AIA i-Med Basic FAQ

Takaful is a mutual assistance scheme based on the principles of solidarity, brotherhood, and cooperation. Each participant agrees to contribute on the basis of Tabarru’ (donation) into a fund called Participants’ Risk Fund (PRF), which will be used to assist each other in times of need. AIA PUBLIC Takaful Bhd. (AIA PUBLIC) as a Takaful Operator is entrusted to properly invest and manage this fund in accordance with the investment strategy that complies with Shariah principles.

AIA i-Med Basic is a yearly renewable Takaful plan which provides coverage for hospitalisation and surgical expenses up to age 70. 

This plan is commission-free and no intermediaries are involved in the marketing of AIA i-Med Basic.

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

This plan covers:

Notes:

1. This plan does not cover pre and post hospitalization and outpatient treatment.

2. Deductible is a fixed amount you have to pay for the medical expenses incurred as cost sharing. You have to pay the first RM300 out of the eligible expenses for any one disability, and we will pay for the rest of the eligible expenses.

3. "Any One Disability" means that if two or more Confinements are due to the same or related disability, or any complications arising from it, such confinements shall be regarded as one confinement if each of them is not separated by more than 90 days from the discharged date.

If you pass away during the certificate’s term, no benefit will be payable as AIA i-Med Basic does not cover death.

Your coverage begins immediately after your contribution is confirmed.

You can contribute for this plan with your debit card or credit card.

The contribution rate for this plan is not guaranteed and may be increased in the future. We reserve the right to revise the contribution rates by giving you 30 days’ written notice prior to the next certificate anniversary.

Contributions are payable until the end of the certificate term. Please note that the contribution rate will increase depending on the attained age last birthday when the contribution is due.

You can refer to the full contribution rates in the Product Disclosure Sheet.

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

This plan is yearly renewable up to age 70. Your certificate will automatically be renewed on each certificate anniversary provided contributions are paid.

No, you can only participate in one (1) AIA i-Med Basic.

No, there is only one plan for AIA i-Med Basic.

Please note that this medical plan is cardless, hence you will not receive any medical card. For the cashless facility at admission, please refer to question 26 for more information.

Upon your successful participation and contribution payment, we will send you a confirmation email together with your e-Certificate. 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 certificate details and download a copy of your e-Certificate. Please click on this link to login or register.

Yes, you have the option to cancel or surrender your certificate. We will refund the unutilised contribution from PRF and the unearned Wakalah Fee from the Takaful Operator’s fund (if any) according the following table, provided that you have not made a claim on the Certificate during the current Certificate Year.

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

Free Look Period – You may cancel your certificate by returning your Takaful certificate and giving a written request signed by you to AIA PUBLIC within fifteen (15) days after you have received your Takaful certificate. The contributions that you have paid will be refunded.

You may reinstate your certificate before the certificate’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 (eg. Medical report) that is satisfactory to Us;
  
• (iii) You have to pay all overdue contributions; and
• (iv) Any other terms and conditions which we may impose at the time of reinstatement.

Please note that the reinstated certificate shall only cover loss or the person covered event which occurs after the reinstatement date and after the applicable waiting period.

The Wakalah fee is deducted upfront as a percentage of contribution to pay for AIA PUBLIC’s management expenses. The expenses include stamp duty of RM 10.

After deduction of Wakalah fee, the balance of contribution paid will be allocated into the Participant’s Risk Fund (PRF) as Tabarru' for the purpose of providing protection and meeting claims on the events/risks covered under the Takaful Certificate. The Tabarru’ will increase as you grow older.

The table below shows the Contribution allocation:

No. There is no additional fees and charges other than your contribution payment. Please note that contribution paid by business organisations are subject to the applicable tax imposed by the Government of Malaysia at the prevailing rate.

Surplus will be determined and declared, if any, once a year by the Takaful Operator. If there is any surplus arising from the PRF, the net surplus, after claims payable and required capital shall be shared by the Takaful Operator and eligible Participant at the following ratios:

The surplus will be shared with the eligible Participants proportionally in accordance to their actual Tabarru’ allocation.

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

Yes. The waiting period for AIA i-Med Basic will apply from the Issue Date or Commencement Date, whichever is later, and is as follows:

Deductible is a fixed amount you have to pay for the medical expenses incurred as cost sharing. You have to pay the first RM300 out of the eligible expenses for any one disability, and we will pay for the rest of the eligible expenses.

For example, if the total eligible expenses are RM5,000, the amount payable by you is RM300 and we will pay for RM4,700

Annual limit is the maximum amount we will pay in a year for this plan and lifetime limit is the maximum claimable amount for this plan throughout your life time.

