Introduction to risk management
Lecturer: Dr. Jafarian Moisen
(DBA2063)
Name and ID of our group :
NO
1
2
3
STUDENT NAME
LIM KAI VOON
SIN ZHEN LAM
PEA YU XIN
STUDENT ID
1002370973
1002372238
1002371607
Table of Contents
Introduction ..................................................................................................................................... 3
All policy line offered by GREAT EASTERN............................................................................... 5
LIFE INSURANCE .................................................................................................................... 5
SMARTPROTECT Wealth Max ............................................................................................ 5
Great Term Direct ................................................................................................................... 9
SMART PROTECT YOU .................................................................................................... 12
Great Generational Care ....................................................................................................... 16
HOSPITAL & SURGICAL INSURANCE .............................................................................. 22
EasiMed Active ..................................................................................................................... 22
HEALTH INSURANCE........................................................................................................... 27
GREAT Medic Lite Secure ................................................................................................... 27
GREAT Health Direct........................................................................................................... 30
PERSONAL ACCIDENT INSURANCE ................................................................................. 33
Great Shield Active ............................................................................................................... 33
Hospital and surgical insurance ................................................................................................ 40
EasiMed Active ..................................................................................................................... 46
Wealth Accumulation ............................................................................................................... 51
Smart Invest Premier............................................................................................................. 51
Great Multi-Gen Wealth ....................................................................................................... 54
Great Flexi Plus..................................................................................................................... 58
Travel insurance ........................................................................................................................ 62
Travel For More+ .................................................................................................................. 62
Great Voyager+ ..................................................................................................................... 66
Motor insurance ........................................................................................................................ 70
Private Car Comprehensive .................................................................................................. 70
Home insurance ........................................................................................................................ 72
GREAT Home 360 ............................................................................................................... 72
Sports insurance ........................................................................................................................ 80
EASI GOLF .......................................................................................................................... 80
Group Insurance ........................................................................................................................ 83
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Great BizCare for SMEs ....................................................................................................... 83
Group Multiple Benefits Insurance Scheme (GMBIS) ......................................................... 85
General Insurance ..................................................................................................................... 87
Easi-Biz Standard/Easi-Biz Premier ..................................................................................... 87
Easi Health SME @ SME Medical Insurance for Employees .............................................. 90
Financial position of GREAT EASTERN .................................................................................... 93
Financial Ratios for Great Eatern Annual Report 2023 ........................................................ 96
New initiatives that were introduced during Covid-19 pandemic ................................................ 99
Reference .................................................................................................................................... 100
2
Introduction
Great Eastern Life started as a representative office of The Great Eastern Life Assurance
Company Limited in 1908. The Malaysian operations were later transferred to a public company
incorporated in Malaysia, GELM pursuant to the Scheme of Transfer of Business. In 1998, the
Company was certified as "The Oldest and Largest Life Insurer" in Malaysia by The Malaysia
Book of Records.
On 31 December 2023, GELM has over RM91 billion worth of assets, over 4.0 million in-force
policies and close to 22,000 agents nationwide. Today, the company still has as many as 21
branches in Malaysia and offer a various of products such as life insurance products, investmentlinked funds, mortgage protection, business protection, staff benefits, healthcare insurance,
including group health benefits. Great Eastern Life (GELM) is a wholly owned subsidiary of
Great Eastern Holding Limited (GEH), and its ultimate holding company is Overseas-Chinese
Banking Corporation Limited (OCBC).
For over years, GELM is a benchmark in the industry for our leadership. GELM recently became
a very special and great history in 2024 as life insurance stand-alone company to be given the
Readers Digest Trusted Brand Gold Award for its Trusted Brand record 21st year running in Life
Insurance category. In addition, GELM stood against in Health Insurance category with Gold for
the 7th year in a row.
It won The BrandLaureate BestBrands Awards 2023-2024, Nation's Choice in the category of
insurance, in recognition of its great brand reputation and fantastic customer loyalty. For the last
3 consecutive years, Great Eastern has been accorded the Brand of the Year at The
BrandLaureate BestBrands Awards, a prestigious award which recognizes the company that sets
the benchmark for excellence in the insurance industry. It also received the Top Brand in Putra
Brand Awards for three consecutive years in its Banking, Investment, & Insurance category,
among many other awards.
Great Eastern Life is committed to making life great for its customers by ensuring their financial
security and fostering good health and meaningful relationships. Its vision is to be the leading
financial services provider in Asia, known for its excellence.
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Great Eastern ensures integrity, fairness, and customer-centricity; thus, the transactions are
transparent, and the services for financial planning are comprehensively performed. Besides this,
the other important values are innovation, continuous improvement, teamwork, and social
responsibility, providing an enabling environment to grow and collaborate. In everything it does,
Great Eastern strives to create value and is committed to active contribution to the community.
4
All policy line offered by GREAT EASTERN
LIFE INSURANCE
SMARTPROTECT Wealth Max
a. Coverage (Perils)
•
Minimum coverage of RM500,000
•
Death Benefit\
o
Pays out the basic sum assured plus any additional sum assured, or the total
investment value, whichever is higher.
•
Total and Permanent Disability (TPD) Benefit:
o
If TPD occurs before age 75, the payout is basic sum assured plus additional
sum assured, minus total investment value.
•
Accidental Death Benefit:
o
General Accidental Death: Extra 100% of the sum assured.
o
Accidental Death in Public Transport: Extra 200% of the sum assured.
•
Additional 5% sum assured every 10 years, up to 30%.
•
Daily cash benefit for hospitalization in Malaysian government hospitals.
•
Optional riders available for added protection (critical illness, premium waiver, etc.).
5
b. Provisions (Conditions)
1. Coverage Terms
a. It can be up to age 70, 80, or 90.
2. Premium Payment Terms
a. Options of 5, 10, or 20 years.
3. No-Lapse Guarantee:
a. The policy remains in force for the first 6 years, even if the total investment value
becomes zero (as long the premiums are paid on time).
4. Policy Maturity Conversion:
a. At policy maturity (but not later than age 80), policyholders may convert to an
endowment or whole life policy without medical underwriting.
5. Exclusions:
a. No suicide benefits within the first policy year, self-inflicted TPD, and accidental
death occurring more than 90 days after the accident.
c. Sum of Benefits
1. Death/TPD Benefit: Basic sum assured plus additional sum assured, or total investment
value, whichever is higher.
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2. Accidental Death:
a. General Accidents: Extra 100% of sum assured.
b. Public Transport Accidents: Extra 200% of sum assured.
3. Booster Rewards: Every 10 years, policyholders receive an extra 5% of sum assured, up
to a maximum of 30%.
4. Maturity Booster:
a. Coverage ≤ 19 years: Extra 2% sum assured.
b. Coverage 20–34 years: Extra 4% sum assured.
c. Coverage ≥ 35 years: Extra 5% sum assured.
5. Double Maturity Booster: Maturity booster would be doubled if no more than 5 partial
withdrawals were made and all premiums are paid.
d. How Much Premium?
1. Premium rates depend on factors like age, gender, health status, smoking habits, and
coverage amount.
2. Charges & Fees:
a. Monthly Policy Fee: RM6.00.
b. Fund Management Charges: 0.50% – 1.50% per annum, depending on the
selected fund.
c. Insurance Charges: Deducted monthly based on net sum assured, age, gender,
smoking status, and health condition.
3. Premiums are not guaranteed and may be revised upon renewal with a 3-month advance
notice.
7
e. Claim Documents
1. Death Claims:
a. Completed claim form.
b. Death certificate.
c. Beneficiary’s identification documents.
d. Medical records (if applicable).
2. TPD Claims:
a. Doctor’s report confirming TPD.
b. Medical records & hospital reports.
3. Accidental Death Claims:
a. Police report (if applicable).
b. Autopsy/post-mortem report (if required).
c. Beneficiary’s identification documents.
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Great Term Direct
a. Coverage (Perils)
1. Death Coverage:
a. If the insured passes away during the policy period, the designated beneficiary
will receive a lump-sum payout.
b. The payout consists of:
i. RM5,000 Bereavement Benefit (paid upfront).
ii. The remaining Basic Sum Assured after deducting the Bereavement
Benefit.
2. Total and Permanent Disability (TPD) Coverage:
a. If the insured suffers TPD before age 65, insured will receive 100% of the Basic
Sum Assured.
b. The payout helps provide financial support in case the insured is unable to work.
3. Available Sum Assured Options:
Plan
Basic Sum
1
2
3
4
5
RM100,000
RM200,000
RM300,000
RM400,000
RM500,000
Assured
b. Provisions (Conditions)
1. Eligibility:
a. Available for Malaysian citizens only.
b. Age requirement: 18 to 60 years next birthday.
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c. Must reside in Malaysia with a valid email & mobile number.
d. No pre-existing serious medical conditions.
2. Policy Term & Renewal:
a. Coverage is available until age 80 next birthday.
b. Guaranteed renewal means the policyholder can renew the plan without additional
medical underwriting.
3. Exclusions:
a. No payout for suicide within the first policy year, whether sane or insane.
b. TPD due to self-inflicted injuries is not covered.
c. Sum of Benefits
1. Death Benefit:
a. RM5,000 Bereavement Benefit is paid immediately to help cover funeral or
urgent expenses.
b. The remaining Basic Sum Assured (after deducting RM5,000) is then paid to the
beneficiary.
2. TPD Benefit:
a. If the insured is totally and permanently disabled before age 65, they receive
100% of the Basic Sum Assured.
b. This provides financial support in the event of disability.
3. Sum Assured Options:
a. RM100,000 / RM200,000 / RM300,000 / RM400,000 / RM500,000.
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d. How Much Premium?
1. Premium Calculation Factors:
a. Based on plan selected, age next birthday, gender, and smoking status.
b. The older the insured, the higher the premium.
c. Premiums increase with age.
2. Premium Payment Duration:
a. Premiums must be paid until the insured reaches age 80.
e. Claim Documents
1. Death Claims:
a. Completed Death Claim Form.
b. Original Death Certificate.
c. Beneficiary’s Identification Documents (IC or Passport).
d. Medical report (if applicable).
2. TPD Claims:
a. Completed TPD Claim Form.
b. Medical Report from a Certified Doctor confirming TPD.
c. Doctor’s Assessment Report.
d. Proof of Disability (e.g., X-rays, MRI, or relevant medical tests).
3. Claim Submission Period:
a. Claims must be submitted within the stipulated period, as per policy terms.
b. Any delay in submission may require additional supporting documents.
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SMART PROTECT YOU
a. Coverage (Perils)
SmartProtect You provides coverage for:
1. Death Benefit – Pays out the Basic Sum Assured + Additional Sum Assured + Total
Investment Value.
2. Total and Permanent Disability (TPD) Benefit – Same as the death benefit but only
applicable before age 75.
3. Additional 1% Sum Assured Increase Per Year – Increases the sum assured annually, up
to a maximum of 40%
4. Optional Riders for Additional Protection:
a. SmartMedic Shield – Medical protection.
b. Smart Multi Critical Care – Covers 188 critical illness conditions across different
stages.
c. IL Critical Illness Benefit Rider – Additional lump sum payout for critical illness.
d. IL Comprehensive Accident Benefits Xtra Rider – Coverage for death and
injuries due to accidents.
e. IL Hospitalisation Benefits Rider – Pays daily hospital income.
f. IL Premium Waiver Extra Rider – Waives premiums upon disability or critical
illness.
b. Provisions (Conditions)
1. Policy Term:
a. Coverage available up to age 80 or 100 next birthday.
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2. No-Lapse Guarantee:
a. Ensures the policy remains in force for the first 3 policy years, as long as
premiums are paid on time and no withdrawals are made.
3. Exclusions:
a. Death by suicide within the first policy year.
b. TPD caused by self-inflicted injuries.
c. TPD that existed before policy commencement or reinstatement.
