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MARKETING
Marketing Name : i-Medik Rider
Distribution Channel : Agency
PLAN DESCRIPTION
(a) This product is a unit-deducting rider that can be attached to
i-Great Damai (Plan Code: A003);
i-Great Iqra (Plan Code: 0701);
any future plans that we may introduce from time to time;
at any time, effective at next monthly due.
(b) Tabarru is deducted from the Participants Unit Account (PUA) and channeled to the
Tabarru Fund.
PLAN BENEFITS
This rider provides coverage for medical expenses incurred on the Person Covered due to illness or
accidental injury or any other covered eventuality, subject to the relevant cotakaful, limits and sub-
limits of the plan purchased as stated in the Schedule of Benefits and the list of exclusions.
Whilst, in the event of expenses incurred on the Person Covered where the expenses is claimed from
other medical plans from other companies or within Great Eastern Takaful (the Takaful Operator),
the cotakaful and/or deductible of other medical plans from other companies or within the Takaful
Operator which to be imposed on the Person Covered can be claimed from this plan, up to the limits
and sub-limits according to the plan purchased as stated in the Schedule of Benefits. The
reimbursement of the cotakaful and/or deductible of other medical plans from other companies or
within the Takaful Operator is subject to i-Medik cotakaful.
Example 1:
Mr. A of attained age 30 next birthday bought IL M200. He also has a medical plan R&B 200 with Z
Company. Mr. A is admitted to hospital and he stayed in R&B 200 for 3 days. He has incurred a total
medical expenses of RM5,000, where RM600 of it is R&B charge.
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i-Medik Rider
Example 2:
Mr. A of attained age 30 next birthday bought IL M200. He also has a medical plan R&B 200 with Z
Company. Mr. A is admitted to hospital and he stayed in R&B 300 for 3 days. He has incurred a total
medical expenses of RM5,000, where RM900 of it is R&B charge.
Example 3:
Mr. A of attained age 30 next birthday bought IL M200. He also has a medical plan R&B 200 with Z
Company. Mr. A is admitted to hospital and he stayed in R&B 500 for 3 days. He has incurred a total
medical expenses of RM5,000, where RM1,500 of it is R&B charge.
nd
Application of this enhanced benefit shall base on hospital admission date which cut off at 2
January 2013.
nd nd
Hospital Admission Date Prior to 2 January 2013 From 2 January 2013 onwards
Claim of cotakaful and/or
deductible of other medical
plans of other companies or Not claimable Claimable
within the Takaful Operator
from IL M
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i-Medik Rider
Examples:-
Is Cotakaful and/or
Deductible of Other Medical
Hospital Admission Plans of Other Companies
Scenario Claim Submission Date
Date or within the Takaful
Operator
Claimable from IL M?
1 11 May 2012 20 December 2012 Not Claimable
2 11 September 2012 2 January 2013 Not Claimable
3 20 October 2012 20 January 2013 Not Claimable
4 2 January 2013 2 January 2013 Claimable
5 2 January 2013 20 February 2013 Claimable
Compensation may be claimed from the start of a course of covered treatment until the time it is
confirmed by the medical opinion acceptable to the Takaful Operator that such treatment is no longer
necessary.
There are five riders available for selection with a daily Room and Board rate of RM100, RM150,
RM200, RM300 and RM400 respectively.
The details of covered benefits are stated in the Schedule of Benefits as follows:
Schedule of the Benefits
IL M100 IL M150 IL M200 IL M300 IL M400
Item Covered Benefits
(RM) (RM) (RM) (RM) (RM)
1 Hospital Room and Board
(Limit per day, subject to a 100 150 200 300 400
maximum of 180 days per
certificate year for Items (1) and
As charged, subject to the limit stated above.
(2) in aggregate)
2 Intensive Care Unit (ICU)
(Subject to a maximum of 180
As charged.
days per certificate year for
Items (1) and (2) in aggregate)
3 Hospital Supplies and Services
4 Surgical Fees
5 Operating Theatre As charged.
6 Anaesthetist Fees
7 In Hospital Physician Visit Reimbursement of Reasonable and Customary Charges
(2 visits per day) which is consistent with those usually charged to a ward
8 Pre-Hospitalisation Diagnostic or room and board accommodation which is approximate
Tests to and within the daily limit of the amount stated in
(Within 60 days before Hospital Room and Board benefit under the plan covered.
hospitalisation)
9 Pre-Hospitalisation Specialist Subject to 10% cotakaful, up to a maximum of RM500.
Consultation
(Within 60 days before If there is an upgrade of Hospital Room and Board, the
hospitalisation) following shall apply:
10 Post-Hospitalisation Treatment 1) 20% cotakaful with no maximum cap for IL M100 and
(Within 90 days after hospital IL M150 plans, or
*
discharge) 2) 20% cotakaful with a maximum cap of RM3,000 for
11 Organ Transplant IL M200, IL M300 and IL M400 plans.
12 Ambulance Fees
13 Day Surgery
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i-Medik Rider
Supreme Assist
In accordance with the benefit provisions in Supreme
23 (Emergency Medical
Assist agreement.
