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More Information for Malaysia Medical and Health Insurance

Malaysia Meidcal and Health Insurance, Malaysia Medical Card, Malaysia Travel Healthcare Insurance, Malaysia Accidental Insurance, Malaysia Dread Disease Insurance and Malaysia Group Hispitalization and Accident Insurance Frequently Asked Questions
 
 
Malaysia Medical Insurance Organisation (MMI)   
Your Trusted and Experience Malaysia Largest Medical Insurance Risk Management Advisory Provider.    
MMI careline : +603-92863323
mmicare@medicalinsurance.com.my 
 
Frequently Asked Questions

Malaysia Medical and Health Insurance is all about information. We believe that no one should make a decision about something as important as their health without a proper understanding of their options and a clear view of their own personal situation and health needs. This is why we have put together a list of some of the most frequently asked questions about insurance coverage in Malaysia. Read on to see what others are asking, and maybe even find a question you didn't even know you should be asking.

 
 

Malaysia Life and Disability Insurance
Malaysia Insurance Act 1996
Malaysia Medical and Health Insurance
Medical Card Services (Cashless Admission) FAQ


Malaysia Life and Disability Insurance

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Q : How do I make a nomination for my insurance policy in Malaysia?
A : For Malaysia Life Insurance and Accidental insurance policy
If you are 18 years old and above, you can nominate an individual or individuals to receive the policy moneys in the event of your demise. Nomination can usually be done at the time of application of the life insurance policy or any other time, when necessary.

You can nominate more than one nominee, and state the proportion to which each nominee would be entitled. For example:
Name
NRIC
Share
Tan Mei Ling
601212-21-1010
50%
Lim Jet Li
850619-22-5000
20%
Lim King Sing
430915-23-6050
30%
If you do not specify the portions to be paid to each person, the policy moneys will be distributed to the nominees in equal share.

Who can I nominate?
You are free to nominate whoever you want. However, not all nominees will receive the policy moneys beneficially or for their own use.

In the case of a non-Muslim policy owner, depending on the relationship between the policy owner and the nominee, a nominee can receive his or her share of the policy moneys either beneficially or as a trustee or an executor.

Where the nominee is the spouse or child, a trust will be created in favour of the nominee who will receive the policy moneys beneficially.

If there is no living spouse or child at the time of nomination and you nominate your parent, then a trust will be created in favour of your parent and he or she will receive the policy moneys beneficially. In such a case, the policy is called a trust policy.

[ Note: When a trust policy has been created, you cannot revoke a nomination under the policy, vary or surrender the policy, or assign or pledge the policy as security, without the written consent of the trustee].

However, where there is a living spouse or child at the time of nomination and you nominate your spouse and parent or you nominate your child and parent, a trust will only be created in favour of your spouse or child but not your parent in both these instances.

Similarly, where there is a living spouse or child at the time of nomination and only your parent is nominated, a trust will not be created in favour of your parent.

Where the nominee is not the policy owner’s spouse or child or parent (if there is no living spouse or child at the time of nomination), the nominee will receive the policy moneys only as an executor and shall distribute it according to the will, or if there is no will, the applicable laws of distribution. In such a case, the policy is called a non-trust policy.

The policy moneys form part of the deceased’s estate and are subjected to his debts.
For example, if you nominate your brother, he will receive the policy moneys as an executor.

The policy moneys will then form part of your estate and your brother would be bound to distribute the policy moneys accordingly, including to your creditors, if any.

If there is a surviving spouse, child, or parent, and there is no will, then according to the Distribution Act 1958, the brother will not inherit any part of the estate.

Note: As previously mentioned, in the case of a Muslim policy owner, the nominee, irrespective of relationship, can only receive the policy moneys as an executor, and the policy moneys must be distributed according to Islamic laws].

The role of trustees
Trustee(s) can also be appointed to receive the policy moneys in a trust policy. Upon the demise of the policy owner, the trustee’s duties would be to receive the policy moneys and distribute them to the nominees accordingly. The trustees must act in the best interest of the nominees at all times.

The appointment of trustee(s) is especially important for children below 18 years of age because, legally, minors are considered incompetent to enter into a contract and therefore not able to receive the policy moneys directly. Where no trustee is appointed and a child is the nominee of the policy, the surviving parent is the trustee.

Where there is no surviving parent, the Public Trustee shall be the trustee. Upon receiving the policy moneys from the insurance company by the trustee, the insurance company shall be discharged of all liabilities in respect of the policy moneys paid to the trustee(s).

In the case where a nominee is 18 years old and above, and no trustee has been appointed, the nominee shall act as the trustee of the policy moneys.

Changing the nomination
You can make changes to a nomination by writing to your life insurance company.

The latest nomination will supersede all previous nominations. A nomination will also be considered revoked upon the demise of a nominee, or all nominees (if there is more than one nominee), during the lifetime of the policy owner.

However, in the case of a trust policy, a nomination cannot be revoked without the written consent of the trustee.

What happens when there is no nomination?
Where no nomination has been made, the insurance company shall pay the policy moneys to the applicant who produces the Grant of Probate or Letters of Administration or Distribution Order.

However, the insurance company may, at its discretion, make payment to a claimant without requiring the Grant of Probate or Letters of Administration or Distribution Order, under the following circumstances:

if the claimants are the policy owner’s spouse, child or parent, the insurance company may pay to the policy owner’s spouse, child or parent in that order of priority. If there is more than one person in any of the above-mentioned categories, then all individuals in that category will be paid in equal shares.

if there is no spouse, child or parent and the policy moneys payable do not exceed RM 100,000:
the insurance company, may pay the policy moneys to whom it is satisfied is entitled and likely to be given the Grant of Probate or Letters of Administration or Distribution Order, or to a person who the insurance company is satisfied is beneficially entitled to the estate of the deceased policy owner.

if there is no spouse, child or parent and the policy moneys payable exceed RM100,000:
the insurance company may pay the first RM100,000 to a person as specified in the immediate paragraph above.

