Max Personal Accident Insurance

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1 PRODUCT DISCLOSURE SHEET (PDS) (Read this Product Disclosure Sheet before you decide to take out this Product. Be sure to also read the general terms and conditions of this Policy) 1. What is this product? RHB Insurance Berhad Max Personal Accident Insurance Date : This is a Personal Accident Plan that provides compensation in the event of injuries, disability or death caused solely by violent accidental, external and visible means. This policy also extends to cover medical expenses, bereavement allowance, personal liability, hospital daily income, snatch theft, travel allowance and more as stated in the below Table of Benefit. Eligibility: Age from 30 days to 65 years old, renewable up to What are the covers/benefits provided? Table of Benefit: Benefit Table Plan A Accidental Death/Permanent Disablement, ,000,000,000 7,000 1,000,000 Double Indemnity 100, ,000,000 1,000,000 1,,000 2,000,000 Medical Expenses (Per disability) Extended to cover Dengue, Malaria, JE or Avian Flu Traditional Treatment (RM per visit up to RM per disability) Plan B Plan C Plan D Plan E Plan F 3, 4, 6, 8, 9,000 10,000 Medical/Post Mortem Report Personal Liability, ,000,000,000 7,000 1,000,000 Bereavement Allowance 5,000 10,000,000,000 75, ,000 Repatriation of Mortal Remains 5,000 5,000 5,000 5,000 5,000 5,000 Daily Hospital Cash Income (Up to 180 days) Daily Hospital Cash Income Whilst Overseas (Up to 90 days) Ambulance Fees 1,000 1,000 1,000 1,000 1,000 1,000 Additional Hospital Allowance Travel Allowance 1,000 1,000 1,000 1,000 1,000 1,000 Blood Transfusion (causing HIV) 5,000 10,000,000,000 75, ,000 Cashless Hospital Admission & Discharge Facility (subject to overall Medical Expenses limit) 3,000 3,000 3,000 3,000 3,000 3,000 Coma Due to Accident, ,000,000,000 7,000 1,000,000 Dental Correction and Corrective Cosmetic Surgery 5,000 5,000 5,000 5,000 5,000 5,000 Funeral Allowance 5,000 5,000 5,000 5,000 5,000 5,000 Kidnap Benefit a) Reward for information leading to recovery of the Insured Person b) Insured Person not recovered after one year from the day of kidnap,000,000,000,000,000,000, ,000,000,000 7,000 1,000,000 Prostheses/Wheelchair Benefit 2,000 2,000 2,000 2,000 2,000 2,000 Medical Expenses for Miscarriage Due to MVA 1,000 1,000 1,000 1,000 1,000 1,000 Snatch Theft Home Nursing Care 3, 3, 3, 3, 3, 3, 2 nd Or 3 rd Degree Burns 5,000 5,000 5,000 5,000 5,000 5,000 No Claim Bonus Weekly Benefit (Optional) Class 1 & 2 Temporary Total Disablement (TTD) Temporary Partial Disablement (TPD) Weekly Benefit (Optional) Class 3 Temporary Total Disablement (TTD) Temporary Partial Disablement (TPD) 12. Duration of cover is for one (1) year. You need to renew your insurance cover annually. 10% of Principal Sum Insured Each Year Up To Maximum 5 Years

2 3. How much premium do I have to pay? Annual Premium Age & Occupation Class Class 1 & 2 Without Weekly Benefit Plan A Plan B 30 days 65 years , years (Renewal) , years (Renewal) , Class 1 & 2 With Weekly Benefit 30 days 65 years , years (Renewal) , , years (Renewal) , , Class 3 Without Weekly Benefit Plan C 30 days 65 years years (Renewal) years (Renewal) Class 3 With Weekly Benefit 30 days 65 years years (Renewal) years (Renewal) Plan D Premium shown is GST inclusive. Please take note that RM10 of stamp duty shall be charged. Children aged between 30 days to 12 years are eligible to