Certificate Document

28/12/2021
CIK AINUL AINA BINTI MOHD NOOR

C-36 KG GONG BERANGIN
TEMPINIS
22020 JERTEH MELALUI POS BERDAFTAR
NOMBOR SIJIL ANDA: 401510256-8

Peserta yang dihormati,
Selamat datang ke keluarga Great Eastern Takaful dan terima kasih di atas keputusan untuk menyertai Sijil Takaful Keluarga ini.
Di sini kami sertakan Sijil Takaful bersama-sama dengan salinan borang cadangan yang telah anda lengkapkan untuk simpanan
anda. Sila semak dokumen-dokumen ini dengan teliti. Sekiranya terdapat mana-mana maklumat yang salah atau tidak tepat di
dalam dokumen-dokumen anda, sila hubungi kami secepat mungkin.
Kami berbangga dapat menguruskan keperluan simpanan dan pelaburan jangka panjang anda.
Penyertaan anda di dalam pelan ini juga akan mendekatkan anda kepada nilai-nilai yang anda percayai. Konsep Takaful adalah
berlandaskan prinsip tanggungjawab bersama, kepentingan bersama dan bantuan secara sukarela. Sebahagian dari sumbangan
anda akan disumbangkan ke dalam tabung Tabarru’ (derma), yang akan digunakan untuk membantu satu sama lain pada saat-saat
yang memerlukan.
Jika anda memerlukan bantuan dan penerangan lanjut, sila hubungi ejen anda pada bila-bila masa atau menelefon talian Careline
kami di 1300 13 8338. Kami menjanjikan perkhidmatan yang terbaik pada setiap masa.
Terima Kasih.
Yang benar,
AGENSI :
860122-1 KAMARUL ARIFFIN BIN HUSSIN SABLI (60)
860115-8 PHILLIP WEALTH PLANNERS SDN BHD (60)
860115-8 PHILLIP WEALTH PLANNERS SDN BHD (60)
SHAHRUL AZLAN SHAHRIMAN

Ketua Pegawai Eksekutif
Lampiran: Sijil & Salinan borang cadangan Takaful Keluarga anda
YOUR CERTIFICATE NUMBER: 401510256-8

Dear esteemed Participant,
We welcome you to our family of Great Eastern Takaful and thank you for making the decision to participate in this Family Takaful
Certificate from us.
We are pleased to enclose your Takaful Certificate together with a copy of your completed proposal form for your safe-keeping.
Please check through these documents carefully. If there is any inaccurate or incorrect information in your documents kindly inform
us immediately.
We are glad to take on the responsibility of looking after your long-term financial and savings needs.
Your participation in this plan will also enable you to be closer to the values you believe in. Takaful concept is based on the
principles of mutual cooperation, shared responsibility and voluntary assistance. Part of your contribution will be donated into a
Tabarru’ (donation) fund, which will be used to support each other in times of needs.
If you require further assistance, please feel free to get in touch with your agent, or call our Careline at Tel 1300 13 8338. We assure
you of our best service at all times.
Thank You.
Yours Faithfully
SHAHRUL AZLAN SHAHRIMAN

Chief Executive Officer
Encl: Certificate & copy of your Family Takaful proposal form
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This page is intentionally left blank.
CERTIFICATE NO: 401510256-8
CERTIFICATE INFORMATION STATEMENT

Dear Participant,
Thank You for taking up this Certificate. This is a financial security product that has been customised
according to Your current requirements.
You would find the following information helpful to You in future. This reflects, where applicable, the
provisions of the Islamic Financial Services Act 2013. All statements and representations (if any) made by Us
in this Certificate Information Statement are made in good faith based on Our reasonable knowledge as at
Issue Date and We accepts and undertakes no liability whatsoever for the accuracy of any and all
subsequent changes or amendments to any law, regulation or practice relating to and affecting the validity or
accuracy of the same. You may at all times seek independent advice from any advocate and/or solicitor and/
or tax consultant in order to ascertain Your rights and entitlements under or relating to this Certificate before
making any decision.
PROOF OF AGE
Proof of age is needed before any benefit can be paid. Please produce one of the following original
documents at any of Our offices as listed on Our website www.greateasterntakaful.com.
· NRIC · Birth Certificate · International Passport · Citizenship Certificate
NOMINATION
If nomination is applicable and Your age is 16 years and above, You may nominate one or more individuals
to receive the Takaful benefits payable upon Your death, either as an Executor or as a beneficiary under a
Conditional Hibah. The nomination form is available on Our website, or You can also perform nomination
online through Our customer portal i-Get In Touch igetintouch.greateasterntakaful.com.
CHANGE OF ADDRESS
It is important that You inform Us immediately in writing of any change in Your address to ensure that You
receive letters or notices, etc. from Us. Any change in Your nominee’s addresses should also be notified to
Us to facilitate the payment of claim.
SURRENDER VALUES
Family Takaful is a financial security. Once You have it, please do not give it up! Any change of health or
circumstance may mean one of two things to You or Your family:
· You may not be able to have Family Takaful protection
or · You may have to contribute substantially more for the same protection.
So, be regular and prompt with Your Contribution payments. Your Certificate is an asset. Should the
Certificate is surrendered, You may receive less than the amount You contribute in. However, You may
surrender this Certificate for its surrender value, if any under Your Certificate. It may not be advantageous
to surrender or replace an existing Certificate with a new one due to high initial cost. Please consult
Your agent or call Our Careline before making Your decision.
CONTRIBUTION PAYMENTS
You can pay Contributions annually, semi-annually, quarterly or monthly, whichever suits you best and
through any of the following methods:
(a) Credit / Debit Card: You can make Contribution payment through Visa or MasterCard card via Our
online portal I-Get-In-Touch (https://igetintouch.greateasterntakaful.com) e-
Payment Service and register the card for recurring Contribution payment.
(b) Banker’s Order: You need to make necessary arrangement in advance with Your respective bank
to remit the Contribution prior to next Contribution due date.
(c) Biro Perkhidmatan This option is only applicable if You are employed with government bodies. You
Angkasa: need to complete and submit the original 1/79 BPA form, Certified true copy
(CTC) contributor NRIC, and Certified true copy (CTC) contributor latest salary
slip to Us for remit the Contribution payment from contributor’s salary.
(d) GIRO / Direct Debit You need to complete the original Autodebit Form (GIRO) / Direct Debit
(DDA): Authorisation Form (DDA) to Us for Your bank to remit the Contribution payment
from Your bank account.
(e) Internet Banking: You can pay Your Contribution through internet banking bill payment service from
Malayan Banking Berhad (MBB), Public Bank Berhad (PBB), and CIMB Bank.
Kindly ensure the Contribution payment is made to Great Eastern Takaful Berhad.
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(f) JomPAY: You can pay Your Contribution online via Internet and mobile banking with your
current or savings account with the JomPAY details:
Biller Code: 16899, Ref-1: Certificate Number, Ref-2: Mobile Phone Number.
No official receipt will be issued and all the payment made under auto payment transaction will be reflected
in Your FAMILY TAKAFUL CONTRIBUTION STATEMENT issued by Us on yearly basis.
FREE LOOK PERIOD

You may cancel Your Takaful Certificate within fifteen (15) days after signing the acknowledgement or e-
acknowledgement receipt upon receiving the Certificate or e-Certificate (where applicable), by way of a
written notice to Us.
The following will be refunded to You:

· any Contribution which has been paid in respect of this Certificate,
less any expenses incurred for the medical examination of the Person Covered, upon which the Certificate
shall be deemed cancelled and our liability thereunder shall cease.
SUBMISSION OF CLAIM
To make a claim, please write to Us immediately after the event occurred and submit all documents and
related forms that are necessary for Your claim under this Certificate. The claims forms can be obtained from
Our website. Proof of claim must be accepted and approved by Us to facilitate payment of any benefit.
ENQUIRIES ON YOUR CERTIFICATE

You can contact any of Our offices listed on Our website at www.greateasterntakaful.com or Our Customer
Careline at 1300 13 8338 for any enquiries on Your Certificate during Our office hours from 8.30 a.m. to 5.15
p.m. by either quoting Your Certificate number or Our reference number.
CUSTOMER FEEDBACK UNIT

Any feedback related to Your Certificate can be made to Our Customer Feedback Unit at:
Customer Feedback Unit
Great Eastern Takaful Berhad, Level 3, Menara Great Eastern, 303 Jalan Ampang, 50450 Kuala Lumpur.
Careline No. : 1 300 13 8338
Telephone No. : (603) 4259 8338
Fax No. : (603) 4252 7528
Email : cfu@greateasterntakaful.com
Website : www.greateasterntakaful.com
If You are not satisfied with Our response, You can refer to the Ombudsman for Financial Services or Bank
Negara Malaysia's BNMLINK or BNMTELELINK.
OMBUDSMAN FOR FINANCIAL SERVICES or CUSTOMER SERVICES BUREAU, BANK NEGARA

MALAYSIA
You may make or submit Your complaint to the Ombudsman for Financial Services or Bank Negara
Malaysia's BNMLINK or BNMTELELINK within six (6) months from Our Customer Feedback Unit's decision.
Please contact Our Customer Feedback Unit for further assistance or if You require any clarification on the
above. The followings are the contact details of OFS or BNM:
Ombudsman for Financial Services

No. 14, Level 14, Main Block Menara Takaful Malaysia, Jalan Sultan Sulaiman, 50000 Kuala Lumpur.
Telephone No. : (603) 2272 2811
Fax No : (603) 2272 1577
Website : www.ofs.org.my
Bank Negara Malaysia

Laman Informasi Nasihat dan Khidmat (BNMLINK) (Walk-in Customer Service Centre)
Ground Floor, D Block. Jalan Dato’ Onn, 50480 Kuala Lumpur
Contact Centre (BNMTELELINK)

Corporate Communication Department, Bank Negara Malaysia, P.O. Box 10922, 50929 Kuala Lumpur
Telephone No. : 1 300 88 5465; Overseas: (603) 2174 1717
Fax No : (603) 2174 1515
Email : bnmtelelink@bnm.gov.my
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What is the electronic medical (e-Medical) card?

e-Medical card is a secured digital version of Medical Card that allows You to access via Your mobile application called
GETCare App where You are able to view Your Certificate information, utilisation balance, search for nearby panel hospital,
and enjoy road assistance service.
How to use the e-Medical card?
If the Person Covered are required to be admitted in any of Our panel hospital and would like to use Our Guarantee Letter
service, please present the e-Medical card (image) on Your smartphone / the Person Covered’s smartphone together with
Person Covered’s identification card (NRIC/Passport) to the admission department in the respective hospital.
You / Person Covered who have medical rider/ plan with Us are able to view their e-Medical cards via “GETCare” App. You /
Person Covered can also save the image of the medical card using the screenshot function of Your/Person Covered’s
smartphone.
Important Note: The e-Medical card can only be used in Our panel hospitals and Guarantee Letter service is subjected to
terms & condition in Your certificate contract. Please refer to the list of Panel Hospitals available in the GETCare App.
e-Medical card cannot be used as a guarantee for hospital deposit
Most hospitals will request for upfront deposit payment as part of the admission requirement. However, the deposit payment
will be refunded by the hospital after deducting the non-covered charges.
e-Medical card does not cover the following items and any non-medical charges such as:-
§ Telecommunication, newspaper, lodger, personal laundry, extra food and beverage
§ Vitamins and food supplements
§ Registration fee, Admission Pack, and Medical Report Fee
§ Special aid / braces and appliances / equipment (artificial limbs, all forms of hearing aids, external or temporary
pacemakers, automatic implanted cardioverter defibrillator and prescriptions thereof)
§ Dental expenses arising from placement of denture and prosthetic services such as bridges, implants and crowns or
their replacement.
§ Any treatment, which is not consistent with the covered disability as well as any preventive treatments and/or
preventive medicines.
The above list are not exhaustive and not reimbursable. Please refer to the terms and condition in your Certificate Contract or
call our Health Care Centre at 1-300-1300-18.
Our Guarantee Letter service is provided subject to validation checks being conducted to ascertain if the hospital admission is
admissible pursuant to the terms and conditions of the Certificate Contract, such validation checks may include but is not
limited to ascertain the existence of any material non-disclosure, pre-existing condition or whether the condition being treated
falls under any certificate exclusion. If a Guarantee Letter is not issued following the completion of such validation checks, you
may still submit your claim for Our consideration on reimbursement basis.
How to Apply for Reimbursement?
For reimbursement cases, You are required to complete and submit the claim form together with the final hospital bills, original
receipts and include any other medical report or any test result to Us. Claims that fall under the reimbursement category are:
§ Admission to non-panel hospitals/ specialist
§ Pre/post hospitalization
§ Accident outpatient treatment at a clinic or specialist clinic
§ Outpatient cancer/ kidney dialysis treatment
§ Dental treatment (due to accident only)
§ For hospital admission where the guarantee letter has not been issued
How to call for Emergency Repatriation/Evacuation?
You may make a reverse charge call to the dedicated telephone number 03-4259 8853 that is available in the e-Medical Card
option on your GETCare app, when You are overseas.
1. You may call the foreign country operator and request to make a collect call (reverse charge) to Malaysia.
2. The Operator will ask for Your identity, number for collect call and the person to whom You wish to speak to.
3. You should state Your name and request to speak to "anyone at Supreme Assist".
4. The Operator will then put the call through to the Customer Service personnel who will respond/accept the collect
call.
How do I renew my e-Medical card?
The e-Medical card is valid as long as You have a valid (inforce) Certificate with Our selected Medical protection plan or rider.
TINFO/V06/10-2020 Page 1 of 2 2912/023043/5

Apakah kad perubatan elektronik (e-Kad Perubatan)?

