Medical Health Takaful PDF

+ MEDICAL AND HEALTH TAKAFUL NICE TO HAVE OR MUST HAVE ?  VIDEOS https://youtu.be/v3QKqMh4gjI Implication without medical policy coverage https://youtu.be/n_iLZAH0QZo Medical costs in Malaysia  TAKAFUL Takaful is a...

+ MEDICAL AND HEALTH TAKAFUL NICE TO HAVE OR MUST HAVE ?  VIDEOS https://youtu.be/v3QKqMh4gjI Implication without medical policy coverage https://youtu.be/n_iLZAH0QZo Medical costs in Malaysia  TAKAFUL Takaful is a type of Islamic insurance wherein members contribute money into a pool system to guarantee each other against loss or damage Takaful - branded insurance is based on shariah or Islamic religious law which explains how individuals are responsible to cooperate and protect one another TAKAFUL INDUSTRY MEDICAL AND HEALTH TAKAFUL Medical and health takaful covers the cost of private medical treatment such as the cost of hospitalization and healthcare if you are diagnosed with certain illness or have had an accident The cover could be on a stand-alone basis or as a supplementary contract to a basic family takaful plan TAKAFUL CONCEPT IN MEDICAL AND HEALTH POLICY When you participate in medical and health takaful, you will contribute a certain sum of money to a takaful fund in a form of participative contribution (tabarru') You will undertake a contract (aqad) to become one of the participants by agreeing to mutually help each other, should any of the participants face a misfortune such as being hospitalised or diagnosed with certain illness.  MEDICAL AND HEALTH TAKAFUL POLICY Main Types Hospital services and professional Hospitalization Critical fees benefits ilness  HOSPITAL SERVICES AND PROFESSIONAL FEES This plan covers for expenses that you incur for :- ⚬ Hospital services and professional fees arising from injury or illness :- ￭ Ward charges ￭ Surgical fees ￭ Intensive care unit charges The benefits can be limited to a maximum amount or number of days  HOSPITALIZATION BENEFITS Under this plan, you will be provided with daily cash allowance for each day that are confined in a hospital due to illness or injury Subject to a maximum number of days  CRITICAL ILLNESS The plan provides a lump sum benefit in the event you are diagnosed to have suffered any of the critical illnesses specified in the certificate. The critical illness plan covers 36 common critical illnesses as follows: Aplastic Anemia Accidental head injury resulting in major head Heart attack Brain surgery Stroke Coronary artery bypass surgery Benign brain tumors trauma Cancer Kidney failure Chronic liver disease Viral Encephalitis Fulminant hepatitis Major organ transplant Acute Bacterial Meningitis Paralysis (paraplegia, tetraplegia) Poliomyelitis Multiple Sclerosis Apallic syndrome Primary pulmonary arterial hypertension Motor Neurone Disease Blindness Brain surgery Heart valve surgery Other serious coronary artery disease Deafness Aorta surgery Full blown AIDS Occupationally acquired HIV Loss of speech Chronic lung disease infection Occupationally acquired HIV Major burns Aplastic Anaemia infection HIV infection from blood Terminal illness Benign brain tumour Alzheimer’s Disease transfusion Parkinson’s Disease Chronic liver disease Coma BENEFITS OF MEDICAL AND HEALTH TAKAFUL PLAN The critical illness plan covers 36 common critical illness Intensive unit Outpatient Hospitalisation care treatment Pre-hospitalisatio Visit by doctors n visits Surgery Anaesthetic Ambulance Death benefits services  IMPORTANT TERMS Pre-existing conditions – These are disabilities that existed before the effective date of the plan, for which you are receiving treatment or have shown symptoms. If you had consulted a medical doctor for any pain or discomfort, this would be regarded as symptom of disability. Overseas treatment – You may be covered for treatment obtained overseas, subject to exclusions, limitations and conditions specified in the certificate. Misstatement of age – Your age is an important factor in your medical and health takaful. If you have misstated your age and lead to a lower contribution, any claim under the certificate will be pro-rated, based on the actual contribution paid to the contribution that should have been charged. Qualifying period – The eligibility of benefits under the takaful plan will only starts 30 days after the effective date of the certificate.  EXCLUSIONS Medical and health takaful will usually not cover the following: Pre-existing illness at the time of application. Claims for illness or injury caused through illegal or unlawful acts. Pregnancy or childbirth. Venereal disease, infection or parasites. Murder or physical assault. Cosmetic or plastic surgery.  HOW DO I MAKE A CLAIM Before you receive any treatment, call your takaful operator to check whether you are covered for the treatment that you will receive. If you incur expenses that are covered under your medical and health takaful certificate, you are advised to do the following: ⚬ Give a written notice to your takaful operator as soon as possible. ⚬ Provide the following documents: ⚬ All original bills and receipts. ⚬ Full physician’s report stipulating the diagnosis of the condition treated. ⚬ Physician’s opinion on the date the disability commenced. ⚬ Physician’s summary of the cost of treatment including medical and services rendered. It is important that you act on proper medical advice, as the takaful operator will not be liable if a treatment or service becomes necessary due to failure on your part to do so.  HOW DO I LODGE A COMPLAINT? You may not be satisfied when the takaful operator has rejected your claim or with its offer of settlement. You should first make a complaint with the takaful operator. If you are still not satisfied with the decision, you can appeal to the Insurance Mediation Bureau (IMB) or Bank Negara Malaysia. You must make your appeal to the IMB within 6 months from the date of the takaful operator's decision. The IMB can only handle claims for an amount up to RM100,000 per claim. For cases not within the purview of IMB, you may refer them to Bank Negara Malaysia. Alternatively, you could take your case straight to the court.  APPLYING TAKAFUL PLAN DO DON'T Disclose all material facts on the risks to be covered. Leave any question in the Proposal Form unanswered. Read the ‘Important Notice’ on the Proposal Form. Use ticks and dashes to answer the questions requiring full answers. Answer all questions fully and accurately. With hold or mis represent any material fact. Otherwise, the certificate issued will be void, meaning that the claim can be Complete and sign the Proposal Form yourself. repudiated. Forget to pay the contribution within the terms allowed by the Takaful Operator. Comply with all the terms, conditions and endorsements of the certificate.  WHAT IS MEDICAL CARD? When you purchase a medical plan, your Takaful Operator will issue a card to you that entitles you to certain privileges as according to your medical plan  What is medical card? How does your medical card work? 9 THINGS YOU Standalone or rider? What are they? NEED TO KNOW Understanding Co-Takaful ABOUT YOUR Annual limit MEDICAL CARD? Lifetime Limit Daily hospital allowance benefit Room and board Panel hospitals MEDICAL AND HEALTH TAKAFUL PRODUCTS AVAILABLE IN THE MARKET  MEDICAL HEALTH TAKAFUL IS A POLICY/PLAN THAT IS NICE TO HAVE OR MUST HAVE?