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AIA Critical Illness Cover
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  • AIA Critical Illness COVER FAQ

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    1. What is AIA Critical Illness Cover?

    AIA Critical Illness Cover is a yearly renewable critical illness insurance plan which provides coverage for 39 critical illnesses up to age 70.

    This plan is commission-free and no intermediaries are involved in the sales or marketing of AIA Critical Illness Cover.


    2. Who can buy this plan?

    This plan is available to individuals aged 16 to 55, subject to underwriting.


    3. How much coverage should I get?

    The amount of coverage you need depends on your affordability, current financial obligations and the future financial needs of you and your family. You can calculate your estimated protection needs by clicking on the “Know Your Budget” button here.


    4. What are the benefits of AIA Critical Illness Cover?
    Benefit Coverage Amount*
    Critical Illness RM 50,000
    RM 100,000
    RM 150,000
    RM 200,000
    RM 250,000

    * Subject to a maximum of RM250,000 per life, per insurance plan.


    5. What are the critical illnesses covered under AIA Critical Illness Cover?

    The 39 covered critical illnesses under this plan are:

    • 1. Stroke – resulting in permanent neurological deficit with persisting clinical symptoms
    • 2. Cancer– of specified severity and does not cover very early cancers
    • 3. Heart Attack – of specified severity
    • 4. Coronary Artery By-Pass Surgery
    • 5. Serious Coronary Artery Disease
    • 6. Angioplasty and Other Invasive Treatments for Coronary Artery Disease
    • 7. Heart Valve Surgery
    • 8. Fulminant Viral Hepatitis
    • 9. End-Stage Liver Failure
    • 10. Primary Pulmonary Arterial Hypertension – of specified severity
    • 11. End-Stage Lung Disease
    • 12. Kidney Failure – requiring dialysis or kidney transplant
    • 13. Surgery to Aorta
    • 14. Chronic Aplastic Anaemia – resulting in permanent Bone Marrow Failure
    • 15. Major Organ / Bone Marrow Transplant
    • 16. Blindness – Permanent and Irreversible
    • 17. Deafness – Permanent and Irreversible
    • 18. Loss of Speech
    • 19. Coma – resulting in permanent neurological deficit with persisting clinical symptoms
    • 20. Third Degree Burns – of specified severity
    • 21. Multiple Sclerosis
    • 22. Paralysis of Limbs
    • 23. Muscular Dystrophy
    • 24. Alzheimer's Disease / Severe Dementia
    • 25. Motor Neuron Disease – permanent neurological deficit with persisting clinical symptoms
    • 26. Parkinson's Disease – resulting in permanent inability to perform Activities of Daily Living
    • 27. Terminal Illness
    • 28. Encephalitis – resulting in permanent inability to perform Activities of Daily Living
    • 29. Benign Brain Tumour – of specified severity
    • 30. Major Head Trauma – resulting in permanent inability to perform Activities of Daily Living
    • 31. Bacterial Meningitis – resulting in permanent inability to perform Activities of Daily Living
    • 32. Brain Surgery
    • 33. Medullary Cystic Disease
    • 34. Loss of Independent Existence
    • 35. HIV Infection Due To Blood Transfusion
    • 36. Cardiomyopathy – of specified severity
    • 37. Full-blown AIDS
    • 38. Occupationally Acquired Human Immunodeficiency Virus (HIV) Infection
    • 39. Systemic Lupus Erythematosus with Severe Kidney Complications

    *In the event of Angioplasty and Other Invasive Treatments for Coronary Artery Disease, 10% of the coverage amount shall be payable, subject to a maximum of RM 25,000 (limited to 1 payment only). The coverage amount shall be reduced by this advance payment.

    Please refer to the Policy Contract for the exact definitions of the covered critical illnesses listed above.


