Podcast
Questions and Answers
What can happen if material facts are withheld or misrepresented on the Proposal Form?
What can happen if material facts are withheld or misrepresented on the Proposal Form?
Which of the following actions is explicitly advised against when completing the Proposal Form?
Which of the following actions is explicitly advised against when completing the Proposal Form?
What does the medical card issued by the Takaful Operator provide to the holder?
What does the medical card issued by the Takaful Operator provide to the holder?
What is a primary responsibility of the participant when applying for a Takaful plan?
What is a primary responsibility of the participant when applying for a Takaful plan?
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In the context of health Takaful, which of the following benefits might be included?
In the context of health Takaful, which of the following benefits might be included?
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What is the primary purpose of contributions made to a takaful fund?
What is the primary purpose of contributions made to a takaful fund?
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Which of the following is NOT a benefit of medical and health takaful?
Which of the following is NOT a benefit of medical and health takaful?
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What type of contract do participants enter into in medical and health takaful?
What type of contract do participants enter into in medical and health takaful?
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Which of the following medical expenses is explicitly covered by hospital services and professional fees?
Which of the following medical expenses is explicitly covered by hospital services and professional fees?
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The critical illness plan in medical takaful provides what type of benefit?
The critical illness plan in medical takaful provides what type of benefit?
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What is a common limitation found in hospitalization benefits under medical takaful?
What is a common limitation found in hospitalization benefits under medical takaful?
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What is the relationship between medical and health takaful and a basic family takaful plan?
What is the relationship between medical and health takaful and a basic family takaful plan?
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What principle underlies the operation of takaful according to Islamic law?
What principle underlies the operation of takaful according to Islamic law?
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What is the minimum period after the effective date of the certificate before benefits can be claimed?
What is the minimum period after the effective date of the certificate before benefits can be claimed?
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Which of the following would be considered a valid reason for rejecting a claim under the medical and health takaful?
Which of the following would be considered a valid reason for rejecting a claim under the medical and health takaful?
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What document is NOT required when lodging a claim?
What document is NOT required when lodging a claim?
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If a claimant misstates their age and this leads to a lower contribution, how will the claims be adjusted?
If a claimant misstates their age and this leads to a lower contribution, how will the claims be adjusted?
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Which of the following conditions is explicitly excluded from coverage under the medical and health takaful?
Which of the following conditions is explicitly excluded from coverage under the medical and health takaful?
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How long does a claimant have to appeal to the IMB from the date of the takaful operator's decision?
How long does a claimant have to appeal to the IMB from the date of the takaful operator's decision?
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Which situation could result in a takaful operator not being liable for treatment costs?
Which situation could result in a takaful operator not being liable for treatment costs?
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What is the maximum amount the IMB can handle for a claim?
What is the maximum amount the IMB can handle for a claim?
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Which critical illness is NOT covered under the plan?
Which critical illness is NOT covered under the plan?
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Which of the following conditions relates specifically to a major surgical procedure listed in the plan?
Which of the following conditions relates specifically to a major surgical procedure listed in the plan?
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Which illness listed is associated with the nervous system?
Which illness listed is associated with the nervous system?
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What statement best describes 'pre-existing conditions' in relation to the critical illness plan?
What statement best describes 'pre-existing conditions' in relation to the critical illness plan?
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Which of the following is an example of a critical illness that can lead to fully covered hospitalization?
Which of the following is an example of a critical illness that can lead to fully covered hospitalization?
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What benefit is NOT typically included in the medical and health takaful plan?
What benefit is NOT typically included in the medical and health takaful plan?
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Which disease listed could be categorized as a viral infection?
Which disease listed could be categorized as a viral infection?
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Which of the following can be classified as a major organ transplant?
Which of the following can be classified as a major organ transplant?
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Which of the following illnesses is categorized under chronic diseases in the plan?
Which of the following illnesses is categorized under chronic diseases in the plan?