The balance of the policy moneys shall be paid to the same person upon production of the Grant of Probate or Letters of Administration or Distribution Order.

However, upon 12 months after the first payment of RM100,000 and no claim has been made on the balance of the policy moneys by any person who holds a Grant of Probate or Letters of Administration or Distribution Order, the insurance company shall pay the balance to the person who has received the first payment.

When no nomination has been made, the person who received the policy moneys is only receiving it as an executor and must distribute it in accordance to the will of the deceased, or if there is no will, the applicable laws of distribution.
Understanding the important terms used

• Beneficiary - a person who is entitled to receive for his own benefit (beneficially) the policy moneys under an insurance policy, and not merely as an executor or trustee holding the policy moneys for others.

• Distribution Order - an order made by the court for the division of the estate of a deceased, who did not leave any will, according to the law.

• Executor - a person who has been appointed in a will to administer a deceased’s estate, in accordance with the deceased’s will, and issued a grant of probate by the court to do so.

For purposes of the Insurance Act 1996, a reference to an “executor” is a reference to a nominee of a non-trust policy who receives policy moneys not as a beneficiary but as someone who must pass the policy moneys to the deceased policy owner’s estate for distribution.

• Grant of Probate - a formal document issued by the court authorising the executor named by a deceased person in his will to administer his estate in accordance to the deceased’s will.

• Letters of Administration - a formal document issued by the court to a person to administer the estate of a deceased who did not make a will.

• Nominee - a person who is named (nominated) in an insurance policy by the policy owner to either receive and/or administer the policy moneys upon the demise of the policy owner.

• Non-Trust Policy - an insurance policy whereby the policy moneys form part of the estate of the deceased policy owner and are subjected to his debts.

• Policy Moneys - total sum of moneys, including any benefit whether of monetary value or not, that is payable under an insurance policy.

• Public Trustee - a statutory body set up to help manage estates of deceased persons, when required. In Malaysia, Amanah Raya Berhad is the public trustee. Amanah Raya Berhad acts as a custodian trustee and may be appointed as trustee of any will or settlement or trust, or perform any trust or duty of certain classes.

It may also be grantedprobates of wills or letters of administration by a court. Upon application by a beneficiary, Amanah Raya Berhad can also be appointed by a court to replace all or any existing executors, administrators or trustees.

• Trust Policy - an insurance policy in which the nominee is the policy owner’s spouse or child, or where there is no living spouse or child at the time of nomination, his parent. Under such a policy, the policy moneys do not form part of the estate of the deceased policy owner and is not subjected to his debts.

• Trustee - a person who is given the legal title to the property which he holds not for his own benefit but on trust for the benefit or interest of another or others.
 
Q : What happens when there is no nomination on your insurance policy?
A : Where no nomination has been made, the insurance company shall pay the policy moneys to the applicant who produces the Grant of Probate or Letters of Administration or Distribution Order.

However, the insurance company may, at its discretion, make payment to a claimant without requiring the Grant of Probate or Letters of Administration or Distribution Order, under the following circumstances:

if the claimants are the policy owner’s spouse, child or parent, the insurance company may pay to the policy owner’s spouse, child or parent in that order of priority.

If there is more than one person in any of the above-mentioned categories, then all individuals in that category will be paid in equal shares.

if there is no spouse, child or parent and the policy moneys payable do not exceed RM 100,000:
the insurance company, may pay the policy moneys to whom it is satisfied is entitled and likely to be given the Grant of Probate or Letters of Administration or Distribution Order, or to a person who the insurance company is satisfied is beneficially entitled to the estate of the deceased policy owner.

if there is no spouse, child or parent and the policy moneys payable exceed RM100,000:
the insurance company may pay the first RM100,000 to a person as specified in the immediate paragraph above.

The balance of the policy moneys shall be paid to the same person upon production of the Grant of Probate or Letters of Administration or Distribution Order.

However, upon 12 months after the first payment of RM100,000 and no claim has been made on the balance of the policy moneys by any person who holds a Grant of Probate or Letters of Administration or Distribution Order, the insurance company shall pay the balance to the person who has received the first payment.

When no nomination has been made, the person who received the policy moneys is only receiving it as an executor and must distribute it in accordance to the will of the deceased, or if there is no will, the applicable laws of distribution.

Understanding the important terms used

• Beneficiary - a person who is entitled to receive for his own benefit (beneficially) the policy moneys under an insurance policy, and not merely as an executor or trustee holding the policy moneys for others.

• Distribution Order - an order made by the court for the division of the estate of a deceased, who did not leave any will, according to the law.

• Executor - a person who has been appointed in a will to administer a deceased’s estate, in accordance with the deceased’s will, and issued a grant of probate by the court to do so. For purposes of the Insurance Act 1996, a reference to an “executor” is a reference to a nominee of a non-trust policy who receives policy moneys not as a beneficiary but as someone who must pass the policy moneys to the deceased policy owner’s estate for distribution.

• Grant of Probate - a formal document issued by the court authorising the executor named by a deceased person in his will to administer his estate in accordance to the deceased’s will.

• Letters of Administration - a formal document issued by the court to a person to administer the estate of a deceased who did not make a will.

• Nominee - a person who is named (nominated) in an insurance policy by the policy owner to either receive and/or administer the policy moneys upon the demise of the policy owner.

• Non-Trust Policy - an insurance policy whereby the policy moneys form part of the estate of the deceased policy owner and are subjected to his debts.

• Policy Moneys - total sum of moneys, including any benefit whether of monetary value or not, that is payable under an insurance policy.