e-Kad Perubatan adalah versi digital Kad Perubatan yang membolehkan Anda mengakses melalui aplikasi mudah alih Anda
yang dipanggil Aplikasi GETCare di mana Anda dapat melihat maklumat Sijil Anda, baki penggunaan, mencari hospital panel
berhampiran, dan menikmati perkhidmatan bantuan jalan raya.
Bagaimana menggunakan e-kad Perubatan?
Sekiranya Orang yang Dilindungi dikehendaki dimasukkan ke mana-mana panel hospital Kami dan ingin menggunakan
perkhidmatan Surat Jaminan Kami, sila kemukakan e-kad Perubatan (gambar) pada telefon pintar anda / telefon pintar Orang
yang Dilindungi beserta kad pengenalan Orang yang Dilindungi (Kad Pengenalan / Pasport) ke jabatan kemasukan di hospital.
Anda / Orang yang Dilindungi yang mempunyai rider / pelan perubatan bersama Kami dapat melihat e-kad Perubatan mereka
melalui Aplikasi "GETCare". Anda / Orang yang Dilindungi juga dapat menyimpan gambar kad perubatan menggunakan fungsi
tangkapan skrin telefon pintar Anda / Orang yang Dilindungi.
Nota Penting: e-Kad Perubatan hanya dapat digunakan di hospital panel Kami dan perkhidmatan Surat Jaminan tertakluk
kepada terma & syarat dalam kontrak sijil Anda. Sila lihat senarai Hospital Panel yang terdapat di Aplikasi GETCare.
e-Kad Perubatan tidak boleh digunakan sebagai jaminan deposit hospital.
Sebilangan besar hospital akan meminta pembayaran deposit muka sebagai syarat kemasukan. Walau bagaimanapun,
pembayaran deposit akan dikembalikan oleh pihak hospital setelah menolak caj yang tidak dilindungi.
e-Kad Perubatan tidak meliputi item berikut dan sebarang caj bukan perubatan seperti: -
§ Telekomunikasi, surat khabar, penginapan, dobi peribadi, makanan dan minuman tambahan
§ Vitamin dan makanan tambahan
§ Bayaran pendaftaran, Kemasukan, dan Bayaran Laporan Perubatan
§ Bantuan khas / pendakap dan perkakas / peralatan (anggota badan tiruan, semua bentuk alat bantu pendengaran,
alat pacu jantung luaran atau sementara waktu, defibrilator kardioverter implan automatik dan preskripsi
daripadanya)
§ Perbelanjaan pergigian yang timbul daripada penempatan perkhidmatan gigi palsu dan prostetik seperti jambatan,
implan dan mahkota atau penggantiannya.
§ Sebarang rawatan, yang tidak selaras dengan kecacatan yang dilindungi serta rawatan pencegahan dan / atau ubat
pencegahan.
Senarai di atas tidak lengkap dan tidak dapat diganti. Sila rujuk syarat dan ketentuan dalam Kontrak Sijil anda atau hubungi
Pusat Penjagaan Kesihatan kami di 1-300-1300-18.
Perkhidmatan Surat Jaminan kami disediakan tertakluk kepada pemeriksaan pengesahan yang dilakukan untuk memastikan
sama ada kemasukan ke hospital boleh diterima menurut terma dan syarat Kontrak Sijil, pemeriksaan pengesahan tersebut
mungkin termasuk tetapi tidak terhad untuk memastikan kewujudan bahan yang tidak dinyatakan , keadaan yang sudah ada
atau sama ada keadaan yang dirawat termasuk dalam pengecualian sijil. Sekiranya Surat Jaminan tidak dikeluarkan setelah
selesainya pemeriksaan pengesahan tersebut, anda masih boleh mengemukakan tuntutan anda untuk pertimbangan Kami
berdasarkan pembayaran balik.
Bagainmana cara untuk Memohon Bayaran Balik?
Untuk kes pembayaran balik, Anda diminta untuk melengkapkan dan menyerahkan borang tuntutan bersama dengan bil
hospital terakhir, resit asal dan menyertakan laporan perubatan lain atau apa-apa hasil ujian kepada Kami. Tuntutan yang
termasuk dalam kategori penggantian adalah:
§ Kemasukan ke hospital / pakar bukan panel
§ Yuran yang dikenakan sebelum atau selepas dimasukkan ke hospital
§ Rawatan pesakit luar secara tidak sengaja di klinik atau klinik pakar
§ Rawatan pesakit luar kanser / dialisis buah pinggang
§ Rawatan pergigian (akibat kemalangan sahaja)
§ Untuk kemasukan ke hospital di mana surat jaminan belum dikeluarkan
Bagaimana cara untuk memanggil Pemulangan / Pemindahan Kecemasan?
Anda boleh membuat panggilan pindah bayaran (reverse charge) ke nombor telefon khusus 03-4259 8853 yang tersedia
dalam pilihan e-Kad Perubatan pada aplikasi GETCare anda, semasa Anda berada di luar negara.
1. Anda boleh menghubungi telefonis negara asing tersebut dan meminta untuk membuat panggilan pindah bayaran ke
Malaysia.
2. Telefonis akan mendapatkan nama anda, talian yang ingin dihubungi dan nama orang yang anda ingin hubungi.
3. Anda perlu menyatakan nama sendiri dan meminta untuk bercakap dengan “sesiapa sahaja di Supreme Assist”
4. Telefonis akan menyambungkan talian kepada Kakitangan Perkhidmatan Pelanggan yang menjawab/ menerima
panggilan pindah bayaran tersebut.
Bagaimana cara untuk saya memperbaharui e-kad Perubatan saya?
e-Kad Perubatan sah selagi Anda mempunyai Sijil yang sah (berkuat kuasa) dengan pelan atau rider perlindungan perubatan
Kami yang dipilih.
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STAMP DUTY EXEMPTED
CERTIFICATE NO : 401510256-8
You, the Participant named in Takaful Schedule A of this certificate, have

agreed to enter into this contract of Takaful (“this Certificate”) with Great
Eastern Takaful Berhad (“the Takaful Operator” or “Us” or “We”).
This Certificate is made up of:

1. the Certificate Information Statement; and
2. the Takaful Schedule(s); and
3. the Privileges and Conditions; and
4. the Annexures (if any); and
5. the Endorsement(s) (if any) made at the Issue Date; and
6. the proposal, application and/or statements made by You and/or the
Person Covered; and
7. the Benefit Illustration; and
8. the Product Disclosure Sheet; and
This Certificate aims to spread the spirit of Takaful based on the principles
of shared responsibility, cooperation and common interest.
This Certificate is signed on the Issue Date.
Chief Executive Officer
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TAKAFUL SCHEDULE A
TYPE OF PLAN: FAMILY TAKAFUL MEDICAL PLAN.
i-GREAT MEDIHARAPAN
APPLICABLE BENEFITS CURRENCY AGE NEXT BIRTHDAY COMMENCEMENT DATE

PLAN OR AMOUNT
SEE SCHEDULE OF BENEFITS RINGGIT MALAYSIA 26 ADMITTED 28/12/2021
BASIC CONTRIBUTION
REFER TO TABLE OF CONTRIBUTION BELOW.
EFFECTIVE DATE ISSUE DATE

28/12/2021 28/12/2021
OFFICE OF TAKAFUL OPERATOR FOR PAYMENT OF CONTRIBUTIONS AND BENEFITS

MALAYSIA
EVENT WHEN THE BASIC SUM COVERED WILL BECOME PAYABLE

WHEN THE PERSON COVERED IS CONFINED IN A HOSPITAL OR IS RECEIVING TREATMENT RELATED TO THE
COVERED BENEFITS, PRIOR TO THE MATURITY DATE 28/12/2095
CERTIFICATE NO: 401510256-8 PROPOSAL NO: JHB/15104/21

PARTICIPANT & PERSON COVERED :
CIK AINUL AINA BINTI MOHD NOOR 960906-11-5524
PARTICIPANT'S : C-36 KG GONG BERANGIN TEMPINIS

ADDRESS 22020 JERTEH
TABLE OF SUPPLEMENTARY BENEFITS

SUPPLEMENTARY LAST CONTRIBUTION EXPIRY
BENEFITS / RIDER DUE DATE DATE AMOUNT OF BENEFITS ANNEXURE
SPECIAL PROVISIONS / ENDORSEMENTS

008(SAssist) 028(T ESO)
BAEEAABEAEABEEAEBAAEEBEAAEBAAEABEEAAFAAEEBEAAAFEAAEBAEABAEEA
TSA6/V01/04-2017 Page 1 of 2 2912/023043/9

TABARRU'
TABARRU’ FOR BASIC BENEFIT SHALL BE DEDUCTED FROM CONTRIBUTION AT STANDARD RATES WHICH ARE
APPLICABLE TO THE PERSON COVERED.
TABLE OF CONTRIBUTION
TYPE OF PLAN/SUPPLEMENTARY BENEFIT MONTHLY CONTRIBUTION LAST CONTRIBUTION DUE DATE
T MEDH200 i-GREAT MEDIHARAPAN RM 96.00 28/11/2095
*The contribution is subject to change and based on the attained age next birthday of the Person Covered on the first
day of the Certificate Year. Please refer to Schedule of Contribution Rates under Takaful Schedule L for the
contribution amount.
TSA6/V01/04-2017 Page 2 of 2 2912/023043/10

TAKAFUL SCHEDULE B
TYPE OF PLAN:
i-GREAT MEDIHARAPAN
TAKAFUL CONTRIBUTION
PLEASE REFER TO TAKAFUL SCHEDULE B2 FOR THE DETAILS OF TAKAFUL CONTRIBUTION

ALLOCATION.
UPFRONT CHARGE (UNALLOCATED CONTRIBUTION)
UPFRONT CHARGE IS DEDUCTED FROM THE CONTRIBUTION PAID FOR DISTRIBUTION

RELATED EXPENSES (INCLUDING AGENT’S COMMISSIONS) AND OTHER MANAGEMENT
EXPENSES INCLUDING STAMP DUTY OF RM10.
Page 1 of 1 2912/023043//11
TXB12/V02/09-2019
TAKAFUL SCHEDULE B2
Allocation Rate for Takaful Contribution - i-GREAT MEDIHARAPAN
Contribution Year Allocation Rate

1 64.00%
2 64.00%
3 64.00%
4 64.00%
5 64.00%
6 64.00%
7 64.00%
8 64.00%
9 64.00%
10 64.00%
11 64.00%
12 64.00%
13 64.00%
14 64.00%
15 64.00%
16 64.00%
17 64.00%
18 64.00%
19 64.00%
20 and above 64.00%
TSB4/V02/10-2012 Page 1 of 1 2912/023043/12

TAKAFUL SCHEDULE L
SCHEDULE OF CONTRIBUTION RATES
Standard Contribution Rates per Annum for i-Great MediHarapan (T MEDH200)

Female Smoker/Non Smoker
Contribution Rate Contribution Rate Contribution Rate

Per Annum with Per Annum with Per Annum with
respect to the respect to the respect to the
Attained Age Next Birthday Person Covered’s Person Person
occupation Covered’s Covered’s
classification of occupation occupation
either 1 or 2 classification of 3 classification of 4
From Until
1 5 1,956 2,436 2,928
6 10 984 1,236 1,476
11 15 948 1,188 1,428
16 20 996 1,248 1,500
21 25 1,032 1,296 1,548
26 30 1,152 1,440 1,716
31 35 1,176 1,476 1,776
36 40 1,368 1,716 2,052
41 45 1,752 2,184 2,616
46 50 2,196 2,748 3,300
51 55 2,712 3,384 4,068
56 60 3,120 3,900 4,680
61 65 4,572 5,712 6,852
66 70 7,860 9,828 11,784
71 75 11,388 14,232 17,076
76 80 13,644 17,052 20,460
81 85 16,968 21,204 25,452
86 90 20,100 25,116 30,144
91 95 23,040 28,800 34,548
96 99 26,076 32,592 39,108
* For renewal only.
Notes:
(1) The contribution rates above are not guaranteed. We may vary the contribution rates in
accordance with Clause 6 of Privileges and Conditions, as the case may be.
(2) Person Covered’s occupation classification under this Certificate is 1
TLZW/V01/09-2019 Page 1 of 1 2912/023043/13

SCHEDULE OF BENEFITS
CERTIFICATE NO : 401510256-8 CAR REGISTRATION NO: NOT APPLICABLE
CERTIFICATE OWNER : AINUL AINA BINTI MOHD NOOR
CURRENCY: RINGGIT MALAYSIA
APPLICABLE BENEFITS PLAN : SEE SCHEDULE BELOW
OR AMOUNT
Item Covered Benefits Maximum Benefits

(1) Hospital Room and Board
(subject to a maximum of 180 days in any RM 200 per day, subject to Overall Annual Limit.
Certificate Year for Covered Benefits (1) and
(2) in aggregate)
(2) Intensive Care Unit
(subject to a maximum of 180 days in any As charged, subject to Overall Annual Limit.
Certificate Year for Covered Benefits (1) and
(2) in aggregate)
(3) Hospital Supplies and Services
(4) Surgical Fees
(5) Operating Theatre
(6) Anaesthetist Fees
(7) In Hospital Physician Visit (subject to a
maximum of 2 visits per day)
(8) Pre-Hospitalisation Diagnosis Tests
(within 60 days prior to Hospitalisation)
(9) Pre-Hospitalisation Specialist Consultation
(within 60 days prior to Hospitalisation)
(10) Post-Hospitalisation Treatment
(within 90 days after discharge from Hospital)
(11) Organ Transplant
(12) Ambulance Fees
(13) Day Surgery
(14) Outpatient Cancer Treatment As charged.
(15) Outpatient Kidney Dialysis Treatment (Including the cost of consultation, examination
tests and take home drugs)
(16) Emergency Accidental Outpatient Treatment
RM 5,000
(subject to a maximum of 30 days from the
As charged, subject to the limit stated above.
date of Accident)
(17) Daily-Cash Allowance at Malaysian
Government Hospital RM 100
(subject to a maximum of 120 days in any
Certificate Year)
(18) Intraocular Lens Up to RM 1,000 per eye and maximum of RM 2,000
per lifetime, subject to Overall Annual Limit.
(19) Overall Annual Limit RM 200,000
(20) Overall Lifetime Limit No Limit
(21) Malaysian Tax Service tax and/or other tax(es) incurred on
Covered Benefits, for which a claim is payable; not
subject to Overall Annual Limit
Note:
The amount of Deductible payable by the Person Covered which applicable for Item one (1) to seven (7)
is subject to a maximum of Ringgit Malaysia Three Hundred (RM300) per Any One Disability.
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PRIVILEGES AND CONDITIONS
GLOSSARY (Clause 1)
1. DEFINITIONS AND INTERPRETATIONS
“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.
“Any One Disability” means all of the periods of disability arising from the same cause including
any and all complications there from except that if the Person Covered completely recovers and
remains free from further treatment (including drugs, medicines, special diet or injection or advice for
the condition) of the disability for at least ninety (90) days following the latest date of discharge and
subsequent disability from the same cause shall be considered as though it were a new disability.
“Attained Age Next Birthday” means the age next birthday of the Person Covered on preceding (or
coincident) Certificate Anniversary.
“Certificate Anniversary” means the anniversary of the Commencement Date.
“Certificate Year” means the one year period which starts on the Commencement Date or any
Certificate Anniversary and ends on the day before the first Certificate Anniversary or the following
Certificate Anniversary, as the case may be, or the one-year period which starts on the date the
Renewal or Renewed Certificate takes effect or any Certificate Anniversary of the Renewal or
Renewed Certificate.
“Clinic” means an establishment duly constituted and registered as a clinic, which is operated for the
treatment of injured or ill patients and provides facilities for diagnosis, minor surgery and dispensing
facilities. Such establishment must be operated by a Physician who is legally registered with
Malaysian Medical Council.
“Commencement Date” means the Commencement Date as specified in Takaful Schedule A. This
reflects the Effective Date where the coverage starts when there is no backdating applied. Where
backdating is applied, the Commencement Date will be earlier than the Effective Date.
“Congenital Conditions” means any medical or physical abnormalities existed at the time of birth,
or neo-natal physical abnormalities developing within six (6) months from the time of birth. This will
include all types of hernias and epilepsy except when caused by trauma, which occurred after the
Effective Date.
“Contribution” means the contribution specified in Takaful Schedule A or in any subsequent
endorsement issued by Us.
“Day Surgery” means a medical process involving a patient who needs the use of a recovery facility
for a surgical procedure on a pre-plan basis at the Hospital or specialist Clinic (but not for overnight
stay) for less than eight (8) hours.
“Deductible” means the amount payable by You in a Certificate Year, as the case may be, which is
stated in the Schedule of Benefits.
“Dentist” means a person who is duly licensed or registered to practise dentistry in the geographical
area in which a service is provided, but excluding a physician or surgeon or dentist who is the Person
Covered himself.
“Disability” means a Sickness, Disease, Illness or the entire Injury arising out of a single or continuous
series of causes.
“Doctor” or “Physician” or “Surgeon” means a registered medical practitioner qualified and
licensed to practise western medicine and who, in rendering his service, is practising within the scope
of his licensing and training in the geographical area of practice, but excluding a doctor, physician or
surgeon who is the Person Covered himself.
“Effective Date” means the date the coverage starts as specified in Takaful Schedule A.
“Eligible Expenses” means Reasonable and Customary Charges incurred due to a covered Disability
but not exceeding the limits stated in the Schedule of Benefits.
“Endorsement” means a variation to this Certificate.
“Hospital” means 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:-
(a) has facilities for diagnosis and major surgery,
(b) provides twenty-four (24) hour a day nursing services by registered and graduate nurses,
(c) is under the supervision of a Physician, and
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(d) 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.
“Hospitalisation” means admission to a Hospital as a registered Inpatient for a continuous period of
at least eight (8) consecutive hours on Medically Necessary treatments for a covered Disability upon
recommendation of a Physician. A patient shall not be considered as an Inpatient if the patient does
not physically stay in the Hospital for the whole period of confinement.
“Illness”, “Sickness” or “Disease” means a physical condition marked by a pathological deviation
from the normal healthy state.
“Injury” means bodily injury caused solely by Accident.
“Inpatient” means a Person Covered who has been assigned to a hospital bed during
Hospitalisation, which is not in the Outpatient department of a Hospital.
“Intensive Care Unit” 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.
“Investment Loss/Profit” means the loss or profit arising from managing the investment of the
Tabarru’ Fund(s) in Shariah-compliant securities and activities.
“Ju’alah” means compensation for a given service, where the Participant will share the Underwriting
Surplus with Us on a pre-agreed ratio.
“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.
“Maturity Date” means the date the coverage ceases as specified in Takaful Schedule A.
“Medically Necessary” means a medical service which is:-
(a) consistent with the diagnosis and customary medical treatment for a covered Disability, and
(b) in accordance with standards of good medical practice, consistent with current standard of
professional medical care, and of proven medical benefits, and
(c) not for the convenience of the Person Covered or the Physician, and unable to be reasonably
rendered out of Hospital (if admitted as an Inpatient), and
(d) not of an experimental, investigational or research nature, preventive or screening nature, and
(e) for which the charges are fair, reasonable and customary for the Disability.
“Misrepresentation” means the definition ascribed to it under the Islamic Financial Services Act
2013 and which includes innocent, reckless or deliberate misrepresentation.
“MMA Guidelines” means the latest available schedule of fees or charges for various descriptions
of medical services and/or treatment which is provided by the Malaysian Medical Association (MMA)
for the guidance of the medical profession in Malaysia.
“Mudharabah” means We, acting as an entrepreneur (Mudharib) that manages the collected funds
based on an investment mandate with a set of predefined ethical guidelines and Participant as capital
provider (Rabbul Mal). In return, We will share the profit with the Participant on the investment return
based on pre-agreed ratio.
“Outpatient” means a Person Covered who is receiving medical care or treatment (including Day
Surgery and treatment in a Daycare centre) without being hospitalised in a Hospital.
“Participant” means the Certificate Owner as specified in Takaful Schedule A.
“Person Covered” means the person who is covered under this Certificate as specified in Takaful
Schedule A.
“Pre-existing Illness” means disabilities that the Person Covered has reasonable knowledge of,
prior to or on the Effective Date or date of any reinstatement, whichever is later. A Person Covered
may be considered to have reasonable knowledge of a Pre-existing Illness where the condition is one
for which:
(a) the Person Covered had received or is receiving treatment; or
(b) medical advice, diagnosis, care or treatment has been recommended; or
(c) clear and distinct symptoms are or were evident; or
(d) its existence would have been apparent to a reasonable person in the circumstances.
“Prescribed Medicines” means 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.
“Qard” means an interest-free loan provided by Us in the event of deficit in the Tabarru’ Fund. The
Qard is repayable from the future Underwriting Surplus of the Tabarru’ Fund.
“Reasonable and Customary Charges” means Medically Necessary charges for medical care
which is considered reasonable and usual 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 Illness, Sickness, Disease or Injury and in accordance with accepted
TPCAZ/V02/12-2020 Page 2 of 19 2912/023044/16

