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Part 1 / Bahagian 1

Date / Tarikh : APR 27, 2018 Policy No./ No. Polisi : 5819576A02

Dear Valued Policyholder / Pemegang Polisi Yang Dihargai,

It is w ith great pleasure that w e are delivering / returning your policy contract to you for safekeeping. If yo u require any further
servicing in respect of your policy, please do not hesitate to contact us at any of our nearest Branch Office.
Please complete Part 2 of this letter and return it to us through your authorized representative or directly to our Branch Office.

Adalah dengan sukacita kami menghantar/memulangkan kontrak polisi anda untuk simpanan anda. Sekiranya anda
memerlukan khidmat selanjutnya berhubung polisi anda, sila hubungi kami di mana-mana pejabat cawangan kami yang
berhampiran.
Sila lengkapkan Bahagian 2 lampiran ini dan hantarkan kepada kami melalui pegawai yang dibenarkan anda atau terus
kepada Pejabat Cawangan kami.

Yours Sincerely / Yang benar,

Part 2 / Bahagian 2

Policy No 5819576A02

Proposed Insured SHAHRIZAL BIN ABD MALEK

Owner/Payor SHAHRIZAL BIN ABD MALEK

Branch Klang

Issue Date APR 27, 2018

To / Kepada : AIA Bhd.


I, _________________________________ hereby acknow ledge receipt of my policy contract as stated above.
Saya,______________________________ dengan ini mengesahkan penerimaan Kontrak Polisi saya yang tersebut di atas.
I confirm that/ Saya mengesahkan bahaw a :
· I am aw are of the insurance product w hich I have purchased, the premium amount payable and the duration of coverage of my
policy/ Saya tahu produk insurans yang telah saya beli, amaun premium yang perlu dibayar dan tempoh perlindungan polisi
saya.
· I have been given a copy of the Product Brochure/Product Disclosure Sheet by my authorized representative and I fully
understood the contents of the Product Brochure/Product Disclosure Sheet as satisfactorily explained to me by my authorized
representative / Saya telah diberikan sesalinan Risalah Produk/ Lembaran Pendedahan Produk Insurans oleh pegawai yang
dibenarkan saya dan saya telah memahami sepenuhnya kandungan Risalah Produk /Lembaran Pendedahan Produk Insurans
seperti yang diterangkan kepada saya secara memuaskan oleh pegawai yang dibenarkan saya.
· My particular attention has been draw n to the essential information on the key benefits and features of the product I have
purchased/ Perhatian khusus saya ditumpukan kepada maklumat penting mengenai faedah-faedah utama dan ciri-ciri produk
yang telah saya beli.
· I am aw are that I am required to read the Product Brochure/Product Disclosure Sheet, Policy Contract and Sales Illustration for
a better understanding of the product purchased/ Saya sedar bahawa saya perlu membaca Risalah Produk /Lembaran
Pendedahan Produk, Kontrak Polisi dan Ilustrasi Jualan untuk pemahaman yang lebih baik mengenai pr oduk yang dibeli.
· I understand that my insurance premiums w ill be invested in the investment fund(s) of my choice. (applicable to Investment -
Linked Plans only)/ Saya memahami bahawa premium insurans saya akan dilaburkan di dalam dana pelaburan pilihan saya.
(hanya untuk Pelan Berkaitan Pelaburan sahaja).
Signature of Assured/ Ow ner / Trustee :
Tandatangan Asured/Pemilik/Pemegang Amanah :_____________________________

Date / Tarikh :_____________________________


(MM/DD/YYYY / BB/HH/TTTT)
Note : This letter is issued in conjunction with any new policy issue/nomination/change of nominee.
Nota : Surat ini dikeluarkan bersama mana-mana polisi baru/penerima namaan baru/pindaan penerima namaan.

5819576A02 06/13 ACK AB001


AIA Bhd. (790895-D)

Menara AIA, 99 Jalan Ampang


50450 Kuala Lumpur
P.O. Box 10140, 50704 Kuala Lumpur
Care Line: 1300 88 1899
T : 03-2056 1111
F : 03-2056 3891
AIA.COM.MY

APRIL 27, 2018 Ref: 5819576A02

SHAHRIZAL BIN ABD MALEK


40 JALAN PUTRA PERMAI 10/2A NB

PUTRA HEIGHTS
47650 SUBANG JAYA

Dear Applicant,

RE: YOUR APPLICATION NO. : 5819576A02


APPLICATION DATE : APRIL 26, 2018
ON THE LIFE OF : SHAHRIZAL BIN ABD MALEK

We are pleased to inform you that your application for our life insurance plan has been approved and we
thank you for placing your trust in us. AIA is recognized as a financially sound and secure life insurer and
we are proud to have you as one of our policyholders.
We trust that your agent has conducted the financial needs analysis with you prior to your signing the
application form.
We have received initial premium for your insurance program, and your servicing agent will be delivering
the policy contract to you when ready. The policy contract has detailed all insured items, the sum assured
and the terms and conditions of your insurance coverage(s). As such please go through the information
in the policy to ensure that it is correct and complete. The projected dividend values, where applicable,
are based on the Company’s current dividend scales and are not guaranteed. The actual dividends paid,
if applicable, may vary with the values being higher or lower than those illustrated.

Please check, confirm and/or ensure the accuracy and completeness of all information declared to and
submitted to the Company in relation to your application upon receipt of the policy contract from the
Company. In the event that you do not notify the Company that such information declared and submitted
to the Company is untrue, inaccurate and/or incomplete, the Company shall treat all information declared
and submitted by your authorized representative as true, accurate and complete.
If you do not receive your policy contract within 14 days from the date of this approval letter or have any
queries, kindly contact your agent or the nearest AIA branch office.
As our valued policyholder, we look forward to your continuous support.
Yours sincerely,

NEW BUSINESS DEPARTME NT


cc (NOR IZA FAZLIN BINTI MUSTAPHA) (KLG STALLION [ ]) (02720 -
5941Q)
STDAPP Klang – EP – ALALR
INSURED : SHAHRIZAL BIN ABD MALEK

FACE AMOUNT : PLAN150-I APR 27, 2018 : POLICY DATE


PLAN : A-Life Med Regular APR 27, 2018 : ISSUE DATE

POLICY NUMBER : 5819576A02 APR 27, 2069 : MATURITY OR


EXPIRY DATE

AGENCY : KLG STALLION []

We shall, subject to the provisions of this Policy, pay the benefits provided under this Policy on being satisfied
that the event on which the benefit is payable has occurred while this Policy is in force.

The basic insurance plan and the supplementary contracts if any, provided by this Policy with their amounts of
coverage are specified in the Schedule of Coverage, Benefits and Premiums on the Policy Information Page.
Entitlement to benefits, benefit exclusions, conditions for payment and other policy details are set out inside.

Executed and signed by Us on the Issue Date of this Policy as stated in the Policy Information Pa ge.

Stamp Duty Paid

5819576A02 -1- 06/13 AD001


POLICY INFORMATION PAGE
POLICY DATA

INSURED : SHAHRIZAL BIN ABD MALEK

FACE AMOUNT : PLAN150-I POLICY DATE : APR 27, 2018

PLAN : A-Life Med Regular ISSUE DATE : APR 27, 2018

POLICY NUMBER : 5819576A02 MATURITY OR EXPIRY DATE: APR 27, 2069

AGE : 49 Age Admitted: ADMITTED GENDER: MALE CURRENCY : MALAYSIAN RINGGIT

OWNER : SHAHRIZAL BIN ABD MALEK


THIS POLICY IS NON-PARTICIPA TING

SCHEDULE OF BENEFITS AND PREMIUMS


Form Maturity/ Amount of Premium
Type of Coverage No. Expiry Date Benefit* Premiums Ceased Date
(RM) (RM)
A-Life Med Regular+ 04/27/ 2069 PLAN150-I 121.76 04/27/2069

+Premium payable will be subject to Goods and Services Tax at the prescribed rate
GOODS AND S ERVI CES TAX: RM 7.31
MONTHLY PREMI UM: RM 121.76
TOTAL AMOUNT PAYABLE: RM 129.07

PREMIUMS ARE PAYABLE ON THE POLICY DATE AND IN ADVANCE EVERY ONE MONTH(S) THEREAFTER
APPLICABLE SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY

*Denote limitations of benefit and actual benefits payable in accordance with the coverage terms

5819576A02 -2- 06/13 AE001


BASIC DEFINITIONS

In this Policy:

"Accident" means a sudden, unintentional, unexpected, unusual, and specific event that occurs at an
identifiable time and place which shall, independently of any other cause, be the sole cause of bodily injury.

"Basic Policy" means A-Life Med Regular.

"Clinic" means any lawfully operated establishment which is operated for the treatment of injured or ill patients
and provides facilities for diagnosis, minor surgery and dispensing facilities. Such an establishment must be
operated by a Physician who is fully registered with the legally recognized medical council of the country.

"Confinement" means admission in a Hospital as an In-Patient for a minimum period of six (6) hours upon the
recommendation of a Physician of an Insured Person and continuously stays in the Hospital prior to his
discharge.

"Contingent Owner" means the person named in the application or appointed by the Owner. On default of such
appointment, it shall mean the legal representative of the Owner.

"Covered Day Procedure" means a Medically Necessary surgical or medical procedure that is performed on
the Insured Person at a Designated Day Procedure Centre or specialist clinic by Us.

"Covered Injury" means Injury occurring after the Issue Date or Commencement Date, whichever is later, of
this Policy.

"Dentist" shall mean a person who is duly licensed or registered to practice dentistry in the geographical area
in which a service is provided, but excluding a Dentist who is the Insured Person himself.

"Dependent" means any or both of the following persons:

(i) Dependent Spouse: a legally married spouse.

(ii) Dependent Child: unmarried children who is at least fourteen (14) days old, and under twenty -three
(23) years of age provided such child is still unmarried.

"Designated Day Procedure Center" means a lawfully operated establishment which has permanent medical
facilities equipped and operated mainly for performing surgical or medical procedures by qualified Physicians;
and which provides proper medical and nursing care but does not provide overnight care or accommodation for
patient to stay as an In-Patient. It is restricted to a list of such establishments approved and specified by Us,
from time to time, which shall be made available upon request at Our head office in Kuala Lumpur, any of Our
branches or call centre.