Assistance Services)
In accordance with the benefit provisions in Car
24 Car Assistance Programme
Assistance Programme agreement.
* The Takaful Operator reserves the right to revise the maximum cap for cotakaful by giving at least
30 days prior written notice.
rd
** Increase to the Initial Overall Annual Limit will be computed at the end of every third (3 ) certificate
year starting from the rider effective date provided that no claim has been made during the immediate
preceding 3 certificate years. If a claim is made within any 3 certificate years, the Increase to the Initial
Overall Annual Limit will not be computed at the end of those 3 certificate years. However, the
computation of the Increase to the Initial Overall Limit will apply again if no claim has been made
during the immediate preceding 3 certificate years.
Note: Please refer to the certificate for detailed benefit of this rider.
Example
Mr. X attained age 30 choose IL M100, with Initial Overall Annual Limit of RM60,000, and Overall
Lifetime Limit of RM600,000.
st rd
1 3 Overall Annual Limit will increase by RM6,000 to RM66,000
No claim th th
Certificate Year from 4 Certificate Year to 6 Certificate Year.
th th th
4 6 Overall Annual Limit will remain at RM66,000 from 7
2 claims th
Certificate Year Certificate Year to 9 Certificate Year.
th th
7 9 Overall Annual Limit will increase by RM6,000 to RM72,000
No claim th th
Certificate Year from 10 Certificate Year to 12 Certificate Year.
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i-Medik Rider
Note: If a late claim submitted after the Takaful Operator has increased the annual limit by 10% due to
no claim within defined interval, the increase in annual limit shall be reversed upon claim approval.
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i-Medik Rider
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i-Medik Rider
- Laparoscopic Endometrial Ablation;
- Laparoscopy;
- Laryngoscopy;
- Laser Photocoagulation treatment for Retinal Detachment;
- Marsupialisation and drainage of Bartholins Cysts;
- Myringotomy or Myringoplasty;
- Reduction of Bone Fracture(s);
- Release of Carpal Tunnel (Carpal Tunnel Decompression);
- Release of Dupuytrens contracture;
- Removal of Cervical Polyps;
- Removal of Nasal Polyps;
- Removal of Plate and Screw/Implants;
- Rubber Banding of Haemorrhoids.
The Takaful Operator may extend the above list of surgical procedures which are commonly
performed safely as Day Surgery, from time to time, at its sole discretion. If any such surgical
procedure is performed while the Person Covered is an Inpatient, only the equivalent benefit
of Day Surgery shall be paid, unless the Takaful Operators appointed medical practitioner
has given prior approval.
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i-Medik Rider
(16) Emergency Accident Outpatient Treatment
Reimbursement of the Reasonable and Customary Charges incurred for Medically Necessary
treatment as an Outpatient at any registered Clinic or Hospital as a result of a covered bodily
injury arising from an Accident, within 24 hours of such Accident and subject to the maximum
amount and the limits stated in the Schedule of Benefits. Follow-up treatment by the same
Doctor or same registered Clinic or Hospital for the same covered bodily Injury shall be provided
up to a maximum of thirty (30) days from date of Accident, subject to the maximum amount and
the limits stated in the Schedule of Benefits.
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i-Medik Rider
19.2 Domestic Emergency Medical Assistance
The following services are applicable to the Person Covered within Malaysia but
outside his state of residence in Malaysia:
(a) Emergency Message Transmission
(b) Medical Service Provider Referral
The following services are applicable to the Person Covered traveling outside his
state of residence in Malaysia for a period not exceeding 120 consecutive days for
any one trip:
(a) Arrangement and Payment of Emergency Medical Evacuation
(b) Arrangement and Payment of Emergency Medical Repatriation
(c) Arrangement for Hospital Admission
The Takaful Operator reserves the right to amend the provision of this benefit at any time, by
giving 30-day notice, subject to the availability of this benefit at reasonable costs from the
Service Provider.
The maximum amount payable by the Takaful Operator in respect of this benefit on the same
Person Covered is limited to RM500,000.
UNDERWRITING GUIDELINES
i. Minimum/Maximum Age at Entry
Minimum: 30 days attained age
Maximum: IL M100 & IL M150: 60 years next birthday
IL M200, IL M300 & IL M400: 65 years next birthday (subject to underwriting)
v. Backdating
Not Allowed.
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i-Medik Rider
CHARGES
Tabarru
(a) Tabarru rates varies by the attained age, gender, and occupation classification of the Person
Covered.
(b) Tabarru is deducted monthly by cancellation of units at the beginning of each certificate
month.
AGENCY COMPENSATION
Basic Commission & Overriding Commission & Other Agency Compensation
Not applicable since these are unit deducting riders. Commission is only payable on the Basic
Contributions.
OTHER FEATURES
i. Surrender Values / Paid-up Takaful / Extended Term Takaful / Premium Loans /
Automatic Contribution Charge/ Bonus Rate
Not applicable
OTHER PRIVILEGES
i. Assignment / Nomination
Not applicable.
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