MEDI TOP UP reimburses the actual medically necessary expenses incurred during hospitalisation and other related benefit where such expenses have exceeded the excess amount stated in the selected plan.

PERSONS ELIGIBLE

• Malaysians who reside in Malaysia for more than 6 months continuously while the Policy is in force.
• Persons who are healthy with no existing medical condition, no recurring illness/disease and/or long term medical treatment
• Persons aged between 15 days and 55 years. Policies are renewable up to age 70, subject to the discretion of the Company.

BENEFITS

Covered benefits during hospitalisation

1. Daily Room and Board
   The actual room and board charges made by the Hospital when the Insured Person is registered as a bed patient. This benefit shall also include general nursing services, except special nursing and doctor services. In no event shall the benefit under this Paragraph (a) exceed the Daily Room and Board set forth in the selected plan
2. Intensive Care Unit
   The actual intensive care ward charges made by the Hospital in which the Insured Person is a bed patient.
3. Hospital Miscellaneous Services
   The actual charges made by the Hospital during hospital confinement of the Insured Person for the following
   • Use of Operating Room
   • Drugs and Medicine consumed on premises
   • Dressings, Ordinary Splints and Plaster Casts
   • X-Ray
   • Laboratory examinations
   • Electrocardiograms
   • Physical Therapy
   • Basal Metabolism Tests
   • Intravenous Injections and Solutions
   • Administration of Blood and Blood Plasma
   • Government Service Tax (5% of eligible expenses reimbursable)
4. Surgical Fees
   The actual fees charged by the Surgeon, including the Surgeon's visits to the Insured Person during hospital confinement and post-operative care.
5. Anaesthetist's Fees
   The actual fees charged by the anaesthetist for the supply and administration of anesthesia during surgical operation.
6. Operating Theatre
   The actual charge for usage of operating theatre incidental to the surgical procedure.
7. Daily in-hospital Physician's Visit
   The actual fees charged by the attending doctor for daily bedside visits to the Insured Person during hospital confinement.
8. Ambulance Fees
   The actual charges incurred for medically necessary domestic ambulance services (inclusive of attendance) to and/or from the Hospital, provided the Insured is/has been hospitalised.
9. Organ Transplantation
   The actual charges incurred for heart, kidney, lung or liver transplantation. The cost of acquisition of the organ and all charges incurred by the donor are not covered.

Benefits Payable when Insured Person is diagnosed to have terminal illness and confined at home

1. Purchase of therapeutic and/or physiotherapy equipment
   The actual charges incurred in purchasing appliance/equipment which is confirmed to be necessary by the treating doctor, subject to the limit as stated in the selected plan
2. Medication
   A lump sum payment to the Insured Person or legal representative for purchase of medicine when diagnosed by the treating doctor to be terminally ill, subject to the limit as stated in the selected plan

Medical Evacuation/Repatriation of mortal remains
The actual charges incurred for emergency medical evacuation of the Insured Person due to an accident whilst overseas or for the transportation of the mortal remains of the deceased Insured Person from place of accident back to Malaysia, subject to the limit as stated in the selected plan.

Bereavement Benefits
The amount as stated in the selected plan shall be paid to the legal representatives when the Insured Person passed away in Hospital after having been hospitalised for more than 60 days consecutively

Emergency Hotline
In the event of a medical emergency or assistance or advice is needed while travelling abroad, the Insured Person can contact Europ Assistance at (603)7660 9199 / 7665 4717 at any time in the day. They will liaise with Jerneh Insurance Bhd on matters of indemnity and will, if required and requested, arrange for the evacuation or repatriation of the Insured Person at either the Insured Person's or the legal representative's expense.

SPECIAL PROVISIONS
Geographical Territory
All benefits provided in this Policy are applicable in Malaysia for 24 hours a day, with the exception of an emergency or an accident while the Insured Person is overseas or if there is no available treatment in Malaysia. In the event that the Insured Person seeks treatment outside Malaysia, the benefits in respect of the treatment shall be limited to 25% of the actual costs incurred after conversion to Ringgit Malaysia and shall exclude the cost of transport to the place of treatment

Comatose
In the event the Insured Person is in a state of coma as a result of an illness or accident, the liability of Jerneh Insurance Bhd in respect of the covered benefits during hospitalisation shall be limited to a period of six months from the date the Insured Person is in coma.

Succeeding Policyholder
In the event of death of the Policyholder while this Policy is in force, the Policyholder's legal spouse if at the time is an Insured Person, shall automatically become the Policyholder and all reference in this Policy to the Policyholder shall thereafter mean such spouse.

DEFINITIONS

Any one disability shall mean all disabilities arising from the same cause including any and all complications therefrom, except after thirty (30) days following the latest discharge from the Hospital, a subsequent disability from the same cause shall be considered as a new disability.

Pre-existing illness/disease shall mean any medical conditions of the Insured Person

• which have been diagnosed, or
• for which symptoms existed that would cause an ordinary prudent person to seek diagnosis, care or treatment, or
• for which medical treatment was recommended by a legally qualified physician, irrespective of whether treatment was actually received.

Prior to the commencement of this Policy or, if the insurance is subsequently reinstated, the date of reinstatement of insurance of the Insured Person.

Congenital conditions refer to congenital anomalies as well as neo-natal physical abnormalities developing within six (6) months of birth

Terminal Illness shall mean the phase in the last part of life, when cure is no longer possible and disease modification produces diminishing returns. Thus, medical effort has turned away from active therapy and become concentrated on the relief of symptoms.

Emergency refers to an event whereby immediate medical attention is required within 12 hours for injury, illness or symptoms which are sudden and severe and failing which will be life threatening.