Personal Accident Insurance

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1 Personal Accident Insurance PRODUCT DISCLOSURE SHEET (Read this Product Disclosure Sheet before you decide to take out the Personal Accident Insurance. Be sure to also read the general terms and conditions.) Date: 1. What is this product about? Personal Accident Insurance is a yearly renewable policy that provides compensation in the event of injuries, disability or death caused solely by violent, accident, external and visible events. 2. What are the covers / benefits provided? A B1 B2 C D E Benefits Accidental Death and Permanent Disablement (with additional Funeral and Cremation Allowance at 10% of capital sum insured or RM2,000 whichever is lower) Temporary Total Disablement Temporary Partial Disablement Accident Hospital Income Travelling Allowance (limit to RM1,000 per accident) Accidental Medical expenses Amount Coverage (RM) RM 10, per week 50 per week 100 per week 100 per week (max) Up to RM5,000 Note: Please refer to the scale of benefits for death and disablement in the sample of policy contract 3. How much premium do I have to pay? A B1 CB2 D E Benefits Accidental Death and Permanent Disablement (with additional Funeral and Cremation Allowance at 10% of capital sum insured or RM2,000 whichever is lower) Temporary Total Disablement Temporary Partial Disablement Accident Hospital Income Travelling Allowance (limit to RM1,000 per accident) Accidental Medical expenses Amount Coverage (RM) Premiums Occupation Class 1 (RM) 2 (RM) 3 (RM) RM 10, per week 50 per week 100 per week 100 per week (max) RM 1,000 RM 2,000 RM 3,000 RM 4,000 RM 5, /5/P/G/S/M PDS/GTS/040/10

2 Class 1 - Person engaged in professional administrative, managerial, clerical and non-manual occupations Class 2 - Person engaged in work supervisory nature but not involved manual labour Class 3 - Person engaged either occasionally or generally in manual work which involves the use of tools or machinery The total annual premium that you have to pay is : RM 4. What are the fees and charges that I have to pay? Type Commissions paid to the insurance agent Stamp Duty Tax (where applicable) Amount 25% of premium or RM RM % of premium 5. What are some of the key terms and conditions that I should be aware of? Importance of disclosure - you must disclose all material facts such as your personal pursuits which would affect risk profile and number of personal accident policies that you have purchased from other insurance companies. Cooling-off period - you may cancel your policy by returning the policy within 15 days after you have received the policy. The premiums that you have paid will be refunded to you. Claims Procedure - You must give written notice to the Company within fourteen (14) days after the occurrence of the accident. *This list is non-exhaustive. Please refer to the policy contract for the terms and conditions under this policy 6. What are the major exclusions under this policy? This policy does not cover death or injury caused by the following events: War, Civil War, Hijacking, Terrorism AIDS and related diseases Childbirth, Miscarriage Provoked Murder or Assault Travelling as an Aircraft Crew Aerial Activities, Martial Arts, Racing Radiation, Nuclear Weapons Material *This list is non-exhaustive. Please refer to the policy contract for full list of exclusions under this policy. 7. Can I cancel my policy? You may cancel your policy by giving a written notice to the insurance company. Upon cancellation, the company will retain the customary short period premium for the time the policy has been in force, provided that you have not made a claim on the policy. 8. What do I need to do if there are changes to my contact personal details? It is important that you inform us of any change in your contact detail / life profile including your occupation and personal pursuits which would affect the risk profile. You can write or fax to us at the below address or fax number. 9. Where can I get further information? Should you require additional information about personal accident insurance, please refer to the insuranceinfo booklet on Personal Accident Insurance', available at all our branches or you can obtain a copy from the insurance agent or visit If you have any enquiries, please contact us at: Zurich General Insurance Malaysia Berhad 11th Floor, Menara Zurich, No. 12, Jalan Dewan Bahasa, Kuala Lumpur, Malaysia. Tel : , Fax : callcentre@zurich.com.my 10. Other types of PA Insurance available Flexi PA Income Pro Personal Sentinel v2

3 IMPORTANT NOTE: Pursuant to Paragraph 5 of Schedule 9 of the Financial Services Act 2013, if you are applying for this Insurance wholly for purposes unrelated to your trade, business or profession, you have a duty to take reasonable care not to make a misrepresentation in answering the questions in the Proposal Form (or when you apply for this Insurance). You must answer the questions fully and accurately. Failure to take reasonable care in answering the questions 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. The above duty of disclosure shall continue until the time your contract of insurance is entered into, varied or renewed with us. In addition to answering the questions in the Proposal Form (or when you apply for this insurance), you are required to disclose any other matter that you know to be relevant to our decision in accepting the risks and determining the rates and terms to be applied. You also have a duty to tell us immediately if at any time after your contract of insurance has been entered into, varied or renewed with us any of the information given in the Proposal Form (or when you applied for this insurance) is inaccurate or has changed. YOU ARE ADVISED TO NOTE THE SCALE OF BENEFITS FOR DEATH AND DISABLEMENT IN YOUR INSURANCE POLICY. YOU MUST NOMINATE A NOMINEE AND ENSURE THAT YOUR NOMINEE IS AWARE OF THE PERSONAL ACCIDENT POLICY THAT YOU HAVE PURCHASED. YOU SHOULD READ AND UNDERSTAND THE INSURANCE POLICY AND DISCUSS WITH THE AGENT OR CONTACT THE INSURANCE COMPANY DIRECTLY FOR MORE INFORMATION. Zurich General Insurance Malaysia Berhad is licensed under the Financial Services Act 2013 and regulated by Bank Negara Malaysia. The information provided in this disclosure sheet is valid as at 01 September IMPORTANT NOTICE All premium and fees shown in this document may be subject to tax or other government levies.