enroll for Plan A (without Weekly Benefit) only Children aged between 13 years to 18 years are eligible to enroll for Plan A & B (without Weekly Benefit) only Adults engaged in Class 3 occupation are eligible to enroll for Plan A, B & C only Housewives & Retirees are not eligible to enroll for plans with Weekly Benefit 4. What are the fees and charges that I have to pay? a. Commission (if any) b. Stamp Duty Type 5. What are some of the key terms and conditions that I should be aware of? Plan E Amount % of gross premium will be paid to the Agent RM10 a) Importance of Disclosure (Statement Pursuant to Schedule 9 of the Financial Services Act 2013) Pursuant to Paragraph 5 of Schedule 9 of the Financial Services Act 2013, if you are applying for this Insurance wholly for purposes unrelated to your trade, business or profession, you have a duty to take reasonable care not to make a misrepresentation in answering the questions in the Proposal Form (or when you apply for this insurance). You must answer the questions fully and accurately. Failure to take reasonable care in answering the questions may result in avoidance of your contract of insurance, refusal or reduction of your claim(s), change of terms or termination of your contract of insurance. The above duty of disclosure shall continue until the time your contract of insurance is entered into, varied or renewed with us. In addition to answering the questions in the Proposal Form (or when you apply for this insurance), you are required to disclose any other matter that you know to be relevant to our decision in accepting the risks and determining the rates and terms to be applied. You also have a duty to tell us immediately if at any time after your contract of insurance has been entered into, varied or renewed with us any of the information given in the Proposal Form (or when you applied for this insurance) is inaccurate or has changed. b) Cash Before Cover It is hereby declared and agreed that it is a fundamental and absolute special condition of this contract of insurance that the premium due must be paid and received by the insurance company before cover commences. c) Will my policy still cover me if I no longer reside in Malaysia? Should you reside outside Malaysia for more than six (6) consecutive months; the policy will cease to be in effect. d) What if I have other similar insurance policies, does this policy still pay? Yes, we will still pay in addition to any other policies you may have except for medical expenses, which are on a reimbursement basis. e) Importance of Keeping the Official Receipt After the premium has been paid, please make sure you have been given an Official Receipt as a proof of payment. You are strongly advised to keep the Official Receipt for any future references. f) Policy Issuance The Policy Schedule will be delivered to you within 30 working days from the date of your application approved. 6. What are the major exclusions under this policy? Some major coverage exclusions are: War, suicide (whether sane or insane), physical impairment/deformity, aircrew members, effects of alcohol, selfinflicted injury, mental disorder, no prescribed use of drugs, childbirth or pregnancy or any complications arising thereof and others. Loss or damage as a result of Pick Pocketing or due to robbery. Pick Pocketing means the act of stealing from the Insured s pocket or handcarried bag unnoticed and discreetly in public places. Plan F 2

