The above duty of disclosure shall continue until the time your contract of insurance is entered into, varied or renewed with us.
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1 SmartCancer Cash Product Disclosure Sheet Important Note 1. Read this Product Disclosure Sheet before you decide to take out the SmartCancer Cash Insurance Policy. Be sure to also read through the general terms and conditions. 2. You are advised to note the table of benefits for Death and Disablement in your insurance policy. You must nominate a nominee and ensure that your nominee is aware of the policy that you have purchased. You should read and understand the insurance policy and discuss with the agent or contact us directly for more information. 3. 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. 1. What is this product about? SmartCancer Cash pays on top of any other insurance you own. We will pay the amount shown in your plan in one lump sum in the event you are diagnosed with cancer, even from the early stage. 2. What are the covers / benefits provided? PLAN SUM INSURED (RM) 125, ,000 75,000 50,000 Generic Cancer 1 We will pay the amount shown for your plan, in one lump sum, 100% of Sum Insured upon the Insured Person being diagnosed with cancer. Gender Specific Cancer 1 We will pay the amount shown for your plan, in one lump sum, upon the Insured Person being diagnosed with cancer of the following organs: Females Males Breasts Cancer Testicular Cancer 200% of Sum Insured Fallopian Tubes Cancer Penile Cancer Ovarian Cancer Prostate Cancer Cervical Cancer Uterus Cancer Vagina / Vulva Cancer Early Stage Cancer We will pay the amount shown for your plan, Generic Cancer 30% of Generic Cancer s Sum Insured in one lump sum, upon the Insured Person being diagnosed with carcinoma-in-situ. For Gender Specific 30% of Gender Specific Cancer s Sum Insured organs covered under: Cancer Note: #1 - In the event a claim is made under Early Stage Cancer benefit of 30%, the amount payable under Generic Cancer or Gender Specific Cancer will be 70% of the Sum Insured. 1 of 4
2 IMPORTANT NOTES: 1. The benefits under Generic Cancer and Gender Specific Cancer are mutually exclusive and are payable once in Insured Person s lifetime, irrespective of the number of diagnosis of cancer. 2. The Early Stage Cancer benefit is payable only once in Insured Person's lifetime, irrespective of the number of diagnosis of carcinoma-in-situ. 3. Cancer of organ specified under Gender Specific Cancer benefit are not covered under the Generic Cancer benefit. 4. Policy coverage shall automatically terminate on the occurrence of the benefit under Generic Cancer or Gender Specific Cancer being paid out. 3. How much premium do I have to pay? The premium rates above are only for selected ages. For the complete premium listing of other ages/gender kindly refer to the brochure. The total premium that you need to pay depends on your age, gender, health status and selected plan of your choice. Premium rates are not guaranteed and the premium payable at renewal shall be determined at each renewal based on the age next birthday of each member. The premium rates then in effect, and any other factors which may materially affect the risks insured. 