/1/2061 1,800 1,800, , , ,000 3,600,000 1/1/2111 2,800 2,800, , , ,000 5,600,000 1/1/2062 1,800 1,800, , , ,000 3,600,000 1/1/2112 2,800 2,800, , , ,000 5,600,000 1/1/2063 1,900 1,900, , , ,000 3,800,000 1/1/2113 2,900 2,900, , , ,000 5,800,000 1/1/2064 1,900 1,900, , , ,000 3,800,000 1/1/2114 2,900 2,900, , , ,000 5,800,000 1/1/2065 1,900 1,900, , , ,000 3,800,000 1/1/2115 2,900 2,900, , , ,000 5,800,000 1/1/2066 1,900 1,900, , , ,000 3,800,000 1/1/2116 2,900 2,900, , , ,000 5,800,000 1/1/2067 1,900 1,900, , , ,000 3,800,000 1/1/2117 2,900 2,900, , , ,000 5,800,000 Page 5 of 30
6 Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Schedule of Limits Plan 3 (Ringgit Malaysia) Jadual Had Pelan 3 (Ringgit Malaysia) 1/1/ ,000 10, , ,000 1,500,000 1/1/2068 1,500 1,500,000 10, , ,000 3,000,000 1/1/ ,000 10, , ,000 1,500,000 1/1/2069 1,500 1,500,000 10, , ,000 3,000,000 1/1/ ,000 10, , ,000 1,500,000 1/1/2070 1,500 1,500,000 10, , ,000 3,000,000 1/1/ ,000 10, , ,000 1,500,000 1/1/2071 1,500 1,500,000 10, , ,000 3,000,000 1/1/ ,000 10, , ,000 1,500,000 1/1/2072 1,500 1,500,000 10, , ,000 3,000,000 1/1/ ,000 10, , ,500 1,650,000 1/1/2073 1,575 1,575,000 10, , ,500 3,150,000 1/1/ ,000 10, , ,500 1,650,000 1/1/2074 1,575 1,575,000 10, , ,500 3,150,000 1/1/ ,000 10, , ,500 1,650,000 1/1/2075 1,575 1,575,000 10, , ,500 3,150,000 1/1/ ,000 10, , ,500 1,650,000 1/1/2076 1,575 1,575,000 10, , ,500 3,150,000 1/1/ ,000 10, , ,500 1,650,000 1/1/2077 1,575 1,575,000 10, , ,500 3,150,000 1/1/ ,000 10, , ,000 1,800,000 1/1/2078 1,650 1,650,000 10, , ,000 3,300,000 1/1/ ,000 10, , ,000 1,800,000 1/1/2079 1,650 1,650,000 10, , ,000 3,300,000 1/1/ ,000 10, , ,000 1,800,000 1/1/2080 1,650 1,650,000 10, , ,000 3,300,000 1/1/ ,000 10, , ,000 1,800,000 1/1/2081 1,650 1,650,000 10, , ,000 3,300,000 1/1/ ,000 10, , ,000 1,800,000 1/1/2082 1,650 1,650,000 10, , ,000 3,300,000 1/1/ ,000 10, , ,500 1,950,000 1/1/2083 1,725 1,725,000 10, , ,500 3,450,000 1/1/ ,000 10, , ,500 1,950,000 1/1/2084 1,725 1,725,000 10, , ,500 3,450,000 1/1/ ,000 10, , ,500 1,950,000 1/1/2085 1,725 1,725,000 10, , ,500 3,450,000 1/1/ ,000 10, , ,500 1,950,000 1/1/2086 1,725 1,725,000 10, , ,500 3,450,000 1/1/ ,000 10, , ,500 1,950,000 1/1/2087 1,725 1,725,000 10, , ,500 3,450,000 1/1/2038 1,050 1,050,000 10, , ,000 2,100,000 1/1/2088 1,800 1,800,000 10, , ,000 3,600,000 1/1/2039 1,050 1,050,000 10, , ,000 2,100,000 1/1/2089 1,800 1,800,000 10, , ,000 3,600,000 1/1/2040 1,050 1,050,000 10, , ,000 2,100,000 1/1/2090 1,800 1,800,000 10, , ,000 3,600,000 1/1/2041 