1. What is the purpose of the changes that have been made to my insurance policy/ takaful certificate and 
mortgage loan documents?
As part of our efforts to support and align with Bank Negara Malaysia’s Policy Document on Fair Treatment of Financial Consumers (FTFC), we may be revising selected terms and conditions in future reprint versions of some of your insurance policy/takaful certificate and mortgage loan documents to ensure adherence to regulations. This is so that:
a. you have the confidence that you are dealing with an insurer/takaful operator that prioritizes your best interests through fair treatment and consideration;
b. you are not subjected to unfair discriminatory practices, including unfair contract terms that are to your disadvantage.
Notwithstanding the terms and conditions that are currently stated in your insurance policy/ takaful certificate and mortgage loan documents, we remain committed to ensuring that you are treated fairly and that such terms and conditions, if any, are not invoked.
2. How do these changes impact me?
These charges are beneficial to you as they ensure that you are always treated fairly and that terms and conditions that may be deemed to be unfair, unclear or ambiguous are either removed from future reprint versions or not invoked. Rest assured, your insurance policy/ takaful certificate benefits remain the same.
3. What are the affected products/plans?
This revision is applicable to all our Life, Investment-Linked, Medical, General, Takaful and Mortgage products.
4. Would the revised terms and conditions affect the benefits of the products?
No, the benefits of the insurance, takaful and mortgage products remain the same.
5. What are the revised terms and conditions?
The terms and conditions that have been revised are those that are regarded as unfair to the customers. A few extracted examples are as set out below. Please note they are examples and not exhaustive and that your insurance contract or takaful certificate may not contain these terms and conditions:
No. |
Terms and conditions that may be regarded as unfair to customers: |
Examples |
Sample Provision / Supplementary Contract |
Before Revision |
After Revision |
1 |
A term which makes the customers fully liable for matters or losses incurred by the insurer/takaful operator that are not caused by customers. (This excludes investment products where financial losses are due to changes in market prices). |
MISSTATEMENT OF AGE AND/OR GENDER If the age and/or gender of the Insured Person has been misstated and the premium paid as a result of this misstatement is insufficient, any claim payable subject to the maximum limits provided under this Policy shall be prorated based on the ratio of the actual premium paid to the correct premium which should have been charged for the Policy Year. Any excess premium, which may have been paid as a result of such misstatement of age and/or gender, shall be refunded without interest. If at the correct age the Insured Person would not have been eligible for cover under this Policy, no benefit shall be payable. |
MISSTATEMENT OF AGE AND/OR GENDER If the age and/or gender of the Insured Person has been misstated and the premium paid as a result of this misstatement is insufficient, any claim payable subject to the maximum limits provided under this Policy shall be prorated based on the ratio of the actual premium paid to the correct premium which should have been charged for the Policy Year. Any excess premium, which may have been paid as a result of such misstatement of age and/or gender, shall be refunded without interest. |
General Provisions |
2 |
A term which excludes or limits the insurer/takaful operator’s liability for any error, omission, misrepresentation or negligence caused by the insurer/takaful operator’s staff, representatives or agents. |
MISREPRESENTATION/ FRAUD We may void this Policy and refuse all claims made in any of the following cases: (a) If any claim made shall be fraudulent or exaggerated; or (b) If any false declaration or statement shall be made in support of any claim, however, if the misrepresentation was careless or innocent, We may at Our absolute discretion, (i) void this Policy and refuse all claims, in which case We shall return the premiums paid without interest. This payment shall be a complete and valid discharge of any liability under this Policy; or (ii) take any necessary remedies in accordance with the Financial Services Act 2013. |
MISREPRESENTATION/ FRAUD We may void this Policy and refuse all claims made in any of the following cases: (a) If any claim made shall be fraudulent or exaggerated; or (b) If any false declaration or statement shall be made in support of any claim, however, if the misrepresentation was careless or innocent, We may, (i) void this Policy and refuse all claims, in which case We shall return the premiums paid without interest. This payment shall be a complete and valid discharge of any liability under this Policy; or (ii) take any necessary remedies in accordance with the Financial Services Act 2013. |
General Provisions |
3 |
A term which excludes or limits the insurer/takaful operator’s liability for breach of contract or non-performance of obligations by the insurer/takaful operator. |