"Disability" means a Sickness, Disease, Illness or the entire Covered Injuries arising out of a single or
continuous series of causes.

"Doctor" or "Physician" or "Surgeon" shall mean a registered medical practitioner qualified and licensed to
practice western medicine and who, in rendering such treatment, is practicing withi n the scope of his licensing
and training in the geographical area of practice, but excluding a Physician or Surgeon who is the Insured
Person himself.

"Eligible Expenses" shall mean Medically Necessary expenses incurred due to a covered Disability but not
exceeding the limits in the Schedule of Benefits.

"Expiry Date" of the Basic Policy is shown in the Policy Information Page.

"Guardian" means the parent or legal guardian of the Insured Person aged below fifteen (15) years at the time
of Hospital admission.

5819576A02 -3- 06/13 (BD) AF035


"Hospital" means only an establishment duly constituted and registered as a hospital for the care and
treatment of sick and injured persons as paying bed-patients, and which:

(i) has facilities for diagnosis and major surgery,

(ii) provides twenty-four (24) hour a day nursing services by registered and graduate nurses,

(iii) is under the supervision of a Physician, and

(iv) is not primarily a clinic; a place for alcoholics or drug addicts; a nursing, rest or convalescent home or a
home for the aged or similar establishment.

"Hospitalization" shall mean admission to a Hospital as a registered In-Patient for Medically Necessary
treatments for a covered Disability upon recommendation of a Physician. A patient shall not be considered as
an In-Patient if the patient does not physically stay in the Hospital for the whole period of Confinement.

"Injury" means an abnormal bodily condition which occurs while this Policy is in force, and is effected directly
and independently of all other causes by violent, external, visible and accidental means only and independent
of any other cause and is not due to any illness or disease.

"In-Patient" means an Insured Person who undergoes Confinement for a Disability as defined in this Policy, as
a registered resident bed-patient using and being charged for the room and board facilities of the Hospital.

"Insured" refers to the person whose name and personal particulars are identified on the Policy Information
Page.

"Insured Person" shall mean the person described in the application including the Insured and his/her
Dependent (if applicable) for this Policy or any endorsement attached.

"Intensive Care Unit" (ICU) means a section within a Hospital which is designated as an Intensive Care Unit
by the Hospital, and which is maintained on a twenty-four (24) hour basis solely for treatment of patients in
critical condition and is equipped to provide special nursing and medical services not available elsewhere in the
Hospital.

"Issue Date" or "Commencement Date" is the date when coverage under this Policy or its relevant
Supplementary Contract takes effect. The Issue Date is shown on the Policy Information Page and the
Commencement Date is the date of issue of any endorsement indicated in the relevant endorsement whenever
the original terms and coverage of this Policy are changed subsequently. Commencement Date is also the
approval date of reinstatement of the Policy and/or its Supplementary Contract in case of any reinstatement.

"Legally Registered Dialysis Centre" means any registered premise that is operated and personally
managed by a Physician to provide facilities for haemodialysis.

"Legally Registered Cancer Treatment Centre" means any registered premise that is operated and managed
by a duly registered cancer Specialist to provide medical, surgical or radiological facilities for the treatment of
Cancer.

"Malaysian Government Hospital" means a hospital which charges of services are subject to the Fee Act
1951, Fees (Medical) Order 1982 and/or its subsequent amendments if any.

"Malaysian Resident" means a person who is in possession of a Malaysian passport or other documents
showing that he has the right to reside permanently in Malaysia.

"Medically Necessary" means a medical service which is:

(i) consistent with the diagnosis and customary medical treatment for a covered Disability; and

(ii) in accordance with standards of good medical practice, consistent with current standard of professional
medical care, and proven medical benefits; and

(iii) not for the convenience of the Insured Person or the Physician, and unable to be reasonably rendered
out of Hospital (if admitted as an In-Patient); and

5819576A02 -4- 06/13 (BD) AF035


(iv) not of an experimental, investigational or research nature, preventive or screening nature; and

(v) for which the charges are fair and considered Reasonable and Customary Charges for the Disability.

"Out-Patient" means an Insured Person is receiving medical care or treatment without being hospitalized and
includes treatment in a daycare centre and Designated Day Procedure Centre.

"Owner" means the person effecting this Policy.

"Policy" refers to the Basic Policy and Supplementary Contracts which may be attached to it.

"Policy Anniversary" refers to the same date each year as the Policy Date.

"Policy Date" as shown on the Policy Information Page is the date from which Policy Anniversaries, Policy
Years, Policy Months and Premium Due Dates are determined.

"Policy Year" refers to the twelve (12) months duration between two (2) Policy Anniversaries.

"Prescribed Medicines" shall mean medicines that are dispensed by a Physician, a registered pharmacist or a
Hospital and which have been prescribed by a Physician or Specialist in respect of treatment for a covered
Disability.

"Reasonable and Customary Charges" shall mean charges for medical care which is Medically Necessary
shall be considered reasonable and customary to the extent that it does not exceed the general level of charges
being made by others of similar standing in the locality where the charge is incurred, when furnishing like or
comparable treatment, services or supplies to individual of the same sex and of comparable age for a similar
Disability and in accordance with accepted medical standards and practice could not have been omitted without
adversely affecting the Insured Person’s medical condition.

"Registered Nurse" shall means a nurse qualified and licensed to practice nursing within the scope of her
licensing and training in the geographical area of practice, but excluding a Registered Nurse who is the Insured
Person herself.

"Sickness, Disease or Illness" means Sickness, Disease or Illness occurring more than thirty (30) days after
the Issue Date or Commencement Date, whichever is later, of this Policy. For this purpose, a Sickness,
Disease or Illness has occurred when it has been investigated, diagnosed or treated or when its signs or
symptoms have manifested which will cause an ordinary prudent person to seek diagnosis, care or treatment.
In the event of any conflict or discrepancy of opinions relating to the signs or symptoms of a Sickness, Disease
or Illness and their manifestation between a Physician and the Insured Person/ You, We will adopt and follow
the Physician's professional opinion.

"Specialist" shall mean a medical practitioner registered and licensed to practice western medicine in the
geographical area of his practice where treatment takes place and who is classified by the appropriate health
authorities as a person with superior and special expertise in specified fields of medicine , but excluding a
Physician or Surgeon who is the Insured Person himself.

"Surgery" shall mean any of the following medical procedures:

(a) To incise, excise or electrocauterize any organ or body part, except for dental services.

(b) To repair, revise, or reconstruct any organ or body part.

(c) To reduce by manipulation a fracture or dislocation.

(d) Use of endoscopy to remove a stone or object from the larynx, bronchus, trachea, esophagus,
stomach, intestine, urinary bladder, or urethra.

"We", "Us", "Our" or "Company" refers to AIA Bhd.

"You" or "Your" means the Owner of this Policy as shown in the Policy Information Page.

Whenever the context requires, masculine shall apply to feminine and singular term shall include the plural.

5819576A02 -5- 06/13 (BD) AF035


A-LIFE MED REGULAR PROVISION

Your Basic Policy is called A-Life Med Regular. It is a standalone Hospital and Surgical Benefit Policy which
expires on the Expiry Date. Your Basic Policy provides benefits subject to the terms and conditions below. The
premium payment term is until the Insured’s age of one hundred (100) years.

BENEFITS

We will pay the following benefits if any of the Insured Person undergoes Confinement, Surgery and/or
emergency accidental Out-Patient treatment due to a Disability subject to the applicable benefit plan and the
terms and conditions stated below:

SCHEDULE OF BENEFITS
No BENEFIT LIMITS Plan 150 Plan 200 Plan 250

Hospital Room and Board Benefit


(120 days maximum per Policy Year and
1 150 200 250
daily maximum not to exceed amount as
show n)

Additional Hospital Room and Board


Whilst Overseas Benefit
2 (120 days maximum per Policy Year and 150 200 250
daily maximum not to exceed amount as
show n)

Intensive Care Unit Benefit


3
(120 days maximum per Policy Year)

4 Hospital Supplies and Services

5 Surgical Fees Benefit

6 Operating Theatre Fees Benefit


As Charged, subject to Reasonable and Customary Charges up to Overall
7 Anaesthetist’s Fees Benefit Annual Limit.

In-Hospital Physician’s Visit Benefit


8
(240 visits maximum per Policy Year)
Pre-Hospitalization Benefits
(w ithin 60 days prior to Hospitalization)
- Pre-Hospital Diagnostic Tests Benefit
- Pre-Hospital Specialist Consultation
9
Benefit
- Pre-Hospital Medication and
Treatment Benefit (RM300 maximum
per Disability)
Post-Hospitalization Treatment Benefits
(w ithin 120 days after Hospitalization)
- Post-Hospitalization Out-patient
10 Diagnostic X-ray and Lab Tests
Benefit
- Post Hospitalization Medical
Expenses and Consultation Benefit
11 Day Procedure Benefit
Out-Patient Physiotherapy and
Acupuncture Treatment Benefit (per Policy
12 4000 6000 8000
Year and w ithin 60 days after
Hospitalization)
Home Nursing Care Benefit (per
13 3,000 4,000 5,000
Confinement) (180 days Lifetime limit)
14 Organ/Bone Marrow Transplant Reasonable and Customary Charges up to Overall Annual Limit

5819576A02 -6- 06/13 (BPP) DA037


No
BENEFIT LIMITS Plan 150 Plan 200 Plan 250
Daily Cash Allow ance at Government
15 Hospital per day (120 days maximum per 100 100 100
Policy Year)
Daily Guardian Benefit per day (120 days
16 90 110 130
maximum per Policy Year)
Overall Annual Limit (Item 1 to 16) Per Insured
100,000 125,000 150,000
Person
Overall Lifetime Limit (Item 1 to 16) Per Insured
N/A N/A N/A
Person
Emergency Accidental Out-Patient
2,000 for 2,500 for 3,000 for
Treatment and 30 days Follow -up
17 both both both
Treatment at Hospital and Clinic Benefit
combined combined combined
(per Accident)
Emergency Accident Out-Patient Dental
18 3,000 4,000 5,000
Treatment Benefit (per Accident)
Out-patient Kidney Dialysis Treatment
250,000 for 312,500 for 375,000 for
Benefit (per Lifetime) and
19 both both both
Out-patient Cancer Treatment Benefit (per
combined combined combined
Lifetime)
Note: All figures shown in the Schedule of Benefits above are in Ringgit Malaysia (RM) unless stated otherw ise.