• Public Trustee - a statutory body set up to help manage estates of deceased persons, when required. In Malaysia, Amanah Raya Berhad is the public trustee.

Amanah Raya Berhad acts as a custodian trustee and may be appointed as trustee of any will or settlement or trust, or perform any trust or duty of certain classes.

It may also be granted probates of wills or letters of administration by a court. Upon application by a beneficiary, Amanah Raya Berhad can also be appointed by a court to replace all or any existing executors, administrators or trustees.

• Trust Policy - an insurance policy in which the nominee is the policy owner’s spouse or child, or where there is no living spouse or child at the time of nomination, his parent. Under such a policy, the policy moneys do not form part of the estate of the deceased policy owner and is not subjected to his debts.

• Trustee - a person who is given the legal title to the property which he holds not for his own benefit but on trust for the benefit or interest of another or others.
 

Malaysia Insurance Act 1996

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Q : Insurance Policy Nomination – S167
A : Q -“I have nominated my brother as the beneficiary for one of my insurance policies. When I am not around on this earth, can my wife and children challenge the nomination in court?”

A- First of all, I assume the nomination was made in accordance to S167 Insurance Act 1996.

As a non-Muslim, you have your liberty and discretion to name your beneficiaries. If you are a Muslim, then the nomination and distribution have to be made according to the Islamic laws.

The nomination made under S167, is only subjected to the challenge made by the debtors. The beneficiary shall receive the distribution net from debts.

Our Court of Appeal, in their latest decision in Lee Heng Moy vs John Hancock Life Insurance (Malaysia) & Anor [2010] 6 CLJ, has reaffirmed the above principle.

In this case, the deceased nominated his ‘mistress’ as the beneficiary and this was challenged by his lawfully married wife.

The High Court and Court of Appeal both held the mistress is entitled to the distribution of the insurance policy, and dismissed the claim made by the wife.

We believe the Court will uphold the wishes of policyholder in nominating of the beneficiaries at all time.
 
Q : Insurance Policy Nomination – S166 Versus S167
A : Q - “What is the difference between the nomination made under S166 and S167 for the insurance policies?”

A - We believe you are making reference to S166 and S167 Insurance Act 1996.

In short, the beneficiaries nominated under S166, will receive the distribution free from encumbrances from everyone, especially the debtors.

However, the beneficiaries nominated under S167, the distribution of the insurance policy needs to pay off the debts incurred by the policyholder.

The beneficiaries only entitle the surplus of the distribution.

In layman term, this is not a creditor-proof-nomination.

There are some restrictions for the nominations made under S166,
• If the policyholder is single, then only his / her parents can be nominated as beneficiaries
• If the policyholder is married, then only his / her spouse and children can be nominated as beneficiaries

Other than this, the nomination has to be made under S167, which the creditors will have priority over the distribution of insurance policy.
 
Q : Insurance Policy Nomination – Minor As Beneficiary
A : Q - "Can I nominate my child (at the age of 8) as the beneficiary of my insurance policy?”

Y - Yes, you can.

Since you are nominating your child as the beneficiary, then S166 Insurance Act 1996 is applicable here.

Upon your departure from this earth, if your child remains as a minor (i.e. below age of 18), his / her surviving parent would be the trustee of the distribution, according S166(3)(b) of the Act.

If he / she has no surviving parent, then the Court may appoint a Public Trustee for your child.

The Insurance Act 1996 has a broad definition for the word ‘child’. Among others, it includes illegitimate child, step-child, and adopted child.

As such, the insurance policy can be an effective financial planning tool, for a parent to make financial provision to his / her child born out of wedlock.

Especially when the parent has no intention to name the child in the Will for family reason.
 
Q : Insurance Nomination And Marriage
A : Q -“I am married. I bought few insurance policies and I made the nomination for the beneficiaries before I am married. So, did my nominations been revoked by my marriage?”

A - Nope. The nominations will remain valid unless and until these are revoked.

S 164(1) Insurance 1996 clearly states, a nomination of the beneficiaries of the insurance policy, would be revoked
•upon the death of the beneficiary; or
•by a written notice by the policy owner; or
•by a subsequent nomination by the policy owner.

Further, S 164(2) of the same Act expressly rules out the possibility that the nomination of the beneficiaries can be revoked by a Will, or by any other act, event or means. I believe, marriage is one of the events indicated in this sub-section.

Therefore, if maintaining the same beneficiaries is the intention of the policy holder, no changes have to be made.

Otherwise, the policy holder shall give a call to his / her insurance agent for making a new nomination.
 
Q : Important Provisions In A Life Insurance Contract
A : Q -“My agent had passed me my newly bought life insurance policy. So, what are the important provisions in the contract I should look for?”

A - My suggestion, the below are some of the important clauses in the contract:
•Beneficiary nomination clause – as an insured, you have the right to name your beneficiary for your insurance policy.
•Grace period – it allows you to pay your insurance premium without penalty, otherwise it lapses.
•Policy reinstatement – a lapsed policy can be put back in force, or reinstated.
•Nonforfeiture clause – a provision prevents the forfeiture of accrued benefits if you choose to drop the policy.
•Incontestability clause – a provision stating that the insurer cannot dispute the validity of a policy after a specific period.
•Automatic premium loans – if the insured does not pay the premium within the grace period, the insurance company automatically pays it out of the policy’s cash value.
•Policy loan provision – allow insured to borrow any amount up to the cash value of the policy.
 
Q : Golden Rules In Buying Life Insurance
A : Q - “Is there any rules to follow when buying life insurance?”

