MEDICAL
ONEMEDIC LITE
That balances medical protection and affordability
Key Benefits
Cash Relief in the event of Medical Quarantine
In the event you suffer from any disease that require you to be admitted in an isolation ward
of government hospital, we will pay double of the Daily Allowance for Hospitalisation
in Government Hospital, so that it can support your daily living expenses and you
can focus on your recovery. This coverage is very relevant in the current situation of
pandemic threats.
Daily Allowance for Hospitalisation in Government Hospital
A daily allowance for you when you are hospitalised in a normal ward for any admission
in a government hospital.
One Medical Plan That Balances Your Medical
Protection Needs And Your Affordability
Every day you are presented with options and we want to make sure the choice that you
made is helping you to become better every day. One of the important choices you have to
make is buying medical insurance for yourself and your family.
There are many medical insurance products available in the market and we are here to help
you make the right choice by offering you OneMedic Lite, the one medical plan that provides
you and your family a peace of mind and at the same time it meets your affordability.
OneMedic Lite provides 4 key features that will fulfill your family and your medical protection
needs.
No Lifetime Limit
We wish to provide you a lifetime of coverage and thus it is necessary to have unlimited
lifetime medical limit to support you up to age 1001. Also, no lifetime limit for Out-Patient
Cancer Treatment and Kidney Dialysis.
Deductible
Choose your option of deductible to enjoy further rebate on your insurance charges,
if you decide to first pay a selected amount on your medical expenses while we will
reimburse the remaining medical expenses.
1
With optional coverage term of 30 years or up to age 80, and this plan will be guaranteed to be
renewed without evidence of insurability at your option up to age 100 provided that the basic plan is
still in-force. You will be notified at least 90 days prior to the expiry age of this rider.
Schedule Of Benefits
Plan Lite 1 Lite 2
Annual Limit (applicable to benefit no. 1 to no. 16) RM250,000 RM500,000
Lifetime Limit No limit
Inflation Defender Not Applicable
Deductible RM0 or RM300
Section A: In-Patient and Surgical Benefit (for any one disability)
1 Hospital Room and Board (daily maximum) RM150 RM150
Maximum number of days 150 days for any one disability
2 Intensive Care Unit As charged
Maximum number of days 150 days for any one disability
3 In-Patient Related Fees
(a) Hospital Supplies and Services (including
medical report charges up to RM200 per
hospitalisation)
(b) Surgical Fees
(c) Anaesthetist Fees
As charged
(d) Operating Theatre Fees
(e) In-Patient Prescribed Medicines
(f) In-Patient Diagnostic Procedures and In-
Patient Physiotherapy
(g) In-Patient Physician Visit (up to 2 visits per day
per physician)
4 Ambulance Fees Up to RM500 per hospitalisation
5 Daily Guardian Benefit (for child aged below 15
As charged
years or senior aged above 65 years)
Maximum number of days 150 days for any one disability
6 Daily Allowance for Hospitalisation in
RM60 per day
Government Hospital
Maximum number of days 60 days for any one disability
7 Additional Daily Allowance for Hospitalisation in
RM60 per day
Government Hospital Isolation Ward
Maximum number of days 30 days for any one disability
Schedule Of Benefits
Plan Lite 1 Lite 2
Section B: Out-Patient Benefit (for any one disability)
8 Day Surgery and Daycare Surgical Procedure As charged
9 Pre-Hospitalisation Benefit
(within 60 days before hospitalisation)
(a) Consultation Up to RM5,000 Up to RM10,000
(b) Diagnostic Tests
(c) Medication and Treatment
10 Post-Hospitalisation Benefit
(within 150 days after hospital discharge)
Up to RM5,000 Up to RM10,000
(a) Medication and Treatment
(b) Out-Patient Physiotherapy2
11 Chiropractic and Acupuncture Treatment
Not applicable
(within 150 days after hospital discharge)
12 Out-Patient Kidney Dialysis Treatment
As charged
13 Out-Patient Cancer Treatment
14 Up to Up to
Home Nursing Care RM5,000 per RM10,000 per
hospitalisation hospitalisation
Maximum number of days 180 days per lifetime
15 Emergency Accidental Out-Patient and Follow-
up Treatment (within 30 days from the date of an As charged
accident)
Section C: Special Benefit
16 Intraocular Lens Up to RM3,000 per lifetime
• Benefit no. 7 is payable in addition to Benefit no. 6.