medical standards and practice which could not have been omitted without adversely affecting the
Person Covered’s medical condition.
“Renewal or Renewed Certificate” means a Certificate which has been renewed without any lapse of
time upon expiry of a preceding Certificate with the same content.
“Specialist” means a registered medical or dental practitioner qualified and licensed 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 or
dentistry, but excluding a physician, dentist or surgeon who is the Person Covered himself.
“Specified Illnesses” means the following disabilities and its related complications, occurring within
the first one hundred and twenty (120) days from the Effective Date. However, if there is a break in
coverage prior to the expiry of the said one hundred and twenty (120) days, a fresh period of one
hundred and twenty (120) days shall apply again from the date of reinstatement:
(a) Hypertension, diabetes mellitus and Cardiovascular disease;
(b) All tumours, cancers, cysts, nodules, polyps;
(c) Stones of the urinary system and biliary system;
(d) All ear, nose (including sinuses) and throat conditions;
(e) Hernias, haemorrhoids, fistulae, hydrocele, varicocele;
(f) Disease of the Reproduction system including endometriosis;
(g) Vertebro-spinal disorders (including disc) and knee conditions.
“Surgery” means 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.
“Tabarru” means a portion of Contribution allocated into the Tabarru’ Fund as donation that You
willingly relinquish in order to help and provide assistance to fellow Participants in need.
“Tabarru’ Fund” means a pool of funds established for the purpose of solidarity and cooperation
among the Participants in Tabarru’ Fund for misfortune events (payment of claims).
“Takaful Operator”,“Our”, “Us” or “We” means Great Eastern Takaful Berhad (916257-H).
“Unexpired Tabarru’” means the portion of Tabarru’ to be refunded for the remaining months upon
surrender.
“Underwriting Surplus” means excess in the Tabarru’ Fund after deduction of claims and reserve
purposes, if any.
“Wakalah” means the contract of agency based on principle of Wakalah bi al-ujrah (or “Upfront
Charge” or “Unallocated Contribution”) where the charge imposed upfront according to the
percentage of Contribution paid as Participant appoints Us to manage Tabarru’ Fund. The amount
will be deducted from Tabarru' Fund.
“Waiting Period” means the first thirty (30) days from the Effective Date except for Specified
Illnesses, which shall be one hundred and twenty (120) days from the Effective Date. The Waiting
Period shall no longer become applicable after the first year of cover unless there is a break in
coverage in any Certificate Year, the Waiting Period shall apply again.
“You” or “Your” or “Yourself” means the Participant named in Takaful Schedule A.
If not specifically provided, the following interpretations will apply to this Certificate:
1.1 Any reference to a “business day” is to a day (not being a Saturday, Sunday or a Public
Holiday in Kuala Lumpur, Malaysia) on which Our Head Office is open for business in
Malaysia and any reference to a “day”, “week”, “month” or “year” is to that day, week, month
or year in accordance with the Gregorian calendar.
1.2 All schedules, annexures, endorsements and attachments to this Certificate shall form part of
this Certificate. If there is any conflict between the schedules, annexures or attachments of
this Certificate with the endorsement or Privileges and Conditions, the endorsement or
Privileges and Conditions (whichever is applicable), will prevail. Where there is any conflict or
discrepancy between the endorsement and the Privileges and Conditions, the endorsement
shall prevail.
1.3 Any reference to the masculine form shall include the feminine, and likewise, the singular
word shall include the plural and vice versa unless otherwise prescribed.
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BASIS OF CONTRACT (Clause 2)
2. TAKAFUL CERTIFICATE
2.1 This Certificate is issued in consideration of the Contribution payment received by Us and
according to:
2.1.1 the answers given by You and/or the Person Covered in Your application or Proposal
for Family Takaful (“Proposal”) or any subsequent questionnaires provided by Us on
any matters relating to Your Proposal and any disclosures made by You between the
time of submission and the time this Takaful Certificate takes effect; and
2.1.2 any other reports and questionnaires;
(collectively referred to as “Material Information”)
Such Material Information shall form part of this contract of Takaful between Us and
You. However, in the event of any pre-contractual Misrepresentation made in relation
to such Material Information, the remedies in Schedule 9 of the Islamic Financial
Services Act 2013 will apply.
2.2 It is Your duty to take reasonable care not to make any Misrepresentation when answering
the questions or confirming or amending any matter previously disclosed before this
Certificate is renewed or varied.
2.3 You must inform Us of any change to the information provided in Your answers or in respect
of any matter previously disclosed to Us if such changes had taken place after You have
submitted the application for renewal or variation but before this Certificate is renewed or
varied.
2.4 This Certificate may be varied with the consent in writing of Our Chief Executive Officer or any
person appointed by Our Board of Directors by way of special provision or Endorsement (“the
Document”) to this Certificate. Any subsequent variation will take effect from the date of the
Document and be deemed part of this Certificate. Any subsequent variation to this Certificate
will be notified to you with a notice in writing and in accordance with the "Notices and
Correspondence" clause below.
CONTRIBUTION AND CHARGES (Clauses 3 - 6)
3. CONTRIBUTION
3.1 The Contribution will be allocated into the Tabarru' Fund.

3.2 The Contribution may be increased by You based on the attained age next birthday of the
Person Covered at each Certificate Anniversary.
3.3 Contribution are to be paid to Us on or before each Contribution due date.
3.4 In the event of non-payment of Contribution while this Certificate is inforce, this Certificate will
lapse immediately after the Grace Period ends.
4. UPFRONT CHARGE
4.1 The Upfront Charge is the amount deducted upfront from the Tabarru' Fund (as a percentage
of Contribution less Service Tax and/or other taxes, if any) and is used to meet Our direct
distribution cost including agent’s commission, and management expenses.
4.2 If the Contribution is paid on annual, half-yearly or quarterly basis and in the event this
Certificate is surrendered or terminated due to any provisions before the date of the next
Contribution due, the Upfront Charge (other than the first year Upfront Charge) less actual
expenses incurred will be refunded.
4.3 Management expenses include Stamp Duty of Ringgit Malaysia ten (RM10).
5. TABARRU’
5.1 We will deduct the Tabarru’ from the Contribution based on the payment mode selected at the
beginning of each Contribution due.
5.2 Tabarru’ amount equals to the remaining contribution paid after Upfront Charge will be placed
into Tabarru’ Fund using the following formula:
Tabarru’ = Contribution Paid x Allocation Rate
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6. VARIATION OF CONTRIBUTION, TABARRU’ RATES AND OTHER CHARGES
6.1 We may vary the Contribution, Tabarru’ rates and other charges ("Rates and Charges")
under this Certificate by giving at least three (3) months’ advance written notice (“Notice
Period”) to You in accordance with the ‘Notices and Correspondence’ Clause. Any revision
whether to increase or decrease the Rates and Charges will take effect on the Certificate
Anniversary immediately following the expiry of the Notice Period, unless and otherwise you
disagree in writing and inform us within the Notice Period of your intention to surrender or
terminate this Certificate.
6.2 The revised Contribution will follow the allocation rate as specified in Takaful Schedule B of
this Certificate according to the Certificate Year.
LAPSE AND REINSTATEMENT (Clauses 7 - 8)
7. GRACE PERIOD AND TERMINATION
7.1 You are allowed up to thirty (30) days from each of the Contribution due dates to pay for Your
subsequent Contributions under this Certificate (“the Grace Period”).
7.2 If any claim occurs during the Grace Period, any amount of indebtedness under this
Certificate will be deducted from the claim proceeds payable to You.
7.3 Upon expiry of the Grace Period, this Certificate will lapse.
8. REINSTATEMENT
8.1 If this Certificate is terminated due to lapse, You may reinstate this Certificate within twelve
(12) months from the date of termination, at Our discretion and subject to the following
conditions:
8.1.1 Your written application for reinstatement is received by Us;
8.1.2 the Person Covered is within the age limit as determined by Us at the time of
reinstatement;
8.1.3 Your justification to be covered is satisfactory and accepted by Us;
8.1.4 You must pay all outstanding contributions to Us; and
8.1.5 any other conditions that We may need to impose.
8.2 We will approve, reject or impose additional conditions in writing on Your application for the
reinstatement at Our discretion.
8.3 If there is any Misrepresentation made in Your application for reinstatement and where this
Certificate has been in effect for two (2) years or less from the date of reinstatement, We
may, at Our discretion, void the Certificate if the misrepresentation is classified as follows:-
8.3.1 a deliberate or reckless Misrepresentation; or
8.3.2 a careless or innocent Misrepresentation in which We would not have reinstated this
Certificate; or
8.3.3 a careless or innocent Misrepresentation in which We would have reinstated this
Certificate.
8.4 If there is any Misrepresentation made in Your application for reinstatement and where this
Certificate has been in effect for more than two (2) years from the date of any reinstatement,
We may, at Our discretion, void the Certificate if the Misrepresentation is classified as a
deliberate or reckless Misrepresentation, in which We would not have reinstated this
Certificate.
8.5 If this Certificate is invalidated or void pursuant to Clause 8.4 above, Our liability shall be
limited to the refund of unearned Upfront Charge less expenses which may have been
incurred for the medical examination of the Person Covered as well as any indebtedness
under this Certificate. Investment Profit and/or Underwriting Surplus, if any, will be forwarded
to any charitable organisation(s) approved by Our Shariah Committee.
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CERTIFICATE OPTION (Clause 9)
9. SURRENDER
You may surrender this Certificate and We will refund the following:
9.1 the unearned Upfront Charge from Our fund (other than the first year Upfront Charge). In the
event the Certificate is surrendered or terminated before the next Contribution date is due
and where the Contribution is paid annually, half-yearly or quarterly, the Upfront Charge less
actual expenses incurred will be refunded; and
9.2 the unexpired Tabarru’ from the Tabarru’ Fund. In the event the Certificate is surrendered
before the next Contribution date is due and where the Contribution is paid annually, half-
yearly or quarterly, the amount of Tabarru’ refund shall be equal to a percentage of Tabarru’
contribution based on the duration of the Certificate that has been inforced and contribution
payment mode.
Refund Semi- Refund

Duration not Refund Annual Refund Monthly
Annual Tabarru’ Quarterly
exceeding Tabarru’ Charge Tabarru’ Charge
Charge Tabarru’ Charge
1 month 90% 85% 65% No refund
2 months 85% 65% 35% No refund
3 months 75% 50% No refund No refund
6 months 50% No refund No refund No refund
9 months 25% 50% No refund No refund
>11 months No refund No refund No refund No refund
This Certificate shall be terminated upon payment of the surrender value and all benefits and rights
under this Certificate shall cease.
TAKAFUL FUNDS PROVISIONS (Clauses 10 - 12)
10. TABARRU’ FUND
10.1 Based on the Shariah concept of Tabarru’, You will donate a portion of Contribution into the
Tabarru’ Fund for the purpose of mutual help. Tabarru’ Fund is owned by a pool of
Participants and managed by Us for the purpose of claims payment on the events covered
under this Certificate.
10.2 Based on the Shariah contract of Mudharabah, You as capital provider appoint Us as
entrepreneur to undertake Shariah-compliant investment activities for the Tabarru’ Fund on
Your behalf. In return, We will share a predetermined percentage share of the investment
profit.
11. UNDERWRITING SURPLUS
11.1 The Underwriting Surplus shall be calculated and distributed annually, after each financial
year.
11.2 Any Underwriting Surplus that is distributable will be determined after a suitable proportion of
it is held back for contingency purpose before it is shared between You and Us in the
proportion of 50% and 50% respectively.
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11.3 Any unutilised amount of Underwriting Surplus held back for contingency purpose, will be
included in the calculation of the Underwriting Surplus for the next financial year.
11.4 The Underwriting Surplus (if any) will not be distributed if in Our judgement, the surplus
should remain in the Tabarru’ Fund to maintain the ability to meet future liabilities or to meet
Your reasonable expectations not specifically provided for in Our actuarial valuation.
11.5 In the event of any deficit from the Tabarru’ Fund, there will be no Underwriting Surplus
distribution for the respective financial year. Under such circumstance, the deficit will be first
funded by the amount allocated for contingency purposes. If the Tabarru’ Fund is still in
deficit, the Qard will be arranged. The Qard will be carried forward to the following financial
year and any surplus will be used to pay off Qard (if any) to Us before it is being distributed.
12. INVESTMENT PROFIT/LOSS
12.1 Any Investment Profit or Investment Loss from the Tabarru’ Fund shall be calculated and
distributed annually, after each financial year.
12.2 Any Investment Profit from the Tabarru’ Fund based on Mudharabah concept will be shared
among the participants and Us in the proportion of 50% and 50% respectively. Your allocated
amount for You will be credited into Your bank account (net of tax).
12.3 Any Investment Loss in the Tabarru’ Fund will be carried forward and accounted for before
arriving at the Underwriting Surplus (or deficit) on the next financial year.
BENEFITS AND CERTIFICATE CONDITIONS (Clauses 13 - 18)
13. MEDICAL BENEFITS
13.1 While this Certificate is inforce and subject to the terms and conditions, upon receipt and
approval of due proof such as original bills, receipts and/or other evidence satisfactory to Us
that the Person Covered is confined to a Hospital for Medically Necessary services and/or
treatments due to Illness or Injury or is receiving Medically Necessary services and/or
treatments in relation to any Covered Benefits as described in Clause 15.3 below, We shall,
after applying the appropriate limit for each Covered Benefit, the Overall Annual Limit and
any Coordination of Benefits as specified in Clause 16.11 below, pay the balance of the
Eligible Expenses, if any, from the Tabarru’ Fund, as provided under this Certificate for:
(a) Illness which existed or was diagnosed after the Waiting Period; or
(b) Injury which occurred on or after the Effective Date.
13.2 For the avoidance of doubt, no benefits shall be payable for:
13.2.1 any condition which existed or diagnosed:
13.2.1.1 during the Waiting Period; or
13.2.1.2 after the expiry of the Waiting Period but which is related to a condition
which existed or diagnosed during the Waiting Period; or
13.2.2 any sign or symptom existed before or during the Waiting Period which would prompt
a reasonable person to seek medical care or attention, though the resulting diagnosis
may occur before or after the expiry of the Waiting Period.
13.3 In addition, a claim as described in Clauses 13.2.1 or 13.2.2 above will not be admissible
only because notification of the said claim was given to Us after the expiry of the Waiting
Period.
14. DEDUCTIBLE
Eligible Expenses incurred for all Covered Benefits accumulated in any Certificate Year as the case
may be, are subject to the Deductible per Any One Disability whereby You will be responsible for
paying the Deductible amount as stated in the Schedule of Benefits. We will reimburse the balance of
the Eligible Expenses in excess of the Deductible during any Certificate Year, subject to Clause 16.
11 (Coordination of Benefits) and the Overall Annual Limit below.
15. DESCRIPTION OF BENEFITS
15.1 Overall Annual Limit

