Coverage

• Provides cover against loss from illness/bodily injury. *
• Can pay for medicines, visits to the doctor, hospital stays and other medical expenses. *

* It depends on the conditions covered & the benefits and/or choices of treatment available on the policy.

What is not covered

1. Cosmetic surgery or treatment
2. Private nursing care
3. Alternative therapies
4. Experimental procedures
5. Sexual dysfunction or infertility
6. Psychotic, mental or nervous disorders
7. Suicide, attempted suicide or intentionally self-inflicted injury
8. Pregnancy
9. Congenital or hereditary illnesses
10. Routine physical examination
11. The use of prosthetic appliances/devices
12. Dental conditions – treatment/surgery

Things to be avoided during hospitalization

Examples of non-covered items are:

1. Extra food
2. Admission kit/Discharge Pack
3. Telephone calls
4. Laundry
5. Unrelated tests
6. Drugs
7. Vitamin & supplements

General procedures

How to submit a claim (reimbursement basis)

1. Claim Form
1. Fill in the MSIG Claim Form.
2. Fill in the Insurance Bank Transfer Form.
3. Ensure completion of the Insurance Claim Document Checklist
2. Submission
1. Submit your completed form and documents to FA at Student Information Centre (SIC).
2. FA will assist to submit your claim to MSIG.
3. MSIG Process
1. MSIG will process your claims and deem if they are payable or not payable.
2. If your claim is approved, your reimbursement will be banked into your local bank account.
3. If your claim is rejected, MSIG will issue a declined letter.

In-patient guide: Admission & discharge procedures

1. Member
1. You are admitted into the hospital. Please notify FA or ISS beforehand.
2. You need to provide the hospital with your membership card, original passport and referral letter (if any).
2. Hospital
1. Will request you to fill in Hospital Admission Form (HAF). Hospital and doctor to complete the HAF. Hospital will contact TPA.
3. TPA
1. Third Party Administrator (TPA) will verify your MSIG membership.
2. Will check your treatment procedures against your policy.
3. Provide admission guarantee OR Issuance of ‘Non issuance of guarantee letter’.
4. Guaranteed / Not Guaranteed
1. If Guaranteed – Will issue superceeding guarantee and monitor biling status with the hospital.
2. If not Guaranteed – Will issue ‘non issuance of guarantee letter’, liaise with patient/insurance company and patient can elect to stay or transfer.
5. Discharge
1. Hospital will bill for calculation, TPA will issue letter of excess, hospital to arrange to collect excess.
2. Patient arrange full payment to hospital.

* Important Notice:

TPA will not extend ‘admission assistance’ in the follow assistance:

• Where you do not provide adequate membership details.
• Where you do not complete our hospital admission form (HAF).
• If your medical condition/treatment cannot be ascertained or if it is not within the scope of your policy.
• Unavailability of relevant medical information from your attending or regular doctor.

Some hospitals may collect additional cash deposit upon your admission. This deposit of for items utilized which may not fall within the coverage of your policy.

Things to be avoided during hospitalisation examples of non-covered items: extra food, admission / discharge pack, telephone calls, laundry, unrelated tests, drugs, vitamins and supplements.

Insurance Benefits

In-Patient Limit: RM15,000.00 (per annum)

Out-Patient Limit: RM500.00 (per annum) * you will be issued an MSIG Medical Card which provides the benefit of cashless hospital admission and out-patient clinical treatments.

COVERAGE

• It is a contract of insurance which provides for the payment of fixed sums consequent upon the death of/or permanent disablement to the insured personas a result of an accident.
• It is a 24-hour cover, worldwide.

What is an accident?

• An event which is unforeseeable, unexpected and not deliberate, which produces an undesirable result.
• In personal accident, death & permanent disablement to the insured person must result from bodily injury caused by violent, accidental, external and visible means.
• Accident not due to illness/disease/mental illness or wear and tear.

Major Exclusions.

This policy does not cover death or injury caused by the following events:

• War and related risks
• Government regulations or acts or authorities
• Hazardous sports including parachuting, hang-gliding, mountaineering, any kind of race (other than on foot or swimming) or trial of speed or reliability
• Suicide, self-inflicted injury or illness
• Pregnancy, childbirth, physical or mental defects or infirmity
• Aids, Aids related complex (arc) or sexually-transmitted diseases
• Drug abuse unless the drug is taken in accordance with an authorized medical prescription (but not for treatment of drug addiction)
• Air travel except as a passenger in a fully licensed passenger carrying aircraft
• Any crew, trade, technical or sporting activity in connection with an aircraft
• Act of terrorism

General Claim Guidelines

1. Download the claim form: https://www.msig.com.my/PDF/PAClaimForm_F_AD_C06_V15.pdf or come and see FASW at Student HQ.
2. Complete and submit the Claim Form to MSIG as soon as possible together with the following documents:

For Non-fatal case

• Medical Report
• Original Medical Bills and Receipts

For Fatal case

• Copy of Police Report
• Copy of Death Certificate
• Copy of Post-mortem Report
• Burial Certificate
• Letter of Administration

COVERAGE

This policy is covered by AmMetLife. This policy covers:

• Death – Provides Financial Protection in the event of loss of life (24 hours worldwide).
• Total Permanent Disability (TPD) – Disability caused by illness or disease, which wholly prevents from performing any work.

Major Exclusions.

This policy does not cover death or injury caused by the following events:

• Self-inflicted injury or any attempt there at while sane or insane.
• Military or naval service in time of declared or undeclared war or while under orders for war like operations or restoration of public order.
• Operating or servicing, ascending or descending from or with any aerial device or conveyance except while the Life Assured is in an aircraft operated by a commercial passenger airline on a regular scheduled passenger trip over its established passenger route or when the Life Assured is a passenger of a fully licenced aircraft/helicopter serviced by a regular scheduled passenger aircraft.
• If the Life Assured is found to be infected by any Human Immunodeficiency Virus (HIV).
• Committing a criminal offence.
• Being under the influence of alcohol or drugs other than in accordance with the directions of a registered medical practitioner.
• Participation in any kind of racing (other than foot racing), hunting, mountaineering, underwater activities, sky diving, parachuting or professional sports.

Claims Procedure (GTL/PTD)

1. Death or Total Permanent Disability
2. Please notify FA within 30 days from the date of death/disability
3. Completed claims documents to be submitted to FASW within 90 days after the date of notification