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This presentation is purely a training tool for AIA PUBLIC Takaful Bhd.s (AIA PUBLIC) internal agency.
This presentation is not to be used directly/indirectly for soliciting Takaful business, Certificate Owner
services and/or facilitating any other form of communications with external parties whatsoever. Whilst
AIA PUBLIC has taken all reasonable care to ensure that the information contained in this presentation
is not untrue or misleading at the time of publication, we cannot guarantee its accuracy or
completeness. You should not act on it without first independently verifying its contents. Any opinion or
estimate contained in this presentation is subject to change without notice.
The information with regard to investment/savings contained herein does not have any regard to the
specific investment objective(s), financial situation or the particular needs of any person. Any
investment and/or savings returns is subject to risks, including the possible loss of the principal amount
invested. Past performance is not necessarily a guide to the future or likely performance of the plans.
Potential investors may wish to seek advice from AIA PUBLICs representative before participating in
any plan. In the event that potential investors choose not to seek advice from a AIA PUBLICs
representative, they should consider whether the plan is suitable for them.
Any comparison contained herein pertains to specific products in the market and is based on information
gathered from marketing materials of the said product. Comparisons are made based on certain
assumptions as stated in this presentation. As such, the analysis is not to be generalized or applied to
all situations. This presentation is only for internal circulation and not to be construed as a marketing
material to be shared with any external party.
Participant
Certificate
Benefits
Rates: The premium rates for A-SME The contribution rates of A-SME Plus-i
Plus are lower vary slightly as compared to A-SME
A-SME Plus does not have Plus due to sharing of Underwriting
Underwriting Surplus sharing Surplus between customer & Takaful
Operator
Policy Is known as Policy Is known as Certificate
Document:
Medical Is known as Sum Insured Is known as Sum Covered
Coverage
Insurance Fund Is called Risk Fund Is called Tabarru Fund
AIA confidential and proprietary information. Not for distribution. 6
Introducing
Key Features
Total 7 plans
A-SME Plus-i
Group
Hospitalisation and Group Term
Surgical Takaful Takaful (GTT)
(GHS)
Basic Basic
Compulsory Rider Compulsory Rider
Optional Rider Optional Rider
Waiting Period:
Eligibility for benefits starts thirty (30) days after the Insured has been included in
the Policy, except for a covered Accident occurring after the effective date of coverage.
Specified Illnesses
No benefits shall be payable for hospitalisation, surgery and/or charges incurred
which are caused directly or indirectly by Specified Illnesses and its related
complications.
Specified Illnesses" shall mean the following disabilities and its related
complications, occurring within the first hundred twenty (120) days of Insurance of
the Insured Person:
i) Hypertension, diabetes mellitus and cardiovascular disease.
ii) All tumours, cancers, cysts, nodules, polyps, stones of the urinary system and
biliary system.
iii) All ear, nose (including sinuses) and throat conditions.
iv) Hernias, haemorrhoids, fistulae, hydrocoele, varicocele.
v) Endometriosis including disease of the reproduction system.
vi) Vertebro-spinal disorders (including disc) and knee conditions.
No Item Guidelines
Medical premium more than
1 Premium per annum
RM10,000
2 Deposit Waived
5 to 50 employees:
Date of Inclusion: Date of Incident: Anniversary date:
1 Jan 2015 30 Jun 2015 31 Dec 2015
During the 90
First 12 months
days preceding
the date of
inclusion of
Insured
Employee
5 to 50 employees:
Date of Inclusion: Date of Incident: Anniversary date:
1 Jan 2015 30 Jun 2015 31 Dec 2015
During the 90
First 12 months
days preceding
the date of
inclusion of
Insured
Employee
i) Cancer
ii) Heart Attack
iii) Other Serious Coronary Artery Disease
iv) Coronary Artery By-Pass Surgery.
