TO

Fakulti Sains & Teknologi

Peranan Takaful Am Dalam Pengurusan

Risiko Pekerjaan

Kau Kong Hoi FSA, FASM

21 November 2015

Growing Beyond Expectations

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IKHLAS Motor Takaful

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PRESENTATION OUTLINE

IKHLAS Motorist P.A. Takaful

Group Personal Accident

Group Hospital & Outpatient Care

Peranan Takaful Am Adalah Untuk

Membahagikan Risiko dan Bukan

Mengurangkan Risiko

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IKHLAS MOTOR TAKAFUL

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Private Car C – Permit Motor

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SCOPE OF COVERAGE

THE ROAD TRANSPORT ACT 1987

( Requirement of Sec. 90 )

Required all motorists to be insured against

liabilities for injuries to third parties resulting from

the use of any vehicle on Public Roads.

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IKHLAS MOTOR TAKAFUL

Introduction

Cash Before Cover Regulation (CBC)

• The „Cash Before Cover‟ regulation means no cover can be granted until the contribution has been paid. Failure to comply with the Takaful Act, 1984 under section 25(6) will result in a maximum penalty of Five Thousand ( RM 5,000.00 ).

No Back-Dated Coverage

• Example : If you issue E-Cover Note today 21/2/2015, the period of cover cannot commence on 20/2/2015.

Contribution Must Be Received Within 7

Working Days

• All documentation related to the issuance of the E-Cover Note together with full contribution must be given to Takaful Ikhlas within 7 working days from the issuing date of the E-Cover Note irrespective of the commencement date of Certificate.

Bank Negara Regulations:

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REGULATION

Act Cover

• Cover the participant against claims from other people for bodily injury (including death) caused by the careless driving of the participant or any participant driver.

• Unlimited Liability of bodily injury ( including death ).

Third Party

• Cover against :-

•Liability to Third Party including death

•Liability to the Third Party Property Damage

• Limit of Liability:-

• Bodily injury (including death Unlimited

• Damage to property belongings to Third Party Limit to RM3,000,000

Comprehensive

•Cover as follows :-

•Own Damage & Liability to Third Party (death )

•Property Damage to Third Party

•Burglary, theft, damage own property due to fire explosion or

• lightning and other damages as stated in the Certificate.

•Limit of Liability :-

•Bodily injury & death to third party

•Unlimited

•Property Damage to third party

•Limited amount to RM3,000,000

•Excess :-

•Excess to Own Damage for claim

•Compulsory Excess of 2(f)

•Limit Liability for Own Damage Accident :-

•The claim limit for payment due to liability whether property damage or theft is based on the Market Value to reinstate to the original position before the accident.

Third Party Fire & Theft

• Cover against :-

• Liability to Third Party including death

• Liability to the Third Party Property Damage

• Vehicle is damaged or lost due to Fire.

• Vehicle is damaged or lost due to Theft.

Bank Negara Regulations:

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TYPES OF COVER

Based on Market Value

Depreciation value must not be more than 10%

If SC below market value “Average Clause” will apply ( Under Participant )

Sum Covered x Total Claim

Market Value

Introduction

Covered below than Market Value / Under Covered

Average clause‟ will apply as follow :-

Example how to calculate „Average Clause‟ :-

Sum Covered: RM 15,000.00

Market Value: RM 24,000.00

Vehicle Model: Perodua Kancil

Claim incurred: RM 6,000.00

Calculation:-

15,000 x 6000 = 3750

24,000

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SUM COVERED

Coverage Comprehensive Third

Party

Breakage Of Glass In Windscreen

•Additional contribution – 15% from the windscreen

sum covered

•Minimum RM 30

√ N/A

Accessories (Radio Cassette, etc)

•Additional contribution – 15% from the accessories

sum covered

•Minimum RM 30

√ N/A

Flood Typhoon Hurricane Earthquake

•Additional contribution – 0.50% from the sum covered

•Minimum RM 15

√ N/A

Strike Riot And Civil Commotion

•Additional contribution – 0.30% from the sum covered

•Minimum RM 5

√ N/A

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ADDITIONAL BENEFITS PRIVATE CAR

The contribution payable may be reduced if the insured have NCD entitlement.