• Please refer to the frequently asked questions for more details on the deductible.
• Please refer to the supplementary contract for full benefit description.
2
Physiotherapy must be performed in the same hospital which the Insured is hospitalised.
Frequently Asked Questions
1. Who can insured under OneMedic Lite?
Coverage Entry Age
Term Option Minimum Maximum
30 years 15 days old 70 years old
Up to age 80 15 days old 50 years old
However, it is subject to our underwriting requirements.
2. How can I take up OneMedic Lite?
You can add OneMedic Lite to our investment-linked insurance plan. Please check with your agent
or contact us for more details.
3. How much do I have to pay?
The insurance charges you have to pay depends on your attained age, gender, occupation, health
condition and the type of plan you choose. The insurance charges payable will increase according
to your attained age. Please refer to Appendix I for the Insurance Charges table for a standard life.
Insurance charges are payable throughout the entire duration of the riders. You must inform us of any
change in your occupation, avocation and sports activities as it may affect the insurance charges
and terms and conditions of the plan.
4. Are the insurance charges payable guaranteed?
Insurance charges are not guaranteed but renewability is guaranteed. We reserve the right to revise
the insurance charges at policy anniversary by giving you at least 90 days’ notice if the overall claim
experience of this class of business is worse than expected.
5. How does deductible work?
The reimbursement of any eligible expenses is always subject to deductible amount, if applicable.
Deductible Amount Conditions
Option (RM)
Zero We shall reimburse the eligible expenses incurred.
300 You must first pay the deductible amount for total eligible expenses
incurred for any one disability and we shall reimburse the excess, if any.
Deductible applies to benefit no. 1 to no. 14 of the Schedule of Benefits.
An example for deductible RM300:
A 30 years old male purchased the OneMedic Lite 1 plan with RM300 deductible. He was admitted
to hospital on December 2020 due to appendicitis. After 3 days of hospitalisation, he was discharged
from hospital with a medical bill of RM10,000.
Assuming the total eligible medical expense is RM10,000. Based on the selected deductible option,
he must first pay RM300 and the balance of RM9,700 will be payable by OneMedic Lite.
6. When does the cover begin?
The coverage begins immediately after the rider has commenced for hospitalisation due to accidents.
There is a waiting period of 120 days for specified illnesses and 30 days for any other causes.
Frequently Asked Questions
Specified illnesses refer to the following disabilities and its related complications:
• Hypertension, diabetes mellitus or cardiovascular disease;
• Growths of any kind including tumours, cancers, cysts, nodules, polyps, kidney stones or gall
bladder stones;
• Any diseases of the ear, nose (including sinuses) or throat;
• Hernias, haemorrhoids, fistulae, hydrocele or varicocele;
• Any diseases of the reproductive system including endometriosis; or
• Any disorders of the spine (including but not limited to a slipped disc) or any knee conditions.
7. Is the renewal guaranteed?
OneMedic Lite is guaranteed to be renewed without evidence of insurability at your option up to
age 100 provided the basic plan is still in-force. There is no selective renewal loading or exclusion
regardless of the claim made during the previous year. However, the renewal of the rider is at your
option until the occurrence of any one of the following:
• Fraud or misrepresentation of material fact during application;
• This rider is cancelled/surrendered at your request;
• On the death of the insured;
• The basic plan to which this rider is attached to terminates, matures, expires or lapses;
• On the policy anniversary prior to the insured attaining the expiry age of this rider, provided that
the renewal privilege of this rider has not been exercised; or
• On the policy anniversary on or following insured’s 100th birthday, provided that the renewal
privilege of this rider has been exercised.
8. Where can I get the latest list of panel hospitals?
You can view our latest list of panel hospitals on our official website at [Link].
9. How do I make a claim?
Where applicable, cashless facility will be provided to the panel hospital for your admission. It is best
for you to arrange for the medical report before any hospital admission for a pre-planned treatment.
Depending on the hospital, you may be required to pay a deposit and the deposit amount may
vary from hospital to hospital. Upon discharge, the hospital will provide the final diagnosis and the
itemised bill. You only need to settle any deductible, ineligible or excess expenses which are not
covered.
