Maax WANITA

PERLINDUNGAN HAYAT & KELUMPUHAN

1. Death Benefit

You have a choice of how much Life Insurance you want which is called the Basic Sum Assured. Upon death both the Basic Sum Assured and the Investment Account balance are payable.

2. Total & Permanent Disability Benefit

Upon Total and Permanent Disability before age 65, the Basic Sum Assured is payable and you have the choice of:

1. Terminating the policy and receiving the Investment Account value; or

2. Continuing with the Investment Account

PELABURAN

The balance of your premium not allocated for Life Insurance Protection is allocated to your Investment Account. You have a choice of many types of professionally managed funds to choose from.

PERLINDUNGAN PENYAKIT KHUSUS WANITA

1.0 Maax Wanita Illnesses Protection (MWIP)

• Pemeriksaan Kesihatan Wanita Tahunan (Ujian Darah, Pap Smear, Mammogram, Abdomen/Pelvis Ultrasound)
• Kanser Wanita (Breasts, Cervix Uteri, Fallopian Tube, Ovary, Uterus, Vagina/Vulva)
• Carcinoma-in-situ (Breast and Cervix Uterix)
• Systemic Lupus Erythematosus (SLE) with Lupus Nephritis
• High Grade Squamous Intraepithelial Lesion (HSIL) with Severe Dysplasia
• Fibroid
• Ovarian Cyst
• Pembedahan Reconstructive Muka Akibat Kemalangan
• Pembedahan Reconstructive Payu Dara Akibat Kemalangan
• Pembedahan Reconstructive Payu Dara Akibat Kanser
• Pembedahan Kulit Akibat Kebakaran
• Pembedahan Kulit Akibat Kanser Kulit
• Keretakan Tulang Akibat Osteoporosis
• Rheumatoid Arthritis with complication

2.0 Maax Wanita Maternity Protection (MWMP)

• Elaun Kelahiran Anak (Maksima 3 kelahiran) antara RM100 - RM500
• Faedah Harian Kemasukan Hospital Akibat Komplikasi Kehamilan (RM200 sehari untuk maksima 7 hari)
• Kematian Ibu Akibat Kelahiran
• Komplikasi Kehamilan seperti : -

- Disseminated Intravascular Coagulation

- Ectopic Pregnancy

- Hydatidiform Mole (Molar Pregnancy)

- Still Birth Death

- Neonatal Death

- Eclampsia

• Penyakit Kongenital Bayi seperti : -

- Down's Syndrome

- Spina Bifida

- Tetralogy of Fallot

- Transposition of Great Vessels

- Atrial Septal Defect (Kecacatan pada bayi)

- Ventricular Septal Defect (Kecacatan pada bayi)

3.0 Maax Golden Wanita Protection (MGWP)

· Faedah Hilang Upaya dari Aktiviti Harian seperti makan, berjalan, mandi dan sebagainya.

TOTAL FLEXIBILITY

You can make withdrawals and cash out your policy at any time. Furthermore, you can stop paying premiums and still enjoy the life insurance protection as long as there are sufficient units in your Maax WANITA Account to pay for the insurance charges and policy fees.

The minimum entry age of the Life Insured/Insured is 16 and the maximum entry age is 69. However the Policyholder / Payor / Applicant of the policy must be aged 18 years and above. The minimum Annual Premium is RM600 but you have the flexibility to also pay the premiums Monthly (minimum monthly premium of RM50), Quarterly (minimum quarterly premium of RM150) or Half-Yearly (minimum half-yearly premium of RM300). Payments by Master and Visa Credit Card are accepted.

Maax WANITA Illness Protection Claim & Waiting Period

Sila klik disini untuk keterangan lebih lanjut berkenaan setiap perlindungan penyakit wanita yang dilindungi seperti di dalam jadual di atas.

Maax WANITA Illness Protection (MWIP)

1. MEDICAL CHECK-UP

The Insured Person will be entitled to a yearly medical examination on Blood Test, Pap Smear, Mammogram and Abdomen/Pelvis Ultrasound with a Medical Practitioner appointed by the Company. Coverage is on a reimbursement basis (pay first, then claim) and up to a maximum of RM100.