1,050 1,050,000 10, , ,000 2,100,000 1/1/2091 1,800 1,800,000 10, , ,000 3,600,000 1/1/2042 1,050 1,050,000 10, , ,000 2,100,000 1/1/2092 1,800 1,800,000 10, , ,000 3,600,000 1/1/2043 1,125 1,125,000 10, , ,500 2,250,000 1/1/2093 1,875 1,875,000 10, , ,500 3,750,000 1/1/2044 1,125 1,125,000 10, , ,500 2,250,000 1/1/2094 1,875 1,875,000 10, , ,500 3,750,000 1/1/2045 1,125 1,125,000 10, , ,500 2,250,000 1/1/2095 1,875 1,875,000 10, , ,500 3,750,000 1/1/2046 1,125 1,125,000 10, , ,500 2,250,000 1/1/2096 1,875 1,875,000 10, , ,500 3,750,000 1/1/2047 1,125 1,125,000 10, , ,500 2,250,000 1/1/2097 1,875 1,875,000 10, , ,500 3,750,000 1/1/2048 1,200 1,200,000 10, , ,000 2,400,000 1/1/2098 1,950 1,950,000 10, , ,000 3,900,000 1/1/2049 1,200 1,200,000 10, , ,000 2,400,000 1/1/2099 1,950 1,950,000 10, , ,000 3,900,000 1/1/2050 1,200 1,200,000 10, , ,000 2,400,000 1/1/2100 1,950 1,950,000 10, , ,000 3,900,000 1/1/2051 1,200 1,200,000 10, , ,000 2,400,000 1/1/2101 1,950 1,950,000 10, , ,000 3,900,000 1/1/2052 1,200 1,200,000 10, , ,000 2,400,000 1/1/2102 1,950 1,950,000 10, , ,000 3,900,000 1/1/2053 1,275 1,275,000 10, , ,500 2,550,000 1/1/2103 2,025 2,025,000 10, , ,500 4,050,000 1/1/2054 1,275 1,275,000 10, , ,500 2,550,000 1/1/2104 2,025 2,025,000 10, , ,500 4,050,000 1/1/2055 1,275 1,275,000 10, , ,500 2,550,000 1/1/2105 2,025 2,025,000 10, , ,500 4,050,000 1/1/2056 1,275 1,275,000 10, , ,500 2,550,000 1/1/2106 2,025 2,025,000 10, , ,500 4,050,000 1/1/2057 1,275 1,275,000 10, , ,500 2,550,000 1/1/2107 2,025 2,025,000 10, , ,500 4,050,000 1/1/2058 1,350 1,350,000 10, , ,000 2,700,000 1/1/2108 2,100 2,100,000 10, , ,000 4,200,000 1/1/2059 1,350 1,350,000 10, , ,000 2,700,000 1/1/2109 2,100 2,100,000 10, , ,000 4,200,000 1/1/2060 1,350 1,350,000 10, , ,000 2,700,000 1/1/2110 2,100 2,100,000 10, , ,000 4,200,000 1/1/2061 1,350 1,350,000 10, , ,000 2,700,000 1/1/2111 2,100 2,100,000 10, , ,000 4,200,000 1/1/2062 1,350 1,350,000 10, , ,000 2,700,000 1/1/2112 2,100 2,100,000 10, , ,000 4,200,000 1/1/2063 1,425 1,425,000 10, , ,500 2,850,000 1/1/2113 2,175 2,175,000 10, , ,500 4,350,000 1/1/2064 1,425 1,425,000 10, , ,500 2,850,000 1/1/2114 2,175 2,175,000 10, , ,500 4,350,000 1/1/2065 1,425 1,425,000 10, , ,500 2,850,000 1/1/2115 2,175 2,175,000 10, , ,500 4,350,000 1/1/2066 1,425 1,425,000 10, , ,500 2,850,000 1/1/2116 2,175 2,175,000 10, , ,500 4,350,000 1/1/2067 1,425 1,425,000 10, , ,500 2,850,000 1/1/2117 2,175 2,175,000 10, , ,500 4,350,000 Page 6 of 30