Benefits payable in respect of Eligible Expenses incurred for Medically Necessary services
and/or treatments provided to the Person Covered during any Certificate Year shall be limited
to the Overall Annual Limit irrespective of the type/types of Disability. If the Overall Annual
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Limit for a particular Certificate Year has been fully exhausted, all coverage on the Person
Covered shall immediately cease to be payable for that remaining Certificate Year.
15.2 Overall Lifetime Limit

While this Certificate is inforce and subject to the terms and conditions, no lifetime limit is
applicable for benefits payable in respect of Eligible Expenses incurred for Medically
Necessary services and/or treatments provided to the Person Covered from the Effective
Date and during the lifetime of the Person Covered irrespective of the type/types of Disability.
15.3 Covered Benefits

Reimbursement of the Eligible Expenses incurred for Covered Benefits is also subject to the
following conditions:
(a) the charges must be Reasonable and Customary Charges which are consistent with
those usually charged to a ward or room and board, and the daily rate is
approximated to and within the daily limit of the amount stated in item (1) of the
Schedule of Benefits; and
(b) such charges are also consistent with and at the same level as those recommended
in the MMA Guidelines.
The Covered Benefits are:
15.3.1 Hospital Room and Board

Reimbursement of the Reasonable and Customary Charges incurred for Medically
Necessary room accommodation and meals. The amount payable for this benefit
shall be equal to the actual charges made by the Hospital during Hospitalisation of
the Person Covered, subject to the daily rate of Hospital Room and Board, the
maximum number of days and the limits stated in the Schedule of Benefits. A
Person Covered will only be entitled to this benefit while confined to a Hospital as
an Inpatient.
15.3.2 Intensive Care Unit

Reimbursement of the Reasonable and Customary Charges for Medically
Necessary actual room and board incurred during confinement of a Person
Covered as an Inpatient in the Intensive Care Unit of a Hospital. The amount
payable for this benefit shall be equal to the actual charges made by the Hospital,
subject to the maximum number of days and the limits stated in the Schedule of
Benefits. No Hospital Room and Board benefit and Intensive Care Unit benefit shall
be paid concomitantly.
For the avoidance of doubt, if Intensive Care Unit benefit is payable for a
confinement period, no Hospital Room and Board benefit shall be payable for the
same confinement period.
15.3.3 Hospital Supplies and Services

Reimbursement of the Reasonable and Customary Charges actually incurred for:
- general nursing;
- prescribed and consumed drugs and medicines;
- dressings, splints and plaster casts;
- x-ray;
- laboratory examinations;
- electrocardiograms;
- physiotherapy;
- basal metabolism tests;
- intravenous injections and solutions; or
- administration of blood and blood plasma but excluding the cost of blood and
plasma while the Person Covered is confined as an Inpatient in a Hospital;
which is Medically Necessary, subject to the limits stated in the Schedule of
Benefits.
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15.3.4 Surgical Fees

Necessary surgery by the Specialists, including Pre-Hospital Specialist
Consultation and Post-Hospitalisation Treatment, subject to the limits stated in the
Schedule of Benefits. If more than one surgery is performed for Any One Disability,
the total payments for all the surgeries performed shall not exceed the limits stated
in the Schedule of Benefits.
15.3.5 Operating Theatre

Reimbursement of the Reasonable and Customary Charges incurred for operating
room incidental to Medically Necessary surgical procedure, subject to the limits
15.3.6 Anaesthetist Fees

Necessary administration of anaesthesia by the anaesthetist, subject to the limits
15.3.7 In Hospital Physician Visit

Necessary Physician’s visit to an Inpatient who is confined for Disability, subject to a
maximum of two (2) visits per day and the limits stated in the Schedule of Benefits.
15.3.8 Pre-Hospital Diagnostic Tests

Reimbursement of the Reasonable and Customary Charges incurred within sixty
(60) days preceding Hospitalisation, for Medically Necessary ECG, x-ray and
laboratory tests which are recommended by a qualified medical practitioner and
performed for diagnostic purposes on account of an Injury or Illness and in
connection with a Disability, subject to the limits stated in the Schedule of Benefits.
No payment shall be made if the Person Covered does not result in Hospitalisation
for the treatment of the medical condition diagnosed upon such diagnostic services.
In addition, medications and consultation charged by the medical practitioner shall
not be payable.
15.3.9 Pre-Hospital Specialist Consultation

Reimbursement of the Reasonable and Customary Charges incurred within sixty
(60) days preceding Hospitalisation, for Medically Necessary first time consultation
by a Specialist in connection with a Disability provided that such consultation has
been recommended in writing by the attending general practitioner, subject to the
limits stated in the Schedule of Benefits. No payment shall be made for clinical
treatment (including medications and subsequent consultation after the Illness is
diagnosed) or where the Person Covered does not result in Hospitalisation for the
treatment of the medical condition diagnosed.
15.3.10 Post-Hospitalisation Treatment

Reimbursement of the Reasonable and Customary Charges incurred within ninety
(90) days immediately following discharge from Hospital for a Disability, for
Medically Necessary follow-up treatment by the same attending Physician, subject
to the limits stated in the Schedule of Benefits. This shall include Prescribed
Medicines during the follow-up treatment but shall not exceed the supply needed
for the maximum of ninety (90) days from the date of discharge.
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15.3.11 Organ Transplant

Reimbursement of the Reasonable and Customary Charges incurred on
transplantation surgery for the Person Covered being the recipient of the transplant
of a kidney, heart, lung, liver or bone marrow. This benefit is applicable only once
per lifetime while this Certificate is inforce and shall be subject to the limits stated in
the Schedule of Benefits. The costs of acquisition of the organ and all costs
incurred by the donors are not covered under this Certificate.
15.3.12 Ambulance Fees

Necessary domestic ambulance services (inclusive of attendant) to and/or from the
Hospital, subject to the limits stated in the Schedule of Benefits. No payment shall
be made if the Person Covered is not hospitalised.
15.3.13 Day Surgery

Reimbursement of the Reasonable and Customary Charges incurred for a
Medically Necessary Day Surgery subject to the limits stated in the Schedule of
Benefits. This shall be limited to the following surgical procedures which are
commonly performed safely as Day Surgery:
- Adenoidectomy;
- Bone Marrow Aspiration and Biopsy;
- Cataract removal;
- Colonoscopy;
- Cystourethroscopy;
- Endolaser Venous Surgery;
- Endoscopic Retrograde Cholangiopancreatography;
- Excision of Bunions;
- Excision of Ganglion, Fibroma(s) and Breast Lump(s);
- Excision of Pterygium;
- Extra corporeal Shock Wave Lithotripsy;
- Herniotomy/Herniorapphy;
- Insertion or Removal of Ureteric J-Stent;
- Laparoscopic Endometrial Ablation;
- Laparoscopy;
- Laryngoscopy;
- Laser Photocoagulation treatment for Retinal Detachment;
- Marsupialisation and drainage of Bartholin’s Cysts;
- Myringotomy or Myringoplasty;
- Reduction of Bone Fracture(s);
- Release of Carpal Tunnel (Carpal Tunnel Decompression);
- Release of Dupuytren’s contracture;
- Removal of Cervical Polyps;
- Removal of Nasal Polyps;
- Removal of Plate and Screw/Implants;
- Rubber Banding of Haemorrhoids.
We may extend the above list of surgical procedures which are commonly
performed safely as Day Surgery, from time to time, at its sole discretion. If any
such surgical procedure is performed while the Person Covered is an Inpatient,
only the equivalent benefit of Day Surgery shall be paid, unless Our appointed
medical practitioner has given prior approval.
15.3.14 Outpatient Cancer Treatment

If a Person Covered is diagnosed with Cancer as defined below, We shall
reimburse the Reasonable and Customary Charges incurred for the Medically
Necessary cancer treatment performed at a legally registered cancer treatment
centre, subject to the limits stated in the Schedule of Benefits.
Such treatment (radiotherapy or chemotherapy including consultation, examination

tests and take home drugs) must be received at the Outpatient department of a
Hospital or a registered cancer treatment centre immediately following discharge
from Hospital.
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Cancer is defined as any malignant tumour positively diagnosed with histological

confirmation and characterised by the uncontrolled growth of malignant cells and
invasion of tissue. The term malignant tumour includes leukemia, lymphoma and
sarcoma.
For the above definition, the following are not covered:
15.3.14.1 all cancers which are histologically classified as any of the
following:
- pre-malignant;
- non-invasive;
- carcinoma in situ;
- having borderline malignancy;
- having low malignant potential;
15.3.14.2 all tumours of the prostate histologically classified as T1N0M0
(TNM
classification);
15.3.14.3 all tumours of the thyroid histologically classified as T1N0M0 (TNM
classification);
15.3.14.4 all tumours of the urinary bladder histologically classified as T1N0M0
(TNM classification);
15.3.14.5 Chronic Lymphocytic Leukemia less than RAI Stage 3;
15.3.14.6 all cancers in the presence of HIV; and
15.3.14.7 any skin cancer other than malignant melanoma.
In addition to the exclusion of Pre-existing Illness, this benefit shall not be payable
for any Person Covered who had been diagnosed as a cancer patient and/or is
receiving cancer treatment prior to the Effective Date.
15.3.15 Outpatient Kidney Dialysis Treatment

If a Person Covered is diagnosed with Kidney Failure as defined below, We shall
reimburse the Reasonable and Customary Charges incurred for the Medically
Necessary kidney dialysis treatment performed at a legally registered dialysis
centre, subject to the limits stated in the Schedule of Benefits.
Such treatment (dialysis including consultation, examination tests and take home
drugs) must be received at the Outpatient department of a Hospital or a registered
dialysis treatment centre immediately following discharge from Hospital.
Kidney Failure – Requiring Dialysis or Kidney Transplant means end-stage

kidney failure presenting as chronic irreversible failure of both kidneys to function,
as a result of which regular dialysis is initiated or kidney transplantation is carried
out.
In addition to the exclusion of Pre-existing Illness, this benefit shall not be payable
for any Person Covered who has developed chronic renal diseases and/or is
receiving dialysis treatment prior to the Effective Date.
15.3.16 Emergency Accidental Outpatient Treatment

Necessary treatment as an Outpatient at any registered Clinic or Hospital as a result
of a covered bodily Injury arising from an Accident, within twenty-four (24) hours of
such Accident and subject to the maximum amount and the limits stated in the
Schedule of Benefits. Follow-up treatment by the same Doctor or same registered
Clinic or Hospital for the same covered bodily Injury shall be provided up to a
maximum of thirty (30) days from date of Accident, subject to the maximum amount
and the limits stated in the Schedule of Benefits.
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15.3.17 Daily-Cash Allowance at Malaysian Government Hospital

Pays a daily allowance for each day of confinement for a covered Disability in a
Malaysian Government Hospital, provided that the Person Covered shall be
confined to a Hospital Room and Board rate that does not exceed the amount
stated in the Schedule of Benefits. No payment shall be made for any transfer or
from any private Hospital and Malaysian Government Hospital for the Covered
Disability.
15.3.18 Intraocular Lens

Reimbursement of Reasonable and Customary Charges incurred for Medically
Necessary Intraocular Lenses for cataract surgery, up to Ringgit Malaysia ONE
THOUSAND (RM1,000) per eye, subject to a maximum of Ringgit Malaysia TWO
THOUSAND (RM2,000) per lifetime while this Certificate is inforce and shall be
subject to the limits stated in the Schedule of Benefits.
15.3.19 Malaysian Tax

Reimbursement of the prevailing service tax and/or other tax(es), if applicable. Tax
applicable to any of the Eligible Expenses incurred on Covered Benefits, for which
a claim is payable, and the amount of such reimbursement shall not form part of the
computation of the Overall Annual Limit as stated in the Schedule of Benefits.
16. CONDITIONS
16.1 Assignee
An Assignee under the Certificate shall not be entitled to any benefit payable under this
Certificate.
16.2 Person Eligible

Person eligible to be covered under this Certificate is:
16.2.1 the Person Covered whose age must be at least fourteen (14) days old but not
exceeding one hundred (100) years next birthday; and
16.2.2 a citizen of Malaysia or a permanent resident of Malaysia or a foreigner holding a
valid and current working permit who is working in Malaysia.
16.3 Misstatement of Age

If the age of the Person Covered has been misstated and the Tabarru’ deducted as a result
of it is insufficient, any claim payable under this Certificate shall be prorated based on the
ratio of the actual deducted Tabarru’ to the Tabarru’ which should have been charged for the
year. Any excess Tabarru’ which may have been paid as a result of such misstatement of
age, shall be credited back into the Tabarru’ Fund.
If at the correct age, the Person Covered would not have been eligible for cover under this
Certificate, no benefit shall be payable and only Tabarru’ which have been deducted will be
credited back into the Tabarru’ Fund.
16.4 Change in Risk

The Person Covered shall give immediate notice in writing to Us of any material change in
his occupation, business, duties or pursuits; and pay any additional contribution that may be
required by Us. However, if such change in risk has rendered the Person Covered no longer
protected by Us, We shall be entitled to terminate this Certificate in accordance with Clause
18.2 (Termination) below.
16.5 Geographical Territory

All benefits provided in this Certificate are applicable worldwide for twenty-four (24) hours a
day.
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16.6 Overseas Treatment

If the Person Covered elects to be treated outside Malaysia 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 Charges for such equivalent local treatment in
Malaysia and shall exclude the cost of transport to the place of treatment. This is however
subject to Clause 16.11 (Coordination of Benefits) below, if applicable.
16.7 Residence Overseas

No benefit shall be payable for any medical treatment received by the Person Covered
outside Malaysia, if the Person Covered resides or travels outside Malaysia for more than
ninety (90) consecutive days.
16.8 Currency of Payment

All payments under this Certificate shall be made in the legal currency of Malaysia. Should any
payment be requested by the Person Covered 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. In the event of
Hospitalisation outside Malaysia, bills rendered in a currency other than Ringgit Malaysia
shall first be converted to Ringgit Malaysia based on a quoted exchange rate in effect on the
date the Person Covered is discharged from Hospital. The quoted exchange rate shall be
obtained from a financial institution as determined by Us and shall be final and binding on the
Person Covered or claimant.
16.9 Continuation of Hospitalisation into the following Certificate Year

Where a period of Hospitalisation, Outpatient treatment, pre-hospitalisation or post-
hospitalisation continues to the following Certificate Year, the Eligible Expenses incurred
shall be apportioned accordingly based on the actual itemised expenses incurred for a
Certificate Year or based on the actual days of Hospitalisation, Outpatient treatment, pre-
hospitalisation or post-hospitalisation occurred in that Certificate Year, as the case may be.
16.10 Certification, Information and Evidence

All certificates, information, medical reports and evidence as required by Us shall be
furnished by the claimant at own expense, and in a such form that We may require. In any
event all notices which We shall require from You must be given in writing and addressed to
Us. A Person Covered shall, at Our request and expense, submit a medical examination
whenever such is deemed necessary.
16.11 Coordination of Benefits

We will not provide any compensation other than on a proportionate basis if the Person
Covered has any other Hospitalisation coverage on reimbursement basis with Us or others,
or is receiving compensation from other sources in respect of Injury or Illness or Disease for
which he is making a claim under this Certificate. The claims payout in aggregate shall be
limited to the Reasonable and Customary Charges, for the disability in which the claim is
made.
16.12 Claim Procedures