4 Zurich General Insurance Malaysia Berhad ( V) 11th Floor, Menara Zurich, No. 12, Jalan Dewan Bahasa, Kuala Lumpur, Malaysia Tel: Fax: Call Centre:

5 Insurans Kemalangan Diri LEMBARAN PENDEDAHAN PRODUK (Baca Lembaran Pendedahan Produk ini sebelum anda membuat keputusan untuk membeli Insurans Kemalangan Diri. Pastikan anda juga membaca syarat-syarat dan peraturan am.) Tarikh: 1. Apakah yang ditawarkan oleh produk ini? Insurans Kemalangan Diri adalah polisi boleh diperbaharui setiap tahun yang memberi pampasan sekiranya berlaku kecederaan, kehilangan upaya dan kematian yang semata-mata disebabkan oleh kejadian yang mendadak, tidak disenga-jakan, luaran dan ketara. 2. Apakah perlindungan / manfaat yang diberikan? A B1 B2 C D E Manfaat Pembakaran pada kadar 10% daripada Jumlah Yang Diinsuranskan atau RM2,000 yang mana lebih rendah) Hilang Upaya Keseluruhan Sementara Hilang Upaya Separa Sementara Pendapatan Hospital Harian Elaun Perjalanan (terhad kepada RM1,000 setiap kemalangan) Biaya Perubatan Akibat Kemalangan Jumlah Perlindungan (RM) RM 10, seminggu 50 seminggu 100 seminggu 100 seminggu (maks) Sehingga RM5,000 Note: Please refer to the scale of benefits for death and disablement in the sample of policy contract 3. Berapakah premium yang perlu saya bayar? Manfaat Jumlah Perlindungan (RM) Premium Kelas Pekerjaan 1 (RM) 2 (RM) 3 (RM) A B1 B2 C D E Kematian atau Hilang Upaya Kekal Akibat Kemalangan (dengan Elaun Pengebumian dan Pembakaran pada kadar 10% daripada Jumlah Yang Diinsuranskan atau RM2,000 yang mana lebih rendah) Hilang Upaya Keseluruhan Sementara Hilang Upaya Separa Sementara Pendapatan Hospital Harian Elaun Perjalanan (terhad kepada RM1,000 setiap kemalangan) Biaya Perubatan Akibat Kemalangan RM 10, seminggu 50 seminggu 100 seminggu 100 seminggu (maks) RM 1,000 RM 2,000 RM 3,000 RM 4,000 RM 5, /5/P/G/S/M PDS/GTS/040/10

