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FOREIGN WORKERS HOSPITALIZATION & SURGICAL (FWHS/SKHPPA) Product Disclosure Sheet (Please read this Product Disclosure Sheet before you decide to take out this insurance. Be sure to also read the general terms and conditions.) 1. What is this product about? Foreign Worker Hospitalization & Surgical Insurance Scheme (SKHPPA) is a yearly renewable hospital and surgical insurance scheme designed to reduce the financial burden of the employer of foreign workers in the event of hospital admission of their foreign workers to a Non-Corporatised Malaysian Government Hospital due to an accident or illness. 2. Who is eligible? Eligible persons for insurance under this policy are those present and future full-time foreign worker employees of policyholder, from the age of eighteen (18) to sixty (60), who are actively engaged at their usual work on the date the persons are eligible to join this policy. 3. What are the covers/benefits provided? This product covers the following benefits:- Item Benefits Amount (RM) 1(a) Daily Hospital Room & Board (Maximum up to 30 days) (b) Intensive Care Unit (Maximum up to 15 days) As charged in accordance to 2 Hospital Supplies & Services charges consistent with Third (3 rd ) Class Room and Board to a 3 Operating Theatre maximum of RM 160.00 per day 4 Surgical Fees (Excluding organ transplantation) in a Non-Corporatised Malaysian 5 Anaesthetist Fees Government Hospital in 6 In-Hospital Physician Visits (Maximum up to 30 days) conformance to the charges 7 In-Hospital Specialist Consultation Visits (Maximum up to specified under Fees Act 1951, 30 days) Fees (Medical) Order 1982. 8 Ambulance Fees / Medical Report Fees Maximum Overall Annual Limit (Item 1-8) per Insured Person RM 20,000.00 Note: The description on the available cover is only a brief summary for quick and easy reference. The precise terms and conditions that apply are stated in the policy contract. 4. What is the Period of Cover and Renewal Options? Duration of cover is for one year. You need to renew the insurance cover annually. 5. How much premium do I have to pay? The annual premium is RM 120.00 per foreign worker insured inclusive of RM 15.00 of the Managed Care Organization (MCO) fee. 6. What are the fees and charges I have to pay? What you have to pay in addition to the premium Service Tax Stamp Duty What is included in the premium Commission paid to the insurance intermediaries (if any) Amount 6% of premium inclusive MCO fees RM 10.00 Amount 10% of premium (FWHS/PDS 092018) 1

7. What are some of the key terms and conditions that I should be aware of? a) Duty Of Disclosure Pursuant to Paragraph 4(1) of Schedule 9 of the Financial Services Act 2013, if you are applying for this Insurance for a purpose related to your trade, business or profession, you have a duty to disclose any matter that you know to be relevant to our decision in accepting the risks and determining the rates and terms to be applied and any matter a reasonable person in the circumstances could be expected to know to be relevant, otherwise 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. The above duty of disclosure shall continue until the time your contract of insurance is entered into, varied or renewed with us. 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. b) Geographical Territory All benefits provided in this policy are applicable within Malaysia only for twenty-four (24) hours a day. Cover ceases from the time the Insured Person leaves Malaysia and resumes upon his/her return to Malaysia. c) Limitation Of Benefits All benefits provided in this policy are only payable in the event the insured person is confined in a noncorporatized Malaysian Government Hospital. d) Grace Period This is a Cash Before Cover policy. Notwithstanding the Cash Before Cover condition, a Grace Period of fourteen (14) days from its due date will be allowed for payment of each premium after the first policy year. During such fourteen (14) days, the Company shall remain liable there under if by the last of such days, the premium is actually paid. If any premium is not paid in respect of this policy contract before the end of the Grace Period, this policy contract shall be deemed as terminated at the expiry date of this policy. Note: The list above is non-exhaustive. Please refer to the policy contract for the full terms and conditions under this policy. 