Group Insurance - Hospitalisation & Surgical
Group insurance is one of the basic staff benefits provided by most organisations in Malaysia. Group Insurance may include Hospitalisation & Surgical, Personal Accident and Term Life.
While considering Group Hospitalisation & Surgical Insurance, besides premium and annual coverage, the following criterias shall also be taken into consideration:
1. Pre-existing Illnesses
Pre-existing illnesses mean any illnesses that existed before the effective date of the insurance policy. Some insurance companies waive the pre-existing illnesses clause, which if an employee is hospitalised for any illnesses existed before the effective date of the insurance policy, shall be covered and claimable. However, some companies impose a minimum of period of time for pre-existing illnesses coverage.
2. Specific Illnesses
There are specific illnesses that are not covered for a period of time (e.g. 6 months, 12 months, etc.) from the effective date of the insurance policy. When the insurance companies waive this clause, all illnesses are covered as long as the insurance policy takes effect.
3. Waiting Period
Waiting period shall mean a period of time between the beginning of the insured person’s disability and the commencement date of the insurance policy. This clause will usually applicable to new employees only.
4. Co-payment
Co-payment means if the insured person is hospitalised at a room & board rate which is higher than his / her eligible benefit, the insured person shall bear a certain percentage of the other eligible benefits described in the Schedule of Benefits. Co-payment will be able to control the hospitalisation expenses and prevent the hike of insurance premium in the coming year.
5. Underwriting Exclusion
Underwriting exclusion clause disallows the insured person to claim for the same illnesses, which are occurred in the previous year, upon renewal.
6. Long-term Illnesses Coverage
Long-term illnesses include outpatient cancer treatment, outpatient kidney dialysis, organ transplant, and outpatient physiotherapy treatment. The annual limits imposed on these long-term illnesses coverage shall be compared when considering Group Hospitalisation & Surgical Insurance.
7. Administration
Whether the insurance companies provide free administration (issuing guarantee letters, etc.), or with charge (medical card, usually on per head basis).
A good insurance company shall be able to provide the basic coverage to the employees, meanwhile take care of the interest of the company.
