Affordable Group Medical Insurance

Waiver of Pre-Existing Conditions*

Applicable to medical inpatient benefit

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Authorised Insurance Agency:

Underwritten By:

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Hospital Admission Assistance features available in the app

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The eCard functionality is available within the MetaFin DIY Digital App

Step-by-Step Guide

Hospital Admission Flow

24/7 Medical Helpline

MiCare Customer Service

callcenter@micaresvc.com

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Hassle-Free Claims

Submit your e-claim
easily without worries!

01
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Login to MiCare MyMed App

02
MiCare e-Claim

Select “Pre/Post Hospital (Inpatient)”

03
MiCare e-Claim

Select policy and fill in claim info

04
MiCare e-Claim

Upload claims photo & submit

05
MiCare e-Claim

Claim submitted

FAQ

Frequently Asked Questions

Who is eligible to apply?

Any duly registered company or organisation is eligible. The company or organisation will be the policyholder.

Who is eligible to be covered?

Full-time Actively-at-work employees who are within the age and occupational class specifications are eligible. The policyholder must declare the job description of the employees. Once covered under the policy, the employee is referred to as the Assured Member or Life Assured, as the case may be. The minimum and maximum ages for new application and renewal are as follows:

Can new employees be eligible for coverage?

All new employees are eligible to be enrolled for coverage within thirty (30) days from the effective date of employment.

Is takeover of policy allowed?

No takeover of policy is allowed.

What is the minimum number of employees required?

Any company with a minimum of 11 eligible employees up to a maximum of 150 eligible employees.

Is evidence of health (underwriting) required?

No evidence of health will be required. However, the coverage will be subject to the terms, conditions and exclusion clauses of the respective policies and riders.

What is Specified Illnesses?

Specified Illnesses means the following disabilities and its related complications, occurring within the first one hundred and twenty (120) days from the Effective Date. However, if there is a break in coverage prior to the expiry of the said one hundred and twenty (120) days, a fresh period of one hundred and twenty (120) days shall apply again from the date of reinstatement:

  • 1. hypertension, diabetes mellitus and cardiovascular disease;
  • 2. all tumours, cancers, cysts, nodules and polyps;
  • 3. stones of the urinary system and biliary system;
  • 4. all ear, nose (including sinuses) and throat conditions;
  • 5. hernias, haemorrhoids, fistulae, hydrocele and varicocele;
  • 6. diseases of the reproduction system including endometriosis;
  • 7. vertebro-spinal disorders (including disc) and knee conditions.

How will the premium rates be charged?

Policy inception premium rates are the same for both male and female employees and are based on the age next birthday of each employee. Policy renewal premium rates will be based on employee’s age next birthday and plan selected at each policy renewal.

Please refer to the Annual Premium Rates Table for premium details.

Note: Premium rates are not guaranteed and subject to be reviewed by Great Eastern Life at each renewal.

What happens when there is a resignation or when a new employee joins the company?

When employees resign, a pro-rated refund is calculated and for new employees, a pro-rated premium will be charged.

Will the policy be automatically renewed?

The policy is a yearly renewable plan where the Period of Insurance is twelve (12) months. Great Eastern Life may invite the employer/policyholder to renew the policy subject to renewal terms and conditions.

Can the benefits be changed during the Period of Insurance?

Changes to benefits can be made by the employer/policyholder on policy anniversary or upon renewal only.

If Great Eastern Life decides to change the benefits in the policy, all policyholders will be notified of the reasons for the changes in writing at least thirty (30) days before the change is made.

Can an insured employee’s Spouse and Dependant be covered?

Yes, but only for the Group Yearly Renewable Hospitalisation and Surgical Policy and Group Comprehensive Outpatient Clinical Rider. The coverage will be subject to the respective terms, conditions and exclusion clauses. The coverage and premium rates for Spouse and Dependant will be in accordance with employee’s choice of coverage and premium rates.

Note: Spouse means a legally married spouse of the Assured Member between seventeen (17) years next birthday and sixty-four (64) years next birthday. A Dependant means any of the unmarried children of the Assured Member aged above fourteen (14) days old but below nineteen (19) years next birthday. If the Dependant is still on full-time higher education and is not gainfully employed, the maximum eligibility age shall be extended to twenty-three (23) years next birthday.

What are some of the key terms and conditions?

  • Importance of Disclosure - the policyholder must disclose all material facts such as type of business, nature of occupations, any information that could affect the risk profile, state the ages of employees correctly and declare to ensure that all employees declare truthfully their details, otherwise effective coverage will be void at inception.
  • Free look period - the policyholder may cancel the policy by returning the insurance policy within fifteen (15) days after receipt, provided no claim has been admitted under the policy. The premium paid (less any expenses incurred for the medical examination of the Assured Member) will be refunded.
  • Grace period – the policyholder is allowed up to thirty (30) days grace period from each of the premium due dates to pay the subsequent total premium due under the policy.

Disclaimer: MetaFin® users have the option to directly self-sign up for the mSME Solutions Program in the MetaFin Digital Platform. This program is underwritten by Great Eastern Life Assurance (Malaysia) Berhad, and the enrollment process is facilitated by authorised insurance agency, Quantum Secure Sdn. Bhd. The information herein may not fully reflect the context of the product disclosure sheet and full terms of the policy. Please refer to the documents for a detailed description of the product's features and the conditions under which any claims are made. MetaFin® is not liable for misinterpretation of product benefits and claim conditions as described in the policy wording sheet and product disclosure sheet. GREAT EASTERN LIFE ASSURANCE (MALAYSIA) BERHAD is a member of PIDM. The benefit(s) payable under eligible certificate is(are) protected by PIDM's TIPS Brochure or contact GREAT EASTERN LIFE ASSURANCE (MALAYSIA) BERHAD or PIDM (visit www.pidm.gov.my)

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