8. What are the major exclusions under this policy? This policy does not cover any hospitalization, surgery or charges caused by any one of the following occurrences: a. Pre-existing conditions unless the Insured Person passes the medical examination as confirmed by Fomema Sdn Bhd (FOMEMA) within 30 days from the Insured Person's arrival to Malaysia. b. Cardiovascular diseases and all cancers occurring within the first one hundred and twenty (120) days of Insurance of the Insured Person. c. Plastic/Cosmetic surgery. d. Dental treatment or oral surgery. e. Treatment or surgical operation for congenital abnormalities or deformities. f. Pregnancy or miscarriage Treatment which is not Medically Necessary. g. Suicide or self-inflicted injury while sane or insane. h. Accidental injuries or illnesses arising from racing or hazardous sports. Note: The list above is non-exhaustive. Please refer to the policy contract for the full list of exclusions under this policy. 2

9. Can I cancel my policy? Yes, you (the Policyholder) may cancel this policy at any time by giving written notice to us. Upon cancellation, you are entitled to a refund of the premium as per the schedule below, provided that you have not made a claim during the current policy year. Period Not Exceeding Refund of Annual Premium 15 days 90% 1 month 80% 2 months 70% 3 months 60% 4 months 50% 5 months 40% 6 months 30% 7 months 25% 8 months 20% 9 months 15% 10 months 10% 11 months 5% Period Exceeding 11 months No refund 10. What do I need to do if there are changes to my contact details? It is important that you inform us if there are changes in your contact details to ensure that all future correspondences reach you in a timely manner. 11. Where can I get further information? Should you require additional information about Medical and Health Insurance, please refer to the InsuranceInfo booklet on Medical and Health Insurance, available at all our branches or you can obtain a copy from the insurance agent or visit www.insuranceinfo.com.my. If you have any enquiries, please contact us during operating hours from 8:30 am to 5:00 pm (Monday Friday) at: Customer Service Centre Berjaya Sompo Insurance Berhad (62605-U) Level 36, Menara Bangkok Bank 105, Jalan Ampang 50450 Kuala Lumpur Tel. : 603-2170 7300 Fax : 603-2170 4800 Toll Free No. : 1-800-889-933 (Within Malaysia) E-mail : info@bsompo.com.my Website : www.berjayasompo.com.my IMPORTANT NOTE: YOU SHOULD SATISFY YOURSELF THAT THIS POLICY WILL BEST SERVE YOUR NEEDS. YOU SHOULD READ AND UNDERSTAND THE INSURANCE POLICY AND DISCUSS WITH THE AGENT OR CONTACT OUR COMPANY DIRECTLY FOR MORE INFORMATION. The information provided in this disclosure sheet is a brief summary for quick and easy reference. The exact terms and conditions that apply are stated in the policy contract. Berjaya Sompo Insurance 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 Sept 2018 3

SKIM KEMASUKAN HOSPITAL DAN PEMBEDAHAN PEKERJA ASING (SKHPPA) Lembaran Pendedahan Produk (Sila baca Lembaran Pendedahan Produk ini sebelum anda membuat keputusan untuk membeli insurans ini. Pastikan anda juga telah membaca terma dan syarat am.) 1. Apakah produk ini? Skim Kemasukan Hospital dan Pembedahan Pekerja Asing (SKHPPA) adalah skim insurans kemasukan hospital dan pembedahan yang diperbaharui setiap tahun bertujuan untuk mengurangkan beban kewangan pihak Majikan ke atas pekerja asing sekiranya pekerja asing tersebut dimasukkan ke Hospital Kerajaan Malaysia Bukan Korporat disebabkan oleh kemalangan ataupun penyakit. 