FAQs - Life Insurance

AXA Life- EGTL Insurance

i) Product Name
e-Group Term Life

ii) Product Type
Group level term

iii) Product Description
This is a yearly renewable non-participating group term insurance. This product is offered on a voluntary basis. This insurance provides benefit for death.

There are optional benefits as below that can be added to the policy:
a) Total and permanent disability (TPD)
b) Cancer
c) Heart Attack
d) Stroke

iv) Individual or Group
This is a group policy

v) Distribution channel
Partnership - Corporate Agent (SenangNVS Sdn Bhd)

vi) Basic or Rider
Basic

vii) Participating or non-participating
Non-participating

Product Benefits

(1) Death Benefit

In the event of the Insured Person’s death, the basic Sum Assured (Sum Assured of Death) is payable.

(2) Total and Permanent Disability (TPD) as used in this Supplementary Contract shall mean the inability of an Insured Person to ever again engage in any gainful occupation or employment for compensation. In order to determine if the total disability has become a permanent one, it must continue uninterruptedly for a period of at least six (6) months and the first day of disablement occurs prior to attainment of age seventy (70).

In this respect, the total irrecoverable loss of sight of both eyes, or the loss by severance of two or more limbs at or above wrists or ankles, or the total irrecoverable loss of one eye and loss by severance of one limb at or above wrist or ankle incurred subsequent to the effective date of coverage of the Insured Person shall be considered as Total and Permanent Disability.

In the event of TPD suffered by an Insured Person prior to attainment of age seventy (70), the benefit payable shall be in a lump sum payment of the Sum Assured of Death, up to a maximum of RM 3,000,000 per life.

(a) If the TPD benefit under the same life is less than or equal to RM 1.5 million, the amount payable for the same life shall be in one lump sum, up to RM 1.5 million.

(b) If the TPD benefit under the same life is:

(i) more than RM 1.5 million, but less than or equal to RM 3 million, the amount payable for the same life shall be in a lump sum payment of RM 1.5 million; and the balance of the TPD benefit shall be payable over twelve (12) months after the date of the first lump sum payment and provided that the TPD has existed continuously; or

(ii) more than RM 3 million, the maximum TPD benefit of RM 3 million shall be payable according to (i) above
The Sum Assured of Death will be reduced by the TPD benefit payout, where the reduced Sum Assured of Death will be payable on subsequent death of the Insured Person provided always that he is still under coverage of the Insurance Certificate.

(3) Cancer

Cancer – of specified severity and does not cover very early cancers Any malignant tumour positively diagnosed with histological confirmation and characterized by the uncontrolled growth of malignant cells and invasion of tissue. The term malignant tumour includes leukemia, lymphoma and sarcoma.

For the above definition, the following are not covered:

(a) All cancers which are histologically classified as any of the following:

pre-malignant

non-invasive

carcinoma in situ

having borderline malignancy

having malignant potential

(b) All tumours of the prostate histologically classified as T1N0M0 (TNM classification)

(c) All tumours of the thyroid histologically classified as T1N0M0 (TNM classification)

(d) All tumours of the urinary bladder histologically classified as T1N0M0 (TNM classification)

(e) Chronic Lymphocytic Leukemia less than RAI Stage 3

(f) All cancers in the presence of HIV

(g) Any skin cancer other than malignant melanoma

(4) Heart Attack

of specified severity Death of heart muscle, due to inadequate blood supply, that has resulted in all of the following evidence of acute myocardial infarction:

(a) A history of typical chest pain;

(b) New characteristic electrocardiographic changes; with the development of any of the following: ST elevation or depression, T wave inversion, pathological Q waves or left bundle branch block and

(c) Elevation of the cardiac biomarkers, inclusive of CPK-MB above the generally accepted normal laboratory levels or Troponins recorded at the following levels or higher:

Cardiac Troponin T or Cardiac Troponin I > / = 0.5 ng/ml

The evidence must show the occurrence of a definite acute myocardial infarction which should be confirmed by a cardiologist or physician.