4. Fund Management:
a. Various investment-linked funds available, with charges between 0.50% to 1.50%
per annum.
c. Sum of Benefits
1. Death or TPD Benefit Calculation:
a. Basic Sum Assured
b. Additional Sum Assured (1% increase per year, up to 40%)
c. Total Investment Value
d. Example: If a person insured for RM100,000 dies after 40 years, the payout =
RM100,000 (Basic) + RM40,000 (Additional) + Investment Value.
d. How Much Premium?
1. Minimum Premium:
a. RM100 per month or RM1,200 per year.
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2. Premium Structure:
a. Level Premiums: Fixed throughout for policies up to age 80.
b. Step-Up Premiums: For policies up to age 100, with fixed premiums until age 70,
75, or 80, then increasing every 5 years.
3. Additional Fees & Charges:
a. Monthly Policy Fee: RM6.00
b. Insurance Charges: Based on sum assured, age, gender, smoking status,
occupation, and health condition.
c. Fund Management Charges: 0.50% – 1.50% per annum, depending on chosen
investment funds.
e. Claim Documents
1. Death Claim:
a. Original Death Certificate (certified true copy)
b. Claimant’s NRIC (or passport, if applicable)
c. Claimant’s bank account details for payout
d. Medical records & reports (if death occurred due to illness)
e. Police report & post-mortem report (if death occurred due to an accident)
f. Original policy document
2. Total and Permanent Disability (TPD) Claim:
a. Completed TPD claim form (provided by Great Eastern)
b. Medical report from a certified doctor confirming permanent disability
c. Policyholder’s NRIC (or passport, if applicable)
d. TPD assessment reports
e. Bank account details for payout
f. Original policy document
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3. Critical Illness Claim (if rider is attached):
a. Completed Critical Illness Claim form
b. Diagnosis report from a specialist doctor
c. Medical test results (e.g., MRI, CT scan, biopsy, blood test)
d. Hospital discharge summary
e. Policyholder’s NRIC
f. Original policy document
4. Hospitalisation Claim (if rider is attached):
a. Hospitalisation Claim Form
b. Hospital admission and discharge summary
c. Original medical bills & receipts
d. Doctor’s report confirming hospitalisation reason
e. NRIC of policyholder
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Great Generational Care
a. Coverage (Perils)
1. Critical Illness Coverage
a. Covers critical illnesses, including Alzheimer’s, cancer, Parkinson’s, heart attack,
stroke, kidney failure, etc.
b. Payout: 100% of Basic Sum Assured or Total Premiums Paid, whichever is
higher.
c. Angioplasty & other invasive coronary artery treatments – Only 10% payout,
capped at RM25,000 per life.
2. Death or Total & Permanent Disability (TPD) Coverage
a. Payout: 100% of Basic Sum Assured or Total Premiums Paid, whichever is
higher.
3. Child Protect Benefit (Complimentary for Children)
a. Covers critical illnesses and child-specific illnesses.
b. Automatically extends coverage to all children (including future-born), up to age
18.
c. Payout (per child):
i. 1st policy year: 5% of Basic Sum Assured (max RM12,500)
ii. 2nd policy year: 10% of Basic Sum Assured (max RM25,000)
iii. 3rd year & beyond: 20% of Basic Sum Assured (max RM50,000)
d. Max lifetime payout per child: RM100,000.
e. No limit on number of claims, but only one payout per child, unless the first claim
is for angioplasty.
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4. Optional Parent Protect Rider (Covers Parents)
a. Covers Alzheimer’s, Cancer, Parkinson’s (Advanced Stage).
b. Payout (per parent):
i. 1st policy year: Refund of total premiums paid.
ii. 2nd policy year: 10% of Basic Sum Assured (max RM25,000).
iii. 3rd year & beyond: 20% of Basic Sum Assured (max RM50,000).
c. Max lifetime payout per parent: RM100,000.
d. Claimable twice (but only once per parent).
5. Emotional Support Benefit
a. Additional 1% of Basic Sum Assured, capped at RM10,000 per life, paid upon
claim of Child Protect Benefit or Parent Protect Rider.
6. Maturity Benefit
a. Upon maturity at age 80, pays 100% of Basic Sum Assured or Total Premiums
Paid, whichever is higher.
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b. Provisions (Conditions)
•
Who Can Apply?
a. Minimum entry age: 17 years next birthday
b. Maximum entry age: 60 years next birthday
•
Coverage Term
a. Up to age 80 (policyholder).
b. Parent Protect Rider covers parents up to age 100.
c. Child Protect Benefit covers children up to age 18.
•
Exclusions (No Benefits Paid If):
a. Death by suicide within first policy year.
b. TPD due to:
i. Self-inflicted injuries.
ii. Skydiving, aerial flights (except as fare-paying passengers).
iii. Criminal acts or war.
c. Critical Illness due to:
i. Pre-existing conditions before policy starts or reinstates.
ii. Diagnosed within the waiting period (30-60 days).
iii. AIDS/HIV (except specific conditions covered).
iv. Drug or alcohol abuse.
v. War or criminal acts.
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•
Child Protect Benefit Exclusions:
a. Child above 18 when illness occurs.
b. Death occurs within 14 days after diagnosis.
c. Congenital conditions diagnosed before age 1.
•
Parent Protect Rider Exclusions:
a. Parents that are above 100 when illness occurs.
b. Death occurs within 14 days after diagnosis.
c. Same exclusions as critical illness claims.
c. Sum of Benefits
•
Critical Illness / Death / TPD: 100% of Basic Sum Assured or Total Premiums Paid,
whichever is higher.
•
Child Protect Benefit up to RM100,000 per child.
•
Parent Protect Rider up to RM100,000 per parent.
•
Maturity Benefit: 100% of Basic Sum Assured or Total Premiums Paid, whichever is
higher.
•
Emotional Support Benefit: Extra 1% of Basic Sum Assured, capped at RM10,000 per
life.
d. How Much Premium?
•
Minimum Sum Assured: RM50,000
•
Maximum Sum Assured: RM5,000,000
•
Premium Rates :
a. Premium depends on genders , smoke status , age & total sum assured
•
Parent Protect Rider Premium:
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a. Age 40: RM40.00 per RM1,000 SA
b. Age 50: RM60.05 per RM1,000 SA
c. Age 60: RM60.10 per RM1,000 SA
e. Claim Documents
1. Critical Illness Claim:
•
Claim form (provided by Great Eastern).
•
Medical report from a specialist confirming the illness.
•
Lab results (MRI, CT scan, biopsy, blood test, etc.).
•
Hospital discharge summary.
•
NRIC of policyholder.
2. Death Claim:
•
Death certificate (certified true copy).
•
NRIC of claimant & deceased.
•
Medical records (if death due to illness).
•
Police report & post-mortem report (if death due to accident).
•
Policy document.
3. TPD Claim:
•
TPD claim form.
•
Medical report confirming permanent disability.
•
Bank details for payout.
•
NRIC of policyholder.
20
4. Child Protect Benefit Claim:
•
Child’s birth certificate & NRIC.
•
Medical report confirming illness.
•
Hospital records & discharge summary.
•
Lab test results.
5. Parent Protect Rider Claim:
•
Medical report confirming critical illness (Alzheimer’s, Cancer, Parkinson’s).
•
Parent’s NRIC.
•
Hospital records & diagnosis confirmation.
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HOSPITAL & SURGICAL INSURANCE
EasiMed Active
a. Coverage (Perils)
1. Inpatient & Outpatient Coverage:
a. Covers room and board, ICU fees, hospital supplies, surgical fees, operating
theatre charges, and anesthetist fees.
b. Daycare procedures and in-hospital physician visits included.
2. Pre & Post-Hospitalization Benefits:
a. Covers pre-hospital diagnostic tests and specialist consultations (60 days before
hospitalization).
b. Post-hospitalization treatment (60 days after discharge) covered.
3. Outpatient Treatment:
a. Cancer & Kidney Dialysis Treatment: Up to RM60,000 per year.
b. Physiotherapy Treatment: Covered for 90 days after discharge.
4. Emergency & Additional Benefits:
a. Emergency Accidental Outpatient Treatment: Covered within 24 hours of the
accident, with follow-ups for 60 days.
b. Ambulance Fees covered.
c. Home nursing care included.
d. Organ transplant & medical report fees covered.
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5. Mental Health Benefit:
a. RM1,500 allowance for hospitalization due to Major Depressive Disorder,
Bipolar Disorder, or Schizophrenia.
6. Annual & Lifetime Limits:
a. Overall Annual Limit up to RM120,000.
b. Unlimited Overall Lifetime Limit .
7. Optional Benefits (Additional Premium Required):
a. Outpatient Chiropractic Treatment: RM150 per visit, up to RM1,000 per year.
b. Hospitalization due to High-Risk Sports Injuries: Up to RM50,000.
b. Provisions (Conditions)
1. Eligibility:
a. Available to individuals aged 30 to 40 years old.
b. Coverage is renewable annually up to age 80.
2. Waiting Period:
a. 30-day waiting period from the policy's effective date for illness coverage (not
applicable for accidents).
b. If the policy lapses and is reinstated, the waiting period restarts.
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3. Overseas Treatment:
a. Treatment outside Malaysia is limited to reasonable and customary charges for
equivalent treatment in Malaysia.
b. Transport costs to overseas facilities are not covered.
4. Exclusions:
1.
a. Pre-existing conditions and specified illnesses in the first 120 days.
b. Pregnancy, congenital conditions, cosmetic surgery, dental treatments (except
accident-related cases).
c. Racing or hazardous sports (unless added as an optional benefit).
d. War, terrorism, radiation, nuclear contamination, HIV/AIDS, and self-inflicted
injuries.
c. Sum of Benefits
1. Hospitalization Coverage:
a. Room & Board: Up to RM450 per day (max 120 days).
b. ICU Fees: Covered as charged (max 20 days).
c. Surgical Fees, Operating Theatre, Anesthetist Fees: Covered as charged.
d. Hospital Supplies & Services: Covered.
e. Daily Cash Allowance at Government Hospital: RM100 per day (max 120 days).
2. Pre & Post-Hospitalization:
a. Pre-Hospital Diagnostic Tests & Specialist Consultations: Covered for 60 days
before hospitalization.
b. Post-Hospitalization Treatment: Covered for 60 days after discharge.
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3. Emergency & Outpatient Treatments:
a. Cancer & Kidney Dialysis Treatment covered to RM60,000 per year.
b. Physiotherapy Treatment covered for 90 days after discharge.
c. For Emergency Accidental Outpatient Treatment covered within 24 hours of the
accident, with follow-ups for 60 days.
d. For Emergency Accidental Dental Treatment covered within 24 hours of the
accident, with follow-ups for 60 days.
e. Covered Ambulance Fees
f. Covered Medical Report Fees.
4. Mental Health Benefit:
a. RM1,500 allowance for hospitalization due to Major Depressive Disorder,
Bipolar Disorder, or Schizophrenia.
5. No Claim Renewal Bonus (NCRB):
a. 10% bonus on Overall Annual Limit per year, up to 50% after 5 years (if no
claims are made).
b. If a claim is made, NCRB stops accumulating.
6. Optional Benefits:
a. Outpatient Chiropractic Treatment: RM150 per visit, up to RM1,000 per year.
b. Hospitalization due to High-Risk Sports Injuries: Up to RM50,000.
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d. How Much Premium?
1. Premium Rates Based on Age & Plan:
a. Premiums vary based on age at next birthday and chosen plan.
b. Higher plans (AM450) have higher premiums compared to basic plans (AM220).
2. Premium Changes:
a. Premiums increase as the policyholder ages.
b. Not guaranteed and may be revised based on claims experience and medical cost
inflation.
e. Claim Documents
1. Hospitalization & Medical Expense Claims:
a. Completed claim form.
b. Original medical bills & receipts.
c. Doctor’s report & discharge summary
2. Emergency Accidental Outpatient Treatment Claims:
a. Police report (if applicable).
b. Medical report & treatment bills.
3. Exclusions for Overseas Treatment:
a. No coverage for medical treatment outside Malaysia if the insured resides/travels
abroad for more than 90 consecutive days.