3 Occupational exclusions are: Air Force, Police, Security Guards, Naval, Army/Military and Law Enforcement Officers, Aircraft testers, Pilots or Crew, Divers, Racing Drivers, Jockeys, Persons engaged in professional sport activities, Persons engaged in underground mining and tunneling, Firemen, Seamen and Sea fishermen, War correspondents, Oil rig workers, Steeplejacks, Stevedores, Persons engaged in demolition of buildings, Persons engaged in ambulance services, Sawyers, Timber logging workers, Drivers/attendants of timber lorries and winches, Wood working machinists and Explosive handlers. Benefits under this insurance will be payable in respect of accidental death, permanent disablement or other loss covered under this policy arising out of bodily injury whilst attending to normal private and social activities outside the scope of the Insurer s employment as specified above. The insurer reserves absolute discretion to decline coverage even if the Insured Person is not involved in any of the occupations mentioned above. Note: This list is nonexhaustive. Please refer to policy documents for full details. 7. Can I cancel my policy? This Policy may be cancelled by the Insured at any time by giving 14 days written notice to the Company. Said termination shall become effective on the date the notice is received by the Company or the date specified in the notice, whichever is earlier. The Insured shall be entitled to a short period refund of premium provided no claim has been made by the Insured during the period policy year. 8. What do I need to do if there are changes to my contact / personal details? It is important that you inform us of any change in your life profile including your occupation and personal pursuits which would affect the risk profile. 9. Where can I get further information? Should you require additional information about Personal Accident Insurance, please refer to the insurance info booklet on Personal Accident Insurance, available at all our branches or visit If you have any enquiries, please contact us at: RHB INSURANCE BERHAD (38000U) is registered under the Financial Services Act 2013 and regulated by Bank Negara Malaysia. Level 12B, West Wing, The Icon No 1, Jalan 1/68F, Jalan Tun Razak Kuala Lumpur Tel : ; Fax : Website : Other types of Personal Accident cover available Please ask you insurer/intermediary for other types of plans offered by the insurer. IMPORTANT NOTE: YOU ARE ADVISED TO NOTE THE SCALES OF BENEFITS FOR DEATH AND DISABLEMENT IN YOUR INSURANCE POLICY. YOU MUST NOMINATE A NOMINEE AND ENSURE THAT YOUR NOMINEE IS AWARE OF THE PERSONAL ACCIDENT POLICY THAT YOU HAVE PURCHASED. YOU SHOULD READ AND UNDERSTAND THE INSURANCE POLICY AND DISCUSS WITH THE AGENT OR CONTACT THE INSURANCE COMPANY DIRECTLY FOR MORE INFORMATION. The information provided in this disclosure sheet is valid as at 01/06/2015 3

4 HELAIAN PENDEDAHAN PRODUK (PDS) (Sila baca Helaian Pendedahan Produk ini sebelum anda membuat keputusan membeli produk ini, Pastikan anda juga membaca termaterma dan syaratsyarat Polisi ini) 11. Apakah produk ini? RHB Insurance Berhad Pelan Insurans Kemalangan Diri Max Tarikh : Ini adalah satu Pelan Kemalangan Diri yang memberi pampasan sekiranya berlaku kecederaan, hilang upaya atau kematian hanya disebabkan oleh nahas kemalangan, faktor luaran yang nyata dan ketara. Polisi ini juga meliputi perlindungan untuk perbelanjaan perubatan, elaun kematian, pendapatan tunai hospital, ragut, elaun perjalanan dan banyak lagi seperti yang dinyatakan dalan Jadual Manfaat di bawah. Kelayakan: Berumur dari 30 hari hingga 65 tahun dan boleh diperbaharui sehingga umur 75 tahun. 