1. HOSPITAL ROOM AND BOARD BENEFIT


Reimbursement of the Reasonable and Customary Charges Medically Necessary for room
accommodation and meals. The amount of the benefit shall be equal to the actual charges made by the
Hospital during the Insured Person’s Confinement, but in no event shall the benefit exceed, for any one
day, the rate of the Room and Board Benefit, and the maximum number of days as stated in the
Schedule of Benefits. The Insured Person will only be entitled t o this benefit while confined to a Hospital
as an In-Patient.

2. ADDITIONAL HOSPITAL ROOM AND BOARD WHILST OVERSEAS BENEFIT


If benefits are payable under the Hospital Room and Board Benefit above (Benefit 1), and should an
Insured Person be hospitalized as an In-Patient whilst overseas, We will pay the Additional Hospital
Room and Board Whilst Overseas Benefit (Benefit 2). The combined amount of benefit payable under
Benefit 1 and 2 for any one day of Hospitalization whilst overseas shall be equal to act ual room and
board charges made by the Hospital for the period for which the Insured Person shall be an In-Patient
but shall not exceed for any one day the aggregate amount of Benefit 1 and 2 as stated in the Schedule
of Benefits. The aggregate benefit under Benefit 1 and 2 shall not exceed one hundred and twenty
(120) days per Policy Year.

The Insured Person must be a Malaysian Resident and must not be abroad for a period longer than one
month prior to Hospitalization as an In-Patient.

3. INTENSIVE CARE UNIT (ICU) BENEFIT


Reimbursement of the Reasonable and Customary Charges for actual room and board incurred for a
Medically Necessary Confinement as an In-Patient in the Intensive Care Unit of the Hospital. This
benefit shall be payable equal to the actual charges made by the Hospital subject to the maximum
benefit for any one day, and the maximum number of days, as stated in the Schedule of Benefits.
Where the period of Confinement in an Intensive Care Unit exceeds the maximum stated in the
Schedule of Benefits, reimbursement will be restricted to the standard Hospital Room and Board
Benefit per day.

No Hospital Room and Board Benefits will be payable for the same Confinement period where Daily
Intensive Care Unit Benefit is payable.

5819576A02 -7- 06/13 (BPP) DA037


4. HOSPITAL SUPPLIES AND SERVICES
Reimbursement of the Reasonable and Customary Charges actually incurred for Medically Necessary:

- General nursing;
- Prescribed and consumed drugs and medicines;
- Dressings, splints, plaster casts, x-ray;
- Laboratory examinations, electrocardiograms;
- Physiotherapy; Acupuncture;
- Basal metabolism tests;
- Intravenous injections and solutions;
- Administration of blood and blood plasma and including the cost of blood and plasma;
- Ambulance Fee incurred for necessary domestic ambulance services (inclusive of attendant) to
and/or from the Hospital of Confinement. Payment will not be made if the Insured Person is not
hospitalized and is subject to the limit not exceeding the Hospital Room and Board Benefit per
day for any Disability.

We may, from time to time, at Our discretion add additional Hospital Supplies and Services.

5. SURGICAL FEES BENEFIT


Reimbursement of Reasonable and Customary Charges for a Medically Necessary Surgery performed
by the Specialist/Surgeon but within the maximum amount of benefit indicated in the Schedule of
Benefits when the Insured Person undergoes Confinement as a registered In-Patient. If more than one
(1) Surgery is performed for any Disability, the total payments for all the Surgeries performed shall not
exceed the Overall Annual Limit stated in the Schedule of Benefits.

If any surgical procedure is performed and Surgeon’s Fees are payable above, We shall also pay the
benefits as stated in clauses 6 and 7 below.

6. OPERATING THEATRE FEES BENEFIT


Reimbursement of Reasonable and Customary Charges made by the Hospital for the use of the
operating theatre and equipment incidental to the surgical procedure.

7. ANAESTHETIST FEES BENEFIT


Reimbursement of Reasonable and Customary Charges by the anaesthetist for the Medically Necessary
administration of anaesthesia not exceeding the limits as stated in the Schedule of Benefits.

8. IN-HOSPITAL PHYSICIAN VISIT BENEFIT


Reimbursement of Reasonable and Customary Charges by a Physician for Medically Necessary
visiting an In-Patient subject to a maximum of two (2) visits per day not exceeding the maximum of two
hundred and forty (240) visits as stated in the Schedule of Benefits. Additional two (2) visits will be
allowed if the In-Patient visiting occurs in ICU. We will determine the amount payable at Our absolute
discretion.

9. PRE-HOSPITALIZATION BENEFITS - If a benefit is payable under the Hospital Room and Board
Benefit, We will pay the Reasonable and Customary amount actually incurred on an Out -Patient basis,
in connection with a subsequent Confinement within sixty (60) days prior to Hospitalization for:

(i) Pre-Hospital Diagnostic Tests Benefit


Reimbursement of Reasonable and Customary Charges for Medically Necessary diagnostic tests
which include but are not limited to ECG, X-ray and laboratory tests, which are performed for
diagnostic purposes in a Hospital on account of a Disability when in connection with a Disability
preceding Hospitalization within the maximum number of days as stated in the Schedule of Benefits
and which are recommended by a qualified Physician. No payment shall be made if upon such
diagnostic services, the Insured Person does not result in Hospital Confinement for the treatment of
the medical condition diagnosed.

5819576A02 -8- 06/13 (BPP) DA037


(ii) Pre-Hospital Specialist Consultation Benefit
Reimbursement of Reasonable and Customary Charges for the consultation by a Specialist in
connection with a Disability within sixty (60) days as stated in the Schedule of Benefits preceding
Confinement in a Hospital and provided that such consultation is Medically Necessary and
consistent with the condition or Disability that resulted in Hospital Confinement for treatment of the
said condition or Disability. Payment will not be made for clinical treatment (including medications
and subsequent consultation after the Disability is diagnosed) or where the Insured Person does not
result in Hospital Confinement for the treatment of the medical condition diagnosed. The number of
consultation payable per day is limited to one (1) consultation of no more than one (1) Specialist per
day.

(iii) Pre-Hospital Medication and Treatment Benefit


Reimbursement of Reasonable and Customary Charges for Medically Necessary treatment or
medication prescribed by a Specialist in connection with a Disability within sixty (60) days as
stated in the Schedule of Benefits preceding Confinement in a Hospital and provided that such
treatment or medication prescribed is consistent with the condition or Disability that resulted in
Hospital Confinement for treatment of the said condition or Disability. Medicines prescribed shall
not exceed the supply needed for sixty (60) days. Payment will not be made for clinical treatment
and medications after the Disability is diagnosed or where the Insured Person does not result in
Hospital Confinement for the treatment of the medical condition diagnosed. The medication and
treatment payable is limited to three hundred Malaysian Ringgit (RM300) per Disability.

10. POST-HOSPITALIZATION TREATMENT BENEFITS - If a benefit is payable under the Hospital Room
and Board Benefit, We will pay the Reasonable and Customary Charges incurred within one hundred
and twenty (120) days after the Insured Person has been discharged from a Hospital for:

(i) Post-Hospitalization Out-Patient Diagnostic X-ray and Lab Tests Benefit


As a result of Disability, an Insured Person undergoes for diagnostic purposes X-rays,
electrocardiograms or laboratory tests upon the written recommendation or approval of a
Physician, We will pay the Reasonable and Customary Charges incurred for such X-rays,
electrocardiograms or laboratory tests for any one Confinement. Such benefits will only be
payable provided such X-rays, electrocardiograms or laboratory tests are done in connection with
that Hospitalization and within one hundred and twenty (120) days after such Hospitalization.

(ii) Post-Hospitalization Medical Expenses and Consultation Benefit


Reimbursement of Reasonable and Customary Charges incurred in Medically Necessary follow-
up treatment by the same Hospital or same treating Physician within one hundred and twenty
(120) days as stated in the Schedule of Benefits. This shall include medicines prescribed during
the follow-up treatment but shall not exceed the supply needed for one hundred and twenty (120)
days as stated in the Schedule of Benefits.

11. DAY PROCEDURE BENEFIT


If, due to a Disability, a Medically Necessary Surgery is performed on the Insured Person as a
Covered Day Procedure at Our Designated Day Procedure Centre or clinic operated by a Specialist,
We shall pay the Reasonable and Customary Charges incurred for the procedure.

We reserve the right to treat any Covered Day Procedure performed during In-Patient Confinement as
Day Procedure Benefit when in the opinion of Our medical examiner, such In-Patient treatment could
have been done as an Out-Patient treatment.

12. OUT-PATIENT PHYSIOTHERAP Y AND ACUPUNCTURE TREATMENT BENEFIT


If a benefit is payable under the Hospital Room and Board Benefit, We will pay the Reasonable and
Customary Charges incurred for a Medically Necessary follow-up physiotherapy and acupuncture
treatment (excluding medications) as a result of the Disability within sixty (60) days immediately
following discharge from the Hospital. The benefit payable shall not exceed the maximum limit stated
in the Schedule of Benefits. Physiotherapy treatment must be referred in writing by a Specialist or
Physician, and must be treated at the Out-Patient department of a Hospital or a legally registered
physiotherapy centre for physiotherapy. Acupuncture treatment shall be obtained at a registered
Chinese traditional medical practitioner for acupuncture.

We will determine the amount payable at Our absolute discretion after consulting with Our medical
doctor.

5819576A02 -9- 06/13 (BPP) DA037


13. HOME NURSING CARE BENEFIT
Reimbursement of Reasonable and Customary Daily Charges incurred for Medically Necessary skilled
nursing care that require execution by a Registered Nurse including therapy, treatments for wound,
respiratory, diabetes care, colostomy care, tube feeding, injections and other medication
administration to the Insured Person in a home when prescribed by the treating Physician within thirty
(30) days following discharge from the Hospital after a minimum of five (5) consecutive days of
Confinement. Reasonable and Customary Charges for medical supplies consumed in and necessary
to the execution of the said nursing care will be reimbursed. The benefit payable shall not exceed the
maximum per confinement limit for the plan as stated in the Schedule of Benefits. Cover is limited to a
maximum period of one hundred and eighty (180) days per lifetime.