Prior to payment of any benefit payable under this Certificate, the amount of any indebtedness
under this Certificate shall first be deducted from the benefits payable.
16.12.1 The Person Covered shall within thirty (30) days of a Disability 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 Prescribed Medicines
and services rendered.
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Failure to furnish such notice within the time allowed shall not invalidate any claim if
it is shown not to have been reasonably possible to furnish such notice and that
such notice was furnished as soon as was reasonably possible.
16.12.2 The Person Covered shall immediately procure and act on proper medical advice
and We shall not be held liable in the event a treatment or service becomes
necessary due to failure of the Person Covered to do so.
16.12.3 All claims must be submitted to Us within thirty (30) days of completion of the
events for which the claim is being made. Claims are not deemed complete and
Eligible Expenses are not payable unless all bills for such claims have been
submitted and agreed upon by Us. Only actual costs incurred shall be considered
for reimbursement. Any variation or waiver of the foregoing shall be at Our sole
discretion.
16.13 Condition Precedent to Liability

The due observance and the fulfillment of the terms and conditions of this Certificate by the
Person Covered and in so far as they relate to anything to be done or complied with by the
Person Covered shall be conditions precedent to any of Our liability.
16.14 Alterations
We reserve the right to amend the terms and conditions of this Certificate by giving thirty (30)
days’ advance written notice in accordance with ‘Notices and Correspondence’ clause of the
Privileges and Conditions, and such amendment shall be applicable from the next Certificate
Anniversary immediately following the expiry of the thirty (30) days’ advance written notice.
No alteration to this Certificate shall be valid unless authorised by Us and such approval is
endorsed thereon.
16.15 Legal Proceeding

No action at law or in equity shall be brought to recover on this Certificate prior to the
expiration of sixty (60) days after written proof of loss has been furnished in accordance with
the requirements of this Certificate. If the Person Covered shall fail to supply the requisite
proof of loss as stipulated by the terms and conditions of this Certificate, the Person Covered
may, within a grace period of one (1) calendar year from the date that the written proof of
loss to be furnished, submit the relevant proof of loss to Us with cogent reason(s) for the
failure to comply with the terms and conditions of this Certificate. The acceptance of such
proof of loss shall be at Our sole and discretion. After such grace period has expired, We will
not accept, for any reason whatsoever, such written proof of loss.
16.16 Subrogation
If We become liable for any payment under this Certificate, We shall be subrogated to the
extent of such payment to all the rights and remedies of the Person Covered against any
party and shall be entitled at its own expense to sue in the name of the Person Covered, the
Person Covered shall give or cause to be given to Us all such assistance in his/her 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 bring suit in the name of
the Person Covered.
17. EXCLUSIONS
17.1 We will not pay the Covered Benefits as stated in Clauses 15.3.1 to 15.3.18 under this
Certificate as a result of, including of any of the following whether directly or indirectly:
17.1.1 Pre-existing Illness as defined in Clause 1 above;
17.1.2 Specified Illnesses as defined in Clause 1 above;
17.1.3 any medical or physical conditions arising within the Waiting Period except for Injury;
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17.1.4 plastic/cosmetic surgery, circumcision, eye examination, glasses, lens and refraction
or surgical correction of nearsightedness and farsightedness (Radial Keratotomy or
Lasik) and the use or acquisition of external prosthetic appliances or devices such as
artificial limbs, hearing aids, implanted pacemakers and prescriptions thereof;
17.1.5 dental conditions including dental treatment or oral surgery; except as necessitated
by Injury to sound natural teeth occurring in any Certificate Year and performed by
Dentist. In addition, expenses arising from placement of denture and prosthetic
services such as bridges, implants and crowns or their replacement will not be
payable;
17.1.6 private nursing, rest cures or sanitaria care, illegal drugs, intoxication (including but
not limited to alcohol and drugs), sterilization, venereal disease and its sequelae,
AIDS (Acquired Immune Deficiency Syndrome) or ARC (AIDS Related Complex) and
HIV related diseases, and any communicable diseases required quarantine by law;
17.1.7 any treatment or surgical operation for Congenital Conditions or deformities including
hereditary conditions;
17.1.8 pregnancy and its complications, child birth (including surgical delivery and any
surgical or non surgical procedure of the female reproductive system during 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
sterilization;
17.1.9 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;
17.1.10 suicide, attempted suicide or self-inflicted injury, while sane or insane;
17.1.11 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;
17.1.12 ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear
waste from process of nuclear fission or from any nuclear weapons material;
17.1.13 expenses incurred for donation of any body organ by a Person Covered and cost of
acquisition of the organ including all costs incurred by the donor during organ
transplant and its complications;
17.1.14 investigations and treatment of sleep and snoring disorders, hyperhidrosis
treatment, hormone replacement therapy, stem cell therapy, PET scan and
alternative therapy such as treatment, medical service or supplies, including but not
limited to chiropractic services, acupuncture, acupressure, reflexology, bone
setting, herbalist treatment, massage, hyperbaric oxygen therapy or aromatherapy
or other alternative treatment;
17.1.15 care or treatment for which payment is not required or to the extent which is
payable by any other insurance companies/Takaful operators or indemnity covering
the Person Covered and disabilities arising out of duties of employment or
profession that is covered under a Workman’s Compensation Insurance Contract or
from either sources in respect in Injury or Illness or Disease for which the claim is
made;
17.1.16 psychotic, mental or nervous disorders, (including any neuroses and their
physiological or psychosomatic manifestations);
17.1.17 costs/expenses of services of a non-medical nature, such as television, telephones,
telex services, broadband services, electricity bills for handphone charging, radios
or similar facilities, admission kit/pack and other ineligible non-medical items;
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17.1.18 Sickness or Injury arising from racing of any kind (except for foot racing),
hazardous sports or activities that involve speed, height, high level of physical
exertion, highly specialized gear or spectacular stunts such as but not limited to
parachuting, sky-diving, scuba-diving, bungee jumping, water skiing, underwater
activities requiring breathing apparatus, winter sports, Professional Sports and
illegal activities. For the avoidance of doubt, “Professional Sports” means engaging
in any physical activity in a professional capacity or where the Person Covered
would or could earn income or remuneration from engaging in such activity;
17.1.19 engaging in aerial flights other than as a crew member or as a fare-paying
passenger of an International Airline operating on a regular scheduled route;
17.1.20 expenses incurred for gender change;
17.1.21 any Outpatient treatment not related to Inpatient treatment, except as provided
under this Certificate; or
17.1.22 charges which are not Reasonable and Customary Charges, or any surgery or
treatment which is not Medically Necessary, or charges in excess of Reasonable
and Customary Charges, or charges which are incurred for Hospitalisation, pre-
hospitalisation and/or post-hospitalisation after the Maturity Date.
17.1.23 any disability of the Person Covered has been caused by injuries arising:
17.1.23.1 in time of declared or undeclared war; or
17.1.23.2 while under orders for war like operations; or
17.1.23.3 while under restoration of public order during strikes, riots and civil
commotion; or
17.1.23.4 from the employment or training of the Person Covered in any Military or
Paramilitary branch of the Armed Services, Navy or Police organisation
of any country.
18. TERMINATION
18.1 This Certificate shall automatically be terminated on the earliest occurrence of the following
events:
18.1.1 on the Certificate Anniversary on which the Person Covered’s age is one hundred
(100) years next birthday; or
18.1.2 upon death of the Person Covered; or
18.1.3 when We receive Your request for termination of this Certificate in writing; or
18.1.4 on the Maturity Date; or
18.1.5 when the Certificate lapses, becomes void, is surrendered or is terminated in any
other manner.
18.2 We shall be entitled to terminate this Certificate immediately when a change in risk as stated
in Clause 16.4 above has, in Our opinion, rendered the Person Covered no longer protected
by 18.3 Any Tabarru’ deducted on this Certificate after its termination shall be credited
back into the Tabarru’ Fund.
OTHER PROVISIONS (Clauses 19 - 32)
19. CONFIRMATION OF AGE
19.1 You must prove the true age of the Person Covered to Us before We are required to pay any
benefit under this Certificate unless this information has been previously verified and
confirmed by Us to be correct.
19.2 We are entitled to adjust the surplus or profit allocated to, or reduces the contribution, under this
Certificate, according to the true age of the Person Covered if it was incorrectly stated in the
proposal for Family Takaful.
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20. PERMISSIBLE TAKAFUL INTEREST
20.1 If the Takaful coverage is provided to a Person Covered other than Yourself, You shall have
Permissible Takaful Interest in the Person Covered at the time the contract of Takaful is
entered into and at the time the Takaful benefits are payable.
20.2 For the purpose of this Clause, You shall be deemed to have a Permissible Takaful Interest
in the Person Covered if the Person Covered is:
20.2.1 Your spouse or child;
20.2.2 Your ward under the age of majority at the time You entered into the contract of
Takaful;
20.2.3 Your employee; or
20.2.4 a person on whom he is wholly or partly dependent for maintenance or education at
the time he entered into the contract of Takaful.
21. CERTIFICATE MATURITY
This Certificate shall be terminated on the Maturity Date and all benefits and rights under this
Certificate shall cease.
22. SUICIDE
If the Person Covered, whether sane or insane, commits suicide within one (1) year from the Effective
Date or from the date of any reinstatement, whichever is later, this Certificate shall be void and Our
liability shall be limited to the refund of the total amount deducted for Tabarru’.
23. INDISPUTABILITY
23.1 We will not dispute the validity of this Certificate during the lifetime of the Person Covered
after two (2) years from the Effective Date, or from the date of any reinstatement, whichever
is later, unless there is fraud.
23.2 In the event that this Certificate is invalidated or void for any reason (except for the reason
specified under Clause 22 (Suicide) above), Our liability shall be limited to the refund of the
unearned Upfront Charge provided by You less expenses which may have been incurred for
the medical examination of the Person Covered as well as any indebtedness under this
Certificate. Investment Profit and/or Underwriting Surplus, if any, will be forwarded to any
charitable organisation(s) approved by Our Shariah Committee.
24. REMEDIES FOR MISREPRESENTATION
24.1 This Clause shall only apply if the duration of this Certificate is two (2) years or less from the
Effective Date.
24.2 We may, at Our discretion, void the Certificate in the event of any pre-contractual
Misrepresentation made by You on all Material Information in applying for this Certificate, if
the Misrepresentation made is classified as:
24.2.1 a deliberate or reckless Misrepresentation; or
24.2.2 a careless or innocent Misrepresentation, in which We would not have issued or
renewed this Certificate; or
24.2.3 a careless or innocent Misrepresentation, in which We would have issued or
renewed this Certificate.
24.3 If this Certificate is invalidated or void pursuant to Clause 24.2.1 above Our liability shall be
limited to the refund of the unearned Upfront Charge less expenses which may have been
incurred for the medical examination of the Person Covered as well as any indebtedness
under this Certificate. Investment Profit and/or Underwriting Surplus, if any, will be forwarded
to any charitable organisation(s) approved by Our Shariah Committee.
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24.4 If this Certificate is invalidated or void pursuant to Clause 24.2.2 above, Our liability shall be
limited to the refund of the following, if any:
24.4.1 unearned Upfront Charge;
24.4.2 Tabarru’ (excluding Underwriting Surplus, if any); and
24.4.3 Investment Profit;
less expenses which may have been incurred for the medical examination of the Person
Covered as well as any indebtedness under this Certificate. Underwriting Surplus, if any, will
be forwarded to any charitable organisation(s) approved by Our Shariah Committee.
24.5 If this Certificate would have been issued or renewed pursuant to Clause 24.2.3 above, We
may, at Our discretion:
24.5.1 vary any of the terms and conditions of this Certificate and treat this Certificate as if
it had been issued or renewed on the varied terms and conditions; and
24.5.2 reduce proportionately the amount to be paid on a claim in accordance with Our
relevant policy at the material time.
25. NOTICE OF ASSIGNMENTS
A written notice of assignment, if applicable, on this Certificate is deemed notified to Us, if it is

delivered to Us at Our offices and acknowledged by Us in writing. Our acknowledgment on your
notice of assignment does not constitute validation of such assignment. Notwithstanding this, we may
accept your notice of assignment and affect such assignment placed under this Certificate.
26. CHANGE OF NOMINEES
You may make changes to Your nomination, if applicable, by informing to Us in writing. The change
will take effect from the date We receive the notice in writing from You.
27. ACCEPTANCE OF INSTRUCTIONS
We will only accept instructions, requests or notices when such forms, documents, information and
consents as required by Us are received.
28. RESIDENCES, OCCUPATION AND TRAVEL
This Certificate is free from restrictions as regards to residence, occupation and travel.
29. NOTICES AND CORRESPONDENCE
29.1 Any notice, request, instruction or correspondence to Us and You shall be in writing. Your
mailing address, email address or handphone number will be as stated in the proposal for
Family Takaful unless there is notification of any changes to Us.
29.2 Any notice, request, instruction or correspondence given by Us to You shall be conclusively
deemed to have been received as follows:
29.2.1 for personal delivery, on the day of delivery; or
29.2.2 for ordinary post, or pre-paid registered post, seven (7) days after the date of
posting, if posted to an address in Malaysia, and fourteen (14) days, if posted
outside of Malaysia; or
29.2.3 for delivery via email or short message services, on the day of delivery; or
29.2.4 for publishing in a local daily newspaper, on the day of publishing; or
29.2.5 for electronic posting on Our official website or other website, the later of the day of
electronic posting or the day of delivery of a separate notification to You of such
electronic posting via any effective means provided under the above Clauses 29.
2.1, 29.2.2, 29.2.3 or 29.2.4 respectively, as determined by Us from time to time.
29.3 With the conditions as stated in Clauses 29.1 and 29.2 above, in the case that any notice,
request, instruction or correspondence is returned undelivered to You after We have made at
least two (2) consecutive attempts at delivery, We may, at Our discretion, at Your own risk,
withhold all subsequent notice, request, instruction or correspondence until We have been
notified by You of Your new mailing address or email address or handphone number.
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30. GOVERNING LAW
30.1 This Certificate shall be governed by the Laws of Malaysia and the Courts of Malaysia shall
have exclusive jurisdiction for any dispute arising out of or in relation to this Certificate.
30.2 We shall have the right at any time, by giving advance written notice to You in accordance
with the ‘Notices and Correspondence’ clause, to amend the terms and conditions of this
Certificate in compliance with any legislative changes, statutory modifications or
amendments which may be enacted from time to time.
31. SANCTION LIMITATION AND EXCLUSION
We reserve the right not to: -

30.1 provide Takaful coverage, including all the benefits in relation to or in connection with such
Takaful coverage nor deemed to provide such Takaful coverage (and where payment has
been made by you under the Certificate, such payment shall not be deemed as received and
accepted by us); or
30.2 be obligated to pay any sum(s), including but not limited to payment of claim(s), refund of
contribution(s), surrender or cancellation of payment,
if providing the Takaful coverage or payment of such sum(s) would expose us to any sanction,
prohibition, restriction or contravention of any laws and/or regulations, administered by any
governmental, regulatory or competent authority, or any law enforcement in any country.
32. CHARITY LIMIT
In the event whereby the amount payable under Your Certificate(s) in a calendar year amounts to
RM10 or below due to the lapse, surrender, termination or maturity of Your Certificate(s) (inclusive of
all products), We will channel such amount to any charitable organisation(s) approved by Our
Shariah Committee. However, if You disagree, You must submit a formal written request to Us.
**END OF PAGE**
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Great Eastern Takaful Berhad