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HEALTH INSURANCE
GREAT Medic Lite Secure
a. Coverage (Perils)
1. Offers basic medical coverage with a deductible each policy year.
2. Covers hospital room & board (up to 180 days per policy year).
3. Surgical fees and Intensive Care Unit (ICU) charges are covered.
4. Pre-hospitalization diagnostic tests (within 60 days before admission).
5. Post-hospitalization treatment (within 90 days after discharge).
6. Outpatient treatments for cancer and kidney dialysis.
7. Emergency accidental outpatient treatment (up to 30 days from the accident date).
8. Accidental Death Benefit.
9. Daily cash allowance for admission to Malaysian government hospitals (RM50 per day,
up to 120 days per year).
b. Provisions (Conditions)
1) Only available to existing policyholders of eligible medical plans/riders.
2) No waiting period or medical underwriting is required when switching from eligible
plans.
3) Deductible starts from RM2,500 per policy year.
4) Hospitalization costs reimbursed based on reasonable and customary charges.
5) Policyholders may choose from five different plan options.
6) Worldwide coverage, but subject to a 90-day limit for treatment outside Malaysia (except
Singapore & Brunei).
7) Policy renewal required annually.
8) Policy cancellation allows for a proportionate refund of the last premium paid (if no
claims were made).
9) Exclusions & Limitations:
o
Death certificate.
o
Pre-existing conditions
27
o
Specified illnesses within the first 120 days
o
Medical conditions arising within the first 30 days (except for injury)
o
Cosmetic & dental treatments, including Lasik, prosthetics, and orthodontics
o
Private nursing, hospice care, and non-essential treatments
o
Congenital conditions & hereditary disorders
o
Pregnancy, childbirth, infertility treatments
o
Hospitalisation for investigation or preventive care
o
Self-inflicted injuries, suicide (sane or insane)
o
War, terrorism, riots, armed forces duty
o
Radiation exposure & nuclear contamination
o
Organ donation & transplant costs
o
Sleep disorders, hormone therapy, alternative treatments
o
Work-related injuries covered by other insurance
o
Mental disorders & psychological conditions
o
Non-medical expenses (e.g., TV, phone, admission kits, taxes)
o
Hazardous sports & illegal activities
o
Private flying (except as a commercial passenger)
o
Sex reassignment procedures
o
Outpatient treatments not linked to hospitalisation
o
Unreasonable, excessive, or unnecessary medical charges
c. Sum of Benefits
o Hospital room & board: RM150 per day (maximum 180 days in a year).
o Surgical fees: Coverage up to RM125,000.
o ICU coverage: As charged, but up to 180 days in a year.
o Pre-hospitalization & post-hospitalization care: Covered up to 90 days.
o Emergency outpatient treatment: RM10,000 annual limit.
o Accidental Death Benefit: RM10,000.
o Outpatient Cancer & Kidney /Dialysis Treatment: Covered.
28
o Daily cash benefit for government hospital admission: RM50 per day (max 120
days/year).
o Cancellation may refund part of the premium (if applicable)：
d. How Much Premium?
o Premium rates depend on age, gender, occupation, and health status.
o Stamp duty of RM10 applies at policy inception and each renewal.
o Premiums are not guaranteed and may be revised upon renewal with 30 days' notice.
e. Claim Documents
•
•
•
Hospitalization claims:
o
Original medical bills & receipts.
o
Doctor’s report & discharge summary.
o
Policyholder's identification documents.
Accidental outpatient treatment claims:
o
Police report (if applicable).
o
Medical report & treatment bills.
Accidental Death Benefit claim:
o
Death certificate.
o
Post-mortem/autopsy report (if required).
o
Beneficiary’s identification & proof of relationship.
29
GREAT Health Direct
a. Coverage (Perils)
•
Hospital Room & Board: Up to RM200 per day, capped at 180 days per policy year.
•
Intensive Care Unit (ICU): Covered as charged, subject to a 180-day limit per policy
year.
•
Surgical Fees, Operating Theatre, Anesthetist Fees: Fully covered as per reasonable and
customary charges.
•
Pre-Hospitalization Diagnostic Tests & Specialist Consultations: Covered up to 60 days
before hospitalization.
•
Post-Hospitalization Treatment covered up to 90 days after discharge.
•
Outpatient Cancer Treatment & Kidney Dialysis: Fully covered as charged.
•
Day Surgery: Includes minor procedures that do not require an overnight hospital stay.
•
Emergency Accidental Outpatient Treatment up to RM2,000 per policy year, subject to a
30-day limit from accident date.
•
Overall Annual Limit: RM100,000.
•
No Lifetime Limit.
•
Emergency Medical Assistance (Supreme Assist): Provides international emergency
support.
•
Car Assistance Programme: Additional roadside support.
b. Provisions (Conditions)
•
•
Eligibility:
o
Available to Malaysian citizens aged 18 to 50 years next birthday.
o
Coverage extends until age 80 next birthday.
Exclusions:
o
Pre-existing conditions are not covered.
30
o
Illnesses occurring within the first 120 days are not covered.
o
Cosmetic surgery, dental treatments (except injury-related), private nursing, and
infertility treatments are excluded.
o
Suicide, war, nuclear incidents, organ transplants, sleep disorders, alternative
therapies, and sex change expenses are not covered.
o
•
Any charges exceeding reasonable & customary limits will not be reimbursed.
Policy Surrender & Cancellation:
1) No surrender value.
2) Cancellation refunds depend on how long the policy has been active:
a. Within 15 days: 90% refund.
b.After 11 months: No refund.
c. Sum of Benefits
•
Hospitalization & ICU Coverage:
o
Hospital Room & Board: RM200/day (max 180 days/year).
o
ICU Charges: Covered as charged (max 180 days/year).
o
Hospital Supplies, Surgery, Operating Theatre, and Anesthetist Fees: Covered as
charged.
•
Pre & Post-Hospitalization:
o
Pre-Hospital Diagnostic Tests & Specialist Consultations: Covered up to 60 days
before hospitalization.
o
•
Post-Hospitalization Treatment: Covered up to 90 days after discharge.
Outpatient & Emergency Benefits:
31
o
Cancer & Kidney Dialysis Treatment: Covered as charged.
o
Day Surgery: Covered as charged.
o
Emergency Accidental Outpatient Treatment: RM2,000 limit per policy year,
valid up to 30 days from accident date.
•
Annual & Lifetime Limits:
o
Overall Annual Limit: RM100,000.
o
Overall Lifetime Limit: No limit.
d. How Much Premium?
1. Premium Factors:
a. Based on age next birthday, gender, and occupation.
b. Premiums increase with age.
c. Premiums are not guaranteed and may be revised with 3 months' notice.
e. Claim Documents
1. Hospitalization Claims:
a. Completed claim form.
b. Original medical bills & receipts.
c. Doctor’s report & discharge summary.
d. Policyholder’s identification documents.
2. Accidental Outpatient Treatment Claims:
a. Police report (if applicable).
b. Medical report & treatment bills.
32
3. Policy Cancellation Refund Process:
a. If no claims were made, a pro-rated refund of the last premium paid applies.
b. Refund percentage decreases over time (no refund after 11 months).
PERSONAL ACCIDENT INSURANCE
Great Shield Active
a. Coverage (Perils)
1) Personal Accident Insurance covering:
a) Accidental Death – Pays out up to RM1,380,000.
b) Permanent Disablement – Pays out up to RM1,380,000.
c) Medical Expenses – Covers up to RM5,000 per accident, including traditional
treatment (limited to RM100 per visit, max RM1,000 per accident).
2) Double Indemnity:
a) Accidental Death on Public Transport/Public Sports Event – Pays double the sum
insured.
3) Triple Indemnity:
a) Total Permanent Disablement on Public Transport/Public Sports Event – Pays
triple the sum insured.
4) Terrorism Coverage:
a) Covers accidental death or permanent disablement due to acts of terrorism, except
for nuclear, chemical, or biological terrorism.
33
5) Additional Benefits:
a) Death Due to Mosquito-Borne Diseases – Covers Dengue, Malaria, Zika Virus,
etc.
b) ATM Withdrawal Protection – Covers up to RM1,000 for robbery within 24
hours of cash withdrawal.
c) Ambulance Fees – Reimburses up to RM500 per accident.
d) Hospital Income – Pays RM100 per day (up to 30 days).
e) Post-Hospitalization Supplement Allowance – Reimburses up to RM500 per
accident.
f) Inconvenience Allowance – Pays RM500 per accident for hospital stays over 24
hours.
g) Loss of Personal Effects – Covers up to RM1,000 per accident.
h) Prosthetics or Wheelchair – Covers up to RM1,000 per accident.
i) Bereavement Allowance – Pays RM5,000.
j) Personal Liability – Covers third-party claims up to RM1,000,000.
k) Optional Weekly Income Benefit – Pays RM100 to RM500 per week for up to 52
weeks.
l) Optional Motorcycling Extension – Extends coverage for motorcycle accidents.
b. Provisions (Conditions)
1. Eligibility:
a. Minimum entry age: 30 days.
b. Maximum entry age: 70 years old.
c. Renewable until 100 years old, subject to health approval.
2. Exclusions:
a. War, radiation, or nuclear-related accidents.
34
b. Suicide, self-inflicted injuries, and mental disorders.
c. HIV/AIDS and related diseases.
d. Pregnancy, miscarriage, childbirth complications.
e. Participation in dangerous sports or criminal activities.
f. Occupational exclusions: Military, police, firemen, bodyguards, construction
workers, loggers, miners, and other hazardous jobs.
c. Sum of Benefits
No
1
2
3
Benefit
Accidental
Death
Permanent
Disablement
Medical
Plan 1
Plan 2
Plan 3
Plan 4
Plan 5
Plan 6
80,000
180,000
280,000
380,000
680,000 880,000
80,000
180,000
280,000
380,000
680,000 880,000
Plan 7
1,380,0
00
1,380,0
00
Up to 5,000
Expenses
Double
Indemnity for
Accidental
4
Death on
Double the payout as per the prevailing Capital Sum Insured (Excludes
Public
Terrorism)
Conveyance
or at Public
Sports Event
Triple
Indemnity for
Total
5
Permanent
Disablement
Triple the payout as per the prevailing Capital Sum Insured (Excludes
Terrorism)
on Public
Conveyance
35
or at Public
Sports Event
Accidental
Death or
Permanent
Disablement
due to
6
Terrorism
80,000
180,000
280,000
380,000
680,000 880,000
(Excludes
1,380,0
00
Nuclear,
Chemical, or
Biological
Terrorism)
7
8
Renewal
Bonus
Death Due to
Mosquito Bite
Increase of 5% per year up to 100% of Capital Sum Insured
40,000
90,000
140,000
190,000
340,000 440,000
690,000
ATM
Withdrawal
9
Protection
Up to 1,000
(Max 4
incidents per
policy year)
Ambulance
10
Fees (Per
Up to 500
Accident)
Hospital
11
Income (Per
100
day, max 30
36
days per
accident)
PostHospitalisatio
12
n Supplement
Up to 500
Allowance
(Per
Accident)
Inconvenience
13
Allowance
(Per
500
Accident)
Loss of
Personal
14
Effects (Due
to snatch
Up to 1,000
theft/robbery
per Accident)
Prostheses or
15
Wheelchair
(Per
Up to 1,000
Accident)
16
Bereavement
Allowance
5,000
Personal
17
Liability (Per
Limit of liability up to 1,000,000
Claim)
Optional Benefits
N
o
Optional Benefit
Plan 1
Plan 2
Plan 3
Plan 4
Plan 5
Plan 6
Plan 7
(RM)
(RM)
(RM)
(RM)
(RM)
(RM)
(RM)
37
Weekly Benefit (Per
1 week, max 52 weeks
100
100
200
200
300
300
500
180,00
280,00
380,00
680,00
880,00
1,380,0
0
0
0
0
0
00
per accident)
2 Motorcycling Extension
80,000
d. How Much Premium?