2. Siapa yang layak? Golongan yang layak untuk insurans di bawah polisi ini adalah pekerja asing yang bekerja pada masa sekarang/masa hadapan secara sepenuh masa dengan Pihak Diinsuranskan, berumur dari lapan belas (18) tahun sehingga enam puluh (60) tahun, yang masih aktif bekerja pada tarikh layak untuk menyertai polisi ini. 3. Apakah yang dilindungi / manfaat yang diberikan? Produk ini melindungi manfaat-manfaat berikut:- Perkara Manfaat Jumlah (RM) 1(a) Bilik Hospital & Makan Harian (Maksimum sehingga 30 hari) Bayaran yang dikenakan 1(b) Unit Rawatan Rapi (Maksimum sehingga 15 hari) mengikut caj yang 2 Bekalan & Khidmat Hospital konsisten dengan Bilik & 3 Bilik Bedah Makan Kelas Ketiga (ke-3) 4 Bayaran Pembedahan (Tidak merangkumi transplan organ) sehingga maksimum 5 Bayaran Pakar Bius RM160.00 sehari di 6 Lawatan Pakar Perubatan Dalam Hospital (Maksimum sehingga 30 Hospital Kerajaan Malaysia hari) Bukan Korporat selaras dengan caj yang 7 Lawatan Rundingan Pakar Dalam Hospital (Maksimum sehingga 30 dinyatakan di bawah Akta hari) Fi 1951, Perintah Fi 8 Bayaran Ambulans / Bayaran Laporan Perubatan (Perubatan) 1982. Had Tahunan Keseluruhan Maksimum (Perkara 1-8) Bagi Setiap Orang RM 20,000.00 Yang Diinsuranskan Nota: Penerangan di atas adalah makluman ringkas untuk rujukan yang cepat dan mudah. Syarat dan terma yang tepat yang digunapakai sepertimana yang dinyatakan di dalam kontr polisi. 4. Apakah Tempoh Perlindungan dan Pembaharuan Pilihan? Tempoh perlindungan adalah selama satu tahun. Anda dikehendaki membaharui polisi insurans anda setiap tahun. 5. Berapakah premium yang saya perlu bayar? Premium tahunan adalah sebanyak RM 120.00 setiap pekerja asing yang diinsuranskan termasuk fi Managed Care Organisation (MCO). 6. Apakah yuran dan caj yang saya perlu bayar? Apa yang anda perlu bayar sebagai tambahan kepada premium Cukai Perkhidmatan Duti Setem Apa yang termasuk dalam premium Komisen yang dibayar kepada pengantara insurans (jika ada) Jumlah 6% daripada premium termasuk fi Managed Care Organisation (MCO) RM 10.00 Jumlah 10% daripada premium (FWHS/PDS 092018) 1

7. Apakah terma dan syarat utama yang saya harus ketahui? a) Kewajipan Pendedahan Menurut Perenggan 4(1) Jadual 9 Akta Perkhidmatan Kewangan 2013, jika anda memohon insurans ini untuk tujuan yang berkaitan dengan perdagangan, perniagaan atau profesion anda, anda berkewajipan untuk mendedahkan apa-apa perkara yang anda tahu akan mempengaruhi keputusan kami dalam menerima risiko dan menentukan kadar dan terma yang dikenakan dan apa-apa perkara yang munasabah yang boleh dijangka, jika tidak ia boleh menyebabkan pembatalan kontrak insurans, keengganan atau pengurangan ganti rugi, perubahan terma atau penamatan kontrak insurans anda. Kewajipan pendedahan diatas hendaklah diteruskan sehingga kontrak insurans anda dimeterai, diubah atau diperbaharui dengan kami. 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 tidak tepat atau sudah berubah. b) Perubahan Risiko Jika pada bila-bila masa atau dari semasa ke semasa, apa-apa penukaran berlaku dan mengubahkan secara material apa-apa fakta yang wujud pada tarikh cadangan, Pihak Diinsuranskan dan/atau Orang Diinsuranskan hendaklah memberi notis secara bertulis kepada Syarikat dalam masa tujuh (7) hari dan hendaklah membayar premium tambahan sedemikian sebagaimana diperlukan oleh Syarikat. c) Pembayaran Sebelum Perlindungan Berkuatkuasa Pembayaran premium mesti dibuat sebelum polisi ini berkuatkuasa. d) Wilayah Geografi Semua manfaat yang dinyatakan di sini adalah terpakai di dalam Malaysia sahaja 24 jam sehari. Perlindungan terhenti sebaik sahaja Orang Yang Diinsuranskan meninggalkan Malaysia dan bersambung semula setelah Orang Yang Diinsuranskan kembali ke Malaysia. e) Had Manfaat Semua manfaat yang disediakan di dalam Polisi ini hanya akan dibayar jika Pihak Diinsuranskan dimasukkan ke Hospital Kerajaan Malaysia Bukan Korporat. f) Tempoh Tangguh Ini adalah Polisi Tunai Sebelum Perlindungan. Meskipun terdapat syarat Tunai sebelum Perlindungan, tempoh tangguh selama empat belas (14) hari dari tarikh perlu dibayar adalah