Member ID Card
Must be used when seeking care at any Panel GP Clinic
Front Back
Member ID Card
Must be used when seeking care at any Panel GP Clinic
You on
Log cantoonly visit a non-Panel
AIA@MyService clinic
for the in an Emergency
Directory or Clinics
of Panel GP there are no Panel GP Clinics within a 5 km radius of your
locationcheck with your HR Department for Monthly Directory updates
Always
PAY
AIA CORPORATE SOLUTIONS
Name of Clinic POLIKLINIK ABC
Patient Name TAN YEN YEN
75090710508202
Membership Number ABC COMPANY Company Name
Visit Date 08/06/2013 TRAN# 000771 Transaction Code
Diagnosis Code DIAG:1028/0 MC: 0 DAY MC Days
CONSULTATION 15.00
MEDICATION 25.00
INJECTION 10.00
Bill Itemization LAB TEST 10.00
X.RAY 10.00
PROCEDURE 10.00
TRANSACTION AMT: 70.00 Total Transaction Amount (billed to AIA
Total Billed Amount TOTAL BILLED: 80.00 Insurance)
(PATIENT TO PAY) 0.00 Amount Payable by Patient (RM0)
---------------------------------------------
SIGNATURE
X __________________________________
Member
Hospital / Gov
Medical Centres
Member
Member
Member
Member
A-Health Maximiser
inquiries: my.ahm@aia.com
Scenario 1:
Contract Incepted : 1 June 2013 with contribution of RM1,250,000 and claims of RM300,000 as at 30 Nov
2013
Surplus payout for : Pro-rated Tabarru (contribution minus Wakalah 30%)
FYE 2013 RM1,250,000 x (100%- 30%) x 183/365 = RM438,699
less claim: RM438,699 - RM300,000= RM138,699
: This eligible surplus of RM 13,869 will be payable upon renewal in Y2014. The remaining
portion (1 Dec 2013 to 1 May 2014) will be determined at FYE2014 and payable in Y2015
Scenario 2:
: No surplus will be payable upon renewal in Y2014 since the claim is higher than
pro-rated Tabarru. The remaining portion (1 Dec 2013 to 1 May 2014) will be determined at
FYE2014 and payable in Y2015
Basic Plan: Death Benefit for all causes Basic Plan: Death Benefit for all causes
Optional Riders - With extra contribution: Optional Riders - With extra contribution:
1.Non-accelerated Critical Illness Benefit 1.Non-accelerated Critical Illness Benefit
(50% of Basic Death Benefit) 2.Executive Screening
Max Entry Age : Up to 60 yrs old Max Entry Age : Up to 65 yrs old
Eligibility age Min Entry Age : 16 yrs old Min Entry Age : 16 yrs old
Renewable Age : Up to 65 yrs old Renewable Age : Up to 70 yrs old
12 months Pre-Existing
Not Applicable Applicable if headcount < 51
Conditions
Pre-Existing Conditions -
12 month of Pre-Existing Conditions
TPD/PPD Applicable.
- Applicable regardless of headcount
90 days: Carcinoma-in-situ
Pre-Existing Conditions - CI
Applicable. N/A
Basic: Group Hospitalisation and Surgical Basic: Group Hospitalisation and Surgical
Care Benefit Care Benefit
Optional Riders: With extra contribution Optional Riders: With extra contribution
1.Out-Patient General Practitioner Benefit 1.Out-Patient General Practitioner Benefit
2.Out-Patient Specialist Benefit 2.Out-Patient Specialist Benefit
3.Out-Patient Diagnostic Services 3.Out-Patient Diagnostic Services
4.Executive Screening
LOG facility Applicable regardless of the contribution Only applicable if the medical
size contribution size is > RM10K
Issued for Admission + 60 days follow up No LOG for inner limit plans.
Issued for Admission only
Compassionate Allowance RM5K RM10K
AIA confidential and proprietary information. Not for distribution. 59
COMPARISON between SMI PLAN GHS
with A-SME Plus-i GHS