•
Premium depends on occupation classification:
o Class 1 & 2: Office-based and non-hazardous occupations.
o Class 3: Jobs involving non-hazardous manual labor.
Annual Premium Without Weekly Benefit
Plan
Class 1 & 2 (RM)
Class 3 (RM)
Plan 1 (RM80,000)
RM160.98
RM313.62
Plan 2 (RM180,000)
RM272.87
RM537.77
Plan 3 (RM280,000)
RM395.13
RM782.30
Plan 4 (RM380,000)
RM517.39
N/A
Plan 5 (RM680,000)
RM823.06
N/A
Plan 6 (RM880,000)
RM986.07
N/A
Plan 7 (RM1,380,000)
RM1,515.89
N/A
38
Optional Benefit 1: Annual Premium With Weekly Benefit
Plan
Class 1 & 2 (RM)
Class 3 (RM)
Plan 1 (RM80,000)
RM211.74
RM395.13
Plan 2 (RM180,000)
RM313.62
RM619.28
Plan 3 (RM280,000)
RM476.65
RM945.32
Plan 4 (RM380,000)
RM598.90
N/A
Plan 5 (RM680,000)
RM945.32
N/A
Plan 6 (RM880,000)
RM1,108.34
N/A
Plan 7 (RM1,380,000)
RM1,719.66
N/A
Optional Benefit 2: Motorcycling Extension
Plan
Class 1 & 2 (RM)
Class 3 (RM)
Plan 1 (RM80,000)
RM24.45
RM45.85
Plan 2 (RM180,000)
RM40.76
RM81.51
Plan 3 (RM280,000)
RM59.10
RM117.17
Plan 4 (RM380,000)
RM76.41
N/A
Plan 5 (RM680,000)
RM122.27
N/A
Plan 6 (RM880,000)
RM147.73
N/A
Plan 7 (RM1,380,000)
RM229.24
N/A
e. Claim Documents
1. Accidental Death/Permanent Disablement Claims:
a. Completed Claim Form.
b. Medical Report confirming disablement.
c. Death Certificate (if applicable).
d. Police Report (if applicable).
39
2. Hospitalization & Medical Expense Claims:
a. Original medical bills & receipts.
b. Doctor’s Report.
3. Theft/Robbery Claims (ATM Protection & Personal Effects):
a. Police Report.
b. Proof of Loss (e.g., ATM receipt, personal item valuation report).
Hospital and surgical insurance
EasiMed Major
Coverage (Perils)
1. Medical Coverage
a. Standalone major medical insurance with an affordable premium.
b. High Overall Annual Limit (OAL) up to RM200,000.
c. Unlimited Overall Lifetime Limit.
d. Covers hospitalization, surgeries, ICU, specialist visits, outpatient treatments
(cancer & dialysis), organ transplant, ambulance fees, and post-hospitalization
care.
e. No co-insurance if staying within the eligible Room & Board limit.
2. Optional Benefits (With Additional Premium):
a. Hospital Cash Plan – Pays RM100 per day for up to 100 days of hospitalization.
b. Accidental Death Benefit – Pays RM30,000 in the event of accidental death.
40
3. No Claim Renewal Bonus
a. Annual 10% increase on Overall Annual Limit upon renewal if no claims were
made (excluding Hospital Cash Plan & Accidental Death Benefit).
b. Can increase continuously for 5 years, up to 50%.
c. If a claim is made, the renewal bonus will be withdrawn.
4. Loyalty & Family Discounts
a. 15% discount if the insured has other Great Eastern General individual health
plans.
b. 10% family discount for policies with 3 or more insured persons.
b.Provisions (Conditions)
1. Entry & Coverage Age
a. Minimum entry age: 30 days old.
b. Maximum entry age: 65 years old.
c. Coverage up to 100 years old, as long as the policy is renewed before age 65.
2. Waiting Periods
a. 30 days for general illnesses.
b. 120 days for specified illnesses (e.g., hypertension, diabetes, cardiovascular
disease, tumors, cysts, kidney stones, sinus conditions, spinal disorders, etc.).
c. Pre-existing conditions are NOT covered.
3. Deductible Per Disability
41
a. Policyholder must pay a fixed amount for medical expenses before the insurance
starts covering additional costs.
b. Deductible per disability depends on the plan selected (RM10,000 – RM50,000).
4. Room & Board Upgrade Co-Payment
a. If hospitalized in a higher category room than the eligible benefit, the insured
must pay 20% of other eligible benefits.
5. Overseas Treatment Limitations
a. Only reimburses charges equivalent to local treatment costs in Malaysia.
b. Excludes travel costs.
6. Residence Overseas
a. No benefits payable if the insured stays abroad for more than 90 consecutive days.
7. Cooling-Off Period
a. 15-day period to cancel the policy with a full refund (minus medical underwriting
fees).
8. Grace Period for Premium Payment
a. 30-day grace period for premium payment after the first policy year.
b. If a claim is made during this period, the outstanding premium must be paid
before the claim is processed.
c. If premium remains unpaid after the grace period, the policy terminates.
42
c. Sum of Benefits (Payout Amounts)
Benefit
Hospital Room & Board
(180 days max)
Plan
Plan
Plan
Plan
Plan
EM600
EM500
EM400
EM300
EM170
RM600/day RM500/day RM400/day RM300/day RM170/day
ICU Fees
Hospital Supplies &
Services
Surgical Fees
Daycare Procedures
Anesthetist Fees
Operating Theatre Fees
In-Hospital Physician
Visits (Max 2 per day)
Pre-Hospital Diagnostic
Tests (60 days before
hospitalization)
As charged, subject to Reasonable & Customary Charges & Overall
Pre-Hospital Specialist
Annual Limit
Consultation (60 days
before hospitalization)
Post-Hospitalization
Treatment (60 days after
discharge)
Outpatient
Physiotherapy (90 days
after discharge)
Ambulance Fees (Road
transport only)
Annual Outpatient
Cancer Treatment
43
Annual Outpatient
Kidney Dialysis
Treatment
Home Nursing Care
Organ Transplant (Once
per lifetime)
Medical Report Fees
Prevailing Government
Tax
Deductible Per
8%
RM50,000
Disability
Overall Annual Limit
RM30,000
RM20,000
RM15,000
RM10,000
RM200,000 RM150,000 RM120,000 RM100,000 RM60,000
(OAL)
Overall Lifetime Limit
Unlimited
d. How Much Premium?
Standard Benefits (Section A)
Age Next Birthday
EM600
EM500
EM400
EM300
EM170
1 - 18 years
RM265
RM241
RM230
RM219
RM186
19 - 25 years
RM292
RM266
RM254
RM242
RM206
26 - 35 years
RM311
RM283
RM270
RM257
RM218
36 - 40 years
RM348
RM318
RM303
RM289
RM246
41 - 50 years
RM461
RM420
RM401
RM382
RM325
51 - 60 years
RM783
RM714
RM681
RM649
RM552
61 - 65 years
RM1,186
RM1,080
RM1,031
RM982
RM835
66 - 70 years
RM1,883
RM1,715
RM1,637
RM1,559
RM1,325
71 - 75 years
RM2,682
RM2,443
RM2,332
RM2,221
RM1,888
76 - 80 years
RM3,623
RM3,300
RM3,150
RM3,000
RM2,550
44
81 - 100 years
RM5,082
RM4,630
RM4,419
RM4,209
RM3,578
Optional Benefits (Section B)
Benefit
Annual Premium (All Plans)
Hospital Cash Plan
RM70
Accidental Death Benefit
RM25
e. Claim Documents
1. Hospitalization Claim:
a. Completed Claim Form (provided by Great Eastern).
b. Hospital admission & discharge summary.
c. Original medical bills & receipts.
d. Physician’s medical report.
2. Surgery or Outpatient Cancer/Dialysis Claim:
a. Medical report & doctor’s diagnosis.
b. Detailed itemized bill & receipts.
3. Accidental Death Claim (If Rider Included):
a. Death certificate.
b. Police report (if applicable).
c. Claimant’s NRIC & bank details.
45
EasiMed Active
a. Coverage (Perils)
1. Inpatient & Outpatient Coverage:
a. Covers room and board, ICU fees, hospital supplies, surgical fees, operating
theatre charges, and anesthetist fees.
b. Daycare procedures and in-hospital physician visits included.
2. Pre & Post-Hospitalization Benefits:
a. Covers pre-hospital diagnostic tests and specialist consultations (60 days before
hospitalization).
b. Post-hospitalization treatment (60 days after discharge) covered.
3. Outpatient Treatment:
a. Cancer & Kidney Dialysis Treatment: Up to RM60,000 per year.
b. Physiotherapy Treatment: Covered for 90 days after discharge.
4. Emergency & Additional Benefits:
a. Emergency Accidental Outpatient Treatment: Covered within 24 hours of the
accident, with follow-ups for 60 days.
b. Ambulance Fees covered.
c. Home nursing care included.
d. Organ transplant & medical report fees covered.
46
5. Mental Health Benefit:
a. RM1,500 allowance for hospitalization due to Major Depressive Disorder,
Bipolar Disorder, or Schizophrenia.
6. Annual & Lifetime Limits:
a. Overall Annual Limit: Up to RM120,000.
b. Overall Lifetime Limit: Unlimited.
7. Optional Benefits (Additional Premium Required):
a. Outpatient Chiropractic Treatment: RM150 per visit, up to RM1,000 per year.
b. Hospitalization due to High-Risk Sports Injuries: Up to RM50,000.
b. Provisions (Conditions)
1. Eligibility:
a. Available to individuals aged 30 to 40 years old.
b. Coverage is renewable annually up to age 80.
2. Waiting Period:
a. 30-day waiting period from the policy's effective date for illness coverage (not
applicable for accidents).
b. If the policy lapses and is reinstated, the waiting period restarts.
47
3. Overseas Treatment:
a. Treatment outside Malaysia is limited to reasonable and customary charges for
equivalent treatment in Malaysia.
b. Transport costs to overseas facilities are not covered
4. Exclusions:
a. Pre-existing conditions and specified illnesses in the first 120 days.
b. Pregnancy, congenital conditions, cosmetic surgery, dental treatments (except
accident-related cases).
c. Racing or hazardous sports (unless added as an optional benefit).
d. War, terrorism, radiation, nuclear contamination, HIV/AIDS, and self-inflicted
injuries.
c. Sum of Benefits
1. Hospitalization Coverage:
a. Room & Board: Up to RM450 per day (max 120 days).
b. ICU Fees: Covered as charged (max 20 days).
c. Surgical Fees, Operating Theatre, Anesthetist Fees: Covered as charged.
d. Hospital Supplies & Services: Covered.
e. Daily Cash Allowance at Government Hospital: RM100 per day (max 120 days).
2. Pre & Post-Hospitalization:
a. Pre-Hospital Diagnostic Tests & Specialist Consultations: Covered for 60 days
before hospitalization.
b. Post-Hospitalization Treatment: Covered for 60 days after discharge.
48
3. Emergency & Outpatient Treatments:
a. Cancer & Kidney Dialysis Treatment: Up to RM60,000 per year.
b. Physiotherapy Treatment: Covered for 90 days after discharge.
c. Emergency Accidental Outpatient Treatment: Covered within 24 hours of the
accident, with follow-ups for 60 days.
d. Emergency Accidental Dental Treatment: Covered within 24 hours of the
accident, with follow-ups for 60 days.
e. Ambulance Fees: Covered.
f. Medical Report Fees: Covered.
4. Mental Health Benefit:
a. RM1,500 allowance for hospitalization due to Major Depressive Disorder,
Bipolar Disorder, or Schizophrenia.
5. No Claim Renewal Bonus (NCRB):
a. 10% bonus on Overall Annual Limit per year, up to 50% after 5 years (if no
claims are made).
b. If a claim is made, NCRB stops accumulating.