6 Kelas 1 - Mereka yang terlibat dalam pekerjaan profesional, pentadbiran, pengurusan, perkeranian dan bukan buruh Kelas 2 - Mereka yang terlibat dalam pekerjaan berbentuk penyeliaan namun bukan dalam kerja buruh Kelas 3 - Mereka yang terlibat sesekali atau pada amnya dalam kerja buruh yang melibatkan penggunaan peralatan atau mesin Jumlah premium yang anda perlu bayar ialah: RM 4. Apakah yuran dan caj yang perlu saya bayar? Jenis Komisen Duti Setem Cukai (yang mana berkenaan) Jumlah 25% daripada premium atau RM RM % daripada premium 5. Apakah syarat-syarat dan peraturan penting yang saya patut ketahui? Pentingnya Pendedahan - anda mesti memberi semua fakta penting seperti kegemaran peribadi anda yang boleh menjejaskan profil risiko dan bilangan polisi kemalangan diri yang anda telah beli daripada syarikat insurans lain. Tempoh Percubaan Percuma - anda boleh membatalkan polisi anda dengan memulangkan polisi dalam masa 15 hari selepas anda menerima polisi. Premium yang anda telah bayar akan dibayar balik kepada anda. Prosedur Tuntutan - Notis mesti diberi secara bertulis kepada Syarikat dalam masa empat belas (14) hari selepas kejadian kemalangan. * Senarai ini tidak lengkap. SiIa rujuk kontrak polisi untuk senarai penuh syarat-syarat dan peraturan di bawah polisi ini. 6. Apakah pengecualian penting di bawah polisi ini? Polisi ini tidak melindungi kematian atau kecederaan disebabkan oleh kejadian berikut: Peperangan, Perang Saudara, Rampasan, Keganasan AIDS dan penyakit berkaitan Kelahiran Anak, Keguguran Pembunuhan atau Serangan Disebabkan Provokasi Menaiki Pesawat sebagai Kakitangan Penerbangan Kegiatan Udara, Seni Mempertahankan Diri, Perlumbaan Radiasi, Bahan Senjata Nuklear *Senarai ini tidak lengkap. Sila rujuk kontrak polisi untuk senarai penuh pengecualian di bawah polisi ini. 7. Bolehkah saya membatalkan polisi? Anda boleh membatalkan polisi anda dengan memberi notis bertulis kepada syarikat insurans. Selepas pembatalan, Syarikat akan menyimpan premium yang dikira pada kadar jangka pendek bagi tempoh polisi telah berkuatkuasa dengan syarat anda belum membuat tuntutan ke atas polisi ini. 8. Apakah yang perlu saya lakukan jika terdapat pertukaran dalam maklumat hubungan saya? Adalah penting bagi anda untuk memaklumkan kepada kami tentang sebarang pertukaran dalam maklumat hubungan / penamaan profil hayat anda termasuk pekerjaan dan kegemaran peribadi yang akan menjejaskan profil risiko. Anda boleh menulis surat / menghantar faks kepada kami di alamat atau nombor faks di bawah. 9. Di mana saya boleh mendapatkan maklumat lanjut? Jika anda memerlukan maklumat tambahan mengenai insurans kemalangan diri, sila rujuk kepada buku insuranceinfo mengenai Insurans Kemalangan Diri yang boleh didapati di cawangan kami atau anda boleh mendapatkan salinannya daripada ejen insurans atau layari laman web Sekiranya anda mempunyai sebarang pertanyaan, sila hubungi kami di: Zurich General Insurance Malaysia Berhad Tingkat 11, Menara Zurich, No. 12, Jalan Dewan Bahasa, Kuala Lumpur, Malaysia. Tel : , Faks : E-mel : callcentre@zurich.com.my 10. Jenis insurans Perlindungan Insurans Kemalangan Diri lain yang ditawarkan Flexi PA Income Pro Personal Sentinel v2

7 NOTA PENTING: Menurut Perenggan 5 daripada Jadual 9 Akta Perkhidmatan Kewangan 2013, jika anda memohon insurans ini sepenuhnya untuk tujuan yang tidak berkaitan perdagangan, perniagaan atau profesion anda, anda mempunyai kewajipan untuk mengambil langkah yang munasabah untuk tidak salah nyata dalam menjawab soalan-soalan dalam Borang Cadangan (atau semasa memohon insurans ini). Anda dikehendaki menjawab soalan-soalan dalam Borang Cadangan ini dengan lengkap dan tepat. Kegagalan untuk mengambil langkah yang munasabah dalam menjawab soalan-soalan, mungkin mengakibatkan pembatalan kontrak insurans anda, keengganan atau pengurangan gantirugi, perubahan terma atau penamatan kontrak insurans anda. Kewajipan pendedahan diatas hendaklah diteruskan sehingga kontrak insurans anda dimeterai, diubah atau diperbaharui dengan kami. Sebagai tambahan kepada soalan-soalan di dalam Borang Cadangan (atau semasa memohon insurans ini), anda dikehendaki untuk mendedahkan apa-apa perkara lain yang anda tahu akan mempengaruhi keputusan kami dalam menerima risiko dan menentukan kadar dan terma yang dikenakan. Anda juga mempunyai kewajipan untuk memberitahu kami dengan serta-merta jika pada bila-bila masa selepas kontrak insurans anda ditandatangani, diubah atau diperbaharui dengan kami (atau semasa permohonan insurans ini), apa-apa maklumat yang dinyatakan dalam Borang Cadangan ini tidak tepat atau telah berubah. ANDA DINASIHATKAN UNTUK MEMASTIKAN SKALA MANFAAT BAGI KEMATIAN DAN KEHILANGAN UPAYA DI DALAM POLISI INSURANS ANDA. ANDA MESTI MENCALONKAN SEORANG PENAMA DAN PASTIKAN PENAMA ANDA TAHU TENTANG POLISI KEMALANGAN DIRI YANG ANDA BELI. ANDA PERLU MEMBACA DAN MEMAHAMI POLISI INSURANS DAN BERBINCANG DENGAN EJEN ATAU HUBUNGI SYARIKAT INSURANS SECARA TERUS UNTUK MENDAPATKAN MAKLUMAT LANJUT. Zurich General Insurance Malaysia Berhad adalah dilesenkan di bawah Akta Perkhidmatan Kewangan 2013 dan telah dikawal selia oleh Bank Negara Malaysia. Maklumat yang terkandung dalam lembaran pendedahan ini sah mulai 01 September NOTIS PENTING Semua premium dan yuran yang tertera dalam dokumen ini mungkin tertakluk kepada cukai atau levi kerajaan yang lain.

8 Zurich General Insurance Malaysia Berhad ( V) Tingkat 11, Menara Zurich, No.12, Jalan Dewan Bahasa, Kuala Lumpur, Malaysia Tel: Faks: Pusat Panggilan:

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