Reimbursement of the Reasonable and Customary Charges incurred for Medically Necessary treatments received when the life assured is hospitalised due to COVID-19 during the Coverage Period.

The reimbursement will be provided based on the limits, terms and conditions* stated in the policy documents of the eligible medical plan.

*Except for the general exclusion in the medical policies referring to communicable disease requiring quarantine by law where COVID-19 coverage is excluded.

1.     A waiting period of 30 days applies from the risk commencement date/ risk effective date of the medical plan/ rider, or reinstatement date of the policy, whichever is later.

2.     The policies that result in the eligibility of this coverage must be in-force upon diagnosis, during the treatment due to COVID-19 and upon claims submission.

3.     Great Eastern Life will assess the reimbursement claim based on Medically Necessary and Reasonable and Customary Charges, as explained below.

-     “Medically Necessary” means a medical service which is:-

(a)   consistent with the diagnosis and customary medical treatment for a covered Disability, and

(b)   in accordance with standards of good medical practice, consistent with current standard of professional medical care, and of proven medical benefits, and

(c)    not for the convenience of the life assured or the doctor, physician or surgeon, and unable to be reasonably rendered out of hospital (if admitted as an Inpatient), and

(d)   not of an experimental, investigational or research nature, preventive or screening nature, and

(e)   for which the charges are fair, reasonable and customary for the Disability.

4.   The RM20 million is a combined limit for Great Eastern Life Assurance (Malaysia) Berhad, Great Eastern General Insurance (Malaysia) Berhad and Great Eastern Takaful Berhad.

5.   The Company reserves the right to change and/or terminate the Programme earlier, should the prevailing conditions and circumstances change such as when COVID-19 is no longer required to be quarantined by law.