What is Medical and Health Insurance and Takaful (MHIT) policy/certificate?
Generally, it is a policy/certificate designed to cover the cost of private medical treatment, e.g. cost of hospitalization and healthcare services if you are diagnosed with covered illnesses or had an accident.
Insurance policy/takaful certificate exclusions.
A MHIT policy/certificate contains certain exclusions e.g. pre-existing condition, specified illness and qualifying/waiting period, which your policy/takaful certificate will not cover. It is crucial that you are aware of what these are and if you don't understand them, please ask the intermediary you purchased your MHIT policy/certificate from such as your agent, broker and your approved financial adviser or insurance company/takaful operator.
How do I make MHIT claims?
Before you receive any treatment, where possible, you should call the intermediary you purchased your MHIT policy/certificate from such as your agent, broker and your approved financial adviser or insurance company/takaful operator to check whether the treatment is covered or if the hospital is the panel hospital. In fact, some insurance companies/takaful operator insist you to do this. Your insurer/takaful provider will give you all the guidance you need, confirm your coverage and, if necessary, send you a claim form as well as tell you how they pay the claims.
What should you do if you are diagnosed with a disability that incurs claimable expenses?
You should immediately inform your insurance company/takaful operator. Procure and act on proper medical advice and the insurer/takaful provider will reimbursing on the actual costs incurred subject to the limits of the policy/certificate.
How do I decide on the best plan for me?
The best MHIT plan for you is the one that gives you the flexibility and benefits that fits your needs at a price you can afford. As you would do when making any major purchase, you’ll need to shop around and get several quotes before choosing a plan that best fits your needs and affordability.
What are the important tips when buying a MHIT policy/certificate?
Some important tips when buying a MHIT policy/certificate include:
- Understand the product features, conditions, limitations, exclusions and benefits;
- Ensure coverage taken under the policy is suitable for your needs;
- Ensure you can afford the premium/contribution payable;
- Ensure you fully and faithfully declare all the facts that you know or ought to know; and
- Only buy from registered insurance/takaful agents or directly from the insurance company/takaful operator.
What does 'guaranteed renewal' condition mean?
Guaranteed renewal means that the insurance company/takaful operator guarantees the renewal of the policy/certificate, subject to the terms and conditions specified. Nevertheless, the premium/contribution payable at the point of renewal, is not guaranteed nor fixed.
When will MHIT policy/certificate be effective?
As soon as the application has been received and accepted by the insurance company/takaful operator and the premium/contribution duly paid.
Under what circumstances will my coverage be cancelled?
It will be cancelled on policy anniversary or when the total benefits paid hasreached the lifetime limit, or when the total benefits paid in any particular year has reached the annual overall limit. It may also be cancelled if you have misrepresented a material fact, e.g. medical condition, during your application.
Why should I buy a MHIT policy/certificate?
It will assist you to pay for the various hospitalisation and medical expenses that you will incur, if you become ill or injured. These expenses may include hospital room and board, professional and surgery fees, and medical supplies and services.
What types of MHIT policies/certificates are there?
There may be many types of MHIT policies/certificates, however these are the four main types:
- Insurance / Takaful hospitalisation and surgical;
- Insurance / Takaful dread disease or critical illness;
- Insurance / Takaful disability income; and
- Insurance / Takaful hospital income.
For further details, please contact your insurance company/takaful operator.
What benefits are covered under a MHIT policy/certificate?
The coverage depends on the type of policy/certificate that you buy. You are advised to read the terms and conditions of your policy/certificate carefully to understand the coverage and the exclusions.
Where can I get a MHIT coverage?
You may get a MHIT coverage through:
- A group insurance/takaful plan at workplace; or
- Individual insurance/takaful plan that can be purchased on your own.
How do I buy a MHIT policy/certificate?
You can buy a MHIT policy/certificate directly from the insurance company/takaful operator, or through the insurance/takaful operator's agents or through approved financial advisers, approved Islamic financial advisers and approved insurance/takaful brokers (generally for group MHIT policies). You may refer to the insurer's or takaful operator's Complaints Unit here.
What can happen when you want to renew your policy/certificate?
When you want to renew your policy/certificate, the insurance company/takaful operator may renew the policy/certificate with no change to premium/contribution; or with a new premium/contribution; or decline to renew the policy/certificate.
Would I be charged if I change my mind and want to cancel my MHIT policy/certificate upon purchase?
You may cancel your MHIT policy/certificate by giving a written notice to the insurance company/takaful operator and not be charged if cancellation is done within the free look period of 15 days. If cancellation is done after 15 days upon purchase, you may not be refunded the premium/contribution paid or you may receive only a partial refund of your premium/contribution paid.
Who should you consult to understand your MHIT policy/certificate?
It is important that you understand the terms used in a MHIT policy/certificate. If you have any doubts about the meanings of these terms, you should ask the intermediary, such as your agent, broker and your approved financial adviser or the insurance company/takaful operator from where you purchased your MHIT policy/certificate.