6. Optional Benefits:
a. Outpatient Chiropractic Treatment: RM150 per visit, up to RM1,000 per year.
b. Hospitalization due to High-Risk Sports Injuries: Up to RM50,000.
d.
49
How Much Premium?
1. Premium Rates Based on Age & Plan:
a. Premiums vary based on age at next birthday and chosen plan.
b. Higher plans (AM450) have higher premiums compared to basic plans (AM220).
2. Premium Changes:
a. Premiums increase as the policyholder ages.
b. Not guaranteed and may be revised based on claims experience and medical cost
inflation.
e. Claim Documents
1. Hospitalization & Medical Expense Claims:
a. Completed claim form.
b. Original medical bills & receipts.
c. Doctor’s report & discharge summary
2. Emergency Accidental Outpatient Treatment Claims:
a. Police report (if applicable).
b. Medical report & treatment bills.
3. Exclusions for Overseas Treatment:
a. No coverage for medical treatment outside Malaysia if the insured resides/travels
abroad for more than 90 consecutive days.
50
Wealth Accumulation
Smart Invest Premier
a. Coverage (Perils)
1. Death Benefit
a. Policy Year 1 & 2: Pays Sum Assured + Total Investment Value (for accidental
causes).
b. Policy Year 3 & Above: Pays Sum Assured + Total Investment Value (for both
accidental and non-accidental causes).
c. If death occurs due to non-accidental causes in Policy Year 1 & 2, only the Total
Investment Value is paid.
2. Total & Permanent Disability (TPD) Benefit
a. Same payout structure as death benefit.
b. TPD coverage available until age 70.
3. No-Lapse Guarantee (First 3 Years)
a. Ensures the policy remains active for the first 3 years, even if the Total
Investment Value becomes zero, as long as premiums are paid on time and no
withdrawals are made.
51
b. Provisions (Conditions)
•
Who Can Apply?
o Minimum Entry Age: 14 days (attained age).
o Maximum Entry Age: 70 years next birthday.
o Coverage Term: Up to age 100.
•
Exclusions (No Payout If):
o Death due to suicide within the first policy year (whether sane or insane).
o TPD caused by self-inflicted injuries.
o Pre-existing TPD before policy commencement or reinstatement.
c. Sum of Benefits
•
Death or TPD Payout Calculation:
o Policy Year 1 & 2 (Accidental Causes Only) = Sum Assured + Total Investment
Value.
o Policy Year 1 & 2 (Non-Accidental Causes) = Total Investment Value Only.
o Policy Year 3 & Above = Sum Assured + Total Investment Value.
•
Loyalty Incentive (Boosts Investment Value)
o 2% additional premium allocation every 3rd policy year (up to Year 10).
o 5% additional premium allocation yearly from Year 11 onwards.
52
d. How Much Premium?
•
Minimum Premium:
o RM2,400 per year or RM200 per month.
•
Premium Allocation to Investment Funds:
o 95% of premiums are invested into unit funds from Year 1 onwards.
o Additional Loyalty Incentives applied every 3rd year and annually after Year 10.
•
Fund Management Charges:
o 0.50% – 1.50% per annum, depending on the chosen investment fund.
•
Additional Fees & Charges:
o Monthly Policy Fee: RM6.00.
o Insurance Charges: Based on sum assured, age, gender, smoking status, and
health condition.
•
Investment Top-Ups:
o Minimum RM1,000 per top-up, with 95% of top-up allocated to unit funds.
53
e. Claim Documents
1. Death Claim:
•
Certified true copy of Death Certificate.
•
Claimant’s NRIC (or passport, if applicable).
•
Medical report (if death occurred due to illness).
•
Police report & post-mortem report (if death occurred due to an accident).
•
Original policy document.
2. Total and Permanent Disability (TPD) Claim:
•
Completed TPD claim form (provided by Great Eastern).
•
Medical report from a certified doctor confirming permanent disability.
•
TPD assessment reports.
•
Bank account details for payout.
•
Original policy document.
Great Multi-Gen Wealth
a. Coverage (Perils)
•
Death Benefit
o Policy Year 1 & 2 (Accidental Causes):
i. Guaranteed Death Benefit (105% of Basic Premiums paid-to-date, minus
any investment booster or survival benefits paid).
ii. Total Investment Value (if any).
o Policy Year 1 & 2 (Non-Accidental Causes):
i. Basic Premiums paid-to-date (minus any investment booster or survival
benefits paid).
ii. Value of allocated units (if any).
54
o Policy Year 3 & Above:
i. Guaranteed Death Benefit.
ii. Total Investment Value (if any).
•
Bereavement Benefit
o Pays 10% of Basic Annualised Premium (capped at RM5,000 per life) if the
initial life assured passes away.
o Not payable if Death Benefit is paid on the death of the initial life assured.
•
Legacy Transfer Option
o Allows appointment of Alternate Policy Owner (APO), Secondary Life Assured
(SLA), and Change of Life Assured (CLA) to extend policy ownership across
generations.
o If SLA is appointed, policy continues without death payout, ensuring long-term
wealth accumulation.
b. Provisions (Conditions)
1. Premium Payment & Coverage Term
o Premium Payment Options: 5, 10, or 20 years.
o Coverage Term Options: Up to age 70, 80, or 90 (next birthday).
o Premium remains the same throughout the term.
55
2. Guaranteed Maturity Benefit
o Lump sum payout at the end of the policy term.
o 450% (5-year term), 850% (10-year term), or 1,200% (20-year term) of Basic
Annualised Premium.
3. Yearly Income Options
o Yearly income based on Basic Annualised Premium, credited as either:
i. Investment Booster (credited into Total Investment Value).
ii. Survival Benefit (paid to policyholder).
o The yearly income percentage increases over time, up to 60% per year.
4. Optional Riders for Extra Protection
o Great Wealth Enhancer Payer – Waives premiums if the policyholder dies or
becomes disabled.
o CI Premium Waiver Rider – Waives premiums if critical illness is diagnosed.
o Payer Waiver Extra Rider – Waives premiums if death, disability, or critical
illness occurs.
c. Sum of Benefits
•
Death Benefit:
o 105% of Basic Premiums paid-to-date, minus any prior withdrawals.
o Total Investment Value (if any).
•
Maturity Benefit:
o 450% (5-year term), 850% (10-year term), or 1,200% (20-year term) of Basic
Annualised Premium.
56
•
Yearly Income (Investment Booster / Survival Benefit):
o Up to 60% per year, based on policy duration and payment term.
d. How Much Premium?
•
Minimum & Maximum Basic Annualised Premiums:
o Minimum: RM6,000 per year.
o Maximum: RM1,000,000 per year.
•
Fund Management Charges (Investment Portion):
o 0.50% – 1.50% per annum, depending on the chosen investment fund.
e. Claim Documents
1. Death Claim:
•
Death Certificate (certified true copy).
•
Claimant’s NRIC (or passport, if applicable).
•
Medical report (if death was due to illness).
•
Police report & post-mortem report (if death was due to an accident).
•
Original policy document.
2. Bereavement Benefit Claim:
•
Claim form.
•
Death certificate of the initial life assured.
•
NRIC of the beneficiary.
57
Great Flexi Plus
a. Coverage (Perils)
•
Death Benefit
o Pays the higher of:
i. 105% of total Basic Premiums paid, minus total Guaranteed Cash
Payments (GCP) paid.
ii. Account 1 value + Account 2 value
iii. Account 1 value is the primary account where premiums paid for the basic
policy are allocated, it is used to accumulate savings and cover insurance
changes.
iv. Account 2 value is an account that is optional which holds any Guaranteed
Cash Payment that the policyholders choose to reinvest rather than
withdraw.
•
Total & Permanent Disability (TPD) Benefit
o If TPD occurs before age 70 (next birthday), the Death Benefit is paid in advance.
•
Accidental Death Benefit
o Pays an additional sum assured equivalent to 105% of total Basic Premiums paid,
minus total GCP paid.
o Public Conveyance Accidental Death Benefit (e.g., bus, train, elevator, public
building fire) pays double the Accidental Death Benefit.
58
•
No-Lapse Guarantee
o Ensures policy remains active even if Account 1 and Account 2 values reach zero,
as long as premiums are fully paid and no overdue premium interest exists.
b. Provisions (Conditions)
•
Premium Payment & Coverage Term
o Premium Payment Term: 20 years.
o Coverage Duration: 30 years.
•
Guaranteed Cash Payment (GCP) – Yearly Payout
o Paid yearly as a percentage of Basic Annualised Premium:
i. Years 1-10: 20% per year.
ii. Years 11-20: 40% per year.
iii. Years 21-Maturity: 60% per year.
iv. Total Payout: 1,200% of Basic Annualised Premium over 30 years.
o Can be withdrawn or reinvested in Account 2 for potential returns.
•
Maturity Benefit
o Upon maturity, pays:
Higher of 105% of total premiums paid (minus GCP) or Account 1 Value,
plus Account 2 Value.
59
•
Exclusions (No Payout If):
o Death due to suicide within first policy year.
o TPD caused by self-inflicted injuries.
o Pre-existing TPD before policy commencement.
o Accidental Death if death occurs more than 90 days after the accident.
c. Sum of Benefits
•
Death/TPD Benefit:
o Higher of 105% of total premiums paid (minus GCP) or Account 1 Value, plus
Account 2 Value.
•
Accidental Death Benefit:
o Additional sum assured equal to 105% of total Basic Premiums paid, minus total
GCP paid.
o Public Conveyance Accidental Death Benefit: Double payout.
•
Maturity Benefit:
o Higher of 105% of total premiums paid (minus GCP) or Account 1 Value, plus
Account 2 Value.
d. How Much Premium?
•
Minimum & Maximum Premiums:
o Minimum: RM2,400 per year.
o Maximum: Subject to underwriting.
60
•
Fees & Charges:
o Insurance Charges: Deducted from Account 1 (varies by age, gender, smoking
status).
o Monthly Policy Fee: RM7.00 (deducted from Account 1).
o Fund Management Charge: 0.5% per annum.
o Supplementary Charge: 0.4% per annum.
o Surrender Charges:
i. Starts at 10% (Year 1) and decreases to 0% after Year 10.
e. Claim Documents
1. Death Claim:
•
Certified true copy of Death Certificate.
•
Claimant’s NRIC (or passport, if applicable).
•
Medical report (if death due to illness).
•
Police report & post-mortem report (if accident-related death).
•
Original policy document.
2. Total and Permanent Disability (TPD) Claim:
•
Completed TPD claim form.
•
Medical report confirming permanent disability.
•
Bank details for payout.
61
Travel insurance
Travel For More+
a. Coverage (Perils)
•
Accidental Death & Permanent Disablement
o Lump sum payout for death or permanent disablement due to an accident.
o Terrorism Coverage included.
•
Medical Expenses & Hospitalization
o Covers medical expenses due to injury or illness while overseas.
o Follow-up medical treatment in Malaysia included.
o Alternative medicine (e.g., chiropractor, sinseh, physiotherapist) covered.
•
Emergency Medical Evacuation & Repatriation
o Covers medical evacuation and repatriation of remains.
•
Travel Inconveniences
o Flight delay, missed connections, and travel reroute covered.
o Loss of baggage, travel documents, or personal money reimbursed.
o Trip cancellation/postponement/curtailment expenses covered.
o Baggage delay compensation provided.
•
Additional Benefits
o Home content protection (fire damage while traveling).
o Rental car excess cover (for rented vehicles).
62
o Emergency telephone charges reimbursed.
o Hijacking inconvenience allowance.
•
Optional Cover: Adventurous Activity Cover
o Covers death, disablement, and accidental damage to equipment while engaging
in adventurous activities.
b. Provisions (Conditions)
•
Who Can Apply?
o Malaysian citizens, PR holders, or foreigners with valid work/study visas.
o Coverage available up to age 80 (adventurous activities covered up to age 70).
•
Trip Duration
o Maximum 120 consecutive days per trip.
