CAMPAIGNS & ACTIVITIES

Goodwill Cashless Health Claims Assistance

CAMPAIGNS & ACTIVITIES

Goodwill Cashless Health Claims Assistance

1.     What is Goodwill Health Claims Assistance for COVID-19 Campaign?
This Medical Plan Covid-19 Coverage Campaign is specially designed by AXA AFFIN Life Insurance Berhad to help our customers during this challenging time, by covering hospitalisation treatment due to COVID-19 for eligible customers. This means, we will provide reimbursement on goodwill basis for hopsitalisation treatment due to COVID-19.

This reimbursement is payable on goodwill basis and will not reduce your medical plan annual limit.

Please refer to the terms and conditions of the campaign.

2.     Do I need to pay additional cost to sign-up for this campaign?
There will be no additional cost required from you for this COVID-19 Medical Plan Coverage Campaign.

3.     What are the eligible criteria for this campaign?
Customer (Insured) has completed COVID-19 vaccination as follow:

  • 2 doses of Pfizer, AstraZeneca  Sinovac;
  • 1 dose of Cansino and Johnson&Johnson; or
  • any new vaccine that will be added to the Immunization Schedule for National Immunisation Program of Malaysia, and must be administered by the Ministry of Health Malaysia.

Customer who purchased the following medical plan listed below will be automatically enrolled in this campaign at no additional cost:
(a)  OneMedic
(b)  AXA Medic Essential
(c)  Medic Assure
(d)  HOPE Medic 3
(e)  HOPE Medic 2
(f)   HOPE Medic
(g)  Medical Care Plus
(h)  Medical Care
(i)   iMed
(j)   AXA eMedic
(k)  eMedic Plus

4.     I am currently covered under AXA AFFIN Life Insurance Berhad policies, but without any of the eligible medical plans, am I still eligible for this campaign?
No, only policies with the eligible medical plans are entitled for this campaign.

5.     I bought a medical policy for my child and he has not been vaccinated. Does my child eligible for this campaign?
Yes. For Insureds below the age of 18 at the time of hospitalization due to Covid-19, a claim for the goodwill assistance can be made up to the Maximum Limits and condition as defined in this campaign.

However, We reserve the right to change or withdraw this consideration upon commencement of the National Vaccination program for children.

6.     I am currently covered under 2 eligible medical plans under this campaign, am I eligible for 2 reimbursements?
No, only one reimbursement per insured will be payable. Only the highest Maximum Limit shall be applied for the same hospitalisation.

Only limited to one claim per insured under this campaign.

7.     Is cashless facility available for this campaign?
Yes, cashless facility is available. To know more, please get in touch with your agent/servicing officer or our Customer Care team: 1300 88 1616 | customer.care@axa-life.com.my

8.     If I am hospitalised overseas due to COVID-19, am I eligible for this campaign?
No.

9.     If I was hospitalised due to COVID-19 before the campaign period, can I submit for reimbursement under this campaign?
No. The onset date of hospitalisation due to COVID-19 must happen during the Campaign Period.

10.  If I have already made claims on my medical plan and have already exhausted the annual limit for that policy year, am I still eligible for this campaign?
Yes, as long as you fulfil the eligibility criteria for this campaign. This reimbursement of the eligible claim under this campaign will not reduce your medical plan annual limit.

Important Note: Please note that the reimbursement will be capped at the Maximum Limit stated above or the respective plan’s annual limit, whichever is lower. For example:  

11.  Can I submit claim under this campaign for any out-patient treatment (inclusive of pre-hospitalisation, post-hospitalisation etc)?
No. We will only reimburse the Reasonable and Customary Charges incurred for Medically Necessary treatments received by the Insured of the eligible medical plans as stated above, who undergoes hospitalization for the purpose of COVID-19 Condition medical treatments during the Campaign Period.

A patient shall not be considered as an In-Patient if the patient does not physically stay in the Hospital for the whole period of hospitalisation. In-Patient means an overnight admission of an Insured into a Hospital in order to receive treatment.

12.  Will a claim under this campaign use up the annual limit under my medical plan?
No, any reimbursement that is provided under this campaign shall not reduce any annual limit that applies to your medical plan.

13.  Is there any waiting period imposed for any claims made under this campaign?
Yes. A 30 days waiting period is for this campaign eligibility and commenced concurrently from your medical plan policy effective date.  

14.  Can I still claim if I am hospitalised due to Covid-19 under Stage 1 and 2?
No.

15.  If my condition progresses from Stage 1 or 2 to Stage 3, 4 or 5, am I eligible for this campaign?
Yes, as long as you fulfill the criteria defined by Stage 3, 4 and 5 of COVID-19, you are eligible for one claim during the campaign period.

16.  If my condition progresses from Stage 4 to Stage 5 during the same hospitalisation period, what is the reimbursement amount that I am entitled to?
If there is more than one claim under different stage of Covid-19 condition, the reimbursement shall only be limited to the the highest Maximum Limit. For this instances, the reimbursement amount shall be capped to the Maximum Limit of Stage 5 or the medical plan’s annual limit, if applicable. Only the highest Maximum Limit shall be applicable for the same hopitalisation. Only limited to one claim per insured under this campaign.

17.  How do I submit a claim under this campaign?
The required documents as below must be submitted to us:  

  • Proof of COVID-19 Vaccination / Vaccination Certificate;
  • Duly Completed Claim Form (By Claimant);
  • Discharge Summary;
  • Hospital bills (detailed / itemized);
  • COVID-19 test report; and
  • Any Imaging and laboratory reports such as x-rays and blood test results.

Campaign Terms & Conditions

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