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What is specifically excluded from coverage under the critical illness plan?
What is specifically excluded from coverage under the critical illness plan?
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Study Notes
Takaful Overview
- Takaful is a type of Islamic insurance where members contribute money to a pool system to guarantee each other against loss or damage.
- Takaful-branded insurance is based on Shariah or Islamic religious law, outlining individual responsibilities for cooperation and protection.
Medical and Health Takaful
- Covers private medical treatment costs, including hospitalization and healthcare, if diagnosed with an illness or injury.
- Can be a stand-alone policy or a supplementary contract to a basic family takaful plan.
Takaful Concept in Medical and Health Policy
- Participants contribute a set amount to a takaful fund (participative contribution-tabarru').
- Participants enter into a contract (aqad) to help each other in case of misfortune, like hospitalization or illness.
Takaful Industry Growth
- Family Takaful new business gross contribution showed growth from 2014 to 2018 (visual aids - charts).
- General Takaful total gross contribution also showed growth trends over the same period. (visual aids - charts).
Medical and Health Takaful Policy Types
- Hospital service and professional fees
- Hospitalization benefits
- Critical illness coverage
Hospital Services and Professional Fees
- Covers expenses arising from injury or illness, including ward charges, surgical fees, and intensive care unit charges.
Hospitalization Benefits
- Provides daily cash allowances for hospital confinement due to illness or injury.
- Benefits are subject to a maximum number of days.
Critical Illness Coverage
- Provides a lump sum benefit if diagnosed with a specified critical illness (a list of 36 common critical illnesses is covered).
- Example illnesses: heart attack, cancer, brain stroke, motor neurone disease, etc.
Benefits of Medical and Health Takaful Plan
- Covers various aspects of medical needs, including: hospitalization, doctor visits, anesthesia, pre-hospitalisation visits, outpatient treatment, surgery, ambulance services, and death benefits.
Important Terms
- Pre-existing conditions: disabilities or symptoms before the plan's effective date.
- Overseas treatment coverage: conditions, limitations, and exclusions apply.
- Misstatement of age: claims might be prorated based on the correct age.
- Qualifying period: eligibility for benefits starts 30 days after the effective date.
Exclusions
- Pre-existing illness at application time.
- Claims from illegal or unlawful acts.
- Pregnancy or childbirth.
- Venereal disease, infection or parasites.
- Murder or physical assault.
- Cosmetic or plastic surgery.
How to Make a Claim
- Contact your takaful operator before any treatment to confirm coverage.
- Provide written notice to your takaful operator as soon as possible after incurring covered expenses.
- Provide necessary documents like bills, receipts, physician's report, and physician's opinion on the commencement of disability/illness.
How to Lodge a Complaint
- First, lodge a complaint with your takaful operator.
- If unsatisfied, appeal to the Insurance Mediation Bureau (IMB) or Bank Negara Malaysia within 6 months of the operator's decision.
Applying Takaful Plan
- Disclosure of all material facts about risks and relevant conditions.
- Complete and accurately answer all questions on proposal forms.
What is Medical Card?
- Takaful operator provides a medical card for those who purchase medical plans, granting access to certain privileges as per plan details.
9 Things to know about Medical Cards
- Definition and function of the medical card.
- Understanding standalone or riders and co-takaful aspects.
- Annual and lifetime limits.
- Daily hospital allowance benefits.
- Room and board benefits.
- Panel hospitals covered.
Medical and Health Takaful Products Available in the Market
- List of various takaful companies and medical card options. (visual aid).
Medical Health Takaful is a Policy/Plan that is Nice to Have or Must Have?
- A question regarding the importance and necessity of a medical policy.
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Description
Explore the concept of Takaful, an Islamic insurance model where members protect each other through collective contributions. This quiz covers various aspects including medical and health Takaful, the principles guiding it, and insights into the industry's growth. Test your knowledge of how Takaful operates under Shariah law.
