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Employee Benefits Basic
Term Assurance
  
Nominee/Trustee
What are the Benefits?
It provides cover for Death and Total & Permanent Disability due to any cause (Illness or accident). The sum assured may be based on a multiple of salary, or fixed amount depending on the job category. The coverage is a worldwide and is for 24 hours a day.
 
When does Cover start?
Cover starts when a person has been underwritten and accepted, and the premium is paid. For the larger groups, a Free Cover or No-evidence Limit is given. Anyone falling within this limit is automatically covered provided he is actively-at-work.
 
Total & Permanent Disability
In the event of total & permanent disability, lump sum of basic sum assured or RM500K whichever is lesser is payable and balance will be payable in 2 equal installments upon receipt of documentary proof.
 
Terminal Illness Benefit
This refer to a condition suffered by the assured, which in the opinion of an appropriate Medical practitioner is highly likely to lead to death within 12 months. The life assured must no longer be receiving an active treatment other than for pain relief. Upon diagnosis, Great Eastern shall advance the death benefit up to amount of RM100,000.
 
Permanent Partial Disablement
In the event that an assured member suffers Permanent Partial Disability as a result of an illness or disease, a percentage of the Sum Assured shall be payable based on the scale specified in the schedule of compensation.
 
Exclusions :
Business Function
Form Type
1. There is no exclusion for death benefit
2. For Total and Permanent Disablement:
    (a) Self-inflicted bodily injuries ( except in an attempt to save human life ) while sane or Insane,
    (b) Injury sustained as a result of flying except as a fare-paying passenger on an aircraft licensed to carry passengers
    (c) Disablement which existed at the effective date
    (d) War, whether declared or undeclared
This write-up is for general information only. The terms and conditions of this Plan are stated in the master policy.
 
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Hospitalisation & Surgical Insurance
This Plan pays the hospital and doctors for medical treatment where a patient is hospitalised, plus specified accident and surgical benefits where there is no hospitalisation, for illness or accident. Hospitalisation means being confined in hospital for at least 12 hours.
 
For convenience, the HealthCare Card facility may be used for insured employees, with extension to dependants where required. Special Emergency Evacuation & Repatriation Benefit is packaged in the Great Eastern's HealthCare Card.
 
What are the Covered Benefits?
The benefits are classified under the following categories:
 
  • Room and Board Benefit
  • Intensive Care Unit
  • Miscellaneous Hospital Benefits
  • Surgical Benefits
  • Anesthetist Fees
  • Pre Hospital Diagnostic Tests
  • Pre Hospital Specialist Consultation
  • Daycare Procedures
  • In Hospital Physician Visit
  • Post Hospitalisation Treatment
  • Emergency Accident Outpatient Treatment Benefit
  • Ambulance Service
  • Emergency Sickness Outpatient Treatment Benefit
  • Government Hospital Daily Cash Allowance
  • Medical Report Reimbursement
  • Optional Extension - Outpatient Cancer Treatment, Kidney Failure Treatment, Major Medical Benefit
    •  
    The above benefits may have individual itemised limit, or an overall per disability limit or overall per annual limit.
     
    Exclusions

    The following items are excluded from coverage:-

    (a) Services and supplies not recommended, approved and performed by a legally qualified Registered Medical Practitioner or for services which are not necessary for the treatment of an illness or injury, or which are for purely diagnostic purposes, or routine physical health check-up purposes.

    (b) Disability resulting from direct participation in a strike, riot or civil commotion, insurrection, or war or any act of war (whether declared or undeclared), or full-time service in any of the armed forces; war.

    (c) Intentional self-inflicted injuries, or injuries sustained as a result of a criminal act of the Insured Member or attempted suicide (while sane or insane);

    (d) Nervous and mental conditions, alcoholism or drug addiction, rest cures, sanitaria care or special nursing care;

    (e) Pregnancy including childbirth, caesarean operation, abortion miscarriage whether natural or accidental and all complications there from;

    (f) Injuries sustained as a result of travel or flight in or on any type of aircraft except as a fare-paying passenger on a regularly scheduled passenger flight of a commercial aircraft over established routes;

    (g) Dental treatment, eye examinations, eye glasses and hearing aids;

    (h) Sterilization; infertility; circumcision; congenital anomalies; cosmetic and plastic treatment which is of an optional nature;

    (i) Non-medical services such as radio, television, telephones, telegrams and the like;

    (j) Any disability which originated before the effective date of the coverage under this Contract unless the Insured Member has been insured under this contract for 12 months.

    (k) Procurement or use of special braces, appliances, equipment or other prosthetic devices.
    Specified Illnesses occurring during the first 120 days of continuous cover.

    This write-up is for general information only. The terms and conditions of this Plan are stated in the master policy.
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