    6. What happens if I am diagnosed with a covered critical illness during the policy’s term?

    If you are diagnosed with a covered critical illness during the policy’s term (except Angioplasty and Other Invasive Treatments for Major Coronary Artery Disease), you will receive 100% of the coverage amount, and the policy will be terminated thereafter.

    In the event you undergo Angioplasty and Other Invasive Treatments for Major Coronary Artery Disease, 10% of the coverage amount will be payable, subject to a maximum of RM25,000. Payment under this benefit will reduce your coverage amount, and is only allowed once. After payment under this benefit, your coverage continues for the remaining 38 covered critical illness with the reduced coverage amount. The premium is still required to be paid continuously.

    Please note that the benefits above will not be payable if you do not survive for at least 15 days after the diagnosis of a critical illness.


    7. What happens if I am diagnosed with more than one covered critical illness at the same time during the policy’s term?

    If you are diagnosed with more than one covered critical illness at the same time during the policy’s term, you are still entitled to claim for only one covered critical illness, and we shall only pay 100% of the coverage amount, and the policy will be terminated thereafter.


    8. What happens if I pass away during the policy’s term?

    If you pass away during the policy’s term no benefit will be payable as AIA Critical Illness Cover does not cover death.


    9. Does this plan pay critical illness claims in addition to other insurance plans that I have with AIA?

    Yes, we will pay the critical illness claims of this plan in addition to any claims that you may have with other AIA insurance plans that covers critical illness.


    10. When does my coverage begin?

    Your coverage begins immediately after your premium payment is confirmed.


    11. How can I pay for this plan?

    You can pay the premium for this plan with your debit card or credit card.


    12. Is the premium for AIA Critical Illness Cover guaranteed?

    The premium for this plan is not guaranteed and may be increased in the future. We reserve the right to revise the premium rates by giving you 3 months’ written notice prior to the next policy anniversary.


    13. How long do I have to pay the premiums for?

    Premiums are payable until the end of the policy term. Please note that the premium rate will increase depending on the attained age last birthday when the premium is due.

    You can find the full premium rates in the Product Disclosure Sheet.


    14. Can I change my premium payment method or payment mode?

    You can change your premium payment method or payment mode at our customer portal, My AIA. Please click on this link to login or register.


    15. How long is the coverage term?

    This plan is renewable every year up to the age of 70. Your policy will be renewed automatically on each policy anniversary as long as premiums are paid.


    16. Can I buy more than one AIA Critical Illness Cover policy?

    Yes, you may buy more than one (1) AIA Critical Illness Cover but the total coverage of all the policies purchased must not exceed RM250,000. However, it is advisable to purchase the amount of coverage that is suitable to your needs in one policy.


    17. Can I change the coverage amount of my AIA Critical Illness Cover policy?

    You may decrease your coverage amount at the next premium due date. However, you may not increase your coverage amount. If you would like to increase your coverage, we would suggest that you purchase an additional policy. Please refer to FAQ number 15 for more information. 


    18. When will I receive my policy contract?

    Upon your successful purchase and premium payment, we will send you a confirmation email together with your e-policy contract. Please keep this email secure as proof of coverage. However, should you lose this email, you can always log on to our customer portal, My AIA, to view your policy details and download a copy of your e-policy contract. Please click on this link to login or register.


    19. Can I cancel or surrender my policy?

    Yes, you have the option to cancel or surrender your policy. We will refund the premium based on the table below, provided that no claims have been made during the current policy year.