A - Yes, the American Council of Life Insurance does provide some golden rules (or guideline) to its consumers:
• Understand and know what your life insurance needs are before you make any purchase, and make sure the company you choose can meet those needs.
• Select an agent who is competent, knowledgeable and trustworthy.
• Shop around and compare costs.
• Buy only the amount of life insurance you need and can afford.
• Read your policy and make sure you understand it.
• Inform your beneficiaries about the kinds and amount of life insurance you own.
• Keep your policy in a safe place.
• Check your coverage periodically, or whenever your situation changes, to ensure that it meets your current needs.

MMI hope these golden rules will assist you in purchasing your next life insurance policy.
 
Q : Common Mistakes In Buying Life Insurance
A : Q - “It was a mistake for me to buy that (life insurance) policy!”

A - “Argh … … that (life insurance) policy serves no purpose to me.”

The above statements are not stranger to me. To most of them, when the insurance they bought no longer suit their needs, they will claim that as ‘mistake’.

So, are these really a mistake?

Ernst & Young‘s Personal Financial Planning Guide (5th Edition), the book highlights several big mistakes when purchasing a life insurance policy.

We find these mistakes are common, and unnoticeable by most of us.

So, did you find yourself for making some of the following mistakes?
• Knowingly underinsuring any major risk that you could cover inexpensively.
• Using term insurance for permanent insurance needs.
• Calculating life insurance needs by rule of thumb rather than by assessing your actual circumstances.
• Overestimating coverage under health care insurance.
• Expecting health care insurance to cover a sustained need for long-term care.
• Ignoring the need for disability insurance.

MMI will elaborate some of the mentioned mistakes, in the future installments of articles.
 

Malaysia Medical and Health Insurance

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Q : Are the public hospitals in Malaysia safe?
A : In general, the answer is definitely YES. The public hospitals in Malaysia are staffed with exactly the same level of doctors that the private hospitals employ. The treatments on the whole are similar as well.

Where the difference becomes evident is in the personalized level of service that is often lacking in public care centers. Private hospitals tend to be much more “patient friendly” with more comfortable accommodations and more personalized service, but with a much higher price tag. Ultimately, all must decide for themselves what they value; price or comfort and attention.
 
Q : Why should I consider private insurance when “universal coverage” is available in Malaysia as well?
A : With the cost of all commodities constantly increasing, it makes complete sense to keep a close eye on expenses. Each person must consider their own situation when deciding what type of coverage they will be happy with. If you are covered by the government subsidized public insurance scheme you will be eligible for public healthcare only. All private care will be at personal expense, even if the care is due to emergency or if the waiting period for the public care is extremely long.

It is important to note that anyone who is not employed by a local Malaysian company is not eligible for public insurance and cannot take advantage of its coverage.

This means that the only choice for persons working for wholly foreign owned entities will need to purchase private coverage for themselves and their families.
 
Q : What benefits are there to private medical insurance in Malaysia?
A : The biggest advantage to private health insurance is the peace of mind it comes with. This is because private insurance comes with the guarantee of fast access to needed care at the most reliable high-quality care centers available.

In almost all cases, coverage plans in Malaysia come with 24-emergency assistance which will help you find a hospital or clinic whenever you need it, and then help you get treatment without long waiting times or the frustrating hassle of being expected to make up front payment for care if you are inadequately insured.

Additional benefits include being able to access the private healthcare sector, which has a much better reputation for comfort and personalized care and will be much appreciated if a hospital stay of more than a few hours is required.
 
Q : I'm covered by health insurance from another country, does it cover me in Malaysia too?
A : Most short-term visitors to Malaysia have coverage from their resident country, but this does not automatically mean they are covered in Malaysia as well. It is up to each person to make sure that their policy includes international coverage by talking with a representative of your policy provider. If you discover that you are not covered by your local provider while in Malaysia, a traveler's plan could be a smart choice, or if you are a frequent traveler then an international insurance plan may be a good fit.

Traveling to Malaysia without coverage can be a risky situation as any care that is needed while in the country will require cash payment, which can be very expensive.
 
Q : Can I get coverage if I have a pre-existing condition?
A : Every insurer will have different restrictions and requirements, but in many cases a pre-existing condition will be excluded in coverage.

To answer this question completely you will need to speak with MMI senior advisor who can explain the coverage for the specific plan you are interested in.

To learn more, please read the Pre-existing Conditions info as below,

Malaysia Pre-Existing Condition Health Insurance Coverage

In some cases, insurance coverage has been denied or restrictions are placed on treatments to be included in the plan due to a pre-existing condition.

While this practice is still common today among some coverage providers, there are situations where an individual's pre-existing condition can be included.

While there is no guarantee that any pre-existing condition can be included in coverage, most of the time options are available so that pre-existing conditions can be covered by either an increase in the premium cost (to account for the potential for future care of the condition) or by selecting a plan which can ignore all or almost all pre-existing conditions entirely.

Of course every plan and provider differs and many treat the pre-existing condition in their own manner, so it is best to discuss options for coverage with a qualified adviser before making a purchase.

Malaysia Pre-Existing Health Condition Insurance Coverage Options

While the easiest and most cost effective way to deal with a pre-existing health condition is to exclude it from coverage entirely and extend coverage for the rest of the individual or family's health exclusive of the condition, insurers understand that this is not always acceptable or practical.

Therefore, three primary methods of arranging coverage are available for anyone with a pre-existing health condition, as listed below.

Moratorium For Coverage – simply stated, a moratorium is a waiting period wherein the insured is covered against injury and illness for a pre-determined period of time (commonly around 24 months) while the pre-existing condition is excluded.

At the end of that waiting period, if no significant symptoms or medical problems related to the pre-existing condition have arisen that require treatment, the policy will be adjusted so as to include the previously excluded condition in its coverage.

Premium Loading – though not as common as a moratorium, there are instances where an insurer will agree to increase the premium payment amount for coverage in exchange for extending coverage for a pre-existing health condition along with the rest of the policy benefits.

