Allianz Prime Care+

The cost of insurance for Prime Care+ is levied through deduction of units from the investment account of your policy. The amount to be charged will depend on the amount chosen, as well as other factors such as age, sex, health status, smoker status, etc.

1. Any illness or surgery which does not fall under the definition of Critical Illness, Diabetes Related Disease or Catastrophic Critical Illness as defined herein;

 

2. If the signs or symptoms of the conditions below manifested prior to or within:

a) Sixty (60) days*:

i. Cancer - of specified severity and does not cover very early cancers, Heart Attack of specified severity, Coronary Artery By-Pass Surgery, Serious Coronary Artery Disease, and Angioplasty and Other Invasive Treatments for Coronary Artery Disease under Advanced Stage Critical Illness;

ii. all Critical Illnesses defined under Early Stage and Intermediate Stage; or

iii. all Diabetic Related Diseases iv. all Catastrophic CI Benefit Diseases

b) thirty (30) days from the Issue Date or Reinstatement Date of this supplementary contract, whichever is later; for all other Critical Illnesses defined under Advanced Stage.

 

3. Any Critical Illness, Diabetes Related Disease or Catastrophic Critical Illness arises directly or indirectly from a Pre-Existing Condition (as defined in the supplementary contract), which existed prior to the Issue Date or Reinstatement Date of the supplementary contract, whichever is later;

 

4. Any Critical Illness, Diabetes Related Disease or Catastrophic Critical Illness, which in our opinion, was caused directly or indirectly by the existence of Acquired Immune Deficiency Syndrome (AIDS) or by the presence of any Human Immuno-deficiency Virus (HIV) infection. We reserve the right to require the life assured to undergo a blood test for HIV as a condition precedent to acceptance of any claim. This exclusion does not apply to HIV Infection due to Blood Transfusion or Occupationally Acquired Human Immunodeficiency Virus (HIV) Infection as defined in the supplementary contract. For the purpose of the supplementary contract,

a) the definition of AIDS shall be that used by the World Health Organization in 1987, or any subsequent revision by the World Health Organization of that definition.

b) the infection shall be deemed to have occurred where in our opinion blood or other relevant test(s) indicate either the presence of any Human Immunodeficiency Virus or Antibodies to such a Virus.

 

5. Any Critical Illness which is within the same or lower stage of the previous Critical Illness claim category, save and except for Angioplasty and Other Invasive Treatments for Major Coronary Artery Disease;

 

6. Any Critical Illness, Diabetes Related Disease or Catastrophic Critical Illness was diagnosed due, directly or indirectly, to a congenital defect or disease, which was manifested or was diagnosed before the Insured attains 17 years of age;

 

7. Any of the Critical Illness, Diabetes Related Disease or Catastrophic Critical Illness which is caused by a self-inflicted injury;

 

8. Any Critical Illness, Diabetes Related Disease or Catastrophic Critical Illness Event resulting directly from alcohol or drug abuse;

 

9. If the life assured did not survive for at least seven (7) days after the diagnosis of an Early Stage Critical Illness; or

 

10. If the life assured did not survive for at least thirty (30) days after:

a) the diagnosis of an Intermediate Stage Critical Illness; or

b) the diagnosis of an Advanced Stage Critical Illness; or

c ) undergoing Angioplasty and Other Invasive Treatment for Coronary Artery Disease; or

d) the diagnosis of a Diabetic Related Disease; or

e) the diagnosis of a Catastrophic Critical Illness.

You should satisfy yourself that this rider will best serve your needs and that the cost of insurance under this rider is affordable. A free look period of fifteen (15) days or such longer period as may be specified by Bank Negara Malaysia, will be given from the receipt date of the supplementary contract for you to review its suitability and should you choose to return this rider within the period, the amount to be refunded shall be the cost of insurance deducted for this rider less any expenses incurred for medical examination.

The Cost of Insurance is not guaranteed and We reserve the right to revise the Cost of Insurance by giving the policyholder three months written notice prior to the next policy anniversary. The adjustment in Cost of Insurance, if any, will aim to reflect Our claim experience. The Cost of Insurance may also be revised under other justified circumstances. Such changes, if any, shall be applicable to all Policy Owners irrespective of their claim experience.

Service Tax (if applicable) will be charged at the rate of 6% on the applicable portion of your premium/fee/charges for the period of insurance coverage.