2. FEMALE CANCERS

A malignant tumour characterised by the uncontrolled growth and spread of malignant cells and the invasion of tissue to any of the following sites: breast, cervix uteri, uterus, ovary, fallopian tube, vagina and vulva.

This excludes secondary cancer, which has originated from other organs and spread to the female genital tract and breast, non-invasive cancer-in-situ, and tumours in the presence of any Human Immunodeficiency Virus (HIV).

Diagnosis must be supported by histological evidence of malignancy.

3. FEMALE CARCINOMA-IN-SITU (BREAST and CERVIX UTERI)

Focal autonomous new growth of carcinomatous cells, which have not yet resulted in the invasion of normal tissues. 'Invasion' means an infiltration and/or active destruction of tissue or surrounding tissue beyond the basement membrane. The disease of carcinoma-in-situ covered is limited only to cervix uteri or the breast. The diagnosis of carcinoma-in-situ must always be positively diagnosed upon the basis of a microscopic examination of fixed tissue additionally supported, in the case of cervix uteri by cone biopsy or colposcopy with cervical biopsy and, in the case of breast, by a biopsy. Clinical diagnosis does not meet this standard.

Cervical Intraepithelial Neoplasia (CIN) classification including CIN I, CIN II, and CIN III (severe dysplasia without carcinoma-in-situ) and all carcinoma-in-situ in the presence of any Human Immunodeficiency Virus (HIV) are specifically excluded.

These benefits will not be payable if, at the point of claim for these benefits, the Insured has already qualified for Female Cancers benefit as stated in Item 2. under the same period of time.

4. SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) WITH LUPUS

Refers to a multisystem, multifactorial, autoimmune disorder which affects mostly females in their childbearing years and is characterised by the development of auto-antibodies, directed against various self-antigens.

In respect of this contract, SLE will be restricted to those forms of systemic lupus erythematosus, which involves the kidneys (Type III to Type V Lupus Nephritis, established by renal biopsy). Other forms, discoid lupus, and those forms with only haematological and joint involvement will specifically be excluded.

WHO Lupus Classification:-

1. Class I (minimal change) - negative, normal urine
2. Class II (mesangial) - moderate proteinuria, active sediment
3. Class III (focal segmental) - proteinuria, active sediment
4. Class IV (diffuse) - acute nephritis with active sediment and/or nephrotic syndrome
5. Class V (membranous) - nephrotic syndrome or severe proteinuria

5. HIGH GRADE SQUAMOUS INTRAEPITHELIAL LESION (HSIL) WITH SEVERE DYSPLASIA

Positively diagnosed on the basis of microscopic examination of fixed tissue additionally supported by a cone biopsy or colposcopy with cervical biopsy showing high-grade squamous intraepithelial lesion with severe dysplasia (which must be at a grading of not less than CIN III and has not yet resulted in the invasion of normal tissues.)

6. FIBROID

One or more benign tumour(s) of fibrous and muscular tissue which has developed in the muscular wall of the uterus (leiomyoma uteri), resulting in the actual undergoing of medically necessary surgery for myomectomy or hysterectomy.

7. OVARIAN CYST

One or more fluid or semi-solid material filled sac(s) that has developed in the ovary(ies) or on their surface resulting in the actual undergoing of medically necessary surgery for the removal of the cyst(s).

Cysts of less than three (3) mm in diameter, follicular cysts and corpus luteum cysts are specifically excluded.

8. FACIAL RECONSTRUCTIVE SURGERY DUE TO ACCIDENT

The actual undergoing of plastic or reconstructive surgery (above the neck) performed under general anaethesia which, in the opinion of the Company's medical advisor, is deemed medically necessary for the treatment of facial disfigurement being a direct result of an accident requiring inpatient treatment and subsequently the performance of such surgery.

Facial/neck disfigurement as a result of an accident occurring before the Issue Date or any reinstatement date of the contract, whichever is later, is excluded

9. BREAST RECONSTRUCTIVE SURGERY DUE TO ACCIDENT

Plastic or reconstructive surgery of the breast performed by a registered surgeon after an accident or mastectomy following diagnosis of invasive Breast Cancer (as defined in the Supplementary Contract). The surgery must, in the opinion of the Company's medical advisor, be deemed medically necessary.