    Period From Policy Anniversary, Not Exceeding 15 days*
    Premium Payment Mode
    Annual
    90%
    Semi-annual
    80%
    Quarterly
    70%
    Monthly
    No Refund
    Period From Policy Anniversary, Not Exceeding 1 month
    Premium Payment Mode
    Annual
    80%
    Semi-annual
    70%
    Quarterly
    50%
    Monthly
    No Refund
    Period From Policy Anniversary, Not Exceeding 2 months
    Premium Payment Mode
    Annual
    70%
    Semi-annual
    50%
    Quarterly
    20%
    Monthly
    No Refund
    Period From Policy Anniversary, Not Exceeding 3 months
    Premium Payment Mode
    Annual
    60%
    Semi-annual
    30%
    Quarterly
    No Refund
    Monthly
    No Refund
    Period From Policy Anniversary, Not Exceeding 4 months
    Premium Payment Mode
    Annual
    50%
    Semi-annual
    20%
    Quarterly
    50%
    Monthly
    No Refund
    Period From Policy Anniversary, Not Exceeding 5 months
    Premium Payment Mode
    Annual
    40%
    Semi-annual
    10%
    Quarterly
    20%
    Monthly
    No Refund
    Period From Policy Anniversary, Not Exceeding 6 months
    Premium Payment Mode
    Annual
    30%
    Semi-annual
    No Refund
    Quarterly
    No Refund
    Monthly
    No Refund
    Period From Policy Anniversary, Not Exceeding 7 months
    Premium Payment Mode
    Annual
    25%
    Semi-annual
    70%
    Quarterly
    50%
    Monthly
    No Refund
    Period From Policy Anniversary, Not Exceeding 8 months
    Premium Payment Mode
    Annual
    20%
    Semi-annual
    50%
    Quarterly
    20%
    Monthly
    No Refund
    Period From Policy Anniversary, Not Exceeding 9 months
    Premium Payment Mode
    Annual
    15%
    Semi-annual
    30%
    Quarterly
    No Refund
    Monthly
    No Refund
    Period From Policy Anniversary, Not Exceeding 10 months
    Premium Payment Mode
    Annual
    10%
    Semi-annual
    20%
    Quarterly
    50%
    Monthly
    No Refund
    Period From Policy Anniversary, Not Exceeding 11 months
    Premium Payment Mode
    Annual
    5%
    Semi-annual
    10%
    Quarterly
    20%
    Monthly
    No Refund
    Period From Policy Anniversary, Not Exceeding Period exceeding 11 months
    Premium Payment Mode
    Annual
    No Refund
    Semi-annual
    No Refund
    Quarterly
    No Refund
    Monthly
    No Refund
    Period From Policy Anniversary,
    Not Exceeding
    Premium Payment Mode
    Annual Semi-annual Quarterly Monthly
    15 days* 90% 80% 70% No refund
    1 month 80% 70% 50% No refund
    2 months 70% 50% 20% No refund
    3 months 60% 30% No Refund No refund
    4 months 50% 20% 50% No refund
    5 months 40% 10% 20% No refund
    6 months 30% No refund No refund No refund
    7 months 25% 70% 50% No refund
    8 months 20% 50% 20% No refund
    9 months 15% 30% No Refund No refund
    10 months 10% 20% 50% No refund
    11 months 5% 10% 20% No refund
    Period exceeding 11 months No refund No refund No refund No refund

    (Note: * not applicable to first Policy Year due to Free Look Period)

    Free Look Period - You may cancel your policy by returning your policy contract and giving a written request signed by you to AIA Bhd. within fifteen (15) days after you have received your policy contract. The premiums that you have paid will be refunded.


    20. If my AIA Critical Illness Cover policy has lapsed, can I reinstate it?

    You may reinstate your policy before the policy’s expiry date by visiting any AIA Customer Centres, subject to the following:

    • (i) You are within the allowable age limits at the time of reinstatement;
    • (ii) You have to produce evidence of insurability that is satisfactory to Us;
    • (iii) You have to pay all overdue premiums; and
    • (iv) Any other terms and conditions which we may impose at the time of reinstatement.

       

    Please note that the reinstated policy shall only cover loss or the insured event which occurs after the reinstatement date after the applicable waiting period.


    21. Are there additional fees, charges and taxes for this plan?

    There are no fees, charges or taxes other than your premium payments. 