In cases where pre-assessment of home nursing care is required and a fee is incurred, the pre-
assessment fee will only be reimbursable if Home Nursing Care Benefit is reim bursable.

We reserve the right to request for any documentation or particulars of a nursing care event, including
original bills, receipts and necessary reports.

14. ORGAN/BONE MARROW TRANSPLANT


If an Insured Person undergoes Major Organ/Bone Marrow Transplant as defined below, We will
reimburse the Reasonable and Customary Charges incurred on transplantation Surgery for the
Insured Person subject to the limit as stated in the Schedule of Benefits.

Major Organ/Bone Marrow Transplant is defined as the receipt of a transplant of:

(a) Human bone marrow using hematopoietic stem cells preceded by total bone marrow ablation; or
(b) One of the following human organs: heart, lung, liver, kidney, pancreas that resulted from
irreversible end stage failure of the relevant organ.

Other stem cell transplants are excluded.

Payment for this benefit is applicable only once per lifetime whilst this Policy is in force. The costs of
acquisition of the organs being transplanted and all costs incurred by the donor are not covered.

15. DAILY CASH ALLOWANCE AT GOVERNMENT HOSPITAL


If, a benefit is payable under the Hospital Room and Board Benefit, We shall pay a daily allowance for
each complete day of Confinement for a covered Disability in a Malaysian Government Hospital up to
the maximum of one hundred and twenty (120) days as stated in the Schedule of Benefits, provided
that the Insured Person shall confine to a room and board rate/charge that does not exceed the
amount shown in the Schedule of Benefits.

16. DAILY GUARDIAN BENEFIT


Reimburses (up to stipulated limits stated on the Schedule of Benefits) the expenses for meals and
lodging incurred to accompany an Insured Person (aged below fifteen (15) years ), in the Hospital up to
the maximum of one hundred and twenty (120) days as stated in the Schedule of Benefits.

17. (i) EMERGENCY ACCIDENTAL OUT-PATIENT TREATMENT AT HOSPITAL BENEFIT


Reimbursement of the Reasonable and Customary Charges incurred for up to the maximum
stated in the Schedule of Benefits, as a result of a Covered Injury arising from an Accident for
Medically Necessary treatment as an Out-Patient at any registered Hospital within forty eight (48)
hours of the Accident causing the Covered Injury. Follow up treatment for the same Covered
Injury will be provided up to the maximum amount and the maximum thirty (30) days as stated in
the Schedule of Benefits.

5819576A02 - 10 - 06/13 (BPP) DA037


(ii) EMERGENCY ACCIDENTAL OUT-PATIENT TREATMENT AT CLINIC BENEFIT
Reimbursement of the Reasonable and Customary Charges incurred for up to the maximum
stated in the Schedule of Benefits, as a result of a Covered Injury arising from an Accident for
Medically Necessary treatment as an Out-Patient at any registered Clinic within forty eight (48)
hours of the Accident causing the Covered Injury. Follow up treatment for the same Covered
Injury will be provided up to the maximum amount and the maximum thirty (30) days as stated in
the Schedule of Benefits.

18. EMERGENCY ACCIDENTAL OUT-PATIENT DENTAL TREATMENT BENEFIT


Reimbursement of Reasonable and Customary Charges incurred shall not exceed the maximum (per
accident) for the plan as stated in the Schedule of Benefits for the replacement of natural teeth,
placement of denture and prosthetic services such as bridges and crowns or their replacement, as a
result of a Covered Injury arising from a traumatic Accident, for Medically Necessary treatment. This is
provided that consultation is made to a Dentist at a dental clinic or as an Out-Patient at any registered
Hospital within forty eight (48) hours of the Accident causing the Covered Injury. The Exclusion Clause
11 stated below shall not apply to this benefit.

19. OUT-PATIENT KIDNEY DIALYSIS TREATMENT AND OUT-PATIENT CANCER TREATMENT


BENEFIT

19.1 OUT-PATIENT KIDNEY DIALYSIS TREATMENT BENEFIT


If an Insured Person is diagnosed with End Stage Kidney Failure as defined below, We will reimburse
the Reasonable and Customary Charges incurred for the Medically Necessary treatment of kidney
dialysis performed at a Legally Registered Dialysis Centre subject to the limit of this Disability as
specified in the Schedule of Benefits. Such treatment must be received at the Out -Patient department
of a Hospital or a Legally Registered Dialysis Centre.

End Stage Kidney Failure means chronic irreversible failure of both kidneys to function, as a result of
which regular renal dialysis is initiated.

This benefit shall not cover any claim whereby the symptoms first occurred prior to the Issue Date or
Commencement Date of this Policy whichever is later or within the thirty (30) day waiting period, from
the said Issue Date or Commencement Date of this Policy.

We reserve the right to treat any In-Patient kidney dialysis treatment as Out-Patient kidney dialysis
treatment to be aggregated under this benefit when in the opinion of Our medical examiner, such In-
Patient treatment could have been done as an Out-Patient treatment.

19.2 OUT-PATIENT CANCER TREATMENT BENEFIT


If an Insured Person is diagnosed with Cancer as defined below, We will reimburse the Reasonable
and Customary Charges incurred for the Medically Necessary treatment of cancer performed at a
Legally Registered Cancer Treatment Centre subject to the limit of this Disability as specified in the
Schedule of Benefits.

Such treatment must be received at the Out-Patient department of a Hospital or a Legally Registered
Cancer Treatment Centre immediately following discharge from Hospital Confinement or Surgery.
Surveillance or prevention after curative cancer treatment or when cancer goes into remission shall not
be covered.

Cancer is defined as any malignant tumour positively diagnosed with histological confirmation and
characterized by the uncontrolled growth of malignant cells and invasion of tissue. The term malignant
tumour includes leukemia, lymphoma and sarcoma. For this definition, the following are not covered:

(i) All cancers which are histologically classified as pre-malignant, non-invasive; carcinoma in situ;
having either borderline malignancy; or having low malignant potential;
(ii) All tumours of the prostate, thyroid and urinary bladder histologically classified as T1N0M0
(TNM classification);
(iii) Chronic Lymphocytic Leukemia less than RAI Stage 3;
(iv) All cancers in the presence of HIV;
(v) Any skin cancer other than malignant melanoma.

5819576A02 - 11 - 06/13 (BPP) DA037


This benefit shall not cover any claim whereby the symptoms first occurred prior to the Issue Date or
Commencement Date of this Policy whichever is later or within the sixty (60) day waiting period, from
the said Issue Date or Commencement Date of this Policy.

We reserve the right to treat any In-Patient cancer treatment as Out-Patient cancer treatment to be
aggregated under this benefit when in the opinion of Our medical examiner such In-Patient treatment
could have been done as an Out-patient Treatment.

OVERALL ANNUAL LIMIT

Benefits payable in respect of expenses incurred for Hospitalization, treatment, Surgery and medical services
provided to each Insured Person during the period of insurance shall be limited to the Overall Annual Limits as
stated in the Schedule of Benefits for any one (1) Policy Year irrespective of the type/types of Disability. In the
event the Overall Annual Limit has been paid, all insurance for that Insured Person under this Policy shall
immediately cease to be payable for the remaining Policy Year.

OVERALL LIFETIME LIMIT

The total amount of benefits payable under the Schedule of Benefits and any attaching value added benefit to
each Insured Person from the Policy Date shall not exceed the Lifetime Limit stated in the Schedule of Benefits.

All benefits payable, in addition to any maximum amount stated above, shall be subject to the limits stated in
the attached Schedule of Benefits.

LIMITATION OF BENEFIT

We are not liable for any Confinement, Surgery and/or emergency accidental Out -Patient treatment for which
compensation or reimbursement is payable under any law, medical program, or insurance policy provided by
any government, company or other insurer except to the extent that such charges are not reimbursed by such
law, medical program or insurance policy.

CONTRIBUTION

If an Insured Person carries other insurance covering any Disability insured by this Policy, We shall not be liable
for a greater proportion of such Disability than the amount applicable under this Policy bears to the total amount
of all valid insurance covering such Disability.

OVERSEAS TREATMENT

If the Insured Person elects to or is referred to be treated outside Malaysia by the attending Physician, benefits
in respect of the treatment shall be limited to the Reasonable and Customary and Medically Necessary Charges
for such equivalent local treatment in Malaysia and shall exclude the cost of transport to the place of treatment.
All documents in a language other than English and Bahasa Malaysia must be submitted together wi th certified
translations. The Consular or the translation agency shall certify the translation (English) to be a true and
correct version of the originals.

We reserve the right to determine whether the fee limit for any particular hospital/medical charge is a
Reasonable and Customary Charge with reference to Malaysian economic and market data. We reserve the
absolute right to determine the amount payable by making reference to the Company medical data.

RESIDENCE OVERSEAS

No benefit whatsoever shall be payable for any medical treatment received by the Insured Person outside
Malaysia apart from Singapore and Brunei, if the Insured Person resides or travels outside Malaysia for more
than ninety (90) consecutive days.

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EXCLUSIONS

This Policy does not cover any Hospitalization, Surgery or charges caused directly or indirectly, wholly or partly, by
any one (1) of the following occurrences:

1. Pre-Existing Illness:

Pre-Existing Illness shall mean Disabilities prior to the Issue Date or Commencement Date of the Policy,
whichever is later, and that the Insured Person/You has/have reasonable knowledge of. An Insured
Person/You may be considered to have reasonable knowledge of a Pre-Existing Illness where the
condition is one for which:

(a) the Insured Person had received or is receiving treatment;


(b) medical advice, diagnosis, care or treatment has been recommended;
(c) clear and distinct symptoms are or were evident; or
(d) its existence would have been apparent to a reasonable person in the circumstances.

2. Specified Illness:

Treatment or Surgery for Specified Illness until the Insured Person has been continuously covered under
this Policy for a period of one hundred and twenty (120) days immediately preceding such treatment or
Surgery.

