In a sense, this is similar to the "excess clause" in a motor insurance policy. Those familiar with having made claims in a comprehensive motor insurance policy for any 'own damage' claim of the motor vehicle will know that the insurer will only reimburse the expenses which are above the "excess" amount.
The Pacific Medi Major operates in a similar manner. Let us have a look at a simple example with actual figures in order to understand how this scheme works.
If a person aged 48 intends to purchase a plan based on Hospital Room and Board of RM300 per day:
He can claim for expenses up to an annual limit of RM75,000.00
He can claim for expenses up to a lifetime limit of RM300,000.00
For every disability he claims from the insurer, he will bear the first RM5000.00 of the expenses
His annual premium will be RM431.00
Other features of this scheme are as follows:
- An individual wishing to enter this scheme must be between the ages of 19 and 60
- The insured has the option to renew the coverage up to the age of 80 (subject to the usual limitations)
- Premiums are the same whether for male or female insured persons
- Premiums are age banded i.e. the same rates will apply within a particular age band. The insurer may, however, increase the premiums based on overall claim experience with the approval of Bank Negara Malaysia
- The insurer only pays out the claim after the insured has claimed from other insurers, if any
- Pre-existing illnesses and other usual exclusions apply
- Other features are very similar to those seen in most medical insurance schemes in the market
The Medi Major Plan is most suitable for:
- Those who are not willing to pay the higher premiums as seen in the market and are able to bear the first portion of the loss
- Those who are already having other medical insurance (for example, as provided by employees) but feel that such coverage is inadequate
Interested readers who require more details can post their questions in the comments section below or alternatively, visit www.pacificinsurance.com.my for further information.