4. What are the fees and charges I have to pay? What you have to pay in addition to the premium: Stamp Duty RM10.00 What is included in the premium: i. Commissions paid to insurance intermediaries 15% of premium ii. Service Tax 6% of premium 5. What are some of the key terms and conditions that I should be aware of? Eligibility Malaysian Citizen New Application : Age as of your next birthday Renewal : Up to age 100 provided you were already a member on your 59 th birthday If you are an existing member who wants to upgrade your plan, it can only be done at renewal before 59 year old of your next birthday. Importance of Disclosure You must disclose all material facts such as personal particulars and any medical condition which you already had when you apply for this policy. This includes any medical condition or symptoms whether or not being treated and any previous medical condition which recurs or which you should reasonable have known about even if you have not consulted a medical practitioner. If you are in any doubt, you should disclose the medical condition. Failure to notify AXA of all material facts and medical condition may result in claims being refused or cover withdrawn. Policy Renewal / Renewal Premium (i) This is a yearly renewable policy. Unless renewed, the coverage will cease on expiry date and the insurance company shall strictly not be liable for any expenses that take place after the expiry date. (ii) The renewal of the policy is at the option of the Policyholder until the occurrence of any of the following: (a) non-payment of premium or premium not made on time; 2 of 4
3 (b) fraud or misrepresentation of material fact during application; (c) the policy is cancelled at the request of the Policyholder; (d) the Insured Person ceases to qualify as a dependent based on the definition of the policy; (e) the Insured Person attains the coverage age limit specified; (f) benefit under either Generic Cancer or Gender Specific Cancer is paid out under this policy; (g) on the death of the Insured Person; and (h) termination of coverage for all policies in a certain market and the Company withdraws this policy completely from the market in accordance with the Portfolio Withdrawal Condition. Cash Before Cover Free-look Period Waiting Period Premium due must be paid and received by us before cover commences. This insurance policy is automatically null and void if this condition is not complied. You may cancel your policy by returning it to us within 15 days from the date of issuance provided no claim has been made. Full premium will be refunded to you less deduction of expenses incurred by the Company. Benefit Generic Cancer Gender Specific Cancer Early Stage Cancer Waiting Period 90 days 120 days *Survival Period 14 days *No benefits will be paid if the Insured Person has been diagnosed with cancer and/or Early Stage Cancer and lives for a period of less than 14 days after the diagnosis. Claim Procedure Step 1 Step 2 Step 3 Contact AXA Customer Service number (603) ; or Visit our website at to obtain a printable claim form. Submit the required documents to AXA. Completed claim form and signed by the Insured and the Medical Practitioner. Completed medical report, bill, HPE/Biopsy report and other related diagnostic report. We may request additional information or report, if necessary. Approval & Payout Upon receipt of full documents, AXA will revert with claim decision within 7 working day. Once approved, claim payment will be via direct credit within 3 working days. 6. What are the major exclusions under this policy? We do not pay claims related to: any cancer and/or carcinoma-in-situ directly or indirectly caused by any pre-existing condition; any signs or symptoms of cancer first occurred within 90 days from the date such Insured Person was first covered under this policy; any signs or symptoms of carcinoma-in-situ first occurred within 120 days from the date such Insured Person was first covered under this policy; cancer and/or carcinoma-in-situ which is diagnosed and the Insured Person lives for a period of less than 14 days after the diagnosis; cancer and/or carcinoma-in-situ for