Specified Illness shall mean the following Disabilities and its related complications:

(a) Hypertension, diabetes mellitus and Cardiovascular disease;


(b) All tumours, cysts, nodules, polyps, stones of the urinary system and biliary system;
(c) All ear, nose (including sinuses) and throat conditions;
(d) Hernias, haemorrhoids, fistulae, hydrocele, varicocele;
(e) Endometriosis including disease of the reproduction system;
(f) Vertebro-spinal disorders (including disc) and knee conditions.

3. Any medical or physical abnormalities existing at the time of birth, as well as neo-natal physical
abnormalities developing within six (6) months from the time of birth. They will include hernias of all types
and epilepsy except when caused by a trauma which occurred after the date that the Insured Person was
continuously covered under this Policy and any congenital or hereditary conditions which has manifested
or was diagnosed before the Insured Person attains seventeen (17) years of age;

4. Any Disability caused by self-destruction, intentional self-inflicted injuries, willful exposure to danger or
any attempt of self-destruction while sane or insane;

5. War, declared or undeclared, strikes, riots, civil war, revolution or any warlike operations;

6. Service in the armed forces in time of declared or undeclared war or while under orders for warlike
operations or restoration of public order;

7. Any violation or attempted violation of the law or resistance to arrest ;

8. Pregnancy, miscarriage or child birth;

9. Mental or nervous disorders, treatment of alcoholism, or drug abuse or any other complications arising
from it or any drug accident not prescribed by a treating Doctor;

10. Elective/Plastic/Cosmetic surgery, circumcision (except circumcision due to infection), eye


examination/elective surgery for visual impairments due to nearsightedness, farsightedness or
astigmatism or radial keratotomy; all corrective glasses, contact lenses and intraocular lens (except
monofocal intraocular lenses in cataract surgery ) or the use or acquisition of external prosthetic
appliances or devices such as artificial limbs, hearing aids, and prescriptions ;

11. Any form of dental care or Surgery unless necessitated by injury but excluding the replacement of
natural teeth, placement of denture and prosthetic services such as bridges and crowns or their
replacement;

5819576A02 - 13 - 06/13 (BPP) DA037


12. Hospitalization primarily for investigatory purposes, diagnosis, X-ray examination, general physical or
medical examinations, not incidental to treatment or diagnosis of a covered Disabili ty or any treatment
which is not Medically Necessary and any preventive treatments, preventive medicines or examinations
carried out by a Physician, vitamins/food supplements and treatments specifically for weight reduction
or gain;

13. Any treatment or investigation which is not Medically Necessary, or convalescence, custodial or rest
care;

14. Any medical or physical conditions arising within the first thirty (30) days of the Issue Date or
Commencement Date of this Policy whichever is later except for Covered Injury; or

15. Ionizing radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of
nuclear fission or from any nuclear weapon material.

ADDITIONS AND DELETIONS OF INSURED PERSONS

(a) New Dependent Children will automatically be insured under this Policy, provided that there is at least
one Dependent Child already insured and the total number of Dependent Children already insured is
below four (4) children. The Insured Person/You is/are required to give not ice and provide a copy of the
child's birth certificate to Us within ninety (90) days of such child having become a Dependent Child.
Failure to give such notice may result in the cancellation of insurance on that Dependent Child.

(b) In the event that no Dependent Child is insured under this Policy, a new Dependent Child may be
added subject to Our approval and to the payment of an additional premium.

(c) The maximum number of Dependent Children who can be insured under this Policy is limited to four (4)
children only.

(d) Provided that no Dependent Spouse is already insured under this Policy, a new Dependent Spouse
may be added as an Insured Person subject to Our approval and to the payment of an additional
premium.

(e) A Dependent shall cease to be an Insured Person on the Policy Anniversary immediately following the
date when he ceases to be a Dependent. If a Dependent Spouse or the only Dependent Child insured
ceased to be an Insured Person under this Policy, the premium will be adjusted accordingly.

(f) Additions and deletions of Insured Person shall be by endorsement and such endorsement will only be
valid if approved by our Registrar.

EXECUTED AND SIGNED BY US ON THE ISSUE DATE/COMMENCEMENT DATE OF THIS POLICY.

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GENERAL PROVISIONS

THE POLICY CONTRACT

This Policy is issued in consideration of the payment of premiums as specified in the Policy Information Page
and pursuant to:

(i) the answers given by You and/or the Insured in Your application/proposal form or any subsequent
questionnaires given by Us on any matters relating to Your proposal and any disclosures made by You
between the time of submission of the application/proposal and the time this contract is entered into;
and

(ii) Medical reports and any other reports and questionnaires;

(collectively referred to as ‘the material information’)

and such material information shall form part of this contract of insurance between Us and You. However, in the
event of any pre-contractual misrepresentation made in relation to such material information, only the remedies
in Schedule 9 of the Financial Services Act 2013 will apply.

If You are required by Us, before the Policy is renewed or varied, to answer any questions or if You are required
to confirm or amend any matter previously disclosed by You to Us in relation to this Policy, it is Your/ duty to
take reasonable care not to make a misrepresentation when answering the questions or confirming or
amending any matter previously disclosed.

You must inform Us of any change to the information given to Us in Your answers or in respect of any matter
previously disclosed to Us in relation to the Policy if such changes had taken place after You have submitted
the application for renewal/variation but before the Policy is renewed or varied.

Your Policy consists of the basic insurance plan (the "Basic Policy") and the Supplementary Contracts which
may be attached to it. The plan name of the Basic Policy and the product and/or code name and form number
of the Supplementary Contract, if attached to this Policy, are shown under the Schedule of Benefits and
Premiums of the Policy Information Page.

MISSTATEMENT OF AGE AND/OR GENDER

If the age and/or gender of the Insured Person has been misstated and the premium paid as a result of this
misstatement is insufficient, any claim payable subject to the maximum limits provided under this Policy shall be
prorated based on the ratio of the actual premium paid to the correct premium which should have been charged
for the Policy Year. Any excess premium, which may have been paid as a result of such misstatement of age
and/or gender, shall be refunded without interest.

If at the correct age the Insured Person would not have been eligible for cover under this Policy, no benefit shall
be payable.

GOVERNING LAW

This Policy shall be governed by the laws of Malaysia and the Courts of Malaysia shall have the exclusive
jurisdiction in respect of any claims arising out of or in relation to this Policy.

OWNERSHIP OF POLICY

Unless otherwise expressly provided for by endorsement in this Policy, We shall be entitled to treat You as the
absolute owner of this Policy. We shall not be bound to recognize any equitable or other claim to or interest in
this Policy and the receipt of this Policy or a Benefit by You (or by Your legal or authorized representative)
alone shall be an effective discharge of all Our obligations and liabilities. You shall be deemed to be the
responsible Principal or Agent of the Insured Person covered under this Policy.

5819576A02 - 15 - 06/15 (GP) DB059


UPGRADED BENEFITS

If the eligible benefits to any Insured Person under the terms of this Policy is increased while this Policy is in
force or at the time of renewal or replacement and if such Insured Person shall have been afflicted with a
Disability before or at the time the benefits were increased, the limits of benefits payable in respect of such
Disability shall not exceed the limit of benefits before the date the benefits were upgraded.

CONVERSION POLICIES

If the eligible benefits provided under this Policy shall have been converted from an existing coverage of an
‘Inner Limits’ to an ‘As Charged/Full Reimbursement’ coverage, and if such Insured Person shall have suffered
from a Disability before or at the time the Benefits were converted, the benefits payable in respect of the
Disability shall be according to the Schedule of Benefits before the date the eligible benefits were converted.

‘Inner Limits’ shall mean benefits that are of restrictive covered amount which can be found in benefit items like
Surgical Fees Benefits such as Surgeon’s Fee, Operating Theatre Fees Benefit and Hospital Supplies and
Services as applicable under this Policy.

As Charged/Full Reimbursement shall mean benefits where the claimable amount can be up to the actual
amount but not exceeding the limits provided under this Policy.

CONDITION PRECEDENT TO LIABILITY

The due observance and the fulfillment of the terms, provisions and conditions of this Policy by the Insured
Person/You in so far as they relate to anything to be done or complied with by t he Insured Person/You shall be
conditions precedent to any of Our liability.

NOTICE

Every notice or communication to Us shall be in writing and sent to Us. No alterations in the terms of this Policy
or any endorsement, will be held valid unless the same is signed or initialed by Our Registrar.

MISREPRESENTATION/ FRAUD

We may void this Policy and refuse all claims made in any of the following cases :

(a) If any claim made shall be fraudulent or exaggerated; or

(b) If any false declaration or statement shall be made in support of any claim, however, if the
misrepresentation was careless or innocent, We may at Our absolute discretion,

(i) void this Policy and refuse all claims, in which case We shall return the premiums paid without
interest. This payment shall be a complete and valid discharge of any liability under this Policy; or

(ii) take any necessary remedies in accordance with the Financial Services Act 2013.

LEGAL PROCEEDINGS

No action at law or in equity shall be brought to recover on this Policy before the expiration of sixty (60) days
after written proof of loss has been submitted according to the requirements of this Policy. If the Insured
Person/You shall fail to supply the required proof of loss as specified by the terms, provisions and conditions of
this Policy, the Insured Person/You may, within a period of one (1) calendar year from the time that the written
proof of loss to be submitted, submit the relevant proof of loss to Us with sound reason(s) for the failure to
comply with this Policy terms, provisions and conditions. The acceptance of such proof of loss shall be at Our
sole and entire discretion. After such period has expired, We will not accept, for any reason whatsoever, such
written proof of loss.

5819576A02 - 16 - 06/15 (GP) DB059


ARBITRATION

All differences arising out of this Policy shall be referred to an arbitrator who shall be appointed in writing by the
parties in difference. If they are unable to agree on who is to be the arbitrator within one (1) month of being
required in writing to do so then both parties shall be entitled to appoint an arbitrator each who shall proceed to
hear the differences together with an umpire to be appointed by both arbitrators. However this is provided that
any disclaimer of liability by Us for any claim under this Policy must be referred to an arbitrator within twelve
(12) calendar months from the date of such disclaimer.