7 Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Schedule of Limits Plan 4 (Ringgit Malaysia) Jadual Had Pelan 4 (Ringgit Malaysia) 1/1/ , , , ,000 1,500,000 1/1/2068 1,500 1,500, , , ,000 3,000,000 1/1/ , , , ,000 1,500,000 1/1/2069 1,500 1,500, , , ,000 3,000,000 1/1/ , , , ,000 1,500,000 1/1/2070 1,500 1,500, , , ,000 3,000,000 1/1/ , , , ,000 1,500,000 1/1/2071 1,500 1,500, , , ,000 3,000,000 1/1/ , , , ,000 1,500,000 1/1/2072 1,500 1,500, , , ,000 3,000,000 1/1/ , , , ,500 1,650,000 1/1/2073 1,575 1,575, , , ,500 3,150,000 1/1/ , , , ,500 1,650,000 1/1/2074 1,575 1,575, , , ,500 3,150,000 1/1/ , , , ,500 1,650,000 1/1/2075 1,575 1,575, , , ,500 3,150,000 1/1/ , , , ,500 1,650,000 1/1/2076 1,575 1,575, , , ,500 3,150,000 1/1/ , , , ,500 1,650,000 1/1/2077 1,575 1,575, , , ,500 3,150,000 1/1/ , , , ,000 1,800,000 1/1/2078 1,650 1,650, , , ,000 3,300,000 1/1/ , , , ,000 1,800,000 1/1/2079 1,650 1,650, , , ,000 3,300,000 1/1/ , , , ,000 1,800,000 1/1/2080 1,650 1,650, , , ,000 3,300,000 1/1/ , , , ,000 1,800,000 1/1/2081 1,650 1,650, , , ,000 3,300,000 1/1/ , , , ,000 1,800,000 1/1/2082 1,650 1,650, , , ,000 3,300,000 1/1/ , , , ,500 1,950,000 1/1/2083 1,725 1,725, , , ,500 3,450,000 1/1/ , , , ,500 1,950,000 1/1/2084 1,725 1,725, , , ,500 3,450,000 1/1/ , , , ,500 1,950,000 1/1/2085 1,725 1,725, , , ,500 3,450,000 1/1/ , , , ,500 1,950,000 1/1/2086 1,725 1,725, , , ,500 3,450,000 1/1/ , , , ,500 1,950,000 1/1/2087 1,725 1,725, , , ,500 3,450,000 1/1/2038 1,050 1,050, , , ,000 2,100,000 1/1/2088 1,800 1,800, , , ,000 3,600,000 1/1/2039 1,050 1,050, , , ,000 2,100,000 1/1/2089 1,800 1,800, , , ,000 3,600,000 1/1/2040 1,050 1,050, , , ,000 2,100,000 1/1/2090 1,800 1,800, , , ,000 3,600,000 1/1/2041 1,050 1,050, , , ,000 2,100,000 1/1/2091 1,800 1,800, , , ,000 3,600,000 1/1/2042 1,050 1,050, , , ,000 2,100,000 1/1/2092 1,800 1,800, , , ,000 3,600,000 1/1/2043 1,125 1,125, , , ,500 2,250,000 1/1/2093 1,875 1,875, , , ,500 3,750,000 1/1/2044 1,125 1,125, , , ,500 2,250,000 1/1/2094 1,875 1,875, , , ,500 3,750,000 1/1/2045 1,125 1,125, , , ,500 2,250,000 1/1/2095 1,875 1,875, , , ,500 3,750,000 1/1/2046 1,125 1,125, , , ,500 2,250,000 1/1/2096 1,875 1,875, , , ,500 3,750,000 1/1/2047 1,125 1,125, , , ,500 2,250,000 1/1/2097 1,875 1,875, , , ,500 3,750,000 1/1/2048 1,200 1,200, , , ,000 2,400,000 1/1/2098 1,950 1,950, , , ,000 3,900,000 1/1/2049 1,200 1,200, , , ,000 2,400,000 1/1/2099 1,950 1,950, , , ,000 3,900,000 1/1/2050 1,200 1,200, , , ,000 2,400,000 1/1/2100 1,950 1,950, , , ,000 3,900,000 1/1/2051 1,200 1,200, , , ,000 2,400,000 1/1/2101 1,950 1,950, , , ,000 