Cosmetic breast surgery is excluded.

10. FRACTURES DUE TO OSTEOPOROSIS

A condition of reduced bone mass with decreased cortical thickness and a decrease in the number and size of the trabeculae of cancellous bone (but normal chemical composition, resulting in increased fracture incidence).

Only osteoporosis of the hip or femur resulting in the actual undergoing of medically necessary invasive surgery to repair or replace parts of the hip or femur bones are covered.

11. RHEUMATOID ARTHRITIS WITH COMPLICATION

Widespread joint destruction with major clinical deformity of three (3) or more of the following joint areas:-

1. Hands;
2. Wrists;
3. Elbows;
4. Cervical spine;
5. Knees;
6. Ankles; and
7. Metatarsophalangeal joints in the feet.

Only severe cases of Rheumatoid Arthritis are covered. The diagnosis must be confirmed by a Medical Practitioner and supported by physicians appointed by the Company, as well as the presence of all of the following diagnostic criteria:-

1. Morning joint stiffness;
2. Symmetric arthritis of joints;
3. Presence of rheumatoid nodules;
4. Elevated titres of rheumatoid factors;
5. Radiographic evidence of severe involvement of joint destruction.

Klausa Pengecualian

This policy does not cover any hospitalisation, surgery or charges caused directly or indirectly, wholly or partly, by any one (1) of the following occurrences:-

1. Pre-existing illness. (Rujuk link Definisi yang perlu diketahui)
2. Specified illnesses occurring during the first 120 days of continuous cover . (Rujuk link Definisi yang perlu diketahui)
3. Any medical or physical conditions arising within the first thirty (30) days of the Insured Person's cover or date of reinstatement whichever is latest except for ACCIDENTAL INJURIES.
4. Plastic/cosmetic surgery, circumcision, eye examination, glasses and refraction or surgical correction of near-sightedness (Radial Keratotomy) and the use or acquisition of external prosthetic appliances or devices such as artificial limbs, hearing aids, implanted pacemakers and prescriptions thereof.
5. Dental conditions including dental treatment or oral surgery except as necessitated by Accidental Injuries to sound natural teeth occurring wholly during the Period of Insurance.
6. Private nursing, rest cures or sanitaria care, illegal drugs, intoxication, sterilisation, venereal disease (VD) and its sequelae, AIDS (Acquired Immune Deficiency Syndrome) or ARC (AIDS Related Complex) and HIV (Human Immunodeficiency Virus) related diseases, and any communicable diseases required quarantined by law.
7. Any treatment or surgical operation for congenital abnormalities or deformities including hereditary conditions.
8. Pregnancy, child birth (including surgical delivery), miscarriage, abortion and prenatal or postnatal care and surgical, mechanical or chemical contraceptive methods of birth control or treatment pertaining to infertility. Erectile dysfunction and tests or treatment related to impotence or sterilisation.
9. Hospitalisation primarily for investigatory purposes, diagnosis, X-ray examination, general physical or medical examinations, not incidental to treatment or diagnosis of a covered Disability or any treatment which is not Medically Necessary and any preventive treatments, preventive medicines or examinations carried out by a physician, and treatments specifically for weight reduction or gain.
10. Suicide, attempted suicide or intentionally self-inflicted injury while sane or insane.
11. War or any act of war, declared or undeclared, criminal or terrorist activities, active duty in any armed forces, direct participation in strikes, riots and civil commotion or insurrection.
12. Ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapons material.
13. Expenses incurred for donation of any body organ by an Insured Person and costs of acquisition of the organ including all costs incurred by the donor during organ transplant and its complications.
14. Investigation and treatment of sleep and snoring disorders, hormone replacement therapy and alternative therapy such as treatment, medical service or supplies other than Western Medicines, including but not limited to chiropractic services, acupuncture, acupressure, reflexology, bonesetting, herbalist treatment, massage or aromatherapy or other alternative treatment.
15. Care or treatment for which payment is not required or to the extent which is payable by any other insurance or indemnity covering the Insured and Disabilities arising out of duties of employment or profession that is covered under a Workmen's Compensation Insurance Contract.
16. Psychotic, mental or nervous disorders (including any neuroses and their physiological or psychosomatic manifestations)
17. Cost/expenses of services of a non-medical nature, such as television, telephones, telex services, radios or similar facilities, admission kit/pack and other ineligible non-medical items.
18. Sickness or injury arising from racing of any kind (except foot racing), hazardous sports such as but not limited to skydiving, water skiing, underwater activities requiring breathing apparatus, winter sports, professional sports and illegal activities.
    Private flying other than as a fare-paying passenger in any commercial scheduled airlines licensed to carry passengers over established routes.
19. Expenses incurred for sex changes.