This plan does not cover:

• (a) Pre-existing illness prior to the Issue Date or Commencement Date, whichever is later; or
• (b) Treatment or surgery for Specified Illnesses until the Person Covered has been continuously covered under this Certificate for a period of one hundred and twenty (120) days; or
• (c) Any medical or physical abnormalities existing at the time of birth, as well as neo-natal physical abnormalities developing within 6 months from the time of birth. These include hernias of all types and epilepsy except when caused by a trauma which occurred after the date that the Person Covered was continuously covered under this certificate and any congenital or hereditary conditions which has manifested or was diagnosed before the Person Covered attains 17 years of age; or
• (d) Any Disability caused by self-destruction, intentional self-inflicted injuries, willful exposure to danger or any attempt of self-destruction while sane or insane; or
• (e) War, declared or undeclared, strikes, riots, civil war, revolution or any warlike operations; or
• (f) Service in the armed forces in time of declared or undeclared war or while under orders for warlike operations or restoration of public order; or
• (g) Any violation or attempted violation of the law or resistance to arrest; or
• (h) Pregnancy, miscarriage or child birth; or
• (i) Mental or nervous disorders, treatment of alcoholism, or drug abuse or any other complications arising from it or any drug accident not prescribed by a treating doctor; or
• (j) Elective/Plastic/Cosmetic surgery, circumcision (except circumcision due to infection), eye examination/elective surgery for visual impairments due to nearsightedness, farsightedness or astigmatism or radial keratotomy; all corrective glasses, contact lenses and intraocular lens (except monofocal intraocular lenses in cataract surgery) or the use or acquisition of external prosthetic appliances or devices such as artificial limbs, hearing aids, and prescriptions; or
• (k) Any form of dental care or Surgery unless necessitated by injury but excluding the replacement of natural teeth, placement of denture and prosthetic services such as bridges and crowns or their replacement; or
• (l) 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, vitamins/food supplements and treatments specifically for weight reduction or gain; or
• (m) Any treatment or investigation which is not medically necessary, or convalescence, custodial or rest care; or
• (n) Any medical or physical conditions arising within the first 30 days of the Issue Date or Commencement Date of this certificate, whichever is later except for covered injury; or
• (o) Ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapon material; or
• (p) Expenses incurred for donation of any body parts or organ by the Person Covered and acquisition of the organ including all costs incurred by the donor during organ transplant and its complications. We will only reimburse the Reasonable and Customary Charges incurred on Major Organ/Bone Marrow Transplant Surgery for the Person Covered being the recipient, limited to once per lifetime; or
• (q) Medical treatment received by the Person Covered outside Malaysia apart from Singapore and Brunei, if the Person Covered resides or travels outside Malaysia for more than 90 consecutive days. 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.

Note: This list is non-exhaustive. Please refer to the Takaful certificate for the full list of exclusions.

You can download the claim form 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) Individual Hospitalisation Claim Form
• 2) Original itemised bills (Invoice/Statement) and original official receipts including deposit receipts
• 3) Copy of Lab and Radiology Reports (MRI, CT Scan, Ultrasound, X-Ray, ECG, Histopathology, Biopsy & Other Medical Tests)
• 4) For Overseas Treatment, to include: Copy of Passport Indicating Biodata, Dates of Departure from Malaysia and Arrival Overseas or copy of Flight Ticket/Boarding Pass,
• 5) Original Detailed Admission Bill showing breakdown of each charges and translation of foreign language.

Any non-original documents (Eg photocopy 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.

The cashless facility is only applicable for our panel and platinum hospitals.

For prompt processing of your admission, please present your Identity Card and referral letter, where applicable, to the hospital admission officer. If you are eligible for the Letter of Guarantee, you are required to sign a claim form upon admission to the hospital and an approved claims statement at the time of discharge. Please also note that you will need to pay the deductible amount of RM300, and any other ineligible expenses upon discharge.

Any non-eligibility or invalidity of the cashless facility will be communicated to you through the hospital. Please note that there will be no Letter of Guarantee issued for the first three months of your certificate. In the event you are hospitalised during this period, you will have to pay the charges in full and submit your claim with all the necessary documentation to us. Please refer to question 25 for more information on the necessary documentation for claims.

Letter of Guarantee is an assurance of payment offered by us confirming that the cost of treatment is eligible under the plan and will be covered by us. This letter is only applicable for our panel and platinum hospitals.

There are some specialists within the appointed panel hospitals that do not have any working arrangement with AIA PUBLIC. Participants who seek treatment from non-panel doctors will have to pay the charges in full and submit your claim with all the documents. Please refer to question 24 for more information on the documents for claims.

In the event you seek treatment from a non-panel hospital, you will have to pay the charges in full. Then, you may submit your claim with all the documents. Please refer to question 24 for more information on the documents for claims.

To locate a panel and platinum hospital near you, please click here.

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 8922.

Please leave us your contact details by clicking on this link. You can also call AIA PUBLIC Customer Contact at 1300 88 8922.

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