In the circumstances of non-cashless admission, you are advised to pay for the treatment first and
after being discharged, file a claim with us.
Cashless facility does not guarantee full payment of your final medical bill which may include excess
and excluded items which must be paid by you.
Please notify us within 30 days of any occurrences for admission to non-panel hospitals, out-patient
treatment or any claims which have been settled by you. Please submit the claim form, original
itemised bills, receipts and other relevant claim documents to us for processing.
10. Where can I check my policy coverage and limits?
You can check on MyGenerali Customer Portal or call us at 1 300 88 1616.
11. What are the consequences of switching policy from one insurer to another?
You may be subject to new underwriting requirements, full waiting period and any applicable period
for the exclusion of specific illnesses or pre-existing conditions of the new plan.
Appendix I
Annual Insurance Charges of One Medic Lite
For Occupation Class 1 & 2 with RM300 Deductible
Lite 1 Lite 2
Attained Age
Male Female Male Female
0–5 917 839 961 878
6 – 10 600 545 628 575
11 – 15 560 510 580 529
16 – 20 598 547 616 560
21 – 25 688 664 708 689
26 – 30 769 802 784 822
31 – 35 835 956 849 968
36 – 40 995 1,058 1,019 1,078
41 – 45 1,142 1,223 1,157 1,252
46 – 50 1,455 1,519 1,467 1,563
51 – 55 1,972 1,997 1,991 2,035
56 – 60 2,398 2,431 2,471 2,483
61 – 65 3,679 3,192 3,797 3,269
66 – 70 5,067 4,275 5,269 4,383
71 – 75 6,690 5,592 6,952 5,807
76 – 80 8,762 6,579 9,142 6,888
81 11,256 8,621 11,826 9,093
82 11,811 9,109 12,565 9,728
83 12,392 9,627 13,306 10,395
84 13,005 10,177 14,101 11,097
85 13,676 10,758 14,930 11,814
86 14,100 11,150 15,517 12,413
87 14,681 11,680 16,122 12,990
88 15,285 12,259 16,734 13,560
89 15,918 12,846 17,360 14,171
90 16,611 13,462 17,995 14,800
91 17,119 13,983 18,677 15,462
92 17,762 14,577 19,342 16,135
93 18,387 15,225 20,019 16,828
94 19,079 15,873 20,714 17,545
95 19,797 16,581 21,389 18,287
96 20,523 17,294 22,237 19,078
97 21,299 18,065 22,983 19,869
98 22,054 18,876 23,704 20,691
99 22,889 19,685 24,486 21,540
Appendix I
Annual Insurance Charges of One Medic Lite
For Occupation Class 1 & 2 with Zero Deductible
Lite 1 Lite 2
Attained Age
Male Female Male Female
0–5 1,145 1,047 1,200 1,098
6 – 10 779 708 815 745
11 – 15 746 679 773 704
16 – 20 830 759 854 777
21 – 25 982 948 1,010 983
26 – 30 1,068 1,114 1,088 1,140
31 – 35 1,083 1,241 1,103 1,257
36 – 40 1,244 1,322 1,273 1,346
41 – 45 1,428 1,528 1,446 1,565
46 – 50 1,775 1,852 1,789 1,906
51 – 55 2,404 2,436 2,428 2,481
56 – 60 2,925 2,963 3,011 3,027
61 – 65 4,487 3,890 4,630 3,985
66 – 70 6,182 5,213 6,425 5,345
71 – 75 8,157 6,821 8,473 7,077
76 – 80 10,687 8,018 11,143 8,397
81 13,732 10,509 14,413 11,095
82 14,410 11,102 15,308 11,864
83 15,123 11,732 16,234 12,671
84 15,873 12,400 17,197 13,521
85 16,662 13,107 18,199 14,414
86 17,184 13,605 18,939 15,131
87 17,900 14,256 19,669 15,828
88 18,645 14,939 20,408 16,544
89 19,426 15,658 21,163 17,284
90 20,241 16,413 21,931 18,045
91 20,882 17,043 22,782 18,869
92 21,650 17,786 23,587 19,683
93 22,442 18,561 24,403 20,524
94 23,270 19,371 25,243 21,391
95 24,129 20,219 26,100 22,289
96 25,032 21,106 27,104 23,272
97 25,961 22,029 28,006 24,230
98 26,920 22,999 28,924 25,226
99 27,921 24,011 29,869 26,254
Note: • The above rates are rounded to the nearest Ringgit.