Penamatan polisi perlindungan

Kad Perubatan MedicaLife 207 akan terbatal atau ditamatkan apabila salah satu daripada keadaan dibawah dicapai atau berlaku :

• Caruman premium anda lewat melebihi 31 hari.
• Anda mencapai umur 80 tahun pada ulang tahun polisi.
• Sekiranya jumlah keseluruhan perlindungan perubatan yang digunakan melebihi had perlindungan perubatan seumur hidup.

Definisi

PRE-EXISTING ILLNESS

Shall mean Disabilities that the Insured Person has reasonable knowledge of. An Insured Person may be considered to have reasonable knowledge of a pre-existing condition where the condition is one for which:-

• the Insured Person had received or is receiving treatment;
• medical advice, diagnosis, care or treatment has been recommended;
• clear and distinct symptoms are or were evident; or its existence would have been apparent to a reasonable person in the circumstances.
  

SPECIFIED ILLNESSES

Shall mean the following disabilities and its related complications, occurring within the first 120 days of insurance of the Insured Person:-

• Hypertension, Diabetes Mellitus and Cardiovascular Diseases
• All Tumours, Cancers, Cysts, Nodules, Polyps, Stones of the Urinary System and Biliary System
• All Ear, Nose (including sinuses) and Throat conditions
• Hernias, Hemorrhoids (piles), Fistulae, Hydrocele, Varicocele Endometriosis including disease of the Reproductive System
• Vertebro-spinal Disorders (including disc) and Knee conditions

Soalan Lazim berkenaan MedicaLife 2007

Q: Kenapa saya perlukan plan ini ?
A: Kerana keperluan untuk mendapatkan rawatan perubatan di hospital terbaik bukan lagi satu pilihan, tapi merupakan keperluan terutama ketika di dalam keadaan yang mendesak. Namun begitu, seiring dengan perkembangan teknologi perubatan yang semakin canggih, kos untuk mendapatkan perkhidmatan menjadi semakin tinggi & mahal. Oleh yang demikian, perkara terakhir yang sepatutnya merunsingkan anda bila perlu mendapatkan rawatan hospital adalah DUIT YANG MENCUKUPI!

Q: Siapa yang layak untuk memohon ?
A: Sesiapa sahaja layak untuk memohon, bermula pada umur tiga puluh (30) hari sehinggalah mereka yang berumur lima puluh sembilan (59) tahun. Namun begitu, tahap KESIHATAN YANG BAIK semasa memohon merupakan kriteria utama yang diambilkira sebelum permohonan diluluskan.

Q: Bila perlindungan akan bermula?
A: Sebaik sahaja borang permohonan anda diluluskan.

Q: Adakah proses pembaharuan (renewal) Plan MedicaLife 207 dijamin?
A: Ya, pembaharuan adalah DIJAMIN sehingga umur pemegang kad berumur 80 tahun ataupun telah mencapai had perlindungan seumur hidup, salah satu yang dicapai.

Q: Adakah premium yang dicarum untuk Plan MedicaLife 207 turut dijamin ?
A: Tidak, jumlah premium yang dicarum adalah tidak dijamin. Ini bagi memastikan kos perlindungan yang diberikan adalah releven dengan kos perubatan yang semakin meningkat seiring dengan teknologi perubatan yang semakin canggih diperkenalkan. Namun begitu, sebarang cadangan perubahan caruman adalah tertakluk kepada kelulusan Bank Negara Malaysia dan tidak boleh dinaikkan sesuka hati.

Q: Adakah tempoh masa menunggu?
A: Ya, selama 30 hari bermula daripada tarikh efektif polisi melainkan kes-kes yang melibatkan kemalangan.