CLAIMS PROCEDURES

(a) The Insured Person/You shall within thirty (30) days from the date of discharge or completion of an Out-
Patient treatment that incurs claimable expenses, give written notice to Us stating full particulars of such
event, including all original bills and receipts, and a full Physician's report stipulating the diagnosis of the
condition treated and the date the Disability commenced in the Physician's opinion and the Physician's
summary of the cost of treatment including medicines and services rendered. Failure to provide such
notice within the time allowed shall not invalidate any claim if it is shown not to have been reasonably
possible to provide such notice and that such notice was given as soon as was reasonably possible.

(b) The Insured Person/You shall immediately obtain and act on proper medical advice and We shall not be
held liable if a treatment or service becomes necessary due to failure of the Insured Person/You to do so.

INCOMPLETE CLAIM

Claims are not deemed complete and eligible benefits are not payable unless all bills for such claims have been
submitted and agreed upon by Us. Any variation or waiver of this requirement shall be at Our sole discretion.

OTHER CLAIMS CONSIDERATIONS

Claims Flow Over Policy Year

If a period of confinement, out-patient, pre- or post- hospitalization treatment or any other related hospitalization
expenses flow into the next Policy Year, the benefits to be reimbursed will be apportioned on the basis of the
actual itemized expenses incurred on a daily basis in the relevant Policy Year.

If there is no itemization of the expenses by daily breakdown, such expenses shall be apportioned as a
percentage of the actual days (including day of admission) of confinement for each respective Policy Year.

In no situations will the benefit limit exceed those as stipulated in the Schedule of Benefits of this Policy and
evidence of hospitalization is required for other than out-patient benefits and Day Procedure Benefits.

PROOF OF TREATMENT AND HOSPITALIZATION

Affirmative proof of Hospitalization, Surgery or treatment as an Out -Patient in such form as We may prescribe
must be furnished to Us at the expense of the Insured Person/Owner within thirty (30) days after the date of
leaving the Hospital/Clinic/Legally Registered Dialysis Centre/Legally Cancer Treatment Centre or receiving
treatment together with the Hospital/Clinic/Legally Registered Dialysis Centre’s/Legally Cancer Treatment
Centre’s original statement of accounts and receipts.

PERIOD OF COVER AND RENEWAL

This Policy will be renewable on each Policy Anniversary, by payment of the premium in advance at the
premium rate determined by Us at the time of renewal.

This Policy will be renewable at Your option subject to the terms, conditions and termination at each
anniversary of the Policy Anniversary.

The renewal premium payable is not guaranteed and We reserve the right to revise the premium rate applicable
by giving You three (3) months notice in writing by ordinary post to Your last known address in Our records. The
revised premium will be applicable from the next renewal of this Policy.

5819576A02 - 17 - 06/15 (GP) DB059


Such changes, if any shall be applicable to all Owners irrespective of their claim experience according to Our
risk assessment.

This Policy is renewable at Your option until the occurrence of any of the following:

(a) non payment of premium or premium not made on time;

(b) fraud or misrepresentation of material fact during application;

(c) this Policy is cancelled at Your request;

(d) the Insured Person ceases to qualify as a Dependent;

(e) the Insured Person attains the coverage age limit specified; or

PAYMENT OF BENEFITS

All benefits are payable to You. If You should die before the settlement of the claim, the benefits shall be paid
according to the Nominee clause under the Ownership Provisions of this Policy. The benefits provided under
this Policy are not assignable.

We reserve the absolute right to request for further evidence, medical report or conduct medical history check
before the benefits are payable to You.

SUBROGATION

If We shall become liable for any payment under this Policy, We shall be subrogated to the extent of such
payment to all rights and remedies of the Insured Person/You against any party and shall be entitled at Our own
expense to sue in the name of the Insured Person/You. The Insured Person/You shall give or cause to be given
to Us all such assistance in his/Your power as We shall require to secure the rights and remedies and at Our
request shall execute or cause to be executed all documents necessary to enable Us to effectively to bring suit
in the name of the Insured Person/You.

CURRENCY OF PAYMENT

All payments under this Policy shall be made in the legal currency of Malaysia. Should any payment be requested
by the Insured Person/You to be payable in any other currency, then such amount shall be payable in the demand
currency as may be purchased in Malaysia at the prevailing currency market rates on the date of the claim
settlement.

FREEDOM FROM RESTRICTIONS

Unless otherwise specified, this Policy is free from any restrictions upon the Insured Person as to travel,
residence or occupation.

5819576A02 - 18 - 06/15 (GP) DB059


ALTERATION

We reserve the right to amend the terms and provisions of this Policy by giving three (3) months prior notice in
writing by ordinary post to Your last known address in Our records, and such amendment will be applicable
from the next renewal of this Policy. No alteration to this Policy shall be valid unless authorized by Us and such
approval is endorsed on this Policy.

FREE LOOK PERIOD

You have the right to cancel this Policy by giving Us a written notice and returning this Policy to Us. The
premiums that You have paid less any expenses which may have been incurred for any medical examination
will be refunded to You. Such notice must be signed by You and received directly by Us within fifteen (15) days
after You have received the Policy.

SANCTION LIMITATION AND EXCLUSION CLAUSE

No insurer shall be deemed to provide cover and no insurer shall be liable to pay any claim or pay any benefit
hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit
would expose that insurer to any sanction, prohibition or restriction under United Nations resolutions or the
trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of
America, or any of its states, and/or any other applicable economic or trade sanction laws or regulations.

REGULATORY IMPOSED CHARGES, FEES ETC

The premium to be paid by the Owner to the Company under this Policy is exclusive of any Tax, and in the
event the Company is required by law to remit the Goods and Services Tax (GS T) on the premium paid by the
Owner, the Company will calculate and collect from the Owner any amount paid or payable under this Policy
on account of any Tax, such amount as calculated by the Company, shall be paid by the Owner as additional to
and without any deduction or set-off from the premium payable under this Policy to the Company. Tax is
defined as any present or future, direct or indirect, tax including goods and services tax, levy, impost, duty,
charge, fee, deduction or withholding of any nature, and any interest or penalties in respect thereof.

OTHER PROVISIONS

(i) Any illegality, invalidity or unenforceability of any clause of these General Provisions under the
Malaysian law shall not affect the legality, validity or enforceability of any other provisions in this Policy.

(ii) Our books and/or accounts shall be conclusive evidence of the state of accounts between the parties in
this Policy. Any certificate by any of Our officers as to the moneys or liabilities for the time being due
and remaining or incurred to Us by the Insured shall be binding and conclusive evidence on the Insured
Person in all courts of law and elsewhere.

(iii) If We delay or fail to exercise any rights/remedies under this Policy, it will not be deemed as a waiver.
Any single/partial exercise of any right/remedy shall not prevent Us from any other or further exercise of
any other right/remedy. The rights and remedies provided in this Policy are cumulative and not
exclusive of any other rights/remedies (whether provided by law or otherwise).

(iv) This Policy shall continue to be valid and binding for all purposes whatsoever despite any change by
amalgamation, change of name, reconstruction or otherwise which may be made in Our constitution.

(v) The terms and conditions stated in this Policy constitute the entire terms and conditions of this Policy.
No prior inconsistent representation or statement made in relation to this Policy whether orally or in
writing shall form part of this Policy.

(vi) We reserve the right to alter the terms of this Policy in such a way as We deem appropriate in the event
of any change in the law or in the basis of taxation levy applicable to Us or this Policy.

5819576A02 - 19 - 06/15 (GP) DB059


CANCELLATION

You may cancel this Policy at any time by giving a written notice to Us, and provided that no claims have been
made during the current Policy Year, You shall be entitled to a refund of the premium as follows:

Period From Policy Premium Payment Mode


Anniversary,
Annual Semi-annual Quarterly Monthly
Not Exceeding
15 days* 90% 80% 70% No Refund
1 month 80% 70% 50%
2 months 70% 50% 20%
3 months 60% 30% No Refund
4 months 50% 20% 50%
5 months 40% 10% 20%
6 months 30% No Refund No Refund
7 months 25% 70% 50%
8 months 20% 50% 20%
9 months 15% 30% No Refund
10 months 10% 20% 50%
11 months 5% 10% 20%
Period exceeding 11 No Refund No Refund No Refund
months
(Note: * not applicable to first Policy Year)

5819576A02 - 20 - 06/15 (GP) DB059


OWNERSHIP PROVISIONS

THE OWNER

You are the Owner of this Policy as shown on the Policy Information Page until changed. As the Owner, only
You can, during the Insured Person's lifetime, exercise all rights, privileges and options provided under this
Policy subject to the written consent of the trustee(s) and assignee's rights, if any. Upon Your death, such
rights, privileges and options shall vest in the Contingent Owner, if any.

THE NOMINEE

(a) The Owner/You who is also the Insured Person may nominate a natural person to receive the moneys
payable upon Your death. You may name the Nominee(s) at the time of Your application or at any time
after this Policy has been issued in Our prescribed form.

You shall have the right, subject to any legal constraints, to revoke any such nominations and/or to
name another Nominee(s) by written notification to Us. Your written notification must be received and
registered by Us during Your lifetime.

(b) If the Insured Person intends to revoke or change the current Nominee(s), the Insured Person firstly has
to be the Owner and a non-Muslim. The Insured Person may then by written notice to Us, by filing the
proper forms and upon obtaining the consent of the trustee(s) (if any) of the Policy moneys, proceed to
revoke the named Nominee(s) and appoint other Nominee(s). This procedure has to be complied if:

(i) the Nominee is the spouse or child of the Insured Person; or

(ii) the Nominee is the parent of the Insured Person and at the time of nomination, the Insured
Person had no living spouse or child.

If the Nominee is not (i) and (ii) above, the Insured Person may proceed to revoke and appoint a
Nominee(s) by written notice to Us, by filling up Our prescribed form. The Insured Person need not
obtain consent from any party.

The revocation and change of Nominee(s) shall take effect from the date of receipt of the written notic e
to Us.

(c) If You have nominated more than one Nominee, We shall pay the moneys payable in equal shares to
the persons nominated who is/are alive at time of the death of the Insured Person unless You have
specified otherwise. This is subject to the laws in force at the time.

Such payment is deemed to be good discharge of the moneys payable under this Policy.