For the above definition, the following are not covered:

(i) Occurrence of an acute coronary syndrome including but not limited to unstable angina.

(ii) A rise in cardiac biomarkers resulting from a percutaneous procedure for coronary artery disease.

(5) Stroke

Stroke – resulting in permanent neurological deficit with persisting clinical symptoms Death of brain tissue due to inadequate blood supply, bleeding within the skull or embolization from an extra cranial source resulting in permanent neurological deficit with persisting clinical symptoms. The diagnosis must be based on changes seen in a CT scan or MRI and certified by a neurologist. A minimum Assessment Period of 3 months applies.

For the above definition, the following are not covered:

(a) Transient ischemic attacks

(b) Cerebral symptoms due to migraine

(c) Traumatic injury to brain tissue or blood vessels

(d) Vascular disease affecting the eye or optic nerve or vestibular functions

Premium Type (Single / Regular)

Regular premium payment

Minimum & Maximum Premium

Age Annual Rate per 1,000 Sum Assured
Death Accelerated TPD Top 3 CI Total
18 - 50 years old 3.76 0.38 4.86 9
Age Annual Rate for GHL Merchants
Death (Sum Assured 15K) Accelerated TPD (Sum Assured 15K) Top 3 CIADD (Sum Assured 3K) Total
18 - 50 years old 56.4 5.7 14.58 76.68

i) Premium Allocation
Not applicable

ii) Premium paying terms
Follow coverage terms, Subject to yearly renewability

iii) Premium Payment Mode
Annual/Quarterly/Half Yearly

iv) Premium Payment Method
Online Transfer, E-Wallet Payment, Credit Card Payment

i) Age Set up
Age Definition : Age Last Birthday

Minimum Entry Age Maximum Entry Age
Death , TPD 25 years old 60 years old
ADD 25 years old 60 years old

ii) Coverage Term

Expiry Age
Death , TPD Until age 70 years old
ADD Until age 65 years old

iii) Sum Assured

Minimum Sum Assured RM 2,000.00
Maximum Sum Assured RM 20,000.00

iv) Substandard Class
Renewal is not guaranteed and subject to re-underwriting at policy anniversary based on experience

v) Occupational Class or Rating
All occupation classes, except stated under “ Excluded Industries/Occupations” (Appendix 2)

vi) Underwriting Questions
No underwriting questions as this is a Guaranteed Insurance Office (GIO) basis.

i) Reinstatement
Allowable subject to the existing business rules of the company

ii) Cancellation (within the Free-Look Period)
15 days free look period

iii) Waiting Period

Benefit Waiting Period
Death 3 months

iii) Waiting Period

Event / Scheme of Benefit Benefit (% Sum Assured)
Death 100%
Loss of two limbs 100%
Loss of both hands, or all fingers and both thumbs 100%
Total loss of sight of both eyes 100%
Total paralysis 100%
Injuries resulting in being permanently bedridden 100%
Any other injury causing permanent total disablement from gainful employment of any kind and every kind 100%
Loss of arm at shoulder 100%
Loss of arm between shoulder and elbow 100%
Loss of arm at elbow 100%
Loss of arm between elbow and wrist 100%
Loss of hand at wrist 100%
Loss of Leg
- At Hip
- Between knee and hip
- Between knee and ankle

100%
100%
100%
Loss of Eye
- Whole eye
- All sight of one eye
- Sight of one eye except perception of light
- Lens of one eye

50%
50%
50%
50%
Loss of four fingers and thumb of one hand 50%
Loss of four fingers 40%
Loss of thumb
- Both phalanges
- One phalanx

25%
10%
Loss of index finger
- Three phalanges
- Two phalanges
- One phalanx

10%
8%
4%
Loss of middle finger
- Three phalanges
- Two phalanges
- One phalanx

6%
4%
2%
Loss of ring finger
- Three phalanges
- Two phalanges
- One phalanx

5%
4%
2%
Loss of little finger
- Three phalanges
- Two phalanges
- One phalanx

4%
3%
2%
Loss of metacarpals
- First or second (additional)
- Third, fourth or fifth (additional)