which the Insured Person is claiming if the Insured Person has been diagnosed with the same cancer and/or carcinoma-in-situ before the date such Insured Person was first covered under this policy; cancer and/or carcinoma-in-situ diagnosed in the presence of Human Immunodeficiency Virus (HIV) and/or Acquired Immune Deficiency Syndrome (AIDS); a diagnosis made by a Medical Practitioner who is an Insured Person or a member of the Insured Person s family; cancer and/or carcinoma-in-situ caused as a result of nuclear contamination, biological contamination or chemical contamination. 7. What is Pre-existing Conditions? Pre-existing Conditions shall mean medical conditions/disabilities that the Insured Person has reasonable knowledge of. An Insured Person may be considered to have reasonable knowledge of a pre-existing condition where the condition is one for which: 3 of 4
4 (a) the Insured Person had received or is receiving treatment; (b) medical advice, diagnosis, care or treatment has been recommended; (c) clear and distinct symptoms are or were evident; or (d) its existence would have been apparent to a reasonable person in the circumstances. 8. Can I cancel my policy? You may cancel your policy at any time by giving a written notice to the Company. Upon cancellation, you are entitled to a certain amount of refund of the premium provided that you have not made a claim on the policy. Period Not Exceeding Refund of Annual Premium 15 days (for renewal only) 90% 1 month 80% 2 months 70% 3 months 60% 4 months 50% 5 months 40% 6 months 30% 7 months 25% 8 months 20% 9 months 15% 10 months 10% 11 months 5% Exceeding 11 months No refund 9. What do I need to do if there are changes to my contact/personal details? It is important that you inform us any change in your contact details to ensure that all correspondences reach you in a timely manner. 10. Where can I get further information? Should you require additional information about our SmartCancer Cash policy, you may contact us or your insurance agent. For additional information about medical and health insurance, please refer to the insuranceinfo booklet on Medical & Health Insurance, which is available at all our branches. You can also obtain a copy of the booklet from your insurance agent or visit AXA Affin General Insurance Berhad (23820-W) Customer Service Centre Ground Floor, Wisma Boustead, Ground Floor, Wisma Boustead, 71 Jalan Raja Chulan, 71 Jalan Raja Chulan, Kuala Lumpur, Kuala Lumpur. Malaysia Tel: (603) Fax: customer.service@axa.com.my Homepage: Any other types of Medical and Health Insurance cover available? SmartCare Optimum InternationalExclusive The information provided in this disclosure is valid as at 01/04/ of 4
5 SmartCancer Cash Lembaran Pendedahan Produk Nota Penting 1. Sila baca Lembaran Pendedahan produk ini sebelum anda membuat keputusan untuk membeli Insurans SmartCancer Cash. Pastikan juga anda telah membaca terma-terma dan syarat-syarat am. 2. Anda dinasihatkan untuk memahami jadual manfaat untuk Kematian dan Hilang Upaya dalam polisi insurans anda. Anda harus memberi penama dan pastikan penama anda tahu tentang polisi yang telah anda beli. Anda hendaklah membaca dan memahami polisi insurans dan berbincang dengan pengantara insurans anda atau hubungi terus kami untuk keterangan lanjut. 3. 