3,900,000 1/1/2052 1,200 1,200, , , ,000 2,400,000 1/1/2102 1,950 1,950, , , ,000 3,900,000 1/1/2053 1,275 1,275, , , ,500 2,550,000 1/1/2103 2,025 2,025, , , ,500 4,050,000 1/1/2054 1,275 1,275, , , ,500 2,550,000 1/1/2104 2,025 2,025, , , ,500 4,050,000 1/1/2055 1,275 1,275, , , ,500 2,550,000 1/1/2105 2,025 2,025, , , ,500 4,050,000 1/1/2056 1,275 1,275, , , ,500 2,550,000 1/1/2106 2,025 2,025, , , ,500 4,050,000 1/1/2057 1,275 1,275, , , ,500 2,550,000 1/1/2107 2,025 2,025, , , ,500 4,050,000 1/1/2058 1,350 1,350, , , ,000 2,700,000 1/1/2108 2,100 2,100, , , ,000 4,200,000 1/1/2059 1,350 1,350, , , ,000 2,700,000 1/1/2109 2,100 2,100, , , ,000 4,200,000 1/1/2060 1,350 1,350, , , ,000 2,700,000 1/1/2110 2,100 2,100, , , ,000 4,200,000 1/1/2061 1,350 1,350, , , ,000 2,700,000 1/1/2111 2,100 2,100, , , ,000 4,200,000 1/1/2062 1,350 1,350, , , ,000 2,700,000 1/1/2112 2,100 2,100, , , ,000 4,200,000 1/1/2063 1,425 1,425, , , ,500 2,850,000 1/1/2113 2,175 2,175, , , ,500 4,350,000 1/1/2064 1,425 1,425, , , ,500 2,850,000 1/1/2114 2,175 2,175, , , ,500 4,350,000 1/1/2065 1,425 1,425, , , ,500 2,850,000 1/1/2115 2,175 2,175, , , ,500 4,350,000 1/1/2066 1,425 1,425, , , ,500 2,850,000 1/1/2116 2,175 2,175, , , ,500 4,350,000 1/1/2067 1,425 1,425, , , ,500 2,850,000 1/1/2117 2,175 2,175, , , ,500 4,350,000 Page 7 of 30
8 Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Schedule of Limits Plan 5 (Ringgit Malaysia) Jadual Had Pelan 5 (Ringgit Malaysia) 1/1/ ,000 7, , ,000 1,000,000 1/1/2068 1,000 1,000,000 7, , ,000 2,000,000 1/1/ ,000 7, , ,000 1,000,000 1/1/2069 1,000 1,000,000 7, , ,000 2,000,000 1/1/ ,000 7, , ,000 1,000,000 1/1/2070 1,000 1,000,000 7, , ,000 2,000,000 1/1/ ,000 7, , ,000 1,000,000 1/1/2071 1,000 1,000,000 7, , ,000 2,000,000 1/1/ ,000 7, , ,000 1,000,000 1/1/2072 1,000 1,000,000 7, , ,000 2,000,000 1/1/ ,000 7, , ,000 1,100,000 1/1/2073 1,050 1,050,000 7, , ,000 2,100,000 1/1/ ,000 7, , ,000 1,100,000 1/1/2074 1,050 1,050,000 7, , ,000 2,100,000 1/1/ ,000 7, , ,000 1,100,000 1/1/2075 1,050 1,050,000 7, , ,000 2,100,000 1/1/ ,000 7, , ,000 1,100,000 1/1/2076 1,050 1,050,000 7, , ,000 2,100,000 1/1/ ,000 7, , ,000 1,100,000 1/1/2077 1,050 1,050,000 7, , ,000 2,100,000 1/1/ ,000 7, , ,000 1,200,000 1/1/2078 1,100 1,100,000 7, , ,000 2,200,000 1/1/ ,000 7, , ,000 1,200,000 1/1/2079 1,100 1,100,000 7, , ,000 2,200,000 1/1/ ,000 7, , ,000 1,200,000 1/1/2080 1,100 1,100,000 7, , ,000 2,200,000 1/1/ ,000 7, , ,000 1,200,000 1/1/2081 1,100 1,100,000 7, , ,000 2,200,000 1/1/ ,000 7, , ,000 