•
COVID-19 Benefits Extension (Plan C only)
o Covers medical expenses, trip cancellation, and emergency medical evacuation
due to COVID-19.
o Only applies if the insured is fully vaccinated and meets travel requirements.
•
Exclusions
o Pre-existing medical conditions.
o War, radiation, nuclear terrorism.
o Extreme sports (unless covered under Adventurous Activity Cover).
63
c. Sum of Benefits
Plan A
Plan B
Plan C (RM, includes
(RM)
(RM)
COVID-19 coverage)
100,000
300,000
300,000
50,000
300,000
300,000
10,000
30,000
30,000
Baggage Delay (Per 6 hours)
400
800
800
Trip Cancellation
5,000
20,000
Unlimited
Unlimited
Benefit
Accidental Death (Adult up to 70
years)
Medical Expenses (Up to 70 years)
Follow-up Medical Treatment
(Malaysia)
Emergency Medical Evacuation &
Repatriation
20,000 (up to 5,000 due to
COVID-19)
Unlimited (up to 150,000 due
to COVID-19)
d. How Much Premium?
•
1-7 days (Asia travel, single trip): RM31 – RM191 (depending on coverage level and
number of travelers).
•
Annual plan: RM282 – RM1,596.
e. Claim Documents
•
Accidental Death Claim:
o Death certificate,
o police report
o claimant’s NRIC.
•
Medical Expenses Claim:
64
o Medical bills
o diagnosis report
o proof of payment.
•
Baggage Loss/Delay Claim:
o Airline confirmation
o police report (if theft involved).
65
Great Voyager+
a. Coverage (Perils)
•
Accidental Death & Permanent Disablement
o Pays a lump sum for death or permanent disablement due to an accident.
o Covers accidental death or disablement due to terrorism.
•
Medical Expenses
o Covers overseas medical expenses for injury or illness (including COVID-19 for
Supreme Plan).
o Follow-up medical treatment in Malaysia is covered for up to 90 days after return.
o Alternative medicine (e.g., chiropractor, sinseh, physiotherapist) included.
•
Emergency Medical Evacuation & Repatriation
o Covers emergency evacuation & repatriation of mortal remains.
•
Travel Inconveniences
o Flight delay, baggage delay, missed connections, rerouting covered.
o Loss of baggage, travel documents, or personal money reimbursed.
o Trip cancellation, postponement, or curtailment expenses covered.
o Baggage delay compensation provided.
•
Additional Benefits
o Child Education Fund if parents pass away due to an accident.
o Compassionate Visit Benefit (pays for a relative to visit if hospitalized overseas).
66
o Child Companion Benefit (covers costs for someone to bring unattended children
home).
o Hijacking inconvenience allowance.
o Personal Liability coverage (up to RM1,000,000).
o Home content protection (fire damage while traveling).
o Rental car excess cover (for rented vehicles).
•
COVID-19 Coverage (Supreme Plan Only)
o Covers medical expenses, trip cancellation, and emergency medical evacuation if
diagnosed with COVID-19 while traveling.
o Only applies if the insured is fully vaccinated.
b. Provisions (Conditions)
•
Who Can Apply?
o Malaysian citizens, PR holders, or foreigners with a valid work/study visa.
o Coverage available up to age 80 (COVID-19 coverage up to age 70).
•
Trip Duration
o Maximum 120 consecutive days per trip.
•
Key Exclusions
o Pre-existing medical conditions.
o War, radiation, nuclear terrorism.
o Extreme sports (unless covered under a special rider).
o COVID-19 claims if insurance was purchased after diagnosis.
67
c. Sum of Benefits
Personal Accident Coverage
Benefit
Essential
Supreme Plan (COVID-19
Plan
Coverage)
Accidental Death (Up to age 70) RM100,000
Accidental Death (Above age
70)
Child Education Fund
RM300,000
RM50,000
RM150,000
RM5,000
RM10,000
Medical & Other Expenses
Benefit
Medical Expenses (Up to 70 years
old)
Follow-up Medical Treatment in
Malaysia
Emergency Medical Evacuation &
Repatriation
Essential Plan
Supreme Plan
RM50,000
RM300,000
RM10,000
RM30,000
Unlimited (up to RM150,000 for
Unlimited
COVID-19)
Travel Inconveniences
Benefit
Essential
Baggage Delay (Per 6 hours)
RM200
Trip Cancellation
RM5,000
Loss of Baggage / Personal
Effects
Supreme Plan
Plan
RM2,000
RM200
RM20,000 (up to RM5,000 for COVID19)
RM6,000
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d. How Much Premium?
Single Trip Coverage
Destination
Essential Plan
Supreme Plan (RM, with COVID-19
(RM)
Coverage)
Asia (1-7 days)
RM26
RM47
Worldwide (1-7 days)
RM48
RM81
RM243
RM504
Annual Plan
(Worldwide)
e. Claim Documents
•
Accidental Death Claim:
o Death certificate
o police report
o claimant’s NRIC
•
Medical Expenses Claim:
o Medical bills
o diagnosis report
o proof of payment.
•
Baggage Loss/Delay Claim:
o Airline confirmation
o police report (if theft involved).
69
Motor insurance
Private Car Comprehensive
A) Perils covered
•
Covers natural disasters (floods, landslides, storms) under Special Perils Coverage.
•
Provides financial relief for accidental damage, theft, and fire.
•
Includes third-party liability coverage for injury, death, or property damage caused by the
insured vehicle.
•
Great E-Hailing extension ensures protection for ride-hailing services.
•
Covers damage caused by riots and civil unrest.
•
Extends legal liability protection to both passengers and third parties.
•
Covers valuable vehicle accessories.
B)Benefits
•
The Waiver of Compulsory Excess eliminates the RM400 excess charge for named
drivers.
•
No Claim Discount (NCD) Relief compensates policyholders for lost discounts after a
claim.
•
Hospital Cash Benefit provides daily financial support for up to 60 days, including ICU
stays.
•
Franchise Workshop Betterment Extension covers repair costs with new parts up to the
car’s market value.
•
Compensation for Assessed Repair Time provides monetary compensation for repair
duration.
70
C) Enhanced Coverage Options
•
Third-party property damage coverage can be increased from RM3 million to RM20
million.
•
Hospitalization benefits cover up to 60 days in the ICU.
•
Easi-Drive 3 bundle includes unlimited towing assistance.
•
Windshield, Window & Sunroof Protection allows repairs without affecting NCD.
D) Premium
•
Exact premium is not specified.
E) Claims Process
•
Submit a completed claim form.
•
Provide a police report for accidents or theft cases.
•
Include clear photographs of the damage.
•
Submit repair cost estimates as supporting evidence.
•
Provide a copy of the insurance policy and vehicle registration card.
•
For medical claims, include hospital or medical reports.
•
Prompt submission ensures a smoother process and faster compensation.
71
Home insurance
GREAT Home 360
A) Perils Covered
•
Fire, lightning, thunderbolt, and subterranean fire
•
Explosion
•
Aircraft and aerial devices or objects dropped from them
•
Impact with buildings by road vehicles or animals
•
Bursting or overflowing of domestic water tanks, apparatus, or pipes
•
Theft (if accompanied by forcible and violent entry/exit)
•
Hurricanes, cyclones, typhoons, and windstorms (subject to Excess Clause)
•
Earthquakes and volcanic eruptions (subject to Excess Clause)
•
Flood (excluding losses caused by subsidence or landslip)
•
Robbery and hold-up inside the premises
Additional perils can be covered by paying an extra premium, including:
•
Riot, strike, and malicious damage
•
Subsidence and landslip
•
Plate glass damage.
72
Benefits
Plan(1)
Additional
SECTION D
250,000
benefits
Public
Plan(2)
Plan(3)
Plan(4)
Liability
up to
SECTION E
Emergency Home Assistances
Home Assistance Program
Note: Indemnified basis
(1) Up to 2 times per policy year free
of
charge up to limit of RM250.00
(Ringgit Malaysia Two Hundred
Fifty Only) each visit, and
(2) If the Emergency Home
Assistance
services exceeds the limit of
RM250.00 (Ringgit Malaysia Two
Hundred Fifty Only), Insured to pay
the balance.
(a) 7 Dedicated Hotline Services
(b) Emergency Electrical Assistance
(c) Emergency Locksmith Service
(d) Emergency Vermin Removal
(e) Emergency Plumbing Service
(f) Emergency Air-Conditioner
Repair
Home Assistance Service
Note: Referral basis only, the cost of
the services and related expenses
shall be borne by you.
(a) General Handyman Services
73
(b) Home Cleaning Services
(c) Disinfection Services
(d) Air-Conditioner Servicing
SECTION F
Pay 1% of Section A2 sum insured as
ESG Benefit
allowance for electricity usage from
national grid in the event of the
outage
caused by damages to the solar panel
due to insured Peril.
74
Optional
SECTION G
Worldwide
Valuable
Optional Add On with worldwide
All Risk
Items
All Risks Coverage separately
(Market
based on
charged
Value)
Declaration
with additional premium
B) Provisions
•
The policy operates on a First Loss Basis, meaning no penalty for underinsurance.
•
Coverage must be renewed annually.
•
Policyholders must ensure their property is insured for an appropriate amount, including
renovations.
•
Claims must be notified and submitted immediately, with supporting documents.
•
A duty of disclosure applies under the Financial Services Act 2013—failure to disclose
relevant information may lead to claim denial or policy cancellation.
C) Sum of Benefits
Main Coverage:
•
Household Contents (Section A1): RM25,000 - RM100,000
•
Building & Renovations (Section A2): RM25,000 - RM100,000
•
Home Gadgets (Section B): RM625 - RM2,500 per gadget
•
Other Unspecified Contents (Section C): RM50,000 - RM200,000
Table of benefits:
Main Coverage
Benefits
Total Sum Insured for (A) to (C)
Plan 1
Plan 2
Plan 3
Plan 4
(RM)
(RM)
(RM)
(RM)
50,000
100,000
150,000
200,000
Basic Cover (First Loss)
75
SECTION A1
25,000
50,000
75,000
100,000
25,000
50,000
75,000
100,000
Household Contents up to
SECTION A2
Building(s) Including Renovations up to
Worldwide All Risk
SECTION B
Up to
Up to
Up to
Component (Market
Home Gadget
2,500 per
3750 per
5,000 per
Value)
up to (Excess of gadget (up
gadget (up
gadget (up
10% per
to 5,000)
to 7,500)
to 10,000)
625
1,250
1,875
gadget)
SECTION C
2,500
Other
Unspecified
Content other
than Electronics
and Furniture
up to
Additional Benefits:
•
Public Liability (Section D): Up to RM250,000
•
Home Assistance Program (Section E): Includes emergency electrical assistance,
plumbing, air-conditioning repair, and more.
Table of additional benefits:
Main coverage
Benefits
Plan(1)
Additional
SECTION D
250,000
benefits
Public
Plan(2)
Plan(3)
Plan(4)
Liability
up to
76
SECTION E
Emergency Home Assistances
Home
Note: Indemnified basis
Assistance
(1) Up to 2 times per policy year free
Program
of
charge up to limit of RM250.00
(Ringgit Malaysia Two Hundred
Fifty Only) each visit, and
(2) If the Emergency Home
Assistance
services exceeds the limit of
RM250.00 (Ringgit Malaysia Two
Hundred Fifty Only), Insured to pay
the balance.
(a) 7 Dedicated Hotline Services
(b) Emergency Electrical Assistance
(c) Emergency Locksmith Service
(d) Emergency Vermin Removal
(e) Emergency Plumbing Service
(f) Emergency Air-Conditioner
Repair
Home Assistance Service
Note: Referral basis only, the cost of
the services and related expenses
shall be borne by you.
(a) General Handyman Services
(b) Home Cleaning Services
(c) Disinfection Services
(d) Air-Conditioner Servicing
77
SECTION F
Pay 1% of Section A2 sum insured as
ESG Benefit
allowance for electricity usage from
national grid in the event of the
outage
caused by damages to the solar panel
due to insured Peril.