• The insurance charges are deducted monthly from the account value of your policy to pay for the
insurance coverage. The insurance charge will increase according to your attained age.
• The insurance charges for age 71-99 are for renewal only.
• The insurance charges above are applicable to standard risk only.
• The Annual Insurance Charges for Occupation Class 3 is additional 15% of the Annual Insurance
Charges for Occupation Class 1 & 2.
• All occupations under Class 4 will not be covered by this plan.
Definition of Occupation Classes
Class 1: Persons engaged in professional, administration, managerial, clerical and non-manual
occupations generally.
Class 2: Persons engaged in work of a supervisory nature and others not in Class 1 whose duties may
involve occasional light manual work but not using tools or machinery or not exposing them to
any special hazards. Persons who are required to travel outside office for business or professional
purposes but not engaging in manual labour.
Class 3: Persons engaged in manual work not of particularly hazardous nature but involving the use of
tools or light machinery.
Class 4: Persons engaged in heavy manual work involving the use of heavy tools and machinery.
Important Notes
We believe it is important that you fully appreciate and understand all the benefits and charges under this
plan.
1. This insurance plan is underwritten by Generali Life Insurance Malaysia Berhad (formerly known as
AXA AFFIN Life Insurance Berhad) 200601003992 (723739-W) (“We/ Us/ Our”), a company licensed
under the Financial Services Act 2013 and regulated by Bank Negara Malaysia.
2. You should satisfy yourself that these riders will best serve your needs and that the premium payable
under the policy is an amount you can afford.
3. If you are not completely satisfied with this rider, you may return this rider and request the cancellation
of this rider within 15 days from the date this rider is delivered to you provided no claim has been
made. We will then refund to you any insurance charge that has been deducted for this rider less any
medical expenses incurred.
4. Please read this brochure together with the basic plan’s brochure. For further information, you may
refer to the sales illustration.
5. OneMedic Lite does not cover any hospitalisation, surgeries or charges incurred caused directly or
indirectly, wholly or partly, by any one of the following occurrences:
• Pre-existing illnesses;
• Specified illnesses occurring within the waiting period;
• Any disabilities, medical or physical conditions and its signs and symptoms occurring within the
waiting period, except for injuries due to accidents;
• Circumcision, eye examination, refractive surgery or surgical procedure for visual impairments
due to astigmatism, farsightedness or nearsightedness (Radial Keratotomy or Lasik), glasses or
contact lenses, High-intensity Focused Ultrasound (HIFU), rhizolysis, robotics surgery that aided
surgical procedure and the use or acquisition of external prosthetic appliances or devices such as
artificial limbs, hearing aids, implanted pacemakers and prescriptions thereof;
Important Notes
• Dental conditions including dental treatment or oral surgery except as necessitated by injuries due
to accidents to sound natural teeth occurring during the period of insurance;
• Private nursing, rest cures or sanitaria care, illegal drugs, intoxication, sterilisation, venereal disease
and its sequelae, Acquired Immune Deficiency Syndrome (AIDS) or AIDS Related Complex (ARC)
and Human Immunodeficiency Virus (HIV) related Diseases, and any communicable diseases
requiring quarantine by law (This exclusion does not apply to any Hospitalisation, Surgery, charges
incurred or death, whichever is applicable, due to Coronavirus Disease (COVID-19));
• Any treatments or surgical operation for congenital conditions or deformities including hereditary
conditions;
• Pregnancy, pregnancy related condition or its complications, child birth (including surgical
delivery), miscarriage, abortion and prenatal or postnatal care and surgical, mechanical or chemical
contraceptive methods of birth control or treatment pertaining to infertility, erectile dysfunction
and tests or treatment related to impotence or sterilisation;
• Hospitalisation primarily for investigatory purposes, diagnosis, X-ray examinations, general
physical or medical examinations that are not related whether directly or indirectly to treatment
or diagnosis of a covered disability, any treatments which is not medically necessary, tests and
investigations done for the purpose of excluding diagnosis other than the final diagnosis in which
final treatment is rendered, any preventive treatments, preventive medicines or examinations
carried out by a physician, and any treatments specifically for weight reduction or gain or bariatric
surgery;
• Suicide, attempted suicide or intentionally self-inflicted injury while sane or insane;
• War or any act of war, declared or undeclared, criminal or terrorist activities, active duty in any
armed forces, direct participation in strikes, riots, civil commotion or insurrection;
• Biological or chemical contamination, ionising radiation or contamination by radioactivity from
any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapons
material;
• Expenses incurred for donation of any body parts or organs by the Insured and costs of acquisition
of the organ including all costs incurred by the donor during organ transplant and its complications;
• Investigation and treatment of sleep and snoring disorders, hormone replacement therapy,
placenta/serum therapy, chelation therapy and alternative therapy such as treatment, medical
service or supplies, including but not limited to acupressure reflexology, bone setting, herbalist
treatment, traditional and complementary medicine (unless otherwise specified), supplementary
medicine, vitamin, nutritional herb, massage or aroma therapy or other alternative treatment;
• Care or treatment for which payment is not required or to the extent which is payable by any other
insurance or indemnity covering the Insured and disabilities arising out of duties of employment or
profession that is covered under a workman’s compensation insurance contract;
• Psychotic, mental or nervous disorders (including any neuroses and their physiological or
psychosomatic manifestations) and any other conditions classified under the Diagnostic and
Statistical Manual of Mental Disorders (DSM-IV Codes) as published by American Psychiatric
Association;
• Costs/expenses of services of a non-medical nature, such as television, telephones, telex services,
radios or similar facilities, admission kit/pack and other ineligible non-medical items;
• Sickness or injury arising from racing of any kind (except foot racing), hazardous sports such as
but not limited to skydiving, water skiing, underwater activities requiring breathing apparatus,
winter sports, professional sports and illegal activities;
• Private flying other than as a fare-paying passenger in any commercial scheduled airlines licensed
to carry passengers over established routes;
• Expenses incurred for sex changes;
• Any treatments directed towards developmental delays and/or learning disabilities of an Insured;
Important Notes
• Any treatments which only offer temporary relief of symptoms on any long-term illnesses and
diseases rather than dealing with the underlying medical condition;
• Any diagnostic tests, procedures, blood tests, investigations or screenings that are not directly
related to the final diagnosis and treatment for the covered disability; or
• Cosmetic/aesthetic/plastic surgery or treatment, or treatment which relates to or is needed
because of previous cosmetic treatment. However, We will pay for the reconstructive surgery if:
(a) it is carried out to restore function or appearance after an accident or following surgery for a
medical condition, provided that the Insured has been continuously covered under this rider
since before the occurrence of accident or surgery;
(b) it is done at a medically appropriate stage after the accident or surgery; and
(c) We agree, in writing, to the cost of the treatment before it is done.
6. This brochure contains only general information about the products and does not in any way represent
a policy. For a detailed description of the terms and conditions and exclusions of the products please
refer to the official policy issued by Us.
Our comprehensive range of insurance plans to
meet your financial needs at every stage of your life:
PROTECTION
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INVESTMENT-LINKED
Generali Life Insurance Malaysia Berhad
(formerly known as AXA AFFIN Life Insurance Berhad)
200601003992 (723739-W)
Correspondence Address:
8th Floor, Chulan Tower,
No. 3 Jalan Conlay, 50450 Kuala Lumpur.
[Link]
+603 2117 6688 +603 2117 3698 1 300 88 1616
OneMedic Lite 042023
Member of PIDM
Generali Life Insurance Malaysia Berhad is a member of Perbadanan Insurans Deposit Malaysia (PIDM). As a member of PIDM, some of
the benefits insured under the insurance policies offered by Generali Life Insurance Malaysia Berhad are protected against loss of part
or all of insurance benefits by PIDM, in the unlikely event of an insurer member failure. For further details of the protection limits and the
scope of coverage, please obtain a PIDM information brochure from Generali Life Insurance Malaysia Berhad or visit PIDM website
([Link]) or call PIDM toll free line (1-800-88-1266).