1,200,000 1/1/2082 1,100 1,100,000 7, , ,000 2,200,000 1/1/ ,000 7, , ,000 1,300,000 1/1/2083 1,150 1,150,000 7, , ,000 2,300,000 1/1/ ,000 7, , ,000 1,300,000 1/1/2084 1,150 1,150,000 7, , ,000 2,300,000 1/1/ ,000 7, , ,000 1,300,000 1/1/2085 1,150 1,150,000 7, , ,000 2,300,000 1/1/ ,000 7, , ,000 1,300,000 1/1/2086 1,150 1,150,000 7, , ,000 2,300,000 1/1/ ,000 7, , ,000 1,300,000 1/1/2087 1,150 1,150,000 7, , ,000 2,300,000 1/1/ ,000 7, , ,000 1,400,000 1/1/2088 1,200 1,200,000 7, , ,000 2,400,000 1/1/ ,000 7, , ,000 1,400,000 1/1/2089 1,200 1,200,000 7, , ,000 2,400,000 1/1/ ,000 7, , ,000 1,400,000 1/1/2090 1,200 1,200,000 7, , ,000 2,400,000 1/1/ ,000 7, , ,000 1,400,000 1/1/2091 1,200 1,200,000 7, , ,000 2,400,000 1/1/ ,000 7, , ,000 1,400,000 1/1/2092 1,200 1,200,000 7, , ,000 2,400,000 1/1/ ,000 7, , ,000 1,500,000 1/1/2093 1,250 1,250,000 7, , ,000 2,500,000 1/1/ ,000 7, , ,000 1,500,000 1/1/2094 1,250 1,250,000 7, , ,000 2,500,000 1/1/ ,000 7, , ,000 1,500,000 1/1/2095 1,250 1,250,000 7, , ,000 2,500,000 1/1/ ,000 7, , ,000 1,500,000 1/1/2096 1,250 1,250,000 7, , ,000 2,500,000 1/1/ ,000 7, , ,000 1,500,000 1/1/2097 1,250 1,250,000 7, , ,000 2,500,000 1/1/ ,000 7, , ,000 1,600,000 1/1/2098 1,300 1,300,000 7, , ,000 2,600,000 1/1/ ,000 7, , ,000 1,600,000 1/1/2099 1,300 1,300,000 7, , ,000 2,600,000 1/1/ ,000 7, , ,000 1,600,000 1/1/2100 1,300 1,300,000 7, , ,000 2,600,000 1/1/ ,000 7, , ,000 1,600,000 1/1/2101 1,300 1,300,000 7, , ,000 2,600,000 1/1/ ,000 7, , ,000 1,600,000 1/1/2102 1,300 1,300,000 7, , ,000 2,600,000 1/1/ ,000 7, , ,000 1,700,000 1/1/2103 1,350 1,350,000 7, , ,000 2,700,000 1/1/ ,000 7, , ,000 1,700,000 1/1/2104 1,350 1,350,000 7, , ,000 2,700,000 1/1/ ,000 7, , ,000 1,700,000 1/1/2105 1,350 1,350,000 7, , ,000 2,700,000 1/1/ ,000 7, , ,000 1,700,000 1/1/2106 1,350 1,350,000 7, , ,000 2,700,000 1/1/ ,000 7, , ,000 1,700,000 1/1/2107 1,350 1,350,000 7, , ,000 2,700,000 1/1/ ,000 7, , ,000 1,800,000 1/1/2108 1,400 1,400,000 7, , ,000 2,800,000 1/1/ ,000 7, , ,000 1,800,000 1/1/2109 1,400 1,400,000 7, , ,000 2,800,000 1/1/ ,000 7, , ,000 1,800,000 1/1/2110 1,400 1,400,000 7, , ,000 2,800,000 1/1/ ,000 7, , ,000 1,800,000 1/1/2111 1,400 1,400,000 7, , ,000 2,800,000 1/1/ ,000 7, , ,000 1,800,000 1/1/2112 1,400 1,400,000 7, , ,000 2,800,000 1/1/ ,000 7, , ,000 1,900,000 1/1/2113 1,450 1,450,000 7, , ,000 2,900,000 1/1/ ,000 7, , ,000 1,900,000 1/1/2114 1,450 1,450,000 7, , ,000 2,900,000 1/1/ ,000 7, , ,000 1,900,000 1/1/2115 1,450 1,450,000 7, , ,000 2,900,000 1/1/ ,000 7, , ,000 1,900,000 1/1/2116 1,450 1,450,000 7, , ,000 2,900,000 1/1/ ,000 7, , ,000 1,900,000 1/1/2117 1,450 1,450,000 7, , ,000 2,900,000 Page 8 of 30
