PACIFIC & ORIENT INSURANCE CO BERHAD (No.

12557W)
SST Registration No./ No.CP W10-1808-31021805

MEDEFEND INDEMNITY INSURANCE

Policy Schedule
Certificate Number: MEDEFEND/2024/32814/03536

SCHEDULE ATTACHING TO AND INCORPORATING THE MEDEFEND POLICY WORDING REFERENCE

259723U7000054
1. Named Insured MINI MOLE THOMAS
2. Named Insured’s Principal Address NO.2A, PERSIARAN ZARIB 11 B
TAMAN PINJI MEWAH
IPOH PERAK MALAYSIA 31500
3. Specialisation Part-Time/Semi Retired General Practitioner-
4. Policy Period (a) Commencement Date 01/01/2024
(b) Expiry Date 31/12/2024
Both 12:01 am at the address of the Named Insured
5. Each Claim Limit
RM 500,000.00 each Claim

6. Extension Sub-Limits
7. Policy Aggregate Limit
Automatic Reinstatement
8. Extended Notification
Period
9. Retroactive Date
10. Insurer
11. Premium (inclusive of SST)
12. Notices to Insurer
13. Jurisdiction
(a) RM 250,000 each Medical Data Protection Claim and in the aggregate
(b) RM 50,000 Public Relations and Counselling Costs in respect of each Claim and in the
aggregate
RM 500,000.00
NO
NO
Unlimited
Any date prior to the Policy Period (except as provided for in definition of Retroactive Date in
the Certificate of Insurance attached)
Pacific & Orient Insurance Co. Berhad
Premium RM 471.70
10% Reinstatement RM 0.00
Extended Notification Period RM 0.00
6% Service Tax (SST) RM 28.30
Total RM 500.00
Claim-Related Notices: All Other Notices:
Marsh Insurance Brokers (Malaysia) Sdn Bhd Pacific & Orient Insurance Co. Berhad
(Company No 198201008640) 11th Floor, Wisma Bumi Raya, No, 10,
Level 42-01A (West Wing) Q Sentral, Jalan Raja Laut, P.O. Box 10953,
No. 2A, Jalan Stesen Sentral 2, 50730 Kuala Lumpur
Kuala Lumpur Sentral,
50470 Kuala Lumpur, Malaysia
Malaysia for Medical Professional Claim, Medical Data Protection Claim, Investigation Claim
and Indemnity Claim. Worldwide for Good Samaritans Act and Training excluding Iran and
any countries sanctioned by the United Nations, European Union, United Kingdom, Canada,
Australia, Japan and United States of America.

14. Territory Worldwide excluding Iran and any countries sanctioned by the United Nations, European
Union, United Kingdom, Canada, Australia, Japan and United States of America

This Policy is only valid if this Schedule is signed and dated below by an authorized representative of Pacific & Orient Insurance Co. Berhad

Issued: 20/09/2023
Signed For: Pacific & Orient Insurance Co Berhad
Registration No. 197201000959 (12557-W)
Authorised Signatory: