I agree that it is an uphill task for consumers to understand the exclusions, limitations and benefits of a medical card. However, it is still worthy to study before putting signature on the application form. Relying on agent is the old habit of the majority consumers in Malaysia. This situation needs to be changed.

In general, there are a few key areas that consumers have to pay attention to when selecting medical card (more appropriate term for medical card is Hospitalisation & Surgical (H&S) Insurance:

1) The structure of the H&S insurance
- standalone?
- attached to life insurance? or
- attached to investment-linked?

2) Types of plan
- H&S insurance with co-insurance?
- H&S insurance with deductible? or
- H&S insurance without co-insurance and deductible

3) Provisions of hospital admission
- with hospital admission assist card? or
- reimbursement basic?

4) Category of the plan
- individual plan?
- husband and wife plan?
- family plan? or
- single parent and children?

5) Renewal conditions
- renew at option of policyholder?
- renew at option of insurance company?
- a combination of renew at option of insurance company follow up renew at option of policyholder?

6) Claim limit for each benefit
- Up to annual limit?
- Up to sub-limit?

7) Co-insurance (if applicable)
- Minimum co-insurance (in Ringgit)?
- Maximum co-insurance (in Ringgit)?

8) Deductible (if applicable)
- Minimum deductible (in Ringgit)?
- Maximum deductible (in Ringgit)?

9) General exclusions
- About 20 exclusions - this one is available in almost all plan brochure - have to read by your own

10) Waiting periods (mandatory)
- 30 days for claim due to sickness
- 120 days for specified illness


Spend some time to study the advantages and disadvantages of the key areas mentioned above for any H&S insurance plan. I believe the consumer will be more informed and able to make a wise decision.

There are 3 types of renewal conditions:
(i) Renewal at option of policy-holder

Over the last few years, the phrase 'guaranteed renewable' has been widely used. However, nowadays, it has been replaced by 'renewal at option of the policy-holder'. In other words, the insurance company cannot cancel (refuse to renew) your policy as long as you continue to pay your premium on time.

However, this renewal option does not mean you have 100% control over the renewal of your policy. This renewal option stops when any of the following events occur:
- Non-payment of premium
- Premium not paid on time
- Fraud or misprensentations of facts during this application
- The insurance company withdrawing policy completely from market in accordance with portfolio withdrawal condition. This withdrawal gives all insurance companies the right to protect themselves from future losses.

(ii) Renewal at the option of insurance company
The insurance has the right to accept or refuse your policy renewal. However, the premium is cheaper and the annual limit is refresh every year.

(iii) Combination of (i) and (ii)
Your policy must be claim-free (claim never made previously) and must be in force for a period of 1 or 2 consecutive years in order for you to qualify for the 'renewal at option of policy-holder' condition.