OVERSEAS TREATMENT If the Insured elects to 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 and Medically Necessary Charges for such equivalent local treatment in Malaysia and shall exclude the cost of transport to the place of treatment. All documents in a language other than English and Bahasa Malaysia must be submitted together with certified translations. The Consular or the translation agency shall certify in English that the translation to be a true and correct version of the originals. We reserve the right to determine whether the fee limit for any particular hospital/medical charge is a Reasonable and Customary Charge with reference to Malaysian economic and market data. We reserve the absolute right to determine the amount payable by making reference to the Company medical data. |
OVERSEAS TREATMENT If the Insured elects to 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 and Medically Necessary Charges for such equivalent local treatment in Malaysia and shall exclude the cost of transport to the place of treatment. All documents in a language other than English and Bahasa Malaysia must be submitted together with certified translations. The Consular or the translation agency shall certify in English that the translation to be a true and correct version of the originals. We reserve the right to determine whether the fee limit for any particular hospital/medical charge is a Reasonable and Customary Charge with reference to Malaysian economic and market data. We reserve the right to determine the amount payable by making reference to the Company medical data. |
Supplementary A-Plus Health Booster Contract |
4 |
A term which excludes or limits the insurer/takaful operator’s obligation to honour commitments to the customer undertaken by the insurer/takaful operator’s staff, representatives or agents. |
5 |
A term which provides the insurer/takaful operator a right to vary the terms of the contract at its discretion without a valid reason and reasonable notice to the customers. |
8. IN-HOSPITAL PHYSICIAN VISIT BENEFIT Reimbursement of Reasonable and Customary Charges by a Physician for Medically Necessary visiting an In-Patient subject to a maximum of two (2) visits per day not exceeding the maximum of two hundred and forty (240) visits as stated in the Schedule of Benefits. Additional two (2) visits will be allowed if the In-Patient visiting occurs in ICU. We will determine the amount payable at Our absolute discretion. |
8. IN-HOSPITAL PHYSICIAN VISIT BENEFIT Reimbursement of Reasonable and Customary Charges by a Physician for Medically Necessary visiting an In-Patient subject to a maximum of two (2) visits per day not exceeding the maximum of two hundred and forty (240) visits as stated in the Schedule of Benefits. Additional two (2) visits will be allowed if the In-Patient visiting occurs in ICU. |
A-Life Med Regular Provision |
6 |
A term which provides the insurer/takaful operator a right to notify on variations to contract terms in any manner the insurer/takaful operator deems appropriate and the customer is deemed to have agreed to the variation. |
RESERVATION (d) We reserve the right to vary any of the provisions contained in this Policy from time to time, without prior notice to the Insured Person. |
RESERVATION (d) We reserve the right to vary any of the provisions contained in this Policy at any time by giving three (3) months’ notice in writing to You. |
Referral Emergency Assistance Programme |
7 |
A term which allows the insurer/takaful operator the exclusive rights to interpret any terms of the contract as it thinks fit. |
MISREPRESENTATION/ FRAUD We may void this Policy and refuse all claims made in any of the following cases: (a) If any claim made shall be fraudulent or exaggerated; or (b) If any false declaration or statement shall be made in support of any claim, however, if the misrepresentation was careless or innocent, We may at Our absolute discretion, (i) void this Policy and refuse all claims, in which case We shall return the premiums paid without interest. This payment shall be a complete and valid discharge of any liability under this Policy; or (ii) take any necessary remedies in accordance with the Financial Services Act 2013. |
MISREPRESENTATION/ FRAUD We may void this Policy and refuse all claims made in any of the following cases: (a) If any claim made shall be fraudulent or exaggerated; or (b) If any false declaration or statement shall be made in support of any claim, however, if the misrepresentation was careless or innocent, We may, (i) void this Policy and refuse all claims, in which case We shall return the premiums paid without interest. This payment shall be a complete and valid discharge of any liability under this Policy; or (ii) take any necessary remedies in accordance with the Financial Services Act 2013. |
General Provisions |
8 |
A term which allows the insurer/takaful operator to assign or transfer the insurer/takaful operator’s rights and obligations under the contract to the detriment of the customer. |
RESERVATION (d) We reserve the right to vary any of the provisions contained in this Policy from time to time, without prior notice to the Insured Person. |
RESERVATION (d) We reserve the right to vary any of the provisions contained in this Policy at any time by giving three (3) months’ notice in writing to You. |
|
6. Are the revised terms and conditions beneficial to the customers?
Yes, these changes are beneficial to you as they ensure that you are always being treated fairly. Rest assured, your insurance policy/takaful certificate benefits remain the same.
7. Who can I contact if I have further enquiries?
If you need further clarification you may contact us at https://www.aia.com.my/en/help-support/contact-us.html or visit any of our Customer Centers nationwide for any assistance. We are always ready to help.