This is not a very common practice as estimating the cost for potential treatment (should it be required) is very difficult.

Medical History Disregarded – this option is almost exclusively available through group coverage plans, often including more than 20 potentially insured members, where the need to offer the same coverage options for a wide range of individuals is necessary.

As indicated by the name, it overlooks all past medical history and extends coverage as if the insured is in excellent health.

Please be aware that not every insurer offers these options for pre-existing condition coverage, and cost may vary greatly depending on insurer, specific condition involved, and other factors such as age.

Most of the time, pre-existing conditions will need to be reviewed on a case by case basis to determine if inclusion is possible. For this reason, it is usually necessary to speak to an adviser prior to any purchase to find out what your options are if you need this type of coverage.
 
Q : I am visiting Malaysia as one of a few or several stops in the area, can I get coverage for all the locations I will be going to?
A : Because Malaysia is such a popular tourist destination and many foreign tourists like to visit several locations in the region in one trip, a number of insurers offer coverage designed specifically to fit this need.

These plans are available in two forms, either as International Insurance or Travel Insurance depending on the specific need of the insured and the length of time coverage will be needed.

These types of plans are usually very flexible in their coverage, sometimes even covering property and financial losses, and can be tailored to fit your individual trip itinerary.
 
Q : I will soon be moving to Malaysia, but may also need to move to another location in the future, can I transfer my coverage later?
A : Because many insurers in Malaysia also offer coverage in other countries, with many even having worldwide coverage available, there is a good possibility that you will be able to find a plan to fit your needs.

It is important to discuss any future planned or possible moves prior to purchasing coverage to make sure that the health insurance you are considering will meet your future needs, since coverage between companies can vary widely.
 
Q : Can I get insurance for my family in Malaysia?
A : Absolutely. family Insurance Packages are one of the core elements of almost every insurer's offerings and lots of options are available.

Family Malaysia Health Insurance Plans

A Malaysia family health insurance coverage plan is designed to provide financial protection in case any member of the covered family encounters injury or illness. In all situations and by all providers, specific guidelines will outline who is considered a family member.

For instance, some plans may cover both parents and all dependent children, whereas in other plans, members may need to be added to the insurance policy individually and thereafter, coverage is extended to them and the policy premium is adjusted accordingly.

Because many families decide to purchase insurance when they start to expand, it is good to know that often an expecting mother and her baby are automatically covered under the policy's terms as part of the insurer's maternity coverage, including all doctor's visits as well as delivery. The baby may sometimes even be automatically covered after birth as a member of the family.

In other plans, the newborn may need to be added as a new member of the family.
 
Q : I am already covered by an insurance plan but the rest of my family is not. What are my options to protect them too?
A : In many cases you can add your family to your insurance policy by converting it into a family plan, but this will almost always increase the premium.

Another option is to purchase a new family plan just for them, or if you are only covering one person (such as a spouse or child) then an individual plan may be appropriate. In all cases, it is best to talk to an adviser to discuss your options prior to purchase.
 
Q : I am an employer and want to offer insurance to my employees. What are my choices in Malaysia?
A : Most major insurers in Malaysia offer group plans designed for just this purpose.

Regardless of the number of unrelated employees, many plans can be adjusted to meet the varying needs of businesses in Malaysia, including adjusting coverage as the company grows.

Because situations vary so much, it is necessary to have a consultation with an adviser to find out which plan will work best for your company.

Group Malaysia Health Insurance Plans

As the economy of Malaysia continues to grow and employers seek to create more desirable and enticing benefit packages to attract and retain quality workers, the value of offering comprehensive private medical insurance to companies for their employees is further reinforced. By offering quality health insurance coverage, both the employers and employees see benefits, resulting in a happy and highly skilled workforce.

To fill this need, dozens of insurers offer Malaysia group health insurance plans for both small, medium and large businesses and corporations. In general, any group of three or more non-related employed individuals can be covered by a Malaysia group health insurance plan while they are employed by the insured company or business.

Other groups that can be covered by this type of insurance include social groups, sports teams, non-government organizations and schools.


Malaysia Group Health Insurance Coverage

Because group plans are intended to provide health insurance to businesses and other organizations with several members who by nature, tend to have associates of various ages and health conditions, most provider companies will extend coverage to a much larger spectrum of potentially insured persons than many individual or family plans may not allow.

In particular, many private group health insurance providers are willing to disregard the prior medical history of the group's members so that all insured are able to access equal high-quality healthcare benefits. Additionally, such options as dental coverage are usually available at extra cost.

As members or employees of a group or company tend to come and go, Malaysia group insurance packages often have provision for the leaving member to take their coverage with them for a period of time and as long as premium dues are paid on time, they can continue to benefit from their coverage. This is especially valuable for long-time members of the plan as they will not be forced to purchase a new insurance policy, which may exclude all health issues that developed during the coverage period wherein they were part of the group coverage plan.

Generally speaking, group medical insurance plans are highly flexible as every company or organization’s needs and circumstances are different and in many cases, different levels of coverage are even required within the same group. To fully understand your options for coverage and to compare plans available, it is best to speak with a qualified adviser.

Some of the benefits available from a group health insurance plan include:
•Dental Coverage
•Pre-existing Condition Inclusion Coverage
•Chronic Condition Inclusion Coverage
•In-patient Coverage
•Out-patient Coverage
•Vaccine & Preventative Treatment Coverage
•Complimentary Medicine & Alternative Therapy Coverage
•Maternity Care Coverage
•New-born Child Coverage
•Emergency Evacuation Or Repatriation Coverage
•Geographic Area Requirements
•Required Waiting Periods

For even more information about insurance coverage available for your group or company, see our Summary Of Coverage page.
 