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 soalan-soalan dalam Borang Cadangan ini (atau semasa permohonan insurans ini). Anda dikehendaki menjawab soalan-soalan dalam Borang Cadangan ini dengan lengkap dan tepat. Kegagalan untuk mengambil langkah yang munasabah dalam menjawab soalan-soalan, 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 soalan-soalan dalam Borang Cadangan ini (atau semasa permohonan insurans ini), anda dikehendaki untuk mendedahkan apa-apa 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 serta-merta jika pada bila-bila masa selepas kontrak insurans anda dimeterai, diubah atau diperbaharui dengan kami, apa-apa maklumat yang dinyatakan dalam Borang Cadangan ini (atau semasa permohonan insurans ini) tidak tepat atau telah berubah. 1. Apakah produk ini? SmartCancer Cash membayar di atas insurans-insurans lain yang anda miliki. Kami akan membayar Jumlah yang Diinsuranskan seperti yang tertera dalam pelan anda, sekaligus, sekiranya anda didiagnos menghidap kanser, walaupun dari peringkat awal. 2. Apakah perlindungan / manfaat yang disediakan? PELAN JUMLAH YANG DIINSURANSKAN (RM) 125, ,000 75,000 50,000 Kanser Generik 1 Kami akan membayar Jumlah yang Diinsuranskan seperti yang tertera dalam pelan anda, sekaligus, apabila Orang yang Diinsuranskan didiagnos menghidap kanser. 100% daripada Jumlah yang Diinsuranskan Kanser Jantina Khusus 1 Kami akan membayar Jumlah yang Diinsurankan seperti yang tertera dalam pelan anda, sekaligus, apabila Orang yang Diinsuranskan didiagnos menghidap kanser organ-organ berikut: Perempuan Kanser Payudara Kanser Tiub Fallopio Kanser Ovari Kanser Serviks Kanser Uterus Kanser Faraj / Vulva Lelaki Kanser Testis Kanser Zakar Kanser Prostat 200% daripada Jumlah yang Diinsurankan 1 of 5
6 Kanser Peringkat Awal Kami akan membayar amaun seperti yang tertera dalam pelan anda, sekaligus, apabila Orang yang Diinsuranskan didiagnos menghidap karsinoma-in-situ (Kanser Peringkat Awal). Bagi organ yang dilindungi seperti : Kanser Generik Kanser Jantina Khusus 30% daripada Jumlah yang Diinsuranskan dalam Kanser Generik 30% daripada Jumlah yang Diinsuranskan dalam Kanser Jantina Khusus Note: #1 Sekiranya manfaat Kanser Peringkat Awal 30% telah dituntut, maka jumlah yang perlu dibayar di bawah manfaat Kanser Generik atau Kanser Jantina Khusus adalah 70% daripada Jumlah Diinsuranskan. NOTA-NOTA PENTING: 1. Manfaat-manfaat di bawah Kanser Generik dan Kanser Jantina Khusus adalah saling eksklusif dan dibayar sekali dalam sepanjang hayat Orang yang Diinsuranskan, tanpa mengira bilangan kanser yang didiagnos. 2. Manfaat-manfaat Kanser Peringkat Awal dibayar hanya sekali dalam sepanjang hayat Orang yang Diinsuranskan, tanpa mengira bilangan karsinoma-in-situ (Kanser Peringkat Awal) yang didiagnos. 3. Kanser organ yang dinyatakan di bawah manfaat Kanser Jantina Khusus tidak dilindungi di bawah manfaat Kanser Generik. 4. Perlindungan polisi akan tamat secara automatik apabila manfaat di bawah Kanser Generik atau Kanser Jantina Khusus telah dibayar. 3. Berapakah premium yang saya perlu bayar? Kadar premium di atas hanyalah untuk peringkat umur yang terpilih. Bagi penyenaraian premium lengkap untuk peringkat umur-umur yang lain/jantina, sila rujuk pada risalah. Jumlah premium yang anda perlu bayar bergantung pada umur, jantina, status kesihatan dan pelan pilihan anda. Kadar premium adalah tidak dijamin dan premium yang perlu dibayar pada pembaharuan akan ditentukan di setiap pembaharuan berdasarkan umur hari jadi berikut setiap ahli. Kadar premium yang telah berkuatkuasa, dan faktorfaktor lain yang secara material mungkin menjejaskan risiko yang dilindungi. 4. Apakah yuran dan bayaran yang saya perlu bayar? Apa yang anda perlu bayar sebagai tambahan kepada premium: Duti Setem RM10.00 Apa yang termasuk dalam premium: i. Komisen yang dibayar kepada pengantara insurans 15% daripada premium ii. Cukai Perkhidmatan 6% daripada premium 5. Apakah terma dan syarat utama yang saya harus ketahui? Kelayakan Warganegara Malaysia Permohonan Baru : Umur pada hari jadi anda yang berikutnya Pembaharuan : Sehingga umur 100 tahun dengan syarat anda telah menjadi ahli pada hari lahir ke-59 anda Jika anda seorang ahli yang sedia ada yang ingin menaik taraf pelan anda, ia hanya boleh dilakukan pada pembaharuan sebelum berumur 59 tahun hari jadi anda yang berikutnya. Kepentingan Pendedahan Anda perlu mendedahkan semua fakta material seperti butir-butir peribadi dan keadaan-keadaan perubatan yang anda telah perolehi semasa anda memohon polisi ini. Ini termasuk keadaan-keadaan perubatan atau 2 of 5