12. Apakah perlindungan yang diberi / manfaat yang disediakan? Jadual Manfaat Manfaatmanfaat Pelan A Pelan B Pelan C Pelan D Pelan E Pelan F Kematian Akibat Kemalangan/Hilang Upaya Kekal, ,000,000,000 7,000 1,000,000 Ganti Rugi Berganda 100, ,000,000 1,000,000 1,,000 2,000,000 Perbelanjaan Perubatan (Setiap Kemalangan) Termasuk Deman Denggi, Malaria, Japanese Encephalitis atau Selsema Burung Rawatan Traditional (RM setiap rawatan sehingga RM setiap kemalangan) 3, 4, 6, 8, 9,000 10,000 Laporan Perubatan/Bedah Siasat Liabiliti Peribadi, ,000,000,000 7,000 1,000,000 Elaun Kematian 5,000 10,000,000,000 75, ,000 Belanja Repatriasi Jenazah 5,000 5,000 5,000 5,000 5,000 5,000 Pendapatan Harian Hospital (Sehingga 180 hari) Pendapatan Harian Hospital Bonus Ketika Di Luar Negara (Sehingga 90 hari) Bayaran Ambulans 1,000 1,000 1,000 1,000 1,000 1,000 Elaun Tambahan Hospital Elaun Perjalanan 1,000 1,000 1,000 1,000 1,000 1,000 Pemindahan Darah 5,000 10,000,000,000 75, ,000 Faedah Kemasukan Dan Pelepasan Hospital Tanpa Tunai 3,000 3,000 3,000 3,000 3,000 3,000 Manfaat Koma, ,000,000,000 7,000 1,000,000 Pembetulan Gigi Atau Pembedahan Pembaikan Kosmetik 5,000 5,000 5,000 5,000 5,000 5,000 Belanja Pengebumian 5,000 5,000 5,000 5,000 5,000 5,000 Faedah Penculikan a) Ganjaran bagi maklumat yang membawa kepada pemulihan Pihak Diinsuranskan b) Pihak Diinsuranskan tidak memulih selepas satu tahun dari tarikh penculikan,000,000,000,000,000,000, ,000,000,000 7,000 1,000,000 Prostesis/Kerusi Roda 2,000 2,000 2,000 2,000 2,000 2,000 Keguguran Akibat Kemalangan Kenderaan Bermotor 1,000 1,000 1,000 1,000 1,000 1,000 Ragut Manfaat Penjagaan Kejururawatan Rumah 3, 3, 3, 3, 3, 3, Terbakar Peringkat Kedua Atau Ketiga 5,000 5,000 5,000 5,000 5,000 5,000 Bonus Tanpa Tuntutan Faedah Mingguan (Pilihan) Kelas 1 & 2 Hilang Upaya Sementara Menyeluruh Hilang Upaya Sementara Separa Faedah Mingguan (Pilihan) Kelas 3 Hilang Upaya Sementara Menyeluruh Hilang Upaya Sementara Separa 10% Dari Jumlah Prinsipal Diinsuranskan Setiap Tahun Sehingga Maksimum 5 Tahun Tempoh perlindungan adalah satu (1) tahun. Anda hendaklah memperbaharui polisi insurans anda secara tahunan. 4

5 13. Berapakah jumlah premium yang perlu dibayar? Premium Tahunan Umur & Kelas Pekerjaan Kelas 1 & 2 Tanpa Faedah Mingguan Plan A Plan B 30 hari 65 tahun , tahun (Pembaharuan) , tahun (Pembaharuan) , Kelas 1 & 2 Dengan Faedah Mingguan 30 hari 65 tahun , tahun (Pembaharuan) , , tahun (Pembaharuan) , , Kelas 3 Tanpa Faedah Mingguan Plan C 30 hari 65 tahun tahun (Pembaharuan) tahun (Pembaharuan) Kelas 3 Dengan Faedah Mingguan 30 hari 65 tahun tahun (Pembaharuan) tahun (Pembaharuan) Plan D Plan E Premium yang dipaparkan adalah termasuk GST. Sila ambil perhatian bahawa duti setem sebanyak RM10 akan dikenakan. Kanakkanak berumur di antara 30 hari hingga 12 tahun hanya layak untuk mendaftar untuk Pelan A (tanpa Faedah Mingguan) sahaja Kanakkanak berumur di antara 13 tahun hingga 18 tahun hanya layak untuk mendaftar untuk Pelan A & B (tanpa Faedah Mingguan) sahaja Dewasa terlibat dalam Pekerjaan Kelas 3 hanya layak untuk mendaftar untuk Pelan A, B & C sahaja Suri rumah dan pesara tidak layak untuk mendaftar bagi pelanpelan dengan Faedah Mingguan Plan F 14. Apakah