Q : If I am pregnant in Malaysia, does my medical insurance automatically cover the pregnancy, delivery and newborn child?
A : Each insurer will treat a pregnancy differently based on several factors, the largest being when you became pregnant, as most will impose a waiting period before extending coverage.

To learn more about maternity restrictions visit the maternity Insurance page.

Fortunately however, if you meet your policy's requirements, then most insurance plans have provisions to cover the pregnancy-related doctor's consultations, delivery and care for the infant for a predetermined amount of time.

If you are already planning on starting or expanding your family while in Malaysia it is the course of wisdom to discuss this with your insurer to find out all your options.


Malaysia Maternity Health Insurance

Starting or expanding a family is an exciting and happy time, but without proper planning it can also be stressful and very expensive. Malaysia's health insurance providers can help reduce both the stress and cost by covering much of the expense of pre-natal care, labor and delivery, and sometimes even new born child care.

Another benefit of a Malaysia maternity insurance plan is that it can provide access to the excellent care available through the county's many private hospitals, which are usually much more comfortable and offer more personalized treatment for the mother to be.

Without maternity insurance, the cost associated with having a baby in Malaysia can be very high, thus using a private hospital and private doctor is out of the question for many due to cost constraints.


Malaysia Maternity Health Insurance Waiting Periods

Most Malaysia medical and health insurance plans will include a waiting period for maternity, labor, and delivery coverage. It is important to review the policy conditions of the plan you are considering to be absolutely sure that you will not have any problems or be denied coverage if you are planning to have a baby.

Maternity waiting periods for many insurance plans are from the start of the plan's coverage, which means that after coverage begins the woman must wait a predetermined amount of time before she can begin to receive covered treatment for her pregnancy. In many cases this type of waiting period will be between 8 and 12 months. Therefore, someone who becomes pregnant immediately after the start of their plan may not have treatment or doctor's visits covered for the first several months of her pregnancy but with an 8 month waiting period, she would likely have her labor and delivery covered for a normal pregnancy.

Alternatively, and less common, some plans carry an until conception waiting period. This means that the insured woman is not going to be covered for any pregnancy-related treatment for a predetermined waiting period and if she conceives a child during that time, that pregnancy will also be excluded even if it extends beyond the end of the wait time. This type of waiting period is not particularly common, but if you are considering a child it is very important to be aware of all the exclusions the plan you are thinking of purchasing features.

While it may be the case that a pre-existing pregnancy is excluded, in some cases the newborn child can be immediately covered, even if it is very early in the plan's coverage. To learn more about this visit the New Born Child Coverage page


Malaysia Maternity Insurance Coverage

Some of the key features of many Malaysia health insurance plans which include maternity coverage are:
•In-hospital delivery cost
•In-home delivery cost with qualified oversight
•Routine delivery without complications
•Delivery with complications
•Medically required caesarean section delivery
•Pre and post-natal care and examinations for mother and child

Some insurers even include fertility and/or conception assistance treatments as part of coverage. Talk to an adviser to discuss a particular insurer's plan details further.
 
Q : What kind of healthcare is available in Malaysia?
A : Malaysia has been a front runner in Southeast Asia for decades in offering ever-improving healthcare to serve the needs of its citizens. The hospitals (both public and private) that take care of the health of Malaysians are some of the very best in the region and many of the private facilities are among the best in the world. In both sectors there is primary, secondary and specialist care available and Malaysia is becoming a hot-spot for medical tourism thanks to its excellent reputation for treatment.
 

Medical Card Services (Cashless Admission) FAQ

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Q : If I am admitted to a non-panel hospital, what should I do?
A : You are required to pay first and file a claim with us, subject to the terms and conditions of the policy.
 
Q : Can I use the Medical Card facility on a weekend / public holiday?
A : Yes, as Hospital Alliance Services is available 24 hours a day, 7 days a week.
 
Q : Why is a deposit required for some hospitals under the panel?
A : Some hospitals require a minimum deposit for non-medical related items or excess charges/fees which may not be payable by Insurance Company (Insurer).

For example:

■Admission fees
■Telephone charges
■Excess room and board
■Co-Insurance / deductibles
 
Q : Will Insurance Company (Insurer) issue the Guarantee Letter (GL) if I did not bring my medical card to the hospital?
A : You can request for a Guarantee Letter (GL) from Insurance Company (Insurer) by providing your IC number to the hospital staff. The hospital staff will then contact Medical Help Centre (Medical Insurance Assistance) staff to verify the patient's policy number and the status of the policy.
 
Q : Will I be able to use Medical Card (issue by insurer from Malaysia) while I am overseas?
A : No. Medical Card is only applicable for panel hospitals in Malaysia. You may file a claim with us once you are back and your claim will be assessed in accordance to terms and conditions of the policy contract.
 
Q : Can I stay in a room that has higher charges than my room and board benefit?
A : Yes, however you will need to pay the difference of amount incurred (excess room and board) or co-payment may apply from selected medical insurance policy.
Please read and understand your medical insurance policy terms and benefits before you purchase for right medical insurance policy.
 
Q : Can I cancel my claim and pay for the admission myself before the final guarantee letter is issued?
A : Yes. If you wish to claim for your medical expenses, you may submit your claims to us via reimbursement basis.
 
Q : What are the things to consider prior to hospital admission (i.e. Non Emergency Admission-Pre-Planned Hospitalization)?
A : i. Consider the following before admission:-
a) Is hospital admission really necessary?
b) Can I choose to rest and recuperate in the comfort of my own home?

c) Can the procedure be conducted as outpatient instead which is covered under the day-care benefit?

ii. Contact your Servicing MMI senior advisor or MMI Customer Service Department +603-92863323 for the most updated list of panel hospitals & deposit listing.

iii. Please consult the financial counselors of the hospital for the estimated cost of hospitalization after consulting with the relevant doctors on the different types of medical treatment and the expected duration of ward stay

iv. Contact your Servicing MMI Senior Advisor (MMI Associate Members) for assistance or contact MMI Customer Service Department +603-92863323 or email to mmicare@medicalinsurance.com.

v. You also can log on our homepage www.medicalinsurance.com.my at Claim Advice page, MMI have provide Claim processing information to assist you.
 