It‟s a „reward‟ scheme for the insured if no claim was made against the policy during

the preceding 12 months of policy

Different NCD rates are applicable for different classes of vehicles

Private Car

Coverage Duration NCD (%)

After 1 Year 25

After 2 Years 30

After 3 Years 38.33

After 4 Years 45

After 5 Years and above 55

Motorcycle

Coverage Duration NCD (%)

After 1 Year 15

After 2 Years 20

After 3 Years 25

The NCD can be transferable to another insurer

or another vehicle that belongs to the insured

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NO CLAIM DISCOUNT (NCD)

Type Of Claim Which Affected The NCD

Type Of Claim Effect To NCD

Own Damage (OD) Affected

Third Party Property Damage Affected

Third Party Bodily Injury Affected

Theft Affected

Windscreen* Not Affected

Accessories* Not Affected

Knock for Knock (KFK) Not Affected

* With additional contribution for additional benefits

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NO CLAIM DISCOUNT (NCD)

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NO CLAIM DISCOUNT (NCD)

Contribution to Takaful Ikhlas is base on the following rating factors :-

1. Sum Covered ( Market Value )

2. Engine Capacity ( c.c )

3. Age of Vehicle

4. Age of Driver

5. History of Claim

6. Type of Vehicle

More than 300 panel workshops nationwide.

ISO 9001 on claims (Theft/Accidental)

No submission of proposal form and cover note.

IKHLAS Motorist P.A is available with contribution as low as RM 50.00 to cover any 5 persons in the vehicle inclusive of the driver.

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Ezi Claim Drive in

In claim settlement below RM3,000, a damage assessor will be on site for an

on the spot claim assessment. The cheque processing will be completed within

the hour.

24 Hours Roadside Assistance (1-800-88-1186)

Towing & Emergency Assistance if the vehicle breaks down and is immobilized,

our call center will arrange & pay up to a maximum amount of RM200.

Includes delivery & installation of new battery, jumpstart, flat tyre assistance &

delivery fuel ( cost of tyre, battery & fuel are borne by the participant.

IKHLAS MOTOR TAKAFUL BENEFITS

IKHLAS MOTORIST

P.A. TAKAFUL

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This product provides protection against accidental death or

permanent disablement to the participant and the

passenger due to road accident whilst entering, riding or

alighting from the covered vehicle.

TABLE OF BENEFITS

IKHLAS MOTORIST P.A. TAKAFUL

Package A (RM) B (RM) C (RM) D (RM) E (RM)

Death & Permanent Disablement 10K 20K 30K 40K 50K

Loss of both hands or both feet 10K 20K 30K 40K 50K

Loss of sight of both eyes 10K 20K 30K 40K 50K

Loss of sight of one eye and one hand or

one foot 10K 20K 30K 40K 50K

Loss of one hand or one foot 5K 10K 15K 20K 25K

Loss of sight of one eye 5K 10K 15K 20K 25K

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Introduction

BENEFITS PLAN & CONTRIBUTION TABLE

WHY CHOOSE IKHLAS MOTORIST P.A TAKAFUL?

IKHLAS MOTORIST P.A. TAKAFUL

Plan Sum Covered Per

Person (RM)

Contribution Per

Vehicle(RM)

Stamp Duty

(RM)

Total Contribution

(RM)

A 10,000.00 40.00 10.00 50.00

B 20,000.00 80.00 10.00 90.00

C 30,000.00 120.00 10.00 130.00

D 40,000.00 160.00 10.00 170.00

E 50,000.00 200.00 10.00 210.00

Easy and fast enrolment

Eligibility :

Issue Ages : 1 – 75 years, age next birthday

Occupational class : 1,2 & 3

One single contribution to cover 5 persons in the vehicle (inclusive driver/authorized driver)

Additional persons are allowed subject to additional contribution RM 10.00 each

Maximum of additional persons subject to seating capacity permitted under JPJ rules and

regulation

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GROUP PERSONAL ACCIDENT

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This certificate provides coverage to protect the employees against Death or Total

Permanent Disablement with Immediate Death Expenses and Hospital Income.

The coverage is 24 hours and worldwide.