bentuk bayaran yang dikenakan dan yang perlu dibayar? Jenis Jumlah c. Komisen (jika ada) d. Duti Setem % daripada premium akan dibayar kepada Ejen RM Apakah terma dan syarat penting yang saya perlu tahu? a) Kepentingan Pendedahan Maklumat (Menurut Kenyataan Jadual 9 Akta Perkhidmatan Kewangan 2013) Menurut Perenggan 5 daripada Jadual 9 Akta Perkhidmatan Kewangan 2013, jika anda memohon insurans ini sepenuhnya untuk tujuan yang tidak berkaitan perdagangan, perniagaan atau profesion anda, anda mempunyai kewajipan untuk mengambil langkah yang munasabah untuk tidak salah nyata dalam menjawab soalansoalan di dalam Borang Cadangan (atau semasa memohon insurans ini). Anda dikehendaki menjawab soalansoalan dalam Borang Cadangan ini dengan lengkap dan tepat. Kegagalan untuk mengambil langkah yang munasabah dalam menjawab soalansoalan, mungkin mengakibatkan pembatalan kontrak insurans anda, keengganan atau pengurangan gantirugi, perubahan terma atau penamatan kontrak insurans anda. Kewajipan pendedahan diatas hendaklah diteruskan sehingga kontrak insurans anda dimeterai, diubah atau diperbaharui dengan kami. Sebagai tambahan kepada soalansoalan di dalam Borang Cadangan (atau semasa memohon insurans ini), anda dikehendaki untuk mendedahkan apaapa perkara lain yang anda tahu akan mempengaruhi keputusan kami dalam menerima risiko dan menentukan kadar dan terma yang dikenakan. Anda juga mempunyai kewajipan untuk memberitahu kami dengan sertamerta jika pada bilabila masa selepas kontrak insurans anda ditandatangani, diubah atau diperbaharui dengan kami (atau semasa permohonan insurans ini), apaapa maklumat yang dinyatakan dalam Borang Cadangan tidak tepat atau sudah berubah. b) Tunai Sebelum Perlindungan Dengan ini diisytiharkan dan dipersetujui bahawa adalah menjadi asas dan syarat khas mutlak bagi kontrak insurans ini bahawa bayaran premium mesti dibayar dan diterima oleh Syarikat Insurans sebelum perlindungan bermula. c) Adakah polisi saya masih memberikan perlindungan berterusan sekiranya saya tidak lagi menetap di Malaysia? Sekiranya anda menetap di luar Malaysia melebihi dari tempoh enam (6) bulan atau lebih berturutturut; polisi ini akan menjadi luput. d) Sekiranya saya memiliki polisi insurans yang serupa, adakah polisi insurans ini akan tetap dibayar? Ya, kami akan tetap membayar sebagai tambahan kepada manamana polisi lain yang anda miliki melainkan untuk perbelanjaan perubatan, dimana akan dibuat atas dasar pembayaran balik. e) Kepentingan Menyimpan Resit Rasmi Setelah premium dibayar, sila pastikan anda diberi resit rasmi sebagai bukti pembayaran. Anda dinasihatkan supaya menyimpan resit rasmi sebagai rujukan pada masa akan datang. 5

6 f) Penghantaran Polisi Jadual Polisi akan dihantar kepada anda dalam tempoh 30 hari selepas tarikh permohonan anda diluluskan. 16. Apakah pengecualian utama di bawah polisi ini? Beberapa pengecualian perlindungan yang utama adalah: Peperangan, bunuh diri (samada siuman atau tidak siuman), kerosakan fizikal/kecacatan, ahli anak kapal terbang, kesankesan alkohol, kecederaan yang disengajakan, gangguan mental, penggunaan ubatubatan yang tidak dipreskripsikan, bersalin atau kehamilan atau apaapa komplikasi yang timbul hasil daripadanya dan lainlain. Kehilangan atau kerosakan akibat Seluk Saku atau disebabkan oleh rompakan. Seluk Saku bermaksud perbuatan mencuri dari saku Pihak Diinsuranskan atau mencuri tas tangan tanpa disedari dan tanpa menimbulkan syak di tempattempat