Q : What are the things to consider prior to hospital admission (i.e. Emergency Admission-Unexpected Hospitalization)?
A : i. Please seek help immediately at the nearest clinic or hospital

ii. You will be attended and assessed by the doctor on duty at Accident & Emergency Department. The hospital staff will guide you through the procedure.

iii. If hospitalization is required at the clinic or hospital which is not a panel hospital of insurance company (insurer), you may either

a. Settle the bill first and file for claims later and arrange to be transferred to our panel hospital on a later date Or

b. You may continue your stay at the non panel hospital and file for claims later.
 
Q : What are things to take note of on the day of admission?
A : i. Bring your medical card upon admission for verification purposes.

ii. Deposit will be required for non payable medical items and co-insurance*.

iii. Bring your own toiletries, comfortable attire, slippers, medication or vitamins (if any) to avoid additional charges to your hospital bill.

iv. Please DO NOT bring or wear your jewelry, excessive cash and also electrical appliances to prevent loss or damage to your valuables

v. Anticipate waiting time of 1 hour during admission / discharge.

vi. Medical card is not meant for
i) Routine check-up.
ii) Investigatory or diagnostic test admission.

*Co-insurance or co-payment may require from selected medical insurance policy.
Note : Please read and understand your medical insurance policy benefits and terms before your purchase your medical insurance policy.
 
Q : Where can I learn more about my rights and responsibilities as a patient?
A : The Malaysian Medical Association (MMA) Patient’s Charter, which was written to create awareness amongst patients on their rights and responsibilities, and sustain the highest possible professional and ethical standard of healthcare.

We strongly encourage you to log on to the website: http://www.mma.org.my/html/patient_charter.html to learn more about your rights and responsibilities.
 
Q : Where Are The Trusted and Experienced Medical Insurance Senior Advisor?
A : Malaysia Medical Insurance Organisation (MMI) management teams have more than 23 years of "hard ground" experiences in medical and health insurance industry in Malaysia.

During these solid 23 years of "hard ground" experiences, we "MMI" have developed wide range of Malaysia Medical and Health Insurance product suits for Malaysian.

These solid years of experience has earned MMI a reputation of " THE LARGEST MALAYSIA MEDICAL AND HEALTH INSURANCE ORGANISATION".

MMI have many successful medical and health insurance schemes with proven track record and in the process of arrange many more new medical and health insurance products.

MMI have a team of young, trusted, experienced, qualified and dynamic team in nationwide and are prepared to take upon any new challenges with the ever changing landscape of the medical and health insurance industries.


MMI provided medical and health insurance professional training course and having experienced help desk support officer, friendly customer services officer and prompt service claim support officer at MMI head office and nationwide.

MMI registered associate members have at least have more than five years experience in medical and health insurance policy. And they have acquired medical insurance knowledge at leading insurance companies. In fact, most of them are attached to prestigious insurance companies in Malaysia.

In addition, MMI registered associate members have a proven track record of servicing more than 100,0000 clients or policy holders in Malaysia Medical and Health Insurance coverage since year 1989.

MMI have more than 1000 registered associate members is your Trusted and Experienced Medical Insurance senior advisors.

For more information, please contact MMI careline +603-92863323 or email mmicare@medicalinsurance.com, or visit MMI homepage www.medicalinsurance.com.my or Facebook link www.facebook.com/medical.insurance.my.

Malaysia Medical Insurance Organisation (MMI)
Head Office,
158-3-7, Blok 158, Kompleks Maluri,
Jalan Jejaka, Taman Maluri, Cheras,
55100 Kuala Lumpur, Malaysia.
(O) +603-92863323
(E) mmicare@medicalinsurance.com.my
(W) www.medicalinsurance.com.my
(FB) www.facebbok.com/medical.insurance.my
 
Q : Where can I obtain the reimbursement claims form (insured paid first without cashless when discharge from hospital) required for submission?
A : You may contact your senior advisor (MMI associate member) or our MMI Customer Service at +603-92863323 or you can also write to us at mmicare@medicalinsurance.com.my.

For you information, MMI homepage have Download page for your to download claim form at www.medicalinsurance.com.my.
 
Q : How do I submit my claim? (Reimbursement inpatient Cases/Reimbursement Pre and Post Hospitalasation or accident outpatient medical expenses or bill)
A : You may submit the completed forms and supporting documents to us via your MMI Senior Advisor (MMI Associate Member), directly to Insurance Company (Insurer) Claim Department or via to us MMI.

For more information, please contact MMI careline +603-92863323 or email mmicare@medicalinsurance.com, or visit MMI homepage www.medicalinsurance.com.my or Facebook link www.facebook.com/medical.insurance.my.

Malaysia Medical Insurance Organisation (MMI)
Head Office,
158-3-7, Blok 158, Kompleks Maluri,
Jalan Jejaka, Taman Maluri, Cheras,
55100 Kuala Lumpur, Malaysia.
(O) +603-92863323
(E) mmicare@medicalinsurance.com.my
(W) www.medicalinsurance.com.my
(FB) www.facebbok.com/medical.insurance.my
 
Q : What happens after i submit my claim?
A : Once a claim had been submitted to Insurance Company (Insurer), Insurer will assess it based on the terms and conditions of the policy.

When a decision had been made or in the event that insurer require further clarification or details, your MMI senior advisor or MMI customer service officer will notify you in writing.
 