9 Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Schedule of Limits Plan 6 (Ringgit Malaysia) Jadual Had Pelan 6 (Ringgit Malaysia) 1/1/ ,000 75, , ,000 1,000,000 1/1/2068 1,000 1,000,000 75, , ,000 2,000,000 1/1/ ,000 75, , ,000 1,000,000 1/1/2069 1,000 1,000,000 75, , ,000 2,000,000 1/1/ ,000 75, , ,000 1,000,000 1/1/2070 1,000 1,000,000 75, , ,000 2,000,000 1/1/ ,000 75, , ,000 1,000,000 1/1/2071 1,000 1,000,000 75, , ,000 2,000,000 1/1/ ,000 75, , ,000 1,000,000 1/1/2072 1,000 1,000,000 75, , ,000 2,000,000 1/1/ ,000 75, , ,000 1,100,000 1/1/2073 1,050 1,050,000 75, , ,000 2,100,000 1/1/ ,000 75, , ,000 1,100,000 1/1/2074 1,050 1,050,000 75, , ,000 2,100,000 1/1/ ,000 75, , ,000 1,100,000 1/1/2075 1,050 1,050,000 75, , ,000 2,100,000 1/1/ ,000 75, , ,000 1,100,000 1/1/2076 1,050 1,050,000 75, , ,000 2,100,000 1/1/ ,000 75, , ,000 1,100,000 1/1/2077 1,050 1,050,000 75, , ,000 2,100,000 1/1/ ,000 75, , ,000 1,200,000 1/1/2078 1,100 1,100,000 75, , ,000 2,200,000 1/1/ ,000 75, , ,000 1,200,000 1/1/2079 1,100 1,100,000 75, , ,000 2,200,000 1/1/ ,000 75, , ,000 1,200,000 1/1/2080 1,100 1,100,000 75, , ,000 2,200,000 1/1/ ,000 75, , ,000 1,200,000 1/1/2081 1,100 1,100,000 75, , ,000 2,200,000 1/1/ ,000 75, , ,000 1,200,000 1/1/2082 1,100 1,100,000 75, , ,000 2,200,000 1/1/ ,000 75, , ,000 1,300,000 1/1/2083 1,150 1,150,000 75, , ,000 2,300,000 1/1/ ,000 75, , ,000 1,300,000 1/1/2084 1,150 1,150,000 75, , ,000 2,300,000 1/1/ ,000 75, , ,000 1,300,000 1/1/2085 1,150 1,150,000 75, , ,000 2,300,000 1/1/ ,000 75, , ,000 1,300,000 1/1/2086 1,150 1,150,000 75, , ,000 2,300,000 1/1/ ,000 75, , ,000 1,300,000 1/1/2087 1,150 1,150,000 75, , ,000 2,300,000 1/1/ ,000 75, , ,000 1,400,000 1/1/2088 1,200 1,200,000 75, , ,000 2,400,000 1/1/ ,000 75, , ,000 1,400,000 1/1/2089 1,200 1,200,000 75, , ,000 2,400,000 1/1/ ,000 75, , ,000 1,400,000 1/1/2090 1,200 1,200,000 75, , ,000 2,400,000 1/1/ ,000 75, , ,000 1,400,000 1/1/2091 1,200 1,200,000 75, , ,000 2,400,000 1/1/ ,000 75, , ,000 1,400,000 1/1/2092 1,200 1,200,000 75, , ,000 2,400,000 1/1/ ,000 75, , ,000 1,500,000 1/1/2093 1,250 1,250,000 75, , ,000 2,500,000 1/1/ ,000 75, , ,000 1,500,000 1/1/2094 1,250 1,250,000 75, , ,000 2,500,000 1/1/ ,000 75, , ,000 1,500,000 1/1/2095 1,250 1,250,000 75, , ,000 2,500,000 1/1/ ,000 75, , ,000 1,500,000 1/1/2096 1,250 1,250,000 75, , ,000 2,500,000 1/1/ ,000 75, , ,000 1,500,000 1/1/2097 