awam. Pengecualian pekerjaan adalah: Tentera Udara, Polis, Pengawal Keselamatan, Tentera Laut, Tentera Darat/Tentera dan Pegawai Penguatkuasa Undangundang, Penguji Pesawat, Juruterbang atau Anak Kapal, Penyelam, Pelumba Kereta, Joki, Seseorang yang terlibat dalam kegiatan sukan professional, Seseorang yang terlibat dalam perlombongan bawah tanah dan pembinaan terowong, Bomba, Pelaut, Nelayan di laut, Wartawan perang, Pekerja pelantar minyak, Pekerja yang membaiki atau mengecat bangunan tinggi, Pekerja pelabuhan, Seseorang yang terlibat dalam perobohan bangunan, Seseorang yang terlibat dalam perkhidmatan ambulans, Penggergaji balak, Pekerja pembalakan, Pemandu/atendan lori balak dan penarik balak, Jurumesin pertukangan kayu dan Pengendali bahan letupan. Faedah di bawah insurans ini akan dibayar dalam hal berlakunya kemalangan maut, hilang upaya kekal atau lainlain kerugian seperti yang terkandung di dalam polisi ini, timbul akibat kecederaan badan semasa menghadiri aktivitiaktiviti normal peribadi dan sosial di luar bidang kerja Pihak Diinsuranskan seperti yang dinyatakan di atas. Penginsurans berhak mengikut budi bicara mutlak untuk menolak perlindungan walaupun Pihak Diinsuranskan tidak terlibat di dalam manamana pekerjaan yang dinyatakan di atas. Nota: Ini adalah tidak menyeluruh. Sila rujuk kepada polisi dokumen untuk butirbutir penuh. 17. Bolehkah saya membatalkan polisi? Polisi ini boleh dibatalkan oleh Pihak Diinsuranskan pada bilabila masa dengan memberi tempoh 14 hari notis bertulis kepada Syarikat. Penamatan ini akan berkuatkuasa bermula dari tarikh notis diterima oleh Pihak Syarikat atau tarikh yang dinyatakan di dalam notis, yang mana lebih awal. Pihak Diinsuranskan akan berhak kepada bayaran balik premium jangka pendek dengan syarat tiada tuntutan telah dibuat oleh Pihak Diinsuranskan semasa tempoh tahun polisi. 18. Apakah yang perlu dilakukan seandainya terdapat perubahan pada maklumat perhubungan/butirbutir peribadi? Adalah penting untuk anda memaklumkan kepada kami sekiranya terdapat sebarang perubahan maklumat profil diri termasuk pekerjaan dan kegiatan peribadi kerana perubahan ini akan memberi kesan terhadap profil risiko anda. 19. Di mana saya boleh mendapatkan maklumat lanjut? Sekiranya Anda memerlukan maklumat tambahan mengenai Insurans Kemalangan Diri, sila rujuk kepada buku kecil info insurans berkenaan Insurans Kemalangan Diri yang boleh didapati di semua cawangan kami atau layari Sekiranya anda mempunyai sebarang pertanyaan, sila hubungi kami di: RHB INSURANCE BERHAD (38000U) didaftarkan di bawah Akta Perkhidmatan Kewangan 2013 dan dikawal selia oleh Bank Negara Malaysia. Tingkat 12B, West Wing, The Icon No 1, Jalan 1/68F, Jalan Tun Razak, Kuala Lumpur Telefon. : ; Faksimili : Laman web: Lainlain perlindungan insurans kemalangan diri yang boleh di dapati Sila rujuk kepada pihak insurans anda/pengantara untuk lainlain pelan insurans yang ditawarkan. NOTIS PENTING : ANDA DINASIHATKAN UNTUK MERUJUK KEPADA SKALA MANFAAT UNTUK KEMATIAN DAN HILANG UPAYA DI DALAM POLISI INSURANS ANDA. ANDA HENDAKLAH MELETAKKAN PENAMA DAN MEMASTIKAN PENAMA TERSEBUT DIMAKLUMKAN TENTANG POLISI KEMALANGAN DIRI YANG TELAH DIBELI. ANDA HENDAKLAH MEMBACA DAN MEMAHAMI POLISI INSURANS DAN BERBINCANG DENGAN EJEN ATAU MENGHUBUNGI SYARIKAT INSURANS UNTUK MAKLUMAT LANJUT. Maklumat yang terkandung di sini adalah berkuatkuasa bermula 01/06/2015 6

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