7 gejala-gejala sama ada telah/sedang dirawat dan keadaan-keadaan perubatan sebelumnya yang berulang atau keadaan kesihatan/gejala yang anda ketahui walaupun tidak berjumpa dengan pengamal perubatan. Jika anda mempunyai keraguan, anda perlu mendedahkan keadaan perubatan tersebut. Kegagalan untuk memaklumkan kepada AXA mengenai semua fakta material dan keadaan perubatan boleh menyebabkan tuntutan ditolak atau perlindungan ditarik balik. Pembaharuan Polisi / Premium Pembaharuan (i) Ini adalah polisi yang diperbaharui setiap tahun. Perlindungan ini akan tamat pada tarikh luput dan syarikat insurans tidak akan bertanggungjawab ke atas sebarang perbelanjaan yang berlaku selepas tarikh luput, melainkan polisi tersebut diperbaharui. (ii) Pembaharuan polisi ini adalah mengikut pilihan Pemegang Polisi sehingga berlaku mana-mana daripada yang berikut: (a) tidak membayar premium atau premium tidak dibayar mengikut masa; (b) penipuan atau salah nyataan fakta penting semasa membuat permohonan; (c) polisi dibatalkan atas permintaan Pemegang Polisi; (d) Orang yang Diinsuranskan tidak lagi layak menjadi tanggungan berdasarkan takrif polisi; (e) Orang yang Diinsuranskan mencapai had umur perlindungan yang ditetapkan; (f) manfaat di bawah Kanser Generik atau Kanser Jantina Khusus telah dibayar di bawah polisi ini; (g) kematian Orang yang Diinsuranskan; dan (h) penamatan perlindungan semua polisi dalam pasaran tertentu dan Syarikat menarik balik polisi ini sepenuhnya dari pasaran menurut Syarat Penarikan Balik Portfolio. Bayar Sebelum Perlindungan Premium mesti dibayar dan diterima oleh pihak kami sebelum perlindungan bermula. Polisi insurans ini akan terbatal secara automatik jika syarat ini tidak dipatuhi. Tempoh Percubaan Anda boleh membatalkan polisi anda dengan mengembalikan polisi tersebut kepada kami dalam tempoh 15 hari dari tarikh pengeluaran dengan syarat tiada tuntutan telah dibuat. Premium penuh akan dikembalikan kepada anda setelah ditolak belanja yang ditanggung oleh Syarikat. Manfaat Kanser Generik Kanser Jantina Khusus Kanser Peringkat Awal Tempoh Menunggu Tempoh Menunggu 90 hari 120 hari *Tempoh Hayat 14 hari * Tiada manfaat akan dibayar sekiranya Orang yang Diinsuranskan telah didiagnos menghidap kanser dan/atau Kanser Peringkat Awal dan hidup untuk tempoh kurang daripada 14 hari selepas didiagnos. Prosedur Tuntutan Langkah 1 Hubungi talian Khidmat Pelanggan AXA (603) ; atau Layari laman web kami di untuk cetakan borang tuntutan. Langkah 2 Hantar dokumen-dokumen yang berkaitan kepada AXA. Borang tuntutan yang lengkap dan ditandatangani oleh Orang yang Diinsuranskan dan Pengamal Perubatan. Laporan perubatan yang lengkap, bil, laporan HPE/Biopsi dan laporan diagnostik lain yang berkaitan. Kami mungkin akan meminta maklumat atau laporan tambahan, jika perlu. Langkah 3 Kelulusan & Pembayaran Setelah menerima dokumen yang lengkap, AXA akan memberi keputusan tuntutan dalam tempoh 7 hari bekerja. Setelah diluluskan, pembayaran tuntutan akan dikredit terus dalam tempoh 3 hari bekerja. 6. Apakah pengecualian utama di bawah polisi ini? Kami tidak membayar tuntutan yang berkaitan dengan: sebarang kanser dan/atau karsinoma-in-situ yang disebabkan secara langsung atau tidak langsung akibat daripada keadaan sedia ada; 3 of 5