Optional
SECTION G
Worldwide
Valuable
Optional Add On with worldwide
All Risk
Items
All Risks Coverage separately
(Market
based on
charged
Value)
Declaration
with additional premium
D) How Much Premium
The gross premium (before tax and stamp duty) depends on the plan chosen:
Benefits
Plan 1 (RM)
Plan 2 (RM)
Plan 3 (RM)
Plan 4 (RM)
Section A1=
25,000
50,000
75,000
100,000
Section B =
Up to 1,250 per
2,500 per gadget
Up to 3,750 per
Up to 5,000 per
Home gadget
gadget (up to
(up to 5,000)
gadget (up to
gadget (up to
7,500)
10,000)
1,875
2,500
household
contents
2,500)
Section C =
625
1250
other
unspecified
contents
Additional premium applies for optional covers like riot/strike damage (RM5 - RM20) and plate
glass protection (RM12.50 - RM50).
If the home has solar panels, a 2.5% ESG discount applied
78
E) Claim Documents
1. Notify Great Eastern General Insurance immediately.
2. Submit a completed Fire/Houseowner/Householder Claim Form along with supporting
documents.
3. Claims can be submitted online, via telephone, or email.
4. For a full list of required documents, refer to the Document Checklist for
Fire/Houseowner/Householder Claims on the insurer’s website
79
Sports insurance
EASI GOLF
Great Eastern's Easi-Golf is a sports insurance plan tailored for golfers, offering comprehensive
coverage to protect against various risks associated with the sport. Below are the key aspects of
the policy:
a. Coverage (Perils)
1. Easi-Golf provides protection against several specific perils:
a. Public Liability: Coverage up to RM500,000 for legal liabilities arising from
accidental bodily injury, death, or property damage caused by the insured while
golfing.
b. Hole-in-One Expenses: Reimbursement for expenses incurred in celebrating a holein-one achievement.
c. Damage or Loss to Golfing Equipment: Compensation up to RM2,500 for accidental
loss or damage to golfing equipment at any golf club or driving range.
d. Personal Accident: Coverage up to RM50,000 for accidental death, permanent
disablement, or bodily injury sustained while playing golf.
e. Personal Effects: Compensation up to RM1,500 for accidental loss or damage to
personal belongings at any golf course or driving range.
f. Breakage of Clubs: Coverage for accidental breakage or damage to golf clubs during
play or practice.
b.
80
Provisions (Conditions)
1. While specific policy conditions are not detailed in the available information, typical
provisions may include:
a. Eligibility Criteria: Requirements related to the insured's age, health status, or golfing
proficiency.
b. Exclusions: Specific scenarios or conditions under which coverage may not be
applicable, such as intentional acts or violations of golf course regulations.
c. Claims Procedures: Guidelines on how to file a claim, including necessary
documentation and timelines.
2. For precise and detailed policy conditions, it's advisable to consult the official policy
documents or contact Great Eastern directly.
c. Sum of Benefits
The maximum benefits provided under the Easi-Golf policy are as follows:
1. Public Liability: Up to RM500,000
2. Hole-in-One Expenses: Coverage amount not specified; typically reimburses actual
expenses incurred
3. Damage or Loss to Golfing Equipment: Up to RM2,500
4. Personal Accident: Up to RM50,000
5. Personal Effects: Up to RM1,500
6. Breakage of Clubs: Coverage amount not specified; typically reimburses repair or
replacement costs
d. Premium
The premium for the Easi-Golf policy is not specified in the available information and may vary
based on factors such as the insured's age, coverage options selected, and other underwriting
considerations. For accurate premium details, it's recommended to contact Great Eastern directly
or consult with an authorized insurance advisor.
81
e. Claim Documents
To file a claim under the Easi-Golf policy, the following documents are generally required:
1. Completed Claim Form: Specific to the type of claim being filed (e.g., personal accident,
equipment damage).
2. Supporting Documents: Such as medical reports, police reports (if applicable), proof of
ownership for damaged or lost items, and original receipts for any expenses incurred.
3. Identification Documents: Certified copies of the insured's NRIC or other identification.
82
Group Insurance
Great BizCare for SMEs
a. Coverage (Perils)
•
Provides coverage up to RM300,000 for death and Total & Permanent Disability (TPD)
•
Outpatient Benefits (Optional Rider):
o Critical Illnesses: Offers additional coverage up to RM150,000 against specified
critical illnesses.
o Accidental Death and Disablement: Offers additional coverage up to RM300,000 for
death and disablement caused by accidents.
•
Covers medical expenses with an overall annual limit of up to RM150,000.
•
Outpatient Benefits (Optional Riders):
o
General Practitioner Care: Unlimited outpatient visits to general practitioners.
o
Specialist Care: Covers outpatient specialist care up to RM2,500.
b. Provisions (Conditions)
•
Eligibility:
o Full-time employees aged 16 to 64 years (extendable to 70). SMEs must enroll at
least 11 to 150 employees.
•
Employer owns the policy and decides benefit structure.
•
No medical check-up required; pre-existing conditions not covered.
83
c. Sum of Benefits
•
Death and TPD Coverage: up to RM300,000.
•
Critical Illness Coverage (Optional) up to RM150,000.
•
Accidental Death and Disablement Coverage (Optional) up to RM300,000.
•
Hospitalization and Surgical Coverage up to Annual limit RM150,000.
•
Outpatient Specialist Care (Optional) up to RM2,500.
d. How Much Premium?
Premium costs are not listed but typically influenced by factors such as the number of
employees, selected coverage options, and the specific risk profile of the organization.
e. Claim Documents
Generally, claim processes for group insurance plans involve submitting a completed claim form
along with relevant supporting documents, such as medical reports, bills, and proof of loss.
84
Group Multiple Benefits Insurance Scheme (GMBIS)
a. Coverage (Perils)
•
•
•
Term Assurance
o
Death due to all causes
o
Total Permanent Disability (TPD) due to all causes
Personal Accident
o
Accidental death: 100% sum assured payable
o
Accidental TPD: 100% sum assured payable
o
Other permanent disablement payout according to the Schedule of Compensation
Critical Illnesses
o
•
Hospitalization Benefit
o
•
Covers 45 critical illnesses (benefits payable upon diagnosis)
RM40 daily hospitalization income (up to 500 days)
Funeral Expenses
o
Lump sum payout upon death (irrespective of the cause)
b. Provisions (Conditions)
•
Eligibility:
o
Member/Spouse: Age 19 - 60 (next birthday)
85
o
Child: Age 30 days - 23 years (unmarried, full-time student, not working)
•
Maturity Age: Coverage ends at age 65 (next birthday)
•
Premiums are fixed regardless of age
•
Coverage remains valid until maturity, even if the insured leaves the organisation
•
Tax relief: Premiums paid are eligible for income tax relief
•
Minimum group size: The scheme is only available to groups/associations/companies
with at least 100 members
c. Sum of Benefits
Example plans based on premium contributions:
1. RM1 per day (RM30/month) Plan:
a. Term Assurance: RM30,000 (Death/TPD)
b. Personal Accident: RM60,000 (Accidental Death/TPD)
c. Critical Illness: RM30,000
d. Funeral Expenses: RM3,000
2. RM1.60 per day Plan:
a. RM80,000 coverage
b. Double payout for personal accident
c. RM40 daily hospitalization income (up to 500 days)
d. How Much Premium?
1. Premium starts as low as RM1 per day (RM30 per month)
2. RM1.60 per day plan offers RM80,000 coverage
3. Premium is fixed for all ages
86
e. Claim Documents
The specific claim documents are not listed in the materials provided, but generally, you may
need:
1. Completed Claim Form
2. Medical Report (for TPD or Critical Illness claims)
3. Death Certificate (for death claims)
4. Police Report (for accidental death or disability claims)
5. Identity Documents (NRIC/passport of insured and claimant)
General Insurance
Easi-Biz Standard/Easi-Biz Premier
a. Coverage (Perils):
Both plans offer protection against a wide range of perils, tailored to meet the specific needs of
businesses:
Section I
Easi-Biz Standard
Easi-Biz Premier
Fire & lightning
Property all risk
Section II
Inconvenience allowance
Section III
Theft, armed robbery, or hold-up
Section IV
Money
Section V
Plate glass
Section VI
Fidelity guarantee
Section VII
Machinery breakdown
Section CIII
Employer’s liability
Section IX
Public liability
Section X
Product liability
87
•
Fire & Lightning (Easi-Biz Standard): Covers loss or damage due to fire or lightning.
•
Property All Risks (Easi-Biz Premier): Covers all risks of physical loss, destruction, or
damage.
•
Inconvenience Allowance: Daily compensation if business operations cease due to
covered damages (max 180 days).
•
Theft, Armed Robbery, or Hold-Up: Covers theft involving forceful entry/exit or robbery.
•
Money: Covers loss of cash, cheques, and financial instruments.
•
Plate Glass: Covers damage to fixed glass in doors, windows, or display cases.
•
Fidelity Guarantee: Covers losses due to employee fraud or dishonesty.
•
Machinery Breakdown: Covers repair/replacement of damaged machinery.
•
Employer’s Liability: Covers legal liability for employee injuries or occupational
diseases.
•
Public Liability: Covers legal liability for injury or property damage caused by
negligence.
•
Product Liability: Covers legal liability for injury or damage caused by your products.
b. Provisions (Conditions):
•
Eligibility: Businesses operating in Malaysia
•
Minimum Premium: Varies based on business type and sum insured
•
Policy Term: Typically, 1 year, renewable annually
•
Exclusions (examples):
•
o
War, terrorism, nuclear risks
o
Radioactive contamination
o
Act of authorities
o
Sonic bangs
o
Existing damage
Coverage Validity: Active if premiums are paid, and policy conditions are met
c. Sum of Benefits:
•
Fire & Lightning (Easi-Biz Standard): Covers loss or damage due to fire or lightning.
88
•
Property All Risks (Easi-Biz Premier): Covers all risks of physical loss, destruction, or
damage.
•
Inconvenience Allowance: Daily compensation if business operations cease due to
covered damages (max 180 days).
•
Theft, Armed Robbery, or Hold-Up: Covers theft involving forceful entry/exit or robbery.
•
Money: Covers loss of cash, cheques, and financial instruments.
•
Plate Glass: Covers damage fixed glass in doors, windows, or display cases.
•
Fidelity Guarantee: Covers losses due to employee fraud or dishonesty.
•
Machinery Breakdown: Covers repair/replacement of damaged machinery.
•
Employer’s Liability: Covers legal liability for employee injuries or occupational
diseases.
•
Public Liability: Covers legal liability for injury or property damage caused by
negligence.
•
Product Liability: Covers legal liability for injury or damage caused by your products.
d. How Much Premium?
•
Premium is not fixed – depends on:
o Type of business & industry risk level
o Chosen coverage & sum insured
o Location of business premises
o Safety measures in place (e.g., security systems)
•
Discounts available for businesses with good risk management
e. Claim Documents:
•
While specific claim documentation requirements may vary based on the nature of the
claim, generally, the following documents are required:
o Completed Claim Form: Duly filled and signed by the policyholder.
o Incident Report: Detailed description of the event leading to the claim.