ENDORSEMENT
ENDORSEMENT NO. TE008 (SAssist)
1. DEFINITIONS
For the purpose of this Endorsement, the following words or expressions, whenever mentioned in
this Endorsement, shall have the following meanings unless otherwise stated. Any word or
expression not specifically defined in this Endorsement shall have the same meaning as ascribed
to it in this Certificate:-
“Annexure” as referred to in this Endorsement means Annexure AHSM or AHMX (if any) which
is attached to this Certificate.
“Certificate” means the basic Certificate to which this Endorsement is attached.
“Pre-existing Illness” means disabilities in which the Person Covered has reasonable
knowledge of, prior to Rider Effective Date. A Person Covered may be considered to have
reasonable knowledge of a Pre-existing Illness where the condition is one for which:
(a) the Person Covered had received or is receiving treatment; or
(b) medical advice, diagnosis, care or treatment has been recommended; or
(c) clear and distinct symptoms are or were evident; or
(d) its existence would have been apparent to a reasonable person in the circumstances.
“Commencement Date” refers to the Commencement Date shown in Takaful Schedule or
Takaful Schedule A, as the case may be.
“Rider Effective Date” refers to the Effective Date or date of inclusion of the Annexure if it has
been subsequently included in this Certificate or date of any reinstatement, whichever is the later.
“Serious Medical Condition” means a condition which in the opinion of Supreme Assist
constitutes a serious medical emergency requiring urgent remedial treatment to avoid death or
serious impairment to the Person Covered’s immediate or long term health prospects. The
seriousness of the medical condition will be judged within the context of the Person Covered’s
geographical location, the nature of the medical emergency and the local availability of
appropriate medical care or facility.
“Supreme Assist” under this Endorsement means the service provider(s) appointed by the
Takaful Operator to provide the Overseas and Domestic Emergency Medical Assistance Services
as described under Section 2 below.
The Takaful Operator has entered into an arrangement with Supreme Assist who upon request by
You and/or Person Covered will provide the following Overseas and Domestic Emergency
Medical Assistance Services to the Person Covered, subject to the terms and conditions of this
Certificate, including this Endorsement.
For the purpose of verification of eligibility for the following Overseas and Domestic Emergency
Medical Assistance Services, the Takaful Operator will issue a membership card to the Person
Covered. The Person Covered must always identify himself by stating his full name, Certificate
number and expiry date of the membership card.
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2.1 Overseas Emergency Medical Assistance

The following services are applicable to the Person Covered who is travelling outside
Malaysia for a period not exceeding one hundred and twenty (120) consecutive days on any
one trip.
The Person Covered may call Supreme Assist from anywhere in the world to obtain the
assistance/services described below:
2.1.1 Travel Assistance
2.1.1.1 Visa Information Services

To provide information concerning visa requirements for foreign countries
worldwide.
2.1.1.2 Inoculation Information Services

To provide information concerning inoculation requirements for foreign
countries worldwide.
2.1.1.3 Weather Information Services

To provide information concerning weather forecasts and temperatures of
foreign countries worldwide.
2.1.1.4 Foreign Exchange Information Services

To provide information concerning exchange rate of major foreign currencies
against the Malaysian Ringgit.
2.1.1.5 Interpreter Assistance

To assist the Person Covered by providing interpreting service over the
telephone by Supreme Assist Alarm Centre.
2.1.1.6 Legal Referral

To provide the name, address and telephone number and, if available and if
requested, hours of opening of lawyers and legal practitioners worldwide.
2.1.1.7 Embassy Referral

To provide the names, telephone numbers and, if possible and requested,
hours of opening of nearest appropriate consulates and embassies
worldwide.
2.1.1.8 Lost Luggage Assistance

To assist the Person Covered who has lost luggage while travelling outside
Malaysia by referring the Person Covered to the appropriate authorities
involved.
2.1.1.9 Lost Passport Assistance

To assist the Person Covered who has lost passport while travelling outside
Malaysia by referring the Person Covered to the appropriate authorities
involved.
2.1.2 International Medical Assistance
2.1.2.1 Emergency Message Transmission

In the event of an emergency or a hospital confinement, Supreme Assist will
undertake to keep the Person Covered’s immediate family informed.
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2.1.2.2 Telephone Medical Advice

Supreme Assist will arrange the provision of medical advice to the Person
Covered over the telephone.
2.1.2.3 Medical Service Provider Referral

Supreme Assist will provide the Person Covered with information about
physicians, hospitals, clinics, dentists and dental clinics worldwide.
2.1.2.4 Arrangement of Appointments with Doctors

Supreme Assist will assist the Person Covered in arranging for appointments
with general practitioners or specialist doctors, if medically necessary.
2.1.2.5 Arrangement for Hospital Admission

If the medical condition of the Person Covered requires hospitalisation,
Supreme Assist will assist the Person Covered by arranging for hospital
admission.
2.1.2.6 Arrangement of Hotel Accommodation

Supreme Assist will arrange for hotel accommodation for a relative or friend
of the Person Covered to visit the Person Covered who has been
hospitalised outside Malaysia.
2.1.2.7 Arrangement and Payment of Emergency Medical Evacuation

Supreme Assist will arrange and pay medically necessary expense of air and/
or surface transportation, medical care during transportation, communications
and all usual ancillary charges incurred in moving the Person Covered when
in a Serious Medical Condition as defined in Section 1 above to the nearest
hospital where appropriate medical care is available and not necessarily to
Malaysia.
Supreme Assist may decide whether the Person Covered’s medical condition
is sufficiently serious to warrant emergency medical evacuation. Supreme
Assist may also decide the place to which such evacuation will be carried out
with all assessed facts and circumstances of which Supreme Assist is aware
at the relevant time.
2.1.2.8 Arrangement and Payment of Emergency Medical Repatriation

Supreme Assist will arrange and pay for the expenses necessarily and
unavoidably incurred in returning the Person Covered to Malaysia following
an emergency medical evacuation for subsequent inpatient treatment in a
place outside Malaysia.
Supreme Assist may decide the means or methods by which such
repatriation will be carried out with all assessed facts and circumstances of
which Supreme Assist is aware at the relevant time.
2.1.2.9 Arrangement and Payment of Repatriation of Mortal Remains

Supreme Assist will arrange and pay for all expenses reasonably and
unavoidably incurred for transporting the Person Covered’s mortal remains
from the place of death only to Malaysia or the cost of local burial at the place
of death as approved by Supreme Assist.
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2.1.2.10 Arrangement and Payment of Compassionate Visit

Supreme Assist will arrange and pay for one economy class return airfare
for a relative or friend of the Person Covered to visit the Person Covered
who, when travelling alone, has been hospitalised outside Malaysia for a
period in excess of seven (7) days and subject to Supreme Assist’s prior
approval and only when this is judged necessary by Supreme Assist on
medical and compassionate grounds.
2.1.2.11 Arrangement and Payment of Return of Minor Child

Supreme Assist will arrange and pay for one-way economy class airfare for
the return of up to three (3) minor children (below age of 18 years next
birthday) to Malaysia if they are left unattended as a result of the Person
Covered’s accident, illness or emergency medical evacuation.
2.2 Domestic Emergency Medical Assistance
2.2.1 The following services are applicable to the Person Covered within Malaysia but
outside his state of residence in Malaysia:
2.2.1.1 Emergency Message Transmission

In the event of an emergency or a hospital confinement, Supreme Assist will
undertake to keep the Person Covered’s immediate family informed.
2.2.1.2 Medical Service Provider Referral

Supreme Assist will provide the Person Covered with information about
physicians, hospitals, clinics, dentists and dental clinics nationwide.
2.2.2 The following services are applicable to the Person Covered travelling outside his
state of residence in Malaysia for a period not exceeding one hundred and twenty
(120) consecutive days for any one trip.
2.2.2.1 Arrangement and Payment of Emergency Medical Evacuation

Supreme Assist will arrange and pay medically necessary expense of air and/
or surface transportation, medical care during transportation, communications
and all usual ancillary charges incurred in moving the Person Covered when
in a Serious Medical Condition as defined in Section 1 above to the nearest
hospital in Malaysia where appropriate medical care is available and not
necessarily to the Person Covered’s state of residence in Malaysia.
Supreme Assist may decide whether the Person Covered’s medical condition
is sufficiently serious to warrant emergency medical evacuation. Supreme
Assist may also decide the place to which such evacuation will be carried out
with all assessed facts and circumstances of which Supreme Assist is aware
at the relevant time.
2.2.2.2 Arrangement and Payment of Emergency Medical Repatriation

Supreme Assist will arrange and pay for the expenses necessarily and
unavoidably incurred in returning the Person Covered to his state of
residence in Malaysia following an emergency medical evacuation for
subsequent inpatient treatment in place outside the Person Covered’s state
of residence in Malaysia.
Supreme Assist may decide the means or methods by which such
repatriation will be carried out with all assessed facts and circumstances of
which Supreme Assist is aware at the relevant time.
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2.2.2.3 Arrangement for Hospital Admission

If the medical condition of the Person Covered requires hospitalisation,
Supreme Assist will assist the Person Covered by arranging for hospital
admission.
3. CONDITIONS
In addition to other provisions of this Endorsement, the Takaful Operator will provide benefits as
stated in Section 2 subject also to the following conditions:
3.1 The services to be rendered by Supreme Assist to the Person Covered are purely on
arrangement basis, with the exception of services described in Sections 2.1.2.7, 2.1.2.8,
2.1.2.9, 2.1.2.10, 2.1.2.11, 2.2.2.1 and 2.2.2.2 above which are subject to the exclusions
stated in Section 4 below.
3.2 The Takaful Operator and Supreme Assist will not be responsible for any third party
expenses which will be Your responsibility and/or the responsibility of the Person Covered.
3.3 Supreme Assist will use its best effort to provide the Overseas and Domestic Emergency
Medical Assistance Services to the Person Covered in a timely and accurate manner and
will exercise care and diligence in providing the services. However, Supreme Assist does
not guarantee the quality of the services rendered and the final decision on use of such
services will be Your responsibility and/or the responsibility of the Person Covered. Supreme
Assist will not be responsible for any consequential loss to You and/or the Person Covered
resulting from the use of such services by the Person Covered or delay in communicating or
providing such services.
3.4 The total amount of costs and/or expenses incurred which are to be borne by Supreme
Assist in providing the services described in Sections 2.1.2.7, 2.1.2.8, 2.1.2.9, 2.1.2.10,
2.1.2.11, 2.2.2.1 and 2.2.2.2 above under this Certificate and all certificates (including
endorsements and annexures, if any) on the same Person Covered shall be limited to
RM500,000.
Under all circumstances, the Takaful Operator and Supreme Assist will not be responsible for any
damage, loss or injury to You and/or the Person Covered resulting from the usage of the
Overseas and Domestic Emergency Medical Assistance Services as decided by the Person
Covered.
4. EXCLUSIONS
The following treatments, events or conditions are specifically excluded under this Endorsement:
4.1 Pre-existing Illness as defined in Section 1 above, unless such Pre-Existing Illness had been
declared and stated in the Proposal Form and specifically accepted by the Takaful Operator
and duly endorsed;
4.2 Emergency Medical Evacuation or Repatriation or costs not approved in advance and in
writing by Supreme Assist and/or not arranged by Supreme Assist. This exclusion will not
apply to emergency medical evacuation from remote or primitive areas which Supreme
Assist cannot be contacted in advance and delay might reasonably be expected to result in
loss of life or extreme prejudice to the Person Covered’s prospects;
4.3 Any event occurring when the Person Covered is within the territory of Malaysia, his usual
country of residence or home country (for Overseas Emergency Medical Assistance
Services) or within his state of residence in Malaysia (for Domestic Emergency Medical
Assistance Services);
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4.4 Any expense if the Person Covered is travelling outside Malaysia or his usual country of
residence (for Overseas Emergency Medical Assistance Services) or outside his state of
residence in Malaysia (for Domestic Emergency Medical Assistance Services), which differs
from the advice of a medical practitioner or for the purpose of obtaining medical treatment or
for rest and recuperation following any prior accident or illness;
4.5 Any expense if the Person Covered is not suffering from a Serious Medical Condition or if
the treatment can be reasonably delayed until the Person Covered returns to Malaysia or his
usual country of residence (for Overseas Emergency Medical Assistance Services) or his
state of residence in Malaysia (for Domestic Emergency Medical Assistance Services);
4.6 Any treatment or expense related to childbirth, pregnancy (except abnormal pregnancy or
vital complication of pregnancy which endangers the life of the mother and/or unborn
children) and in any event childbirth, miscarriage (spontaneous abortion) or pregnancy after
the sixth (6th) month;
4.7 Any expense related to sickness or injury arising from racing of any kind (except foot racing);
4.8 Any expense incurred for emotional, mental illness and psychiatric disorder as opposed to
physical and strictly medical reason;
4.9 Self-inflicted injury, suicide, drug addiction or abuse, alcohol abuse, sexually transmitted
diseases, acquired immune deficiency syndrome (AIDS) or any AIDS related conditions or
diseases;
4.10 Any treatment performed or ordered by a non-registered practitioner not in accordance with
the standard medical practice as defined in the country of treatment;
4.11 The cost of burial in the Person Covered’s home country;
4.12 Any expense resulting from participation in war, riot or civil commotion or any illegal act
resulting in imprisonment or while serving in a police or military unit;
4.13 Overseas and Domestic Emergency Medical Assistance Services or cost incurred on a
Person Covered who is more than sixty-five (65) years next birthday;
4.14 The cost of transporting the Person Covered by means of the Person Covered’s owned or
leased watercraft unless agreed in writing by Supreme Assist prior to the Rider Effective
Date.
5. ALTERATIONS
The Takaful Operator may amend the terms and conditions of this Endorsement by giving thirty
(30) days advance notice in writing by ordinary post to You at Your last known address in the
Takaful Operator’s records, and such amendment will be applicable from the next renewal of this
Certificate. No alteration to this Endorsement will be valid unless authorized by the Takaful
Operator and such approval is endorsed thereon.
6. CANCELLATION
This Endorsement is automatically cancelled on the date of termination of this Certificate or the
Annexure, whichever is earlier.
**END OF PAGE**
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Great Eastern Takaful Berhad

ENDORSEMENT
EXECUTIVE SECOND OPINION
ENDORSEMENT NO. TE028 (ESO)
1. DEFINITIONS
For the purpose of this Endorsement, the following words or expressions, whenever mentioned in this
Endorsement, shall have the following meanings unless otherwise stated. Any word or expression not
specifically defined in this Endorsemernt shall have the same meaning as ascribed to it in this
Certificate:-
“Activities of Daily Living” means all of the following:

(a) Transfer
Getting in and out of a chair without requiring physical assistance.
(b) Mobility
The ability to move from room to room without requiring any physical assistance.
(c) Continence
The ability to voluntarily control bowel and bladder functions such as to maintain personal
hygiene.
(d) Dressing
Putting on and taking off all necessary items of clothing without requiring assistance of other
person.
(e) Bathing/Washing
The ability to wash in the bath or shower (including getting in or out of the bath or shower) or
wash by any other means.
(f) Eating
All tasks of getting food into the body once it has been prepared.
“Consultant Neurologist” means a medical practitioner who is board certified in neurology and a
Fellow of the Neurological Society in any of the following countries; the United Kingdom, the United
States of America, Canada or Australia.
“Covered Condition” means any of the medical conditions specified in Clause 3 below.
“Diagnosis” means the definitive diagnosis made by a practitioner or Consultant Neurologist, based
upon such specific evidence, referred tbelow in the definition of the particular Covered Condition
concerned or, in the absence of such specific evidence, based upon radiological, clinical, histological
or laboratory evidence acceptable to Us.
Such diagnosis must be supported by Our appointed medical practitioner who may base his/her
opinion on the medical evidence submitted by the claimant and/or any additional evidence he/she may
require.
“Irreversible” means the condition which cannot be reasonably improved upon by medical treatment
and/or surgical procedures consistent with the current standard of the medical services available in
Malaysia.
“Panel” means an independently assembled panel of medical facilities who provides the Executive
Second Opinion Service, the list of which may be changed by Supreme Assist from time to time.
“Permanent” means expected to last throughout the lifetime of the Participant/Person Covered.
“Permanent Neurological Deficit with Persisting Clinical Symptoms” means symptoms of
dysfunction in the nervous system that are present on clinical examination and expected to last
throughout the lifetime of the Participant/Person Covered. Symptoms that are covered include
numbness, paralysis, localised weakness, dysarthria (difficulty with speech), aphasia (inability to
speak), dysphagia difficulty swallowing), visual impairment, difficulty in walking, lack of coordination,
tremor, seizures, dementia, delirium and coma.
“Medical Cover” means the Annexure of Medical Cover (Rider) or the certificate of Medical Cover
(Basic Plan), where applicable as referred to in this Endorsement.
“Medical Cover Effective Date” means the Effective Date of the Medical Cover as referred to this
Endorsement.
“Supreme Assist” under this Endorsement means the service provider(s) appointed by Us to provide
the Executive Second Opinion Service as described under Clause 2 below.
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We have entered into an arrangement with Supreme Assist who upon request by You and/or Person
Covered will make necessary arrangements with any one (1) member of the Panel to provide the
following Executive Second Opinion Service (“ESO Service”) to the Person Covered, subject to the
terms and conditions of the Certificate, including this Endorsement:
(A) File Review
The Panel will prepare a report, which will summarize the documentation of review data,
findings and observations and other treatment alternatives. In addition, the File Review will
include a recommendation for the medical necessity of a treatment plan, procedure, length of
stay, level of care, future discharge plan or ongoing services. Second surgical opinion issues
may also be addressed in the report.
(B) Tele-Consultation of Medical Opinion
After the receipt of the medical File Review as described in Section (A) above, the Person
Covered will be entitled for a free telephone medical consultation with the Panel for a period not
exceeding one (1) hour. The telephone medical consultation refers to a medical/surgical or
allied health telephonic discussion on a specific case with the Panel. Issues to be addressed
include medical necessity of treatment, appropriateness of site of treatment, proper length of
stay and discharge planning which are in addition to the requirements stated in the File Review
above.
Provided that:
2.1 The Person Covered is diagnosed under the Covered Condition after the Waiting Period.
2.2 ESO Service will not be provided on any Covered Condition for which:
2.2.1 any condition which existed or diagnosed:
2.2.1.1 during the Waiting Period; or
2.2.1.2 after the expiry of the Waiting Period but which is related to a condition which
existed or diagnosed during the Waiting Period; or
2.2.2 any sign and symptom existed before or during the Waiting Period which would prompt a
reasonable person to seek medical care or attention, though the resulting diagnosis may
occur before or after the expiry of the Waiting Period.
2.3 ESO Service for a Covered Condition described in Clause 2.2.1 and/or 2.2.2 above will not be
provided merely because Supreme Assist has been notified of such need after the expiry of the
Waiting Period.
2.4 ESO Service will be arranged for a Covered Condition under Covered Conditions (41) to (49) of
Clause 3 below if the Person Covered is diagnosed of any such Covered Conditions after the
Waiting Period and before he attains the age of twenty-one (21) years next birthday.
2.5 If the evidence or opinion of a consultant paediatrician is required for any of the Covered
Conditions (41) to (49) on a Person Covered over the age of fourteen (14) years next birthday,
the requirement for evidence or opinion of a consultant paediatrician may be substituted by that
of an appropriate attending medical practitioner at the sole discretion of Us or Supreme Assist.
For the purpose of verification of eligibility for the ESO Service, We will issue a membership card to
the Person Covered. The Person Covered must always identify himself by stating his full name,
certificate number and expiry date of the membership card.
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3. DEFINITIONS OF COVERED CONDITIONS
(1) “Heart Attack – of Death of heart muscle, due to inadequate blood supply, that has
Specified Severity” resulted in all of the following evidence of acute myocardial infarction:
A history of typical chest pain;

(i) new characteristic electrocardiographic changes; with the
development of any of the following: ST elevation or depression, T
wave inversion, pathological Q waves or left bundle branch block;
and
(ii) elevation of the cardiac biomarkers, inclusive of CPK-MB above the
generally accepted normal laboratory levels or Troponins recorded
at the following levels or higher:
(a) Cardiac Troponin T or Cardiac Troponin I > / = 0.5 ng/ml
The evidence must show the occurrence of a definite acute myocardial

infarction which should be confirmed by a cardiologist or physician.

· occurrence of an acute coronary syndrome including but not limited
to unstable angina; and
· a rise in cardiac biomarkers resulting from a percutaneous
procedure for coronary artery disease.
(2) “Stroke – Resulting Death of brain tissue due to inadequate blood supply, bleeding within
in Permanent the skull or embolization from an extra cranial source resulting in
Neurological Deficit permanent neurological deficit with persisting clinical symptoms. The
with Persisting Clinical diagnosis must be based on changes seen in a CT scan or MRI and
Symptoms” certified by a neurologist. A minimum Assessment Period of three (3)
months applies.

(i) transient ischemic attacks;
(ii) cerebral symptoms due to migraine;
(iii) traumatic injury to brain tissue or blood vessels; and
(iv) vascular disease affecting the eye or optic nerve or vestibular
functions.
(3) “Coronary Artery By- Refers to the actual undergoing of open-chest surgery to correct or treat
Pass Surgery” Coronary Artery Disease (CAD) by way of coronary artery by-pass
grafting.
(i) angioplasty;
(ii) other intra-arterial or catheter based techniques;
(iii) keyhole procedures; and
(iv) laser procedures.
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(4) “Cancer – of Specified Any malignant tumour positively diagnosed with histological
Severity and Does Not confirmation and characterized by the uncontrolled growth of malignant
Cover Very Early cells and invasion of tissue. The term malignant tumour includes
Cancers” leukaemia, lymphoma and sarcoma.

(i) all cancers which are histological classified as any of the following:
a. pre-malignant;
b. non-invasive;
c. carcinoma in situ;
d. having borderline malignancy;
e. having malignant potential;
(ii) all tumours of the prostate histologically classified as T1N0M0
(TNM classification);
(iii) all tumours of the thyroid histologically classified as T1N0M0 (TNM
classification);
(iv) all tumours of the urinary bladder histologically classified as
T1N0M0 (TNM classification);
(v) chronic Lymphocytic Leukemia less than RAI Stage 3;
(vi) all cancers in the presence of HIV; and
(vii) any skin cancer other than malignant melanoma.
(5) “Kidney Failure – End-stage kidney failure presenting as chronic irreversible failure of
Requiring Dialysis or both kidneys to function, as a result of which regular dialysis is initiated
Kidney Transplant” or kidney transplantation is carried out.
(6) “Fulminant Viral A sub-massive to massive necrosis (death of liver tissue) caused by
Hepatitis” any virus as evidenced by all of the following diagnostic criteria:
(i) a rapidly decreasing liver size as confirmed by abdominal
ultrasound;
(ii) necrosis involving entire lobules, leaving only a collapsed reticular
framework;
(iii) rapidly deteriorating liver functions tests; and
(iv) deepening jaundice.
Viral hepatitis infection or carrier status alone (inclusive but not limited
to Hepatitis B and Hepatitis C) without the above diagnostic criteria is
not covered.
(7) “Major Organ / Bone The receipt of a transplant of:

Marrow Transplant” · human bone marrow using hematopoietic stem cells preceded by
total bone marrow ablation; or
· 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 not covered.
(8) “Paralysis of Limbs” Total, permanent and irreversible loss of use of both arms or both legs,
or of one arm and one leg, through paralysis caused by illness or injury.
A minimum Assessment Period of six (6) months applies.
(9) “Multiple Sclerosis” A definite diagnosis of multiple sclerosis by a neurologist. The diagnosis
must be supported by all of the following:
(i) investigations which confirm the diagnosis to be Multiple Sclerosis;
and
(ii) multiple neurological deficits resulting in impairment of motor and
sensory functions occurring over a continuous period of at least six
(6) months; and
(iii) well documented history of exacerbations and remissions of said
symptoms or neurological deficits.
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(10) “Primary Pulmonary A definite diagnosis of primary pulmonary arterial hypertension with
Arterial Hypertension substantial right ventricular enlargement established by investigations
– of Specified including cardiac catheterization, resulting in permanent physical
Severity”” impairment to the degree of at least Class III of the NYHA classification
of cardiac impairment.
Pulmonary arterial hypertension resulting from other causes shall be

excluded from this benefit.
The NYHA Classification of Cardiac Impairment for Class III and Class
IV means the following:
Class III: Marked limitation of physical activity. Comfortable at rest
but less than ordinary activity causes symptoms.
Class IV: Unable to engage in any physical activity without
discomfort. Symptoms may be present even at rest.
(11) “Blindness – Permanent and irreversible loss of sight as a result of accident or illness
Permanent and to the extent that even when tested with the use of visual aids, vision is
Irreversible” measured at 3/60 or worse in both eyes using a Snellen eye chart or
equivalent test and the result must be certified by an ophthalmologist.
(12) “Heart Valve Surgery” The actual undergoing of open-heart surgery to replace or repair
cardiac valves as a consequence of heart valve defects or
abnormalities.
(i) repair via intra-arterial procedure; and
(ii) repair via key-hole surgery or any other similar techniques.
(13) “Deafness – Permanent and irreversible loss of hearing as a result of accident or

Permanent and illness to the extent that the loss is greater than 80 decibels across all
Irreversible” frequencies of hearing in both ears. Medical evidence in the form of an
audiometry and sound-threshold tests result must be provided and
certified by an Ear, Nose, and Throat (ENT) specialist.
(14) “Surgery To Aorta” The actual undergoing of surgery via a thoracotomy or laparotomy
(surgical opening of thorax or abdomen) to repair or correct an aortic
aneurysm, an obstruction of the aorta or a dissection of the aorta. For
this definition, aorta shall mean the thoracic and abdominal aorta but
not its branches.
(i) angioplasty;
(ii) other intra-arterial or catheter based techniques;
(iii) other keyhole procedures; and
(iv) laser procedures.
(15) “Loss of Speech” Total, permanent and irreversible loss of the ability to speak as a result
of injury or illness. A minimum Assessment Period of six (6) months
applies. Medical evidence to confirm injury or illness to the vocal cords
to support this disability must be supplied by an Ear, Nose, and Throat
specialist.
All psychiatric related causes are not covered.
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(16) “Alzheimer's Disease/ Deterioration or loss of intellectual capacity confirmed by clinical

Severe Dementia” evaluation and imaging tests arising from Alzheimer's Disease or
Severe Dementia as a result of irreversible organic brain disorders. The
Covered Event must result in significant reduction in mental and social
functioning requiring continuous supervision of the Person Covered.
The diagnosis must be clinically confirmed by a neurologist.
From the above definition, the following are not covered:

(i) non organic brain disorders such as neurosis;
(ii) psychiatric illnesses; and
(iii) drug or alcohol related brain damage.
(17) “Third Degree Burns – Third degree (i.e. full thickness) skin burns covering at least twenty
of Specified Severity” percent (20%) of the total body surface area.
(18) “Coma – Resulting in A state of unconsciousness with no reaction to external stimuli or

Permanent internal needs, persisting continuously for at least ninety six (96) hours,
Neurological Deficit requiring the use of life support systems and resulting in a permanent
With Persisting neurological deficit with persisting clinical symptoms. A minimum
Clinical Symptoms” Assessment Period of thirty (30) days applies. Confirmation by a
neurologist must be present.
The following is not covered:

Coma resulting directly from alcohol or drug abuse.
(19) “Terminal Illness” The conclusive diagnosis of a condition that is expected to result in
death of the Participant / Person Covered within twelve (12) months.
The Participant / Person Covered must no longer be receiving active
treatment other than that for pain relief. The diagnosis must be
supported by written confirmation from an appropriate specialist and
confirmed by Our appointed doctor.
(20) “Motor Neuron A definite diagnosis of motor neuron disease by a neurologist with
Disease – Permanent reference to either spinal muscular atrophy, progressive bulbar palsy,
Neurological Deficit amyotrophic lateral sclerosis or primary lateral sclerosis. There must be
with Persisting Clinical permanent neurological deficit with persisting clinical symptoms.
Symptoms”
(21) “HIV Infection Due To Infection with the Human Immunodeficiency Virus (HIV) through a blood
Blood Transfusion” transfusion, provided that all of the following conditions are met:
(i) the blood transfusion was medically necessary or given as part of a
medical treatment;
(ii) the blood transfusion was received in Malaysia or Singapore after
the commencement of the Certificate;
(iii) the source of the infection is established to be from the institution
that provided the blood transfusion and the institution is able to
trace the origin of the HIV tainted blood;
(iv) the Person Covered does not suffer from haemophilia; and
(v) the Person Covered is not a member of any high risk groups
including but not limited to intravenous drug users.
(22) “Parkinson's Disease A definite diagnosis of Parkinson's Disease by a neurologist where all
– Resulting in the following conditions are met:
Permanent Inability to (i) cannot be controlled with medication;
Perform Activities of (ii) shows signs of progressive impairment; and
Daily Living” (iii) confirmation of the permanent inability of the Person Covered to
perform without assistance three (3) or more of the Activities of
Daily Living.
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Only idiopathic Parkinson’s Disease is covered. Drug-induced or toxic

causes of Parkinsonism are not covered.
(23) “End-Stage Liver End-stage liver failure as evidenced by all of the following:
Failure” (i) permanent jaundice;
(ii) ascites (excessive fluid in peritoneal cavity); and
(iii) hepatic encephalopathy.
Liver failure secondary to alcohol or drug abuse is not covered.
(24) “End-Stage Lung End-stage lung disease causing chronic respiratory failure. All of the
Disease” following criteria must be met:
(i) the need for regular oxygen treatment on a permanent basis;
(ii) permanent impairment of lung function with a consistent Forced
Expiratory Volume (FEV) of less than 1 liter during the first second;
(iii) shortness of breath at rest; and
(iv) Baseline Arterial Blood Gas analysis with partial oxygen pressures
of 55mmHg or less.
(25) Major Head Trauma – Physical head injury resulting in permanent functional impairment
Resulting in verified by a neurologist. The permanent functional impairment must
Permanent Inability to result in an inability to perform at least three (3) of the Activities of Daily
Perform Activities of Living. A minimum Assessment Period of three (3) months applies.
Daily Living”
(26) “Chronic Aplastic Irreversible permanent bone marrow failure which results in anaemia,
Anemia - Resulting in neutropenia and thrombocytopenia requiring at least two (2) of the
Permanent Bone following treatments:
Marrow Failure” (i) regular blood product transfusion;
(ii) marrow stimulating agents;
(iii) immunosuppressive agents; or
(iv) bone marrow transplantation.
The diagnosis must be confirmed by a bone marrow biopsy.
(27) “Muscular Dystrophy” The definite diagnosis of a Muscular Dystrophy by a neurologist which
must be supported by all of the following:
(i) clinical presentation of progressive muscle weakness;
(ii) no central/ peripheral nerve involvement as evidenced by absence
of sensory disturbance; and
(iii) characteristic electromyogram and muscle biopsy findings.
No benefit will be payable under this Covered Event before the Person
Covered has reached the age of twelve (12) years next birthday.
(28) “Benign Brain Tumor – A benign tumour in the brain or meninges within the skull, where all of
of Specified Severity” the following conditions are met:
(i) it is life threatening;
(ii) it has caused damage to the brain;
(iii) it has undergone surgical removal or has caused permanent
neurological deficit with persisting clinical symptoms; and
(iv) its presence must be confirmed by a neurologist or neurosurgeon
and supported by findings on MRI, CT or other reliable imaging
techniques.
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The following are not covered:

(i) cysts;
(ii) granulomas;
(iii) malformations in or of the arteries or veins of the brain;
(iv) hematomas;
(v) tumours in the pituitary gland;
(vi) tumours in the spine; and
(vii) tumours of the acoustic nerve.
(29) “Encephalitis – Severe inflammation of brain substance, resulting in permanent

Resulting in functional impairment. The permanent functional impairment must
Permanent Inability to result in an inability to perform at least three (3) of the Activities of Daily
Perform Activities of Living. A minimum Assessment Period of thirty (30) days applies. The
Daily Living” Covered Event must be certified by a neurologist.
Encephalitis in the presence of HIV infection is not covered.
(30) “Poliomyelitis” Unequivocal diagnosis by a Consultant Neurologist of infection with the

Poliovirus leading to paralytic disease as evidenced by impaired motor
function or respiratory weakness. Cases not involving paralysis will not
be eligible for this benefit.
Other causes of paralysis (such as Guillain-Barre syndrome) are
specifically excluded.
(31) “Brain Surgery” The actual undergoing of surgery to the brain under general
anaesthesia during which a craniotomy (surgical opening of skull) is
performed.