8 sebarang tanda-tanda atau gejala-gejala kanser yang pertama kali berlaku dalam tempoh 90 hari dari tarikh Orang yang Diinsuranskan mula dilindungi dalam polisi ini; sebarang tanda-tanda atau gejala-gejala karsinoma-in-situ yang pertama kali berlaku dalam tempoh 120 hari dari tarikh Orang yang Diinsuranskan mula dilindungi dalam polisi ini; Orang yang Diinsuranskan didiagnos menghidap kanser dan/atau karsinoma-in-situ dan hidup untuk tempoh kurang daripada 14 hari selepas didiagnos; kanser dan/atau karsinoma-in-situ yang mana Orang yang Diinsuranskan mendakwa jika Orang yang Diinsuranskan tersebut telah didiagnos menghidap kanser yang sama dan/atau karsinoma-in-situ sebelum tarikh Orang yang Diinsuranskan tersebut mula dilindungi dalam polisi ini; kanser dan/atau karsinoma-in-situ yang disebabkan oleh jangkitan Virus Kurang Tahan Penyakit (HIV) dan / atau Sindrom Kurang Daya Tahan (AIDS); diagnosis yang dibuat oleh Pengamal Perubatan yang merupakan Orang yang Diinsuranskan atau ahli keluarga mereka; kanser dan/atau karsinoma-in-situ yang disebabkan akibat daripada pencemaran nuklear, pencemaran biologi atau pencemaran kimia. 7. Apa itu Keadaan Sedia Ada? Keadaan Sedia Ada bermaksud keadaan kesihatan/ketidakupayaan yang diketahui sewajarnya oleh Orang yang Diinsuranskan. Orang yang Diinsuranskan dianggap mengetahui sewajarnya keadaan sedia ada itu apabila: (a) Orang yang Diinsuranskan telah atau sedang menerima rawatan; (b) nasihat perubatan, diagnosis, jagaan atau rawatan telah disyorkan; (c) gejala yang jelas dan tepat dapat atau telah dilihat dengan nyata; atau (d) kewujudannya dapat diperhatikan dengan jelas pada orang yang mengalami keadaan itu. 8. Bolehkah saya batalkan polisi ini? Anda boleh membatalkan polisi anda pada bila-bila masa dengan memberikan notis bertulis kepada Syarikat. Selepas pembatalan, anda layak mendapat bayaran balik premium dengan syarat tiada tuntutan telah dibuat ke atas polisi. Tempoh Tidak Melebihi Bayaran Balik Premium Tahunan 15 hari (untuk pembaharuan sahaja) 90% 1 bulan 80% 2 bulan 70% 3 bulan 60% 4 bulan 50% 5 bulan 40% 6 bulan 30% 7 bulan 25% 8 bulan 20% 9 bulan 15% 10 bulan 10% 11 bulan 5% Melebihi 11 bulan Tiada Bayaran Balik 9. Apakah yang harus saya lakukan jika terdapat perubahan dalam butiran peribadi saya? Adalah penting untuk anda memaklumkan kepada kami sebarang perubahan mengenai maklumat anda bagi memastikan semua surat-menyurat sampai kepada anda tepat pada masanya. 10. Di mana saya boleh mendapatkan maklumat lanjut? Anda boleh menghubungi kami atau ejen insurans anda, sekiranya anda memerlukan maklumat lanjut mengenai polisi SmartCancer Cash kami. Untuk maklumat lanjut mengenai insurans perubatan dan kesihatan, sila rujuk pada buku panduan insuranceinfo mengenai 'Insurans Perubatan dan Kesihatan', yang boleh didapati di semua cawangan kami. Anda juga boleh mendapatkan salinan buku panduan tersebut daripada ejen insurans anda atau layari AXA Affin General Insurance Berhad (23820-W) Customer Service Centre Ground Floor, Wisma Boustead, Ground Floor, Wisma Boustead, 71 Jalan Raja Chulan, 71 Jalan Raja Chulan, Kuala Lumpur, Kuala Lumpur. Malaysia Tel: (603) Fax: customer.service@axa.com.my Homepage: 4 of 5
9 11. Apakah jenis-jenis Insurans Perlindungan Perubatan dan Kesihatan yang ada? SmartCare Optimum InternationalExclusive Maklumat yang dinyatakan dalam pendedahan ini adalah sah pada 01/04/2016 Sekiranya ada pertikaian dan percanggahan mengenai Terma-terma dan Syarat-syarat ini di dalam Bahasa Inggeris dan Bahasa Malaysia, versi Bahasa Inggeris akan digunapakai. 5 of 5
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