GROUP PERSONAL ACCIDENT

Descriptions Coverage /Payable

Basic Benefit :-

Death - In the event of an insured employee died from accident

cause, eligible employees are covered without geographical

limitation for 24 hours a day

Sum Covered as per HR

list

Supplementary Benefits :

Total and Permanent Disability Benefit

Immediate Death Expense

Accidental Death Benefit & Disability

Partial and Permanent Disability Benefit Due To Accidental

Daily Hospital Income

Sum Covered as per HR

list

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Introduction

GROUP HOSPITALISATION &

OUTPATIENT CARE

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Takaful IKHLAS is the Risk underwriter, issues certificates & bills

MediExpress (M) Sdn

Bhd is one of our

appointed third party

administrator

Administration

Medical Management

Member Services

• Entitlements, Claims Review &

Settlement, Letter of Guarantees

• Working Relationship with major

hospitals

• Manage more than 2600 Panel Clinics

Nationwide

• Enquiries on LOG, LOG issuance, 24

hours Emergency Line

GROUP HOSPITAL & OUTPATIENT CARE

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Introduction

Hospital & Surgical Care Option 1 Option 2 Option 3 Option 4

1.In-Hospital Care

2.Hospital Room & Board (max. daily benefits) (i) Ordinary Room (up to 120 days max. per disability) (ii) Intensive Care (max. daily benefits) (up to 20 days max. per disability)

350

230

180

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3.Hospital Supplies & Services •As Charged

-Max. 120 days per disability -For non surgical disability, max 2 visit per day, up to 120 days per disability

4.Surgical Fees

5.Anaesthetic Fees

6.Operating Theatre Charges

7.In-Hospital Physician‟s Fees

8.Malaysian GH Daily Allowance ( Max 120 days per disability)

200 150 100 50

SCHEDULE OF BENEFITS FOR INPATIENT - SAMPLE

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Any use, copying or distribution without written permission from MediExpress (M) Sdn Bhd is prohibited.

Participants Hospital

Or Call

Present card at Admission Counter

Go Direct to hospital

Fax

• Medical Form

•Provisional

Diagnosis

Repudiation Letter

If NOT

Coverable

• Treatment

• Final Diagnosis

• Billing

• Lab report

Discharge

Final LG /

Excess Letter

HOSPITALIZATION FLOW CHART – Private

Coverable

Initial Letter of Guarantee (LG)

Admission

MediExpress for Pre-plan Admission

ADMISSION & DISCHARGE

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Coverage Plan 1 Plan 2 Plan 3 Plan 4

Outpatient GP Care

• Routine Consultation

Cover Cover Cover Cover

• Medication

• Injection

• Diagnostic Lab / X-Ray Procedures

• Outpatient Surgical Procedures

Outpatient Specialist Care With Panel GP Referral Letter

• Consultation Cover Cover Cover Cover

• Medication Cover Cover Cover Cover

• Injection Cover Cover Cover Cover

• Diagnostic Lab / X-Ray Procedures Cover Cover Cover Cover

• Outpatient Surgical Procedures Cover Cover Cover Cover

Outpatient Limit Per Employee

Per Annum 5000 3000 2000 1000

SCHEDULE OF BENEFITS FOR OUTPATIENT - SAMPLE

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CONSULTATION FLOW CHART

Participant goes to a

panel clinic.

Doctor fills up claim form

1) Treats patient

2) Dispense Medicine

3) Charges, MC and etc

Participants

1) Signs the claim form

2) Takes medicine.

At the Clinic, present

1) Membership Card,

2) Identity Card.

1) Nurse verifies membership

online

2) Member fills up Patient‟s

Details on Claim Form.

1 2

4

Clinic bills HC monthly or fortnightly

if volume is high. HC will process

invoices, provide reports to

Employer, pays clinics

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OUT-PATIENT MEDICAL BENEFIT

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OUTPATIENT SPECIALIST FLOW CHART

Participants

1) Calls Specialist Clinic to make an

appointment/ Directly go to specialist

clinic with referral letter.

2) Fax Referral Letter/Appointment Card to

MediExpress. (603-7803 2005)

3) MediExpress faxes GL to the specialist

clinic/member (15min to 30min)

Doctor

1) Treats patient

2) Dispense Medicine (If any)

Participants

1) Signs the claim form

2) Takes medicine. (If any)

1) Nurse checks the Appointment

card/GL

2) Nurse fills up Patient‟s Details

on Medical Form.

At the Specialist Clinic,

present

1) Membership Card

2) Identity Card.

3) Letter of Guarantee

(If any)

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OUT-PATIENT MEDICAL BENEFIT

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Sekian, Terima Kasih.

Kau Kong Hoi FSA, FASM

21 November 2015

Growing Beyond Expectations

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