Q: Sekiranya saya membuat pembaharuan polisi Plan MedicaLife 207 sedia ada, adakah tempoh masa menunggu selama 30 hari masih terpakai ?
A: Tidak.

Q: Berapa banyak yang saya boleh tuntut?
A: Anda boleh membuat tuntutan sehingga had tahunan setiap tahun dan sehingga had seumur hidup sepanjang polisi berkuatkuasa, bergantung kepada jenis plan yang dipilih.

Q: Apakah Co-Insurance/Co-Payment dan naik taraf bilik wad ?
A: Sekiranya pencarum dimasukkan ke hospital dan memilih untuk masuk ke wad yang mempunyai rate yang melebihi daripada rate wad plan perlindungan yang diambil, pencarum berkenaan perlu menanggung lebihan kepada rate wad tersebut, serta 10% daripada kos keseluruhan seperti yang tertakluk kepada faedah yang terkandung di dalam plan yang diambil.

Q: Sekiranya Plan MedicaLife 207 Plan adalah dengan kemasukan secara "cashless" di panel-panel hospital yang dilantik, mengapa pencarum masih perlu membayar amaun tertentu sebagai deposit semasa proses kemasukan ?
A: Kebiasaanya bayaran ini adalah deposit untuk perbelanjaan bukan berkaitan rawatan hospital seperti penggunaan telefon, dobi dan lain-lain ataupun co-insurance yang perlu ditanggung oleh pihak pencarum seperti yang diterangkan di atas. Bergantung kepada hospital, deposit yang dikenakan adalah di dalam linkungan RM200 ke RM2,500. Namun begitu, deposit yang tidak digunakan akan dipulangkan semula kepada pencarum oleh pihak hospital.

Q: Bolehkan saya mendapatkan rawatan di hospital yang bukan panel ?
A: Boleh, namun begitu pencarum perlu membayar dahulu kos keseluruhan dan membuat tuntutan kemudian kepada pihak syarikat, berdasarkan jumlah yang customary & reasonable. Sila hubungi no 1-800-88-1320 (MediExpress) untuk keterangan lanjut.

Q: Kenapa ada kes hospital yang tidak menerima Kad Perubatan MedicaLife 207?
A: The followings are common circumstances whereby this can happen: 1) illness is not covered, first 30 days waiting period, Specific illnesses, Underwriting exclusions, General exclusions or Non-disclosure of Pre-existing illnesses; 2) Final diagnosis is different from the initial diagnosis; 3) Policy has expired; 4) Application has not been approved; 5) Policy has expired, but renewal premium was paid (could possibly due to policy could not be approved as there is a shortage of premium or relevant documents are not complete or timing is incorrect); 6) Hospital Admission Staff refused to contact MediExpress; and/or 7) Policyholder goes to a Non-Panel Hospital.

Q: Bolehkah saya upgrade plan sedia ada kepada plan yang tinggi nilai perlindungannya?
A: Boleh. Namun begitu setiap permohonan akan dianggap & diklasifikasikan sebagai permohonan baru & anda berkemungkinan perlu mengemukakan status kesihatan terkini anda secara terperinci, tertakluk kepada terma-terma yang telah ditetapkan.

Q: How do I make a hospitalisation and/or surgical claim?
A: In the event you have been treated at a hospital which is not a participating hospital, just call 1-800-88-1320 (MediExpress) to make your claim. All services from MediExpress on admission & discharge are subject to eligibility, benefits of your plan and a waiting period of 90 days at the first policy year.

Q: Saya amat berminat untuk menyertai Plan MedicaLife 207 untuk saya seisi keluarga. Bagaimana caranya?
A: AMAT MUDAH. Telefon saya sekarang, Aznan 013-3916433 atau emailkan kepada maatakaful.advisor@gmail.com untuk mengatur temu janji mengikut kesesuaian masa & lokasi anda (Lembah Klang & Selangor sahaja) . Saya akan memberikan khidmat rundingan secara percuma sebelum anda memilih jenis plan yang terbaik untuk anda dan keluarga, selain borang permohonan yang perlu diisi dan ditandatangani untuk pengesahan. Selebihnya, akan saya uruskan!