1,250 1,250,000 75, , ,000 2,500,000 1/1/ ,000 75, , ,000 1,600,000 1/1/2098 1,300 1,300,000 75, , ,000 2,600,000 1/1/ ,000 75, , ,000 1,600,000 1/1/2099 1,300 1,300,000 75, , ,000 2,600,000 1/1/ ,000 75, , ,000 1,600,000 1/1/2100 1,300 1,300,000 75, , ,000 2,600,000 1/1/ ,000 75, , ,000 1,600,000 1/1/2101 1,300 1,300,000 75, , ,000 2,600,000 1/1/ ,000 75, , ,000 1,600,000 1/1/2102 1,300 1,300,000 75, , ,000 2,600,000 1/1/ ,000 75, , ,000 1,700,000 1/1/2103 1,350 1,350,000 75, , ,000 2,700,000 1/1/ ,000 75, , ,000 1,700,000 1/1/2104 1,350 1,350,000 75, , ,000 2,700,000 1/1/ ,000 75, , ,000 1,700,000 1/1/2105 1,350 1,350,000 75, , ,000 2,700,000 1/1/ ,000 75, , ,000 1,700,000 1/1/2106 1,350 1,350,000 75, , ,000 2,700,000 1/1/ ,000 75, , ,000 1,700,000 1/1/2107 1,350 1,350,000 75, , ,000 2,700,000 1/1/ ,000 75, , ,000 1,800,000 1/1/2108 1,400 1,400,000 75, , ,000 2,800,000 1/1/ ,000 75, , ,000 1,800,000 1/1/2109 1,400 1,400,000 75, , ,000 2,800,000 1/1/ ,000 75, , ,000 1,800,000 1/1/2110 1,400 1,400,000 75, , ,000 2,800,000 1/1/ ,000 75, , ,000 1,800,000 1/1/2111 1,400 1,400,000 75, , ,000 2,800,000 1/1/ ,000 75, , ,000 1,800,000 1/1/2112 1,400 1,400,000 75, , ,000 2,800,000 1/1/ ,000 75, , ,000 1,900,000 1/1/2113 1,450 1,450,000 75, , ,000 2,900,000 1/1/ ,000 75, , ,000 1,900,000 1/1/2114 1,450 1,450,000 75, , ,000 2,900,000 1/1/ ,000 75, , ,000 1,900,000 1/1/2115 1,450 1,450,000 75, , ,000 2,900,000 1/1/ ,000 75, , ,000 1,900,000 1/1/2116 1,450 1,450,000 75, , ,000 2,900,000 1/1/ ,000 75, , ,000 1,900,000 1/1/2117 1,450 1,450,000 75, , ,000 2,900,000 Page 9 of 30
This Policy reflects the terms and conditions of the contract of insurance as agreed between you and the Company.
(62605-U) This Policy is issued in consideration of the payment of premium as specified in the Policy Schedule and pursuant to the answers given in your Proposal Form (or when you applied for this insurance)
No Unilateral Amendment No amendment to this Policy shall be valid unless mutually agreed upon by the Company and the Policyholder.
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The above duty of disclosure shall continue until the time your contract of insurance is entered into, varied or renewed with us.
DMS/18/MMCF/P/003/Sept. LONPAC INSURANCE BHD (307414-T) Head Office : LG, 6th, 7th, 21st to 26th Floor, Bangunan Public Bank, 6, Jalan Sultan Sulaiman, 50000 Kuala Lumpur, Malaysia P.O. Box 10708, 50722
Coverage Description Sum Insured (RM) 50,000per unit per person
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