A yearly renewable hospital and surgical insurance scheme designed to reduce the financial burden of the employer of foreign workers in the event of hospital admission of their foreign workers to a Non-Corporatised Malaysian Government Hospital due to an accident or illness.
Compulsory scheme for all foreign workers with effect from 01/01/2011 for West Malaysia, Sabah with effect from 1/7/2012 and Sarawak with effect from 1/2/2013
For all present and future full-time foreign worker employees of policyholder
Actively engaged at their usual work on the date the persons are eligible to join this policy.
The duration of cover is for one year.
All benefits provided in this policy are only payable in the event the insured person is confined in a non-corporatised Malaysian Government Hospital.You may login to SPIKPA web at www.spikpa.com.my for list of the hospitals.UKM, UM are NOT considered as non-corporatised Malaysian Government Hospital.
Overview Of Insurance Benefits
*Standardized Benefits, Premium, and Claims Procedures for all Insurers.
*Medical Report Fees @ RM80.00.
*Insurance Cover for Hospitalization and Daycare Surgery.
*Private Hospital – Accident / Emergency only. Claims to be assessed based on MOH rates. Reimbursement basis.
*Outpatient treatments including follow-up treatment is not covered.
*No waiting period.
*Within Malaysia only
*Twenty-four (24) hours a day
*Cover ceases from the time
*the Insured Person leaves Malaysia and resumes upon his/her return to Malaysia
*your foreign worker leaves Malaysia and resumes upon his/her return to Malaysia.
Not necessary as long as the foreign workers are legally working in Malaysia and have passed the medical examination administered by Fomema Sdn. Bhd. (FOMEMA).
Admission, Discharge Billing And Payment
PRE-EXISTING ILLNESS shall be limited to disabilities which existed before the effective date of cover and for which the Insured Person should have reasonably been aware of. An Insured Person may be considered to have reasonable knowledge of a pre-existing condition where the condition is one for which:
- The Insured Person had received or is receiving treatment;
- medical advice, diagnosis, care or treatment has been recommended;
- clear and distinct symptoms are or were evident; or
- its existence would have been apparent to a reasonable person in the circumstances
SPECIFIED ILLNESSES shall mean the following disabilities and its related complications, occurring within the first one hundred and twenty (120) days of Insurance of the Insured Person:
- Cardiovascular disease
- All cancers
*Pre-existing illness. However, this exclusion is waived in the event the Insured Person passes the medical examination as confirmed by Fomema Sdn. Bhd. (FOMEMA) within 30 days from the Insured Person’s arrival to Malaysia.
*Plastic/Cosmetic surgery, circumcision, eye examination, glasses and refraction or surgical correction of nearsightedness (Radial Keratotomy) and the use or acquisition of external prosthetic appliances or devices such as artificial limbs, hearing aids, implanted pacemakers and prescriptions thereof.
*Dental conditions including dental treatment or oral surgery except as necessitated by Accidental Injuries to sound natural teeth occurring wholly during the Period of Insurance.
*Ionizing radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapons material.
*Expenses incurred for donation of any body organ by an Insured Person and costs of acquisition of the organ including all costs incurred by the donor during organ transplant and its complications.
*Investigation and treatment of sleep and snoring disorders, hormone replacement therapy 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 or aroma therapy or other alternative treatment.
*Care or treatment for which payment is not required or to the extent which is payable by any other insurance or indemnity covering the Insured and Disabilities arising out of duties of employment or profession that is covered under a Workman’s Compensation Insurance Contract.
*Psychotic, mental or nervous disorders, (including any neuroses and their physiological or psychosomatic manifestations).
*Costs/expenses of services of a non-medical nature, such as television, telephones, telex services, radios or similar facilities, admission kit/pack and other ineligible non-medical items.
*Sickness or Injury arising from racing of any kind (except foot racing), hazardous sports such as but not limited to skydiving, water skiing, underwater activities requiring breathing apparatus, winter sports, professional sports and illegal activities.
*Private flying other than as a fare-paying passenger in any commercial scheduled airlines licensed to carry passengers over established routes.
*Expenses incurred for sex changes.
Inter Gig emphasizes in providing the best after sales claims service.
Our services include:
- Providing guidance to assist our clients to protect their interests.
- Providing clear instructions to assist our clients to gather the necessary supporting documents for prompt and efficient handling and settlement of the claims
- Dedicated claims team to handle foreign worker claims