(i) burr hole procedures;
(ii) transphenoidal procedures;
(iii) endoscopic assisted procedures or any other minimally invasive
procedures; and
(iv) surgery as a result of an accident.
(32) “Bacterial Meningitis - Bacterial meningitis causing inflammation of the membranes of the
Resulting in brain or spinal cord resulting in permanent functional impairment. The
Permanent Inability to permanent functional impairment must result in an inability to perform
Perform Activities of at least three (3) of the Activities of Daily Living. A minimum
Daily Living” Assessment Period of thirty (30) days applies.
The diagnosis must be confirmed by:

(i) an appropriate specialist; and
(ii) the presence of bacterial infection in the cerebrospinal fluid by
lumbar puncture.
For the above definition, other forms of meningitis, including viral

meningitis are not covered.
(33) “Serious Coronary The narrowing of the lumen of Right Coronary Artery (RCA), Left
Artery Disease” Anterior Descending Artery (LAD) and Circumflex Artery (not inclusive
of their branches) occurring at the same time by a minimum of sixty
percent (60%) in each artery as proven by coronary arteriography
(non- invasive diagnostic procedures are not covered). A narrowing of
sixty percent (60%) or more of the Left Main Stem will be considered
as a narrowing of the Left Anterior Descending Artery (LAD) and
Circumflex Artery. This Covered Event is payable regardless of
whether or not any form of coronary artery surgery has been
performed.
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(34) “Apallic Syndrome” Universal necrosis of the brain cortex, with the brainstem remaining
intact. Diagnosis must be confirmed by a Consultant Neurologist.
(35) “AIDS Cover of Infection by any Human Immunodeficiency Virus (HIV) only if the
Medical Staff” Person Covered is a Medical Staff as defined below, and that such
infection was considered by the medical authorities involved to be
caused by a needlestick/sharp instrument injury or by exposure to
blood or bloodstained body fluid which occurred after the
commencement of this Medical Cover. The accident must have
occurred whilst the Person Covered was following his normal
occupational duties and reported in accordance with the established
occupational procedures for such accidents. The Person Covered
must, within 5 days of the accident have undergone a blood test
indicating the absence of HIV or its antibodies but a further blood test
performed within 6 months of the accident must indicate the presence
of HIV or its antibodies after the commencement of this Medical Cover.
“Medical Staff” is defined as Doctors (General Physicians and
Specialists), nurses, laboratory technicians, dentists (surgeons and
nurses), ambulance workers who are working in the medical centre or
hospital or dental clinics/polyclinics in Malaysia.
(36) “Full-Blown AIDS” The clinical manifestation of AIDS (Acquired Immuno-deficiency

Syndrome) must be supported by the results of a positive HIV (Human
Immuno-deficiency Virus) antibody test and a confirmatory test. In
addition, the Person Covered must have a CD4 cell count of less than
two hundred (200) and one or more of the following criteria are met:
(i) weight loss of more than 10% of body weight over a period of six
(6) months or less (wasting syndrome);
(ii) Kaposi Sarcoma;
(iii) Pneumocystis Carinii Pneumonia;
(iv) progressive multifocal leukoencephalopathy;
(v) active Tuberculosis;
(vi) less than one-thousand (1000) Lymphocytes; or
(vii) Malignant Lymphoma.
(37) “Angioplasty” First time of Coronary Balloon Angioplasty, artherectomy, laser

treatment or the insertion of a stent to correct a narrowing or blockage
of one or more coronary arteries.
Intra-arterial investigative procedures without ballon, laser and
artherectomy angioplasty are specifically excluded.
Angioplasty procedures as provided above must be certified and
recommended by a qualified cardiologist acceptable to Us.
(38) “Medullary Cystic A progressive hereditary disease of the kidney characterized by the
Kidney” presence of cysts in the medulla, tubular atrophy and interstitial fibrosis
with the clinical manifestations of anaemia, polyuria and renal loss of
sodium, progressing to chronic kidney failure. Diagnosis must be
supported by a renal biopsy.
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(39) “Cardiomyopathy – of A definite diagnosis of cardiomyopathy by a cardiologist which results

Specified Severity” in permanently impaired ventricular function and resulting in permanent
physical impairment of at least Class III of the New York Heart
Association (NYHA) classification of cardiac impairment. The diagnosis
has to be supported by echocardiographic findings of compromised
ventricular performance.
The NYHA Classification of Cardiac Impairment for Class III and Class
IV means the following:
Class III: Marked limitation of physical activity. Comfortable at rest but
less than ordinary activity causes symptoms.
Class IV: Unable to engage in any physical activity without discomfort.
Symptoms may be present even at rest.
(40) “Systemic Lupus A definite diagnosis of Systemic Lupus Erythematosus confirmed by a
Erythematosus With rheumatologist.
Severe Kidney
Complications” For this definition, the Covered Event is payable only if it has resulted
in Type III to Type V Lupus Nephritis as established by renal biopsy.
Other forms such as discoid lupus or those forms with only
haematological or joint involvement are not covered.
WHO Lupus Classification:

Type III: Focal Segmental glomerulonephritis
Type IV: Diffuse glomerulonephritis
Type V: Membranous glomerulonephritis
(41) “Bone Marrow The confirmation of acceptance on to the official Malaysia waiting list
Transplant” for a Medically Necessary transplant of bone marrow from a human
donor as a recipient which is to be supported by a qualified consultant
hematologist acceptable to Us.
(42) “Glomerulonephritis Glomerulonephritis with nephrotic syndrome, which has continued for
with Nephrotic a period of at least six (6) months, with or without intervening periods
Syndrome” of remission. The diagnosis of nephrotic syndrome must be made by a
qualified paediatrician, acceptable to Us and who should confirm that
a treatment regimen appropriate to the clinical presentation has been
followed throughout the period to which the syndrome relates.
(43) “Insulin Dependent Insulin dependent diabetes mellitus as characterised by the

Diabetes Mellitus” continuous dependence on exogenous insulin for the preservation of
life as diagnosed by a consultant endocrinologist. Evidence of
continuous dependence on exogenous insulin as certified by the
attending physician or paediatrician shall be required before a claim is
considered.
(44) “Intellectual Significant and Permanent Neurological Impairment or Significant and

Impairment due to Permanent Loss of Intellectual Capacity as diagnosed by a consultant
Accident or Sickness” paediatrician or Consultant Neurologist as a direct result of accident or
sickness.
The Neurological Impairment or Loss of Intellectual Capacity must be
confirmed for the Person Covered who is under the age of six (6) by a
Denver Development Screening Test, Singapore (DDST, Singapore)
to be performed in Malaysia with a reading of “Abnormal”, or for the
Person Covered aged six (6) or above, by an IQ score of less than 70.
The Significant Neurological Impairment or Significant Loss of

Intellectual Capacity must result in the need for special child care or
special schooling as certified by a consultant paediatrician or
Consultant Neurologist and must persist for at least six (6) months.
There must be unequivocal proof that the Significant and Permanent
Neurological Impairment or Significant and Permanent Loss of
Intellectual Capacity is a direct result of an accident sustained or
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sickness suffered by the Person Covered after the commencement of

this Medical Cover.
(45) “Kawasaki Disease The diagnosis of Kawasaki disease by a consultant paediatrician or

with Heart qualified cardiologist acceptable to Us. There must be
Complications” echocardiographic evidence of cardiac involvement manifested by
dilation or aneurysm formation in the coronary arteries.
(46) “Leukaemia” Unequivocal diagnosis of Leukaemia, confirmed by histology,

requiring chemotherapy and/or radiotherapy treatment.
(47) “Rheumatic Fever A confirmed diagnosis by a consultant paediatrician acceptable to Us
with Valvular of acute rheumatic fever according to the revised Jones criteria for its
Impairment” diagnosis. There must be involvement of one (1) or more heart valves
and at least mild valve incompetence attributable to rheumatic fever
as confirmed by quantitative investigations of the valve function by a
qualified cardiologist acceptable to Us.
(48) “Severe Asthma” “Severe Asthma” as evidenced by either

(1) An acute attack of severe asthma leading to admission to a
Medical Centre or Hospital and assisted ventilation with a
mechanical ventilator for a continuous period of at least four (4)
hours to establish control of the asthma attack on the advice of a
consultant paediatrician; or
(2) At least three (3) of the following features of chronic, severe
asthma:
(a) Continuous daily usage of oral corticosteroids for a minimum
period of six (6) months on the advice of a consultant
paediatrician to control the child’s asthma.
(b) The presence of Harrison’s sulcus chest deformity as
confirmed by a consultant paediatrician.
(c) Significant growth impairment attributed by a consultant
paediatrician to the child’s asthma (which is for this purpose
defined as a height below the third percentile for the child’s
age and sex in a child with asthma whose height has
previously been recorded at or above the fifth percentile at a
routine developmental examination at the age of at least one
year).
(d) An average of at least three (3) admissions to Medical Centre
or Hospital per year in the previous two years to control acute
attacks of asthma. An admission to Medical Centre or Hospital
will be counted for this purpose if it results in a stay in Medical
Centre or Hospital of at least two (2) nights’ duration on the
advice of a consultant paediatrician.
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Significant and persistent limitation of the peak expiratory flow rate

(which is for this purpose defined as maximum peak expiratory flow
rate recordings of less than 80% of the rate predicted for a child of the
same age, sex and build while taking the treatment prescribed by a
consultant paediatrician for asthma). The recordings are to be made
by a consultant paediatrician on at least four occasions at intervals of
no less than one (1) month in a period of at least twelve (12) months.
The paediatrician certifying the recordings should be satisfied that the
child is complying with optimal prescribed asthma medication
throughout the period to which the recordings relate.
(49) “Severe Juvenile Severe juvenile rheumatoid arthritis as diagnosed by a consultant

Rheumatoid Arthritis rheumatologist, with widespread joint destruction and major clinical
(including Still’s deformity of at least three (3) or more of the following joint areas:
Disease)” hands, wrists, elbows, knees, hips, ankle, cervical spine or
metatarsophalangeal joints in the feet.
4. CONDITIONS
In addition to other provisions of this Endorsement, We will provide benefits as stated in Clause 2
subject to the following conditions:
4.1 The services to be rendered by Supreme Assist to the Person Covered are purely on
arrangement basis.
4.2 We and Supreme Assist will not be responsible for any third party expenses which will be Your
responsibility and/or the responsibility of the Person Covered. To avoid any doubts, third party
expenses stated above shall include but is not limited to the cost incurred pertaining to surface
transportation, medical care during transportation, accommodations, communications and all
other ancillary charges incurred by the Person Covered in seeking the ESO Service.
4.3 Supreme Assist will use its best efforts to provide the ESO Service to the Person Covered in a
timely and accurate manner and will exercise care and diligence in selecting the Panel.
However, Supreme Assist does not guarantee the quality of the Panel.
4.4 Eligibility for the ESO Service shall not be construed as an automatic admission of claim by Us
for payment of any other benefits under the Medical Cover and all other certificates (including
endorsements and annexures, if any) on the same Person Covered.
4.5 The usage of the ESO Service as stipulated in Section 2 (A) and (B) above on any one Person
Covered shall be limited to:
4.5.1 one (1) time on any one Covered Condition in any one Certificate Year; and
4.5.2 three (3) times in total under the Certificate and all certificates on the same Person
Covered.
Under all circumstances, We and Supreme Assist will not be responsible for any damage, loss or
injury to You and/or the Person Covered resulting from the usage of the ESO Service as decided by
the Person Covered.
5. EXCLUSIONS
ESO Service will not be provided for any of the following services, products and conditions:
5.1 Diagnosis of a Covered Condition as a result of Pre-existing Illness, unless such Pre-Existing
Illness had been declared and stated in the Proposal Form and specifically accepted by Us and
duly endorsed;
5.2 Any Covered Condition resulting directly or indirectly, to any medical or physical anomalies
existed at the time of birth or manifested the symptoms later after birth, or neo-natal physical
abnormalities developing within six (6) months from the time of birth. This will include all types of
hernias and epilepsy except when caused by a trauma, which occurred after the
Commencement Date or Rider Effective Date;
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5.3 ESO Service or costs not approved in advance and in writing by Supreme Assist and/or not
arranged by Supreme Assist;
5.4 Any Covered Condition resulting directly or indirectly from self-inflicted injuries, while sane or
insane.
6. ALTERATIONS
We may amend the terms and conditions of this Endorsement by giving a thirty (30) days advance
notice in writing to You, and such amendment will be applicable from the next renewal of this Medical
Cover. No alteration to this Endorsement will be valid unless authorized by Us and such approval has
been endorsed.
7. CANCELLATION
This Endorsement is automatically cancelled

7.1 upon utilisation of three (3) times of the ESO Service stipulated in Clause 2 above; or
7.2 on the date of termination of the Medical Cover, whichever is applicable.
**END OF PAGE**
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Certificate Document

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Certificate Document

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28/12/2021

CIK AINUL AINA BINTI MOHD NOOR

NOMBOR SIJIL ANDA: 401510256-8

SHAHRUL AZLAN SHAHRIMAN

YOUR CERTIFICATE NUMBER: 401510256-8

SHAHRUL AZLAN SHAHRIMAN

TLCIL/V08/07-2018 Page 1 of 1 2912/023042/1

CERTIFICATE INFORMATION STATEMENT

TCIF/V03/12-2020 Page 1 of 2 2912/023043/3

FREE LOOK PERIOD

The following will be refunded to You:

ENQUIRIES ON YOUR CERTIFICATE

CUSTOMER FEEDBACK UNIT

OMBUDSMAN FOR FINANCIAL SERVICES or CUSTOMER SERVICES BUREAU, BANK NEGARA

Ombudsman for Financial Services

Bank Negara Malaysia

Contact Centre (BNMTELELINK)

TCIF/V03/12-2020 Page 2 of 2 2912/023043/4

What is the electronic medical (e-Medical) card?

TINFO/V06/10-2020 Page 1 of 2 2912/023043/5

Apakah kad perubatan elektronik (e-Kad Perubatan)?

TINFO/V06/10-2020 Page 2 of 2 2912/023043/6

You, the Participant named in Takaful Schedule A of this certificate, have

This Certificate is made up of:

This Certificate is signed on the Issue Date.

Chief Executive Officer

TCCA/V08/12-2020 Page 1 of 1 2912/023043/7

APPLICABLE BENEFITS CURRENCY AGE NEXT BIRTHDAY COMMENCEMENT DATE

EFFECTIVE DATE ISSUE DATE

OFFICE OF TAKAFUL OPERATOR FOR PAYMENT OF CONTRIBUTIONS AND BENEFITS

EVENT WHEN THE BASIC SUM COVERED WILL BECOME PAYABLE

CERTIFICATE NO: 401510256-8 PROPOSAL NO: JHB/15104/21

PARTICIPANT'S : C-36 KG GONG BERANGIN TEMPINIS

TABLE OF SUPPLEMENTARY BENEFITS

SPECIAL PROVISIONS / ENDORSEMENTS

TSA6/V01/04-2017 Page 1 of 2 2912/023043/9

TSA6/V01/04-2017 Page 2 of 2 2912/023043/10

PLEASE REFER TO TAKAFUL SCHEDULE B2 FOR THE DETAILS OF TAKAFUL CONTRIBUTION

UPFRONT CHARGE (UNALLOCATED CONTRIBUTION)

UPFRONT CHARGE IS DEDUCTED FROM THE CONTRIBUTION PAID FOR DISTRIBUTION

Allocation Rate for Takaful Contribution - i-GREAT MEDIHARAPAN

Contribution Year Allocation Rate

20 and above 64.00%

TSB4/V02/10-2012 Page 1 of 1 2912/023043/12

SCHEDULE OF CONTRIBUTION RATES

Standard Contribution Rates per Annum for i-Great MediHarapan (T MEDH200)

Contribution Rate Contribution Rate Contribution Rate

* For renewal only.

(2) Person Covered’s occupation classification under this Certificate is 1

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Item Covered Benefits Maximum Benefits

TB44/V02/09-2019 Page 1 of 1 2912/023043/14

PRIVILEGES AND CONDITIONS

1. DEFINITIONS AND INTERPRETATIONS

TPCAZ/V02/12-2020 Page 1 of 19 2912/023044/15

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BASIS OF CONTRACT (Clause 2)

CONTRIBUTION AND CHARGES (Clauses 3 - 6)

3.1 The Contribution will be allocated into the Tabarru' Fund.

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6. VARIATION OF CONTRIBUTION, TABARRU’ RATES AND OTHER CHARGES

LAPSE AND REINSTATEMENT (Clauses 7 - 8)