(d) If on the death of the Insured Person, no effective nomination is in force, or the person(s) nominated are
dead, the moneys payable may be paid to Your legal personal representatives. This is subject to the
laws in force at the time.

(e) The interest of any Nominee shall be subject to the rights of any assignee under an absolute
assignment or encumbrance on or attached to this Policy.

CHANGE OF OWNERSHIP

While this Policy is in force, You may change ownership of this Policy and/or the Nominee by filing a written
notice. Such change is valid only if recorded by Us during the lifetime of the Insured Person and endorsed on
this Policy.

5819576A02 - 21 - 06/13 (OP) DC002


PREMIUM PROVISIONS

PAYMENT

All premiums for this Policy are payable on or before their due dates to Us either at Our issuing office or to Our
authorized agent or cashier. We will issue an official receipt for each payment received by Our Office. However,
if you pay Your premiums by credit/debit card or autodebit of Your bank account, We will not issue an official
receipt for the payment. The validated deposit slip or premium deduction shown in either the credit/debit card
statement or bank statement shall be considered as proof of payment.

CHANGE

You may change the frequency of premium payments by submitting a written request to Us. Subject to Our
minimum premium requirements, premiums may be paid on an annual, semi-annual, quarterly or monthly mode
at the premium rates applicable on the Issue Date.

DEFAULT
st
After payment of the first (1 ) premium, failure to pay a subsequent premium on or before its due date will
constitute a default in premium payment.

GRACE PERIOD

A Grace Period of thirty-one (31) days from the due date will be allowed for payment of each subsequent
premium. This Policy will remain in force during the period. If any claim arises during the Grace Period, any
unpaid balance of the premium due shall be deducted from the proceeds payable under this Policy. If any
premium remains unpaid at the end of its Grace Period, this Policy shall lapse.

REINSTATEMENT

If a premium is still in default after the stipulated Grace Period, this Policy may be reinstated by Us at Our own
discretion. This however has to be within two (2) years from the date of lapse and it is also subject to the
following:

(i) A written application is made by You to have this Policy reinstated;

(ii) The Insured Person is within the allowable age limits as determined by Us at the time of reinstatement;

(iii) The Insured Person has to produce evidence of insurability that is satisfactory to Us;

(iv) Payment of Pro-rated premium until the next Policy Year; and

(v) Any other terms and conditions which We may impose at the material time.

(vi) Any reinstatement shall only cover loss or the insured event which occurs after the reinstatement date.

5819576A02 - 22 - 06/13 (PP) DD005


REFERRAL EMERGENCY ASSISTANCE PROGRAMME

This Referral Emergency Assistance Programme is a value added service programme, in collaboration with our
service provider, to offer to the Insured Persons under the Supplementary Hospital and Surgical Benefit
Contract or Hospital and Surgical Benefit Policy.

AIA Bhd.
24 Hours Service Hotline: 03-2166 5421

The Insured Person may place a reverse charge call/call collect to Our 24 Hours Service Hotline at any time,
seven (7) days a week for any of the services described below:

1. International Medical Assistance Programme

Services described in this Clause are available to the Insured Person t raveling anywhere outside
Malaysia with each trip not exceeding ninety (90) consecutive days.

1.1 Tele-medical consultation and evaluation of the Insured Person’s condition

When medical advice is needed during travel outside Malaysia, Our service provider’s doctor
on duty will provide help over the phone.

Important:
The telephone conversation must be considered as advice only and is not a diagnosis.

1.2 Medical Referral and arrangement of medical appointments

Upon request, Our service provider shall provide the names, addresses and telephone
numbers of physicians (including both general practitioners and specialists), hospitals, dentists,
and dental clinics. Our service provider will attempt upon request to confirm the availability of
the applicable medical or dental professional to make an appointment for treatment.

1.3 Arrangement of hospital admission guarantee

If emergency admission is needed and the Insured Person has no means for the required
hospital admission deposit, Our service provider will provide admission guarantee on behalf of
the Insured Person, such service shall be subjected to Our service provider having first
securing payment guarantee through credit card or funds from the Insured Person’s family.

1.4 Dispatch of medication not available locally

Our service provider will dispatch the necessary medication not available locally in case of an
emergency and where local laws, rules and regulations allow such a dispatch. Cost of
medication shall be borne by the Insured Person and Our service provider shall pay for the cost
of such dispatching.

1.5 Emergency Medical Evacuation

Following a medical emergency and hospitalisation, when Our service provider’s doctor in
consultation with the attending medical practitioner determines that local medical facility is
inadequate to treat the Insured Person, Our service provider will arrange for medical
evacuation under constant medical supervision to the nearest adequate medical facility.

1.6 Medically Supervised Repatriation

If Our service provider’s doctor, in consultation with the local attending medical practitioner,
determines that treatment should continue at a medical facility nearer home following
stabilisation, Our service provider will arrange for the repatriation under constant medical
supervision.

5819576A02 - 23 - 06/13 (REA) FF001


All decisions as to the means of transportation and the final destination will be made by Our
service provider or its authorised representative, and will be based solely upon medical
necessity.

The Evacuation and Repatriation services described in 1.5 and 1.6 above shall be organised by
Our service provider and paid by Us. All costs incurred are subject to a limit of USD One Million
(USD 1,000,000.00) per Insured Person per event.

1.7 Medical Monitoring and Emergency Message Transmission

Our service provider will monitor the Insured Person’s condition if the Insured Person is
hospitalised and will keep the Insured Person’s employer/family informed, with prior agreement
of the Insured Person in writing, unless this is not practicable.

1.8 Repatriation of Mortal Remains

If an Insured Person dies while on the trip due to an illness or an accident, Our service provider
or its authorised representative will organise and pay for all expense incurred for the return of
the body or remains to the Insured Person’s country of origin. All costs incurred for such
repatriation is subject to a maximum limit of USD Seven Thousand Five Hundred (USD7,
500.00).

1.9. Visit to bedside by a friend/relative

Should the Insured Person’s hospitalisation outside Malaysia be expected to last more than
seven (7) consecutive days, and Our service provider’s duty doctor agrees that it is medically
necessary for a relative/friend to be by the Insured Person’s bedside provided no travel
companion is with the Insured Person, Our service provider will arrange and We shall pay for
one (1) economy class return transportation and hotel room accommodation for a relative/friend
to visit the Insured Person. The cost of hotel room accommodation is subject to a limit of USD
Two Hundred and Fifty (USD250.00) per night up to a maximum of USD One Thousand
(USD1, 000.00).

1.10 Return of children traveling with the Insured Person

In the event that the Insured Person is hospitalised and the Insured Person’s medical conditi on
prevents the Insured Person from caring for the Insured Person’s minor children (below age of
eighteen (18) years) traveling with the Insured Person and no relative on the spot is able to
care for them, Our service provider will arrange for one-way economy class transportation for
the children to be sent back to their home country. We shall pay for the cost incurred for the
one-way economy class ticket for all minor children then traveling with the Insured Person.

2. Domestic Medical Assistance Programme

The services described in this Clause are available to the Insured Persons traveling anywhere within
Malaysia.

2.1 Tele-medical consultation and evaluation of the Insured Person’s condition

When medical advice is needed during traveling within Malays ia, Our service provider’s doctor
on duty will provide help over the phone.

Important:
The telephone conversation must be considered to be an advice only and does not amount to a
diagnosis.

2.2 Medical Referral and arrangement of medical appointments

Upon request, Our service provider shall provide the names, addresses and telephone
numbers of physicians (including both general practitioners and specialists), hospitals, dentists,
and dental clinics. Our service provider will attempt upon request to confirm the availability of
the applicable medical or dental professional to make an appointment for treatment.

5819576A02 - 24 - 06/13 (REA) FF001


2.3 Arrangement of hospital admission guarantee

If the Insured Person requires emergency hospitalisation, Our service provider will assist in the
arrangement of the hospital admission guarantee up to RM Two Thousand (RM 2,000.00) to
facilitate the emergency admission. All hospital charges incurred shall be borne by the Insured
Person and the Insured Person is required to ensure that such hospital bills are settled upon
discharge. This guarantee is not a form of settlement of hospital bills but to facilitate emergency
admission. This service shall not be available for an Insured Person who is already admitted to
the hospital. Such service is subject to Our service provider having first received the letter of
indemnity to be signed by the Insured Person or the Insured Person’s next of kin.

2.4 Dispatch of medication not available locally

Our service provider will dispatch the necessary medication not available locally in case of
emergency and when local law, rules and regulations allow such a dispatch. Cost of medication
shall be borne by the Insured Person and We shall pay for the cost of such dispatching.

2.5 Emergency Medical Evacuation

Following a medical emergency, when an Insured Person is hospitalised and local medical
facility is inadequate, Our service provider will arrange for medical evacuation under constant
medical supervision to the nearest adequate medical facility.

2.6 Medically Supervised Repatriation

If Our service provider’s doctor, in consultation with the local attending physician, determines
that treatment should continue at a medical facility nearer home following stabilisation, Our
service provider will arrange for the repatriation under constant medical supervision.

All decisions as to the means of transportation and the final destination will be made by Our
service provider or its authorised representative, and will be based solely upon medical
necessity.

The Evacuation and Repatriation services described in 2.5 and 2.6 above shall be organised by
Our service provider and paid by Us. All costs incurred are subject to a limit of USD One Million
(USD1,000,000.00) per Insured Person per event.

3. Travel Assistance

3.1 Visa, Passport and Inoculation Requirements

Our service provider will provide information concerning Visa, inoculation, passport or
immunization requirements of the foreign countries in which the Insured Person will be
traveling.

3.2 Location of Lost Items

Our service provider will assist the Insured Person in the location of lost luggage, documents
and personal items. Airlines, government authorities and credit card issuers are among those
who will be contacted, if necessary.

3.3 Emergency Message Relay

In case of an emergency, Our service provider will attempt to establish a national or


international message relay to a designated addressee.

3.4 Arrangement of flights

Our service provider will assist with the arrangement of flights for family return if traveling with
the Insured Person.

5819576A02 - 25 - 06/13 (REA) FF001


3.5 Legal referral

Should the Insured Person seek legal assistance for an emergency while on a trip, Our service
provider will refer the Insured Person to local legal advisors.