Q : How do I check on the progress of my claims submission?
A : Once a claim has been submitted to insurance company (insurer), you may contact your servicing MMI senior advisor or MMI Customer Service at +603-92863323 or Insurer Claim Department (Contact number will advice by MMI) or write to us at mmicare@medicalinsurance.com.my for more information on your claims progress.
 
Q : Can I appeal for a reassessment?
A : You may write in your appeal, together with relevant supporting documents for via MMI to insurer to reassess your claims again.

Any assistance, please contact MMI Customer Service Department +603-92863323 or email mmicare@medicalinsurance.com.my.
 
Q : How long will I have to wait for my claims cheque?
A : The time taken will depend on the completeness of the documentation received.

If all requirement document is fully completed, claim cheque should delivery with 30 days.
 
Q : Whose name will the claims cheque be issued under?
A : For death claims, the claims cheque will be issued to the beneficiary / or the assignee of the policy. For life claims, the claims cheque will be issued to the assured / policy owner or the assignee of the policy.




 
Q : If my employer / other insurer does not covered my medical expenses in full, can I claim the balance under my medical insurance policy arranged by MMI?
A : Yes, you may submit your claims documentation to insurer via MMI and insurer will assess it in accordance with your policy terms and conditions. Please refer to the amount that was not covered by your employer / other insurers for the document requirements.
 
Q : What is Pre Hospitalization?
A : Pre Hospitalization refers to the expenses incurred at the clinic / hospital prior to your admission to the hospital.

Eg: You consulted your nearby clinic for fever and your doctor referred you to be admitted to the hospital for dengue fever. In this scenario, you may claim for the clinic consultation payment under Pre Hospitalisation.

Important note : Only applicable for expenses incurred up to 30 days* prior to hospitalization.

*Different Medical Insurance Policy will have different days or benefits or terms.
 
Q : What is Post Hospitalization?
A : Post Hospitalization refers to the expenses incurred at the specialist clinic/ hospital after your admission and subsequent discharge from the hospital.

Eg: After your discharge from the hospital, you go for follow-up with your doctor. In this scenario, the payment for the follow up will be part of the post hospitalisation expenses.

Important note:

i) Only applicable for expenses incurred 90 days after the hospitalisation.

*For different of Medical insurance policy will be different days coverage or benefits or terms.

ii) Follow-up treatment must be by the same attending physician.

Tips : If your follow up is with a different doctor, please ask the doctor to indicate on the receipt the diagnosis and the type of treatment endorsed by the doctor.
 
Q : What is Emergency and Accident Treatment (EAT)?
A : EAT refers to consultation and medical expenses incurred upon an accident. For example, you suffer injuries due to an accidental fall and seek treatment for the injuries sustained.

Important note: Only applicable if medical treatment is sought within 24 hours* from the accident and for expenses incurred within 30 days* from the date of the accident.

Tips: If your medical bills are below RM 500.00*, please ask the doctor to indicate the date of accident, nature of accident and the type of treatment on the receipt.

* Please refer your actual medical insurance policy benefits or terms and condition.
 
Q : What is Co-Insurance or Co-payment ?
A : Co-Insurance* is a cost sharing arrangement between you and the insurer whereby you will need to pay a specified percentage of the cost of your eligible benefit.

*Please refer your actual medical insurance policy benefits and terms and conditions.
 
Q : If I am admitted overseas, will I still be able to claim back the expenses incurred?
A : For overseas medical expenses, please submit in your claim and insurer shall assess it accordingly as per the terms and conditions stated in your policy stated annexure.
 
Q : What you want your medical insurance policy protect your medical bill expenses ?
A : You should consider:
A) Have your medical expenses paid?
@ Medical expense insurance.

B) Receive a fixed amount of cash when you are in hospital?
@ Hospital cash insurance.

C) Reduce your financial burden when you are diagnosed with a major illness (for example, cancer)?
@ Critical illness insurance / Dread Disease insurance.

D) Protect your income when you are unable to work?
@ Disability income insurance
 
Q : Few questions you should know the answer to before taking up medical and health insurance ?
A : A) What will your health insurance policy cover?

B) Are you already covered for the same thing under another medical and health insurance policy?

C) What is not covered under this medical and health insurance policy and when will you not be covered?

D) How much will you be paying for your health insurance and will you be able to afford the premiums over the long term?

E) How often will the premium be charged and will it be a fixed or variable sum?

F) Will your medical and health insurance policy automatically be renewed, until when, and what is the penalty if you do not pay any premium on time?

G) When or in what circumstances will your health insurance policy lapse ?

H) What is your policy's claim process ?
I) Will you be covered for medical treatment performed outside your resident country?

J) Are there any limits to the benefits that can be paid out from your policy?

K) How will your future premiums be affected after you have made a claim?

You need to choosing one to suit your needs and therefore, please do not hesitate to contact our "MMI" Customer Service Department +603-92863323 or email to enquiry@medicalinsurance.com.my about the Malaysia Medical and Health insurance policy that you are planning to apply.
 

Note: The above information serves as a guide. In the event that you have any queries on the above, kindly contact your MMI senior advisor / Insurer Customer Service department / MMI Customer Service Department at +603-92863323 or write to us at mmicare@medicalinsurance.com.my.
 
 
Malaysia Medical Insurance Organization (MMI)
Your Trusted Malaysia Medical Insurance Risk Management Advisory Provider

Malaysia Medical Insurance Organization (MMI)
Head Office,
158-3-7, BLOK 158, KOMPLEKS MALURI,
JALAN JEJAKA, TAMAN MALURI,CHERAS,
55100 KUALA LUMPUR, MALAYSIA.
MMI careline +603-92863323
mmicare@medicalinsurance.com.my
www.medicalinsurance.com.my
 
 
How To Become MMI Associate Members please click HERE
 
Please click HERE for MMI Associate Members Application Form