    22. What does waiting period mean?

    The eligibility for benefits under the policy will only start after a specific period from the issue date or commencement date, whichever is later, of the policy. This period is known as the “waiting period”.


    23. Are there any waiting periods for AIA Critical Illness Cover?

    Yes. The waiting period for AIA Critical Illness Cover will apply from the Issue Date or Commencement Date, whichever is later, and is as follows:

    Description Waiting Period
    Cancer, Heart Attack, Coronary Artery By-Pass Surgery, Serious Coronary Artery Disease and Angioplasty and Other Invasive Treatments for Coronary Artery Disease 60 days
    Other covered critical illnesses not mentioned above 30 days

    24. What are the major exclusions under this policy?

    This policy does not cover:

    • (a) any illness other than a diagnosis for the covered Critical Illness;
    • (b) any pre-existing conditions prior to the Issue Date or Commencement Date, whichever is later;
    • (c) Cancer, Heart Attack, Coronary Artery By-Pass Surgery, Serious Coronary Artery Disease and Angioplasty and Other Invasive Treatments for Coronary Artery Disease, for which the signs or symptoms first occurred within sixty (60) days following the Issue Date or Commencement Date, whichever is later;
    • (d) all other critical illnesses for which the signs or symptoms first occurred within thirty (30) days following the Issue Date or Commencement Date, whichever is later;
    • (e) any critical illness diagnosed due, directly or indirectly, to a congenital defect or disease which has manifested or was diagnosed before you attain seventeen (17) years of age;
    • (f) the diagnosis of Fulminant Viral Hepatitis, Cancer, Encephalitis, Bacterial Meningitis, Alzheimer's Disease/ Severe Dementia or Terminal Illness of the Insured/You, where in Our opinion, was directly or indirectly due to an Acquired Immune Deficiency Syndrome (AIDS) or infection by any HIV. We reserve the right to require the Insured/You to undergo a blood test for HIV as a condition precedent to any acceptance of any claim. For the purpose of this policy:
      • (i) The definition of AIDS shall be that used by the World Health Organization in 1987, or any subsequent revision by the World Health Organization of that definition.
      • (ii) Infection shall be deemed to have occurred where blood or other relevant test(s) indicate in Our opinion either the presence of any HIV or Antibodies to such a Virus.
    • (g) any of the critical illnesses or covered surgeries defined here which is caused by a self-inflicted injury;
    • (h) if the Insured did not survive for at least 15 days after the diagnosis of a critical illness.

    Note: This list is non-exhaustive. Please refer to your policy contract for the full list of exclusions.


    25. Where can I obtain the claims form & how to claim?

    You can download the forms required (item 1, 2 and 5 listed below) for claim here. Please complete the form, including your bank information as we will pay the approved claim directly to your bank account via e-payment.

    Below is the list of documents for your claims’ submission:

    • 1) Critical Illness Claim Form
    • 2) Attending Physician’s Statement (by disease type)
    • 3) Certified Medical Test Results e.g. MRI/ CT Scan, Dialysis card, Biopsy / Histopathology report. (Please refer to the checklist in the Claim Form for relevant medical test results)
    • 4) Copy of your NRIC
    • 5) 5 copies of the Consent Form
    • 6) Patient’s Appointment Card

    Any non-original documents must be certified as true copy by AIA’s authorised staff at any AIA Customer Centres.

    You can submit the completed claim form together with the necessary documents at any AIA Customer Centres.


    26. How do I check on the progress of my claim?

    You can check your claims’ status by at our customer portal, My AIA. Please click on this link to register. You can also visit any AIA Customer Centres or contact our Care Line at 1300 88 1899


    27. Who should I contact if I would like to find out more?

    Please leave us your contact details by clicking on this link. You can also call our Care Line at 1300-88-1899.


    28. When will AIA respond to my queries?

    If you send us an email, you will receive an immediate automated acknowledgement. Our customer service representatives will respond to your email within 3 working days. 


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