dibenarkan untuk sebarang pembayaran premium setelah tamat polisi tempoh pertama. Dalam tempoh selama empat belas (14) hari tersebut, Syarikat akan bertanggungjawab jika pada akhir tempoh berkenaan, premium telah dibayar. Sekiranya sebarang premium berkaitan dengan Polisi Kontrak ini tidak dibayar sebelum tarikh tamat tempoh tangguh, Polisi Kontrak ini dianggap sebagai terbatal pada tarikh luput polisi ini. Nota: Senarai ini bukannya senarai yang lengkap. Sila rujuk kepada kontrak polisi untuk senarai penuh bagi terma dan syarat di bawah polisi ini. 8. Apakah pengecualian utama di bawah polisi ini? Polisi ini tidak melindungi mana-mana penghospitalan, pembedahan atau bayaran yang disebabkan oleh mana-mana satu kejadian yang berikut:- i. Penyakit sedia ada kecuali Orang Yang Diinsuranskan telah lulus pemeriksaan perubatan serta telah disahkan oleh Fomema Sdn. Bhd. (FOMEMA) dalam masa 30 hari ketibaan Orang Yang Diinsuranskan ke Malaysia. ii. Penyakit kardiovaskular dan semua jenis kanser yang berlaku dalam masa seratus dua puluh (120) hari pertama insurans Orang Yang Diinsuranskan. iii. Pembedahan plastik/kosmetik. iv. Rawatan pergigian atau pembedahan oral. v. Rawatan atau operasi pembedahan untuk keabnormalan atau kecacatan kongenital. vi. Kehamilan atau keguguran. Rawatan yang tidak perlu dari segi perubatan. vii. Bunuh diri atau kecederaan diri sendiri yang disengajakan ketika siuman atau tidak siuman. viii. Penyakit atau kecederaan yang timbul daripada apa-apa jenis perlumbaan atau sukan berbahaya. Nota: Senarai ini bukannya senarai yang lengkap. Sila rujuk kepada kontrak polisi untuk senarai penuh bagi pengecualian di bawah polisi ini. 2

9. Bolehkah saya membatalkan polisi saya? Ya, anda (Pihak Diinsuranskan) boleh membatalkan polisi ini bila-bila masa dengan memberikan notis secara bertulis kepada kami. Di atas pembatalan tersebut, anda adalah layak untuk pembayaran balik premium seperti jadual di bawah, dengan syarat anda tidak pernah membuat tuntutan semasa tahun polisi semasa. Tempoh Tidak Melebihi Bayaran Balik Premium Tahunan 15 hari 90% 1 bulan 80% 2 bulan 70% 3 bulan 60% 4 bulan 50% 5 bulan 40% 6 bulan 30% 7 bulan 25% 8 bulan 20% 9 bulan 15% 10 bulan 10% 11 bulan 5% Tempoh melebihi 11 bulan Tiada bayaran balik 10. Apakah yang harus saya lakukan jika terdapat perubahan dalam butiran peribadi saya? Adalah penting bagi anda untuk memaklumkan pihak kami tentang sebarang perubahan mengenai maklumat anda bagi memastikan semua surat-menyurat dapat disampaikan kepada anda tepat pada masanya. 11. Di manakah saya boleh dapatkan maklumat lanjut? Sekiranya anda memerlukan maklumat lanjut berkaitan Insurans Perubatan dan Kesihatan, sila rujuk kepada buku panduan InfoInsurans mengenai Insurans Perubatan dan Kesihatan yang boleh didapati dari semua cawangan kami atau dapatkan satu salinan daripada pengantara insurans anda atau layari laman web www.insuranceinfo.com.my. Sekiranya anda mempunyai sebarang pertanyaan, sila hubungi kami waktu beroperasi dari jam 8:30 pagi hingga 5:00 petang (Isnin Jumaat) di: Pusat Khidmat Pelanggan Berjaya Sompo Insurance Berhad (62605-U) Tingkat 36, Menara Bangkok Bank 105, Jalan Ampang 50450 Kuala Lumpur Tel. : 603-2170 7300 Faks : 603-2170 4800 Talian Bebas Tol:1-800-889-933 (Dalam Malaysia) E-mel : info@bsompo.com.my Laman Web : www.berjayasompo.com.my NOTA PENTING: ANDA SEHARUSNYA BERPUAS HATI BAHAWA POLISI INI ADALAH TERBAIK UNTUK KEPERLUAN ANDA. ANDA HARUS MEMBACA DAN MEMAHAMI POLISI INSURANS INI DAN BERBINCANG DENGAN EJEN ATAU MENGHUBUNGI SYARIKAT INSURANS SECARA LANGSUNG UNTUK MAKLUMAT LANJUT. Maklumat yang diberikan di dalam Lembaran Pendedahan Produk ini cuma penerangan ringkas untuk rujukan cepat dan mudah. Terma dan syarat yang lengkap yang dikenakan adalah terkandung di dalam kontrak polisi. Berjaya Sompo Insurance Berhad dilesenkan di bawah Akta Perkhidmatan Kewangan 2013 dan dikawalselia oleh Bank Negara Malaysia. Maklumat yang disediakan dalam lembaran pendedahan ini adalah sah bermula dari 01 Sept 2018. 3