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o Police Report: For incidents involving theft, robbery, or malicious damage.
o Proof of Loss: Inventory of damaged or lost items, along with their estimated values.
o Repair or Replacement Estimates: Quotations or invoices for repairing or replacing
damaged property.
o Supporting Photographs: Visual evidence of the damage or loss
Easi Health SME @ SME Medical Insurance for Employees
a. Coverage (Perils):
•
•
•
•
Hospitalization Benefits:
o
Hospital room and board
o
Intensive care unit
o
Hospital supplies and services
o
Surgical fees
o
Anesthetist fees
o
Operating theatre charges
o
In-hospital physician visits
Pre- and post-hospitalization:
o
Pre-hospital diagnostic tests
o
Pre-hospital specialist consultation
o
Post-hospitalization treatment
Specialized Treatments:
o
Organ transplant
o
Out-patient cancer treatment
o
Out-patient kidney dialysis treatment
Additional Benefits:
o
Ambulance fees (by road only)
o
Day surgery benefit
o
Emergency accident outpatient treatment
o
Daily cash allowance at government hospitals
o
Accidental death benefits up to RM15,000
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o
Bereavement allowance (accidental cause only)
o
Medical report fees
b. Provisions (Conditions):
•
Eligibility:
o
Full-time employees and their dependents.
o
Age criteria:
i. Employees: 19 to 60 years old
ii. Spouses: Below 60 years old
iii. Unmarried children: 30 days to 19 years old or up to 24 years old if in fulltime higher education and not gainfully employed
o
•
Minimum group size: Five employees
Policy Terms:
o
Specific terms, conditions, and exclusions apply as per the policy document.
c. Sum of Benefits:
o Overall annual limit up to RM100,000, varying based on the selected plan.
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d. How Much Premium?
Premiums are determined by factors such as the chosen plan, number of employees, and specific
coverage options.
e. Claim Documents:
•
While specific documentation requirements may vary based on the nature of the claim,
generally, the following documents are required:
o
Completed Claim Form: Duly filled and signed by the policyholder.
o
Medical Reports: Detailed diagnosis and treatment information from attending
physicians.
o
Hospital Bills and Receipts: Original or certified copies of all medical expenses
incurred。
o
Discharge Summary: Official document from the hospital detailing the treatment and
discharge status.
o
Police Report: If applicable, especially in cases of accidents.
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Financial position of GREAT EASTERN
To assess the financial position of Great Eastern Life Assurance Berhad (GELM) based on the
the their latest annual report, GREAT EASTERN Annual Report 2023. Below is a detailed
evaluation of GELM's financial position as of December 31, 2023, focusing on its profitability,
assets, liabilities, equity, and capital adequacy.
1. Profitability
GELM demonstrated strong profitability in FY2023:
•
Net Profit After Tax: RM1,123.7 million.
•
Total Weighted New Sales: RM1,471.3 million, reflecting robust business activity.
•
Insurance Service Results: RM1,220.5 million, derived from insurance revenue of
RM7,491.2 million less insurance service expenses of RM6,073.1 million and net
expenses from reinsurance contracts of RM197.6 million.
•
Net Investment Income: RM5,273.5 million, including investment income of
RM3,524.9 million, rental income of RM81.0 million, gain on exchange differences of
RM224.2 million, and a gain on sale of investments and changes in fair value of
RM1,474.2 million, offset by a slight decrease in provision for impairment of assets
(RM30.9 million).
2. Assets
•
Total Assets: RM91,716.4 million.
•
Financial Investments: RM86,790.5 million, primarily held in the Life Insurance Fund
(RM84,605.4 million).
•
Investment Income and Capital Loss: RM5,074.4 million, indicating solid returns from
investment activities.
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•
Gross Premiums: RM10,167.7 million, highlighting strong revenue from insurance
contracts.
•
Reinsurance and Insurance Contract Assets: RM145.6 million and RM16.5 million,
respectively.
•
Other Assets: RM4,763.8 million, including various operational assets.
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3. Liabilities
•
Insurance Contract Liabilities: RM86,798.1 million, representing obligations to
policyholders.
•
Total Liabilities: RM89,528.3 million.
•
Reinsurance Contract Liabilities: RM242.7 million.
•
Other Liabilities: RM2,487.5 million, covering operational and financial obligations.
4. Equity and Shareholders’ Fund
•
Total Equity: RM2,188.0 million.
•
Shareholders’ Fund: RM2,188.0 million, comprising retained earnings and reserves.
•
Dividend Policy: An interim dividend of RM5.90 per ordinary share was paid, with no
final dividend recommended to retain funds for the proposed acquisition of AmMetLife
Insurance Berhad.
5. Capital Adequacy
•
Total Capital Available: RM20,064.5 million.
•
Eligible Tier 1 Capital: RM20,181.5 million, including paid-up share capital of RM100
million and reserves/retained earnings of RM20,081.5 million.
•
Tier 2 Capital: RM71.5 million, with deductions for intangible assets and deferred tax
assets amounting to RM188.6 million.
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Financial Ratios for Great Eatern Annual Report 2023
1. Return on Equity (ROE)
•
Formula: Net Profit After Tax ÷ Total Equity
•
Calculation: RM1,123.7 million ÷ RM2,188.0 million = 0.5136 or 51.36%
•
An ROE of 51.36% indicates that GELM generates RM0.5136 in profit for every RM1 of
equity, reflecting excellent profitability and efficient use of shareholders’ funds.
2. Return on Assets (ROA)
•
Formula: Net Profit After Tax ÷ Total Assets
•
Calculation: RM1,123.7 million ÷ RM91,716.4 million = 0.01225 or 1.23%
•
An ROA of 1.23% shows that GELM earns RM0.0123 per RM1 of assets.
3. Loss Ratio
•
Formula: Insurance Service Expenses ÷ Insurance Revenue
•
Calculation: RM6,073.1 million ÷ RM7,491.2 million = 0.8106 or 81.06%
•
A loss ratio of 81.06% means that 81.06% of insurance revenue is spent on claims and
related expenses
4. Combined Ratio (Simplified for Life Insurance)
•
Formula: (Insurance Service Expenses + Net Expenses from Reinsurance Contracts) ÷
Insurance Revenue
•
Calculation: (RM6,073.1 million + RM197.6 million) ÷ RM7,491.2 million =
RM6,270.7 million ÷ RM7,491.2 million = 0.8370 or 83.70%
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•
The combined ratio of 83.70% reflects the proportion of insurance revenue consumed by
claims and reinsurance costs
5. Solvency Ratio (Capital Adequacy Ratio)
•
Formula: Total Capital Available ÷ Insurance Contract Liabilities
•
Calculation: RM20,064.5 million ÷ RM86,798.1 million = 0.2312 or 23.12%
•
A solvency ratio of 23.12% shows that GELM’s available capital covers 23.12% of its
insurance liabilities
6. Liabilities-to-Equity Ratio
•
Formula: Total Liabilities ÷ Total Equity
•
Calculation: RM89,528.3 million ÷ RM2,188.0 million = 40.91
•
A ratio of 40.91 means liabilities are 40.91 times equity, which is high but typical for
insurance companies due to their reliance on policyholder funds
7.Premium-to-Equity Ratio
•
Formula: Gross Premiums ÷ Total Equity
•
Calculation: RM10,167.7 million ÷ RM2,188.0 million = 4.65
•
A ratio of 4.65 indicates that gross premiums are 4.65 times equity, showing GELM’s
ability to generate significant premium income relative to its equity base
8. Investment Yield
•
Formula: Net Investment Income ÷ Financial Investments
•
Calculation: RM5,273.5 million ÷ RM86,790.5 million = 0.0608 or 6.08%
•
An investment yield of 6.08% reflects the return on GELM’s financial investments
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9. Equity-to-Assets Ratio
•
Formula: Total Equity ÷ Total Assets
•
Calculation: RM2,188.0 million ÷ RM91,716.4 million = 0.0239 or 2.39%
•
An equity-to-assets ratio of 2.39% shows that equity constitutes 2.39% of total assets
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New initiatives that were introduced during Covid-19 pandemic
During quarter 1 of 2022, GELM had launch several Covid-19 related campaigns such as
Complimentary Coverage Campaign for Covid-19 Vaccination Complications and Protection ++
Campaign. These initiatives had offered free additional coverage against unintentional death due
to natural causes. Moreover, hospitalization income benefits were introduced due to Covid-19.
This was found in the research about this campaign aimed at providing financial relief and
enhanced protection during uncertain times. Another initiative that was introduced is regarding
retirement and wealth protection. Generally, this initiative helps to support long-term financial
security and retirement planning. GELM introduced various savings and investment products
which are GREAT saver 3.2, it was launched in September 2022 and was a two-year
nonparticipating endowment plan designed to enhance retirement savings. GREAT Flexi Wealth
Plus and GREAT Wealth enhancer aimed to provide flexible and enhanced long-term
opportunities for savings
Furthermore, GELM has implemented AI solutions to enhance customers interactions drastically,
Great Eastern Integrated their chatbot, GERICA with Pand.ai’s AI engine and TE01 which
utilizes Natural Language Processing so that human is able to understand AI. Doing so allows
agents to efficiently check claim statuses and access policy details on the go, reducing errors in
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References
https://www.greateasternlife.com/my/en/personal-insurance/our-products/hospital-surgicalinsurance/easimed-active.html
https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-brandcomm/gegm/gegm-product/easi-med-active/gegm-pdt-pd-easimedactive-brochure.pdf
https://www.greateasternlife.com/my/en/personal-insurance/our-products/health-insurance/greathealth-direct.html
SMARTPROTECT Wealth Max
https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-mcmmarcom/product-/life-insurance/smart-protect-wealth-max/gelm-mmc-pd-smartprotect-wealthmax-brochure1.pdf
Great Term Direct
https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-mcmmarcom/product-/life-insurance/great-term-direct/gelm-mmc-pd-great-term-direct-brochure(002).pdf
GREAT Medic Lite Secure
https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-mcmmarcom/product-/health-insurance/great-medic-lite-secure/gelm-mmc-pd-great-medic-litesecure-brochure.pdf
Great Health Direct
https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-mcmmarcom/product-/health-insurance/great-health-direct/gelm-mmc-pd-great-health-directbrochure-(002).pdf
Great Shield Active
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https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-brandcomm/gegm/gegm-product/great-shield-active/gegm-pdt-pd-greatshieldactive-brochure.pdf
EasiMed Active
https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-brandcomm/gegm/gegm-product/easi-med-active/gegm-pdt-pd-easimedactive-brochure.pdf
Great BizCare for SMEs
https://www.greateasternlife.com/my/en/corporate-solutions/group-insurance/great-bizcare.html
Group Multiple Benefits Insurance Scheme (GMBIS)
https://www.greateasternlife.com/my/en/corporate-solutions/group-insurance/group-multiplebenefits-insurance-scheme-gmbis.html
https://www.greateasternlife.com/content/dam/corp-site/my/homepage/corporatesolutions/group-insurance/group-multiple-benefits-insurance-scheme/gmbis-product-flyer.pdf
Easi-Biz Standard/ Easi-Biz Premier
https://www.greateasternlife.com/my/en/corporate-solutions/general-insurance/easi-biz-standardpremier.html
Easi Health SME @ SME Medical Insurance for Employees
https://www.greateasternlife.com/my/en/corporate-solutions/general-insurance/easi-healthsme.html
https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-mcmmarcom/product-/life-insurance/smartprotect-you/gelm-mcm-pd-smartprotect-you-brochure2.pdf
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https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-mcmmarcom/product-/health-insurance/great-medic-lite-secure/gelm-mmc-pd-great-medic-litesecure-brochure.pdf
https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-brandcomm/gegm/gegm-product/great-shield-active/gegm-pdt-pd-greatshieldactive-brochure.pdf
https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-brandcomm/gegm/gegm-product/easi-med-major/gegm-pdt-pd-easimedmajor-brochure.pdf
https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-mcmmarcom/product-/wealth-accumulation/smartinvest-premier-3/gelm-mcm-pd-smartinvestpremier-brochure2.pdf
https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-brandcomm/gegm/gegm-product/travel-for-more/gegm-pdt-pd-travelformore-brochure.pdf
https://www.greateasternlife.com/my/en/personal-insurance/our-products/motorinsurance/motor-insurance.html
https://www.greateasternlife.com/content/dam/corp-site/my/malaysia/gelm-brandcomm/gegm/gegm-product/great-home-360/gegm-da-pd-great-home-360-brochure.pdf
https://www.greateasternlife.com/my/en/personal-insurance/our-products/sports-insurance/easigolf.html
https://www.greateasternlife.com/content/dam/dmassets/great-eastern/malaysia/gelm-brandcomm/gelm-homepage/gelm-bcd-hp-pidm-tips-brochure.pdf
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