3.6 Referral to interpreter/translator

Should the Insured Person need translation assistance for an emergency in the course of the
Insured Person’s trip, Our service provider will refer the Insured Person to a local translator.

3.7 Weather and Foreign Exchange Information

Our service provider shall provide information on foreign weather condition as well as foreign
exchange rates when required.

4. Car Assistance

4.1 Twenty four (24) hours Emergency Towing and Minor Roadside Repair

Our service provider shall assist in the event that a Insured Person’s car is immobilised due to
accident or breakdown when required.

If it is considered possible to repair the Insured Person’s car on the spot, Our service provider
shall arrange for such minor roadside repair. If it is not possible to repair the car on the site, Our
service provider shall arrange for the car to be towed to the nearest workshop for repairs. Any
cost incurred for the towing and minor roadside repair shall be borne by the Insured Person.

Territorial Limits
The emergency towing and minor roadside repair referred to in this Clause shall be available
where such services are required within Peninsular Malaysia and Singapore excluding the
islands (except for Penang and Langkawi). In East Malaysia, services shall only be available in
Kota Kinabalu, Sandakan, Tawau, Labuan, Sibu, Bintulu, Miri and Kuching.

4.2 Car Rental Assistance

Should the Insured Person require a car replacement in the event of a car breakdown, Our
service provider shall refer to designated third party service providers and assist the Insured
Person in arranging for car rental. Cost of car rental shall be borne by the Insured Person.

4.3 Arrangement for Hotel Accommodation

If an Insured Person needs hotel accommodation as a result of a car breakdown, Our service
provider shall refer the Insured Person to hotels designated by Our service provider in order to
make reservation and arrangement for hotel accommodation. All costs incurred for such hotel
accommodation and additional charges shall be solely borne by the Insured Person.

4.4 Referral to Service Centre

Our service provider will arrange for referral to the nearest repair and service centre for car
servicing or repair when required. Our service provider shall also arrange for prior appointment
for the Insured Person. All costs incurred in such car repair or servicing shall be borne by the
Insured Person.

5. Home Assistance

The following Home Assistance Services shall only be available to the Insured Person residing in major
towns of Peninsular Malaysia.

5819576A02 - 26 - 06/13 (REA) FF001


5.1 Plumbing Assistance

If the Insured Person requires plumbing services at home, Our service provider shall provide
referral information to plumbers. Our service provider will also assist in arranging for house call
if necessary.

5.2 Locksmith Assistance

Our service provider will arrange for referral or house call service in the event that the Insured
Person requires the service of a locksmith.

5.3 General Repair Assistance

Our service provider will also provide information for general repair services such as repairs of
home electrical appliances.

5.4 Air conditioning Assistance

If the Insured Person requires repair to air conditioners, Our service provider shall refer the
Insured Person to persons who can provide such services and would also arrange for house
call if necessary.

5.5 Pest Control Assistance

Our service provider shall assist the Insured Person by referring the Insured Person to pest
control, pest prevention, soil treatment, anti termite and mosquito c ontrol services. Our service
provider will also arrange for house call if necessary.

The services described in the Travel, Car and Home Assistance above shall be purely on
referral and arrangement basis. Our service provider or Us shall not be responsible for any third
party cost incurred, such cost shall be borne directly by the Insured Person.

DEFINITIONS

(a) Medical Emergency

A situation which in the opinion of Our service provider’s doctor constitutes a serious medical
emergency requiring urgent remedial treatment to avoid death or serious impairment to the Insured
Person’s immediate or long term health prospects. The severity of the medical condition will be judged
within the context of the Insured Person’s geographical location, the nature of the medical emergency
and the local availability of appropriate medical care or facilities.

(b) Minor Roadside Repair

Minor repairs are such that are considered possible to be repaired on the spot including but not limited
to change of tyres, minor wiring work and change of battery. The minor roadside repairs are also
subject to the availability of parts and component at the time of the breakdown.

EXCLUSIONS

The International and Domestic Medical Assistance Programme described above will not be provided on the
following occurrences:

(a) Emergency medical evacuation, repatriation or costs not approved in advance and in writing by Our
service provider and/or not arranged by Our service provider. This exclusion shall not apply to
Emergency Medical Evacuation from remote or primitive areas which Our service provider cannot be
contacted in advance and delay might reasonably be expected to result in loss of life or extreme
prejudice to the well-being of the Insured Person; or

5819576A02 - 27 - 06/13 (REA) FF001


(b) If the Insured Person is traveling despite the advice of a medical practitioner or for rest and recuperation
following any prior accident or illness; or

(c) If in the opinion of Our service provider, the Insured Person is not suffering from a serious medical
condition or if the treatment can be reasonably delayed until the Insured Person returns to Malaysia or
usual country of residence; or

(d) If the Insured Person is participating or engaging in war (declared or undeclared), strikes, riots, civil war,
revolution, any warlike operations; or

(e) If the Insured Person is servicing in the armed forces in time of declared or undeclared war or while
under orders for warlike operations or restoration of public order; or

(f) If the Insured Person is suffering from any condition result ing from ionising radiation or contamination
by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any
nuclear weapons material; or

(g) Failure by the Insured Person to take reasonable precautions following warnings of any intended strike,
riot or civil commotion via the mass media; or

(h) Willful exposure to danger or attempted self-destruction or self-inflicted injuries while sane or insane; or

(i) Any expenses arising from childbirth, miscarriage or pregnanc y; or

(j) Any injuries arising from racing of any kind (other than racing on foot), sports exhibitions, bungee
jumping, mountaineering or rock climbing necessitating the use of guides or ropes, scuba diving,
aeronautics or aviation activities other than as a fare paying passenger or crew member on a
commercial passenger airline on a regular scheduled passenger trip over its established passenger
route, and professional sports; or

(k) Any health condition which constitutes one of the reasons to undertake the trip.

RESERVATION

(a) Our service provider and Us shall not be held responsible for the failure or delay to provide the services
caused by strikes or conditions beyond their/Our control including, but not limited to, flight conditions or
where local laws of regulatory agencies prohibit Our service provider from rendering such services.

(b) The legal professionals, medical professionals, car assistance and/or home assistance providers
referred by Our service provider to provide direct services to the Insured Person are not employees or
agents of Our service provider and/or its subsidiaries or affiliated companies. Our service provider
and/or its subsidiaries or affiliated companies and Us cannot be held responsible for the quality or
results of any services provided by independent practitioners to whom Our service provider refers to the
Insured Person.

(c) This programme shall cease when the Supplementary Hospital and Surgical Benefit Contract or the
Hospital and Surgical Benefit Policy is terminated.

(d) We shall be entitled to vary any of the provisions contained in this Policy from time to time and at Our
absolute discretion, without prior notice to the Insured Person.

(e) We reserve the right to withdraw or revise this programme at any time by giving three (3) months notice
in writing to You.

5819576A02 - 28 - 06/13 (REA) FF001


POLICY INFORMATION STATEMENT

Your life insurance Policy is a valuable piece of property and serves as a useful aid to assist Your family against
potential uncertainties of the future.

You may not have time to familiarize Yourself with all the Policy provisions, but it is important that You know the
unique benefits of this AIA Policy. This Policy Information Statement is specially prepared in plain language to
give You a better understanding of some of these benefits.

1. (a) Your premium payments may be made annually, semi-annually, quarterly or monthly, whichever
suits You best.

(b) You may pay the premiums in any of the following ways at Our discretion:

(i) Autodebit from a Visa/MasterCard card (applicable for regular premium plan only);

(ii) Autodebit through banks as specified by Us;

(iii) Payment at any bank authorized by Us;

(iv) Direct to Us.

If You pay Your premium by Visa/MasterCard card or autodebit, We will not send You any prior
notice that Your premium is due. No official receipt will be issued if payment is made by way of (i),
(ii) or (iii) above. The validated deposit slip or premium deduction shown in either the
Visa/MasterCard card statement or bank statement shall be considered as proof of payment.

2. If Your age has not been admitted, You are required to submit a copy of any of the following documents for
proof of age:

(a) Identity Card

(b) Birth Certificate

(c) Passport

3. You may nominate a person to receive the Policy moneys by giving a written notice to Us or stating it in the
application form.

4. It is important that You advise Us of any change in Your or Your nominee's address.

5. You may return Your Policy together with a written notice to Us within fifteen (15) days after receiving Your
Policy. We shall immediately refund any premium You have paid in respect of Your Policy, without interest,
and Your Policy shall be cancelled subject to the deduction of expenses incurred for Your medical
examination.

6. In case of any dispute arising from this Policy, You may write to:

AIA Bhd.
Customer Relations Unit
Menara AIA
99 Jalan Ampang
50450 Kuala Lumpur
P.O. Box 10140
50704 Kuala Lumpur
Care Line: 1 300 88 1899
Tel: 03-2056 1111
Fax: 03-2056 2291

5819576A02 - 29 - 10/16 LA003


If there are disputes on Our final decision relating to this Policy involving the amounts below RM250,000
and subject to the Ombudsman for Financial Services’ (OFS) jurisdiction which is available at
www.ofs.org.my, You may refer the dispute to OFS at the address stated below to resolve the dispute
within six (6) months from the date of Our final decision:

Chief Executive Officer


Ombudsman for Financial Services
(Formerly known as Financial Mediation Bureau)
Level 14, Main Block, Menara Takaful Malaysia
No. 4, Jalan Sultan Sulaiman, 50000 Kuala Lumpur
Tel: 03-2272 2811
Fax: 03-2272 1577
E-mail: enquiry@ofs.org.my

If the dispute exceeds RM250,000 or if it does not come within OFS’s jurisdiction, You may refer to Bank
Negara Malaysia for further enquiries at the following address:

Pengarah
Jabatan LINK & Pejabat Wilayah
Bank Negara Malaysia
P.O Box 10922
50929 Kuala Lumpur
Tel: 1-300-88-5465
Fax: 03-2174 1515
E-mail: bnmtelelink@bnm.gov.my

7. If You have any enquiries pertaining to Your Policy, You may contact Your AIA agent or any of the AIA
branches listed in AIA.COM.MY.

Note:
The above explanation is intended as an aid to Your understanding of the Policy terms and is not to be taken or
interpreted as an alteration or amendment of the Policy provisions.

5819576A02 - 30 - 10/16 LA003

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