3%
2%
Loss of toes
- All
- Great, both phalanges
- Great, one phalanx
- Other than great ; If more than one toe each of any other toe

15%
5%
2%
1%
Loss of hearing
- Both ears
- One ear

75%
15%
Loss of speech 50%

Below is a list of industries, occupations, businesses or groups that are not acceptable from an automatic risk perspective. These can be considered on a facultative basis:

a) Professional sports players, while on sports team duty

b) Cabin crew of airline companies, while on flight duty

c) Sea-faring personnel, while on navigation duty

d) Persons who work in a mine and are involved directly either in the extraction process or in the underground construction or in the exploration for minerals

e) Persons who work in any offshore site, a submarine or a boat and are involved directly in the construction on or under water

f) Persons who work in an industrial site and are involved directly in the oil and gas exploration, production or refining

g) Persons who are in direct contact with ammunition, explosive or explosive devices

h) Field military police and armed -security forces, during active service

i) Nuclear facility workers, during active service

j) Any Group where operations of the eligible employees are seasonal

k) Groups which involve special hazards (such as toxic chemicals or explosive materials) or unskilled, part time or transient employees

l) Political / religious group

m) Nuclear / chemical / electrical plants

n) Group of guards /police / firemen / armed personnel

o) Asbestos worker

p) Divers / drillers (oil / water)

q) Offshore oil rig workers

r) Mining Industry / Quarry or mine workers

(1) Death
No benefit shall be payable if death resulted from:

(a) suicide, while sane or insane or by hands of justice, within twelve (12) months from the Effective Date of the Insurance Certificate.

(b) Pre-existing Conditions for which the Insured Person received medical treatment, diagnosis, consultation or prescribed drugs during the ninety (90) days preceding the effective date of coverage unless the Insured Person affected by these conditions has been insured under the Insurance Certificate for twelve (12) months.

(2) TPD
The benefit under this Supplementary Contract shall not be payable if the disability has been caused directly or indirectly, voluntarily or involuntarily, by any one of the following events:

(a) Self-inflicted injuries or any attempt thereat while sane or insane, suicide; or

(b) Insurrection, war (declared or undeclared) or any warlike operations or military or naval service under orders for warlike operations; or

(c) Participation in a strike, riot or civil commotion or committing an assault or felony; or

(d) Any form of radioactivity or radiation; or

(e) Entering, operating or servicing, riding in or on, ascending or descending from or with any aerial device or conveyance except while the Insured Person is in an aircraft operated by a commercial passenger airline on a regular scheduled passenger trip over its established passenger route; or

(f) Pre-existing Conditions for which the Insured Person received medical treatment, diagnosis, consultation or prescribed drugs during the ninety (90) days preceding the effective date of coverage unless the Insured Person affected by these conditions has been insured under the Insurance Certificate for twelve (12) months.

(3) CI
This Supplementary Contract shall not cover any disease or surgery caused directly or indirectly, wholly or partly, by any of the following:

(a) Any Pre-existing Conditions prior to the Effective Date or any reinstatement date, whichever is later; or

(b) If the Insured Person is diagnosed of having Stroke within thirty (30) days from the Effective Date or any reinstatement date, whichever is later; or

(c) If the Insured Person is diagnosed of having Heart Attack or Cancer within sixty (60) days from the Effective Date or any reinstatement date, whichever is later; or

(d) If the death of the Insured Person occurs within thirty (30) days from the date the Critical Illness is first diagnosed (including the date of diagnosis); or

(e) If the Critical Illness is caused by or related to any Human Immuno-deficiency Virus (HIV) including Acquired Immune Deficiency Syndrome (AIDS) and/or any mutations, derivations or variations thereof, other than HIV Infection Due to Blood Transfusion.

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