Page 24 - LIAM Annual Report 2020
P. 24
22 ANNUAL REPORT 2020
REPORT OF THE
Management Committee
was indeed a
2020 challenging
year for the industry due
to the COVID-19 pandemic.
Nevertheless, the industry
continued to remain
focussed and diligent in
carrying out its duties and
responsibilities with the full
support of its 16 member
companies to weather
the challenges during the
pandemic.
We are pleased to report the
key highlights of activities
held and issues handled
during the year under
review.
INDUSTRY RELIEF MEASURES
FOR COVID-19
INSURANCE AND TAKAFUL INDUSTRY SET
UP RM8MILLION COVID-19 TEST FUND
In March 2020, the insurance and takaful
industry responded to the Government’s call
to conduct more tests on Malaysians to curb RM8 Million COVID-19 Test Fund (CTF)
the spread of the pandemic, by setting up the Frequently Asked Questions (FAQ)
for Surgery and Hospital Admission
COVID-19 Test Fund (CTF). 1. What is the COVID-19 Test Fund (CTF) set up by the insurance and takaful industry?
COVID-19 testing. CTF provides a fixed cash reimbursement up to RM300 for the cost of
The CTF is an urgent response in support of RM8 Million COVID-19 Test Fund (CTF) A RM8 million fund to support the Ministry of Health’s (MoH) efforts to conduct more
COVID-19 testing for individuals covered under individual or group Medical and Health
Insurance policies/takaful certificates.
for Patients Requiring Surgery
A RM8 million fund to support the Ministry of Health’s (MoH) efforts to conduct more
the Ministry of Health’s efforts to conduct Frequently Asked Questions (FAQ) 2. Who is eligible to claim from the CTF?
The CTF is only applicable for insurance policyholders/ takaful certificate holders who have
been referred by registered doctors for COVID-19 testing at recognised private labs as listed
CTF provides a fixed cash reimbursement up to RM300 for the cost of COVID-19 testing for
on the MoH COVID-19 website.
individuals covered under individual or group Medical and Health Insurance policies/takaful
more COVID-19 tests for Malaysians who 1. What is the COVID-19 Test Fund (CTF) set up by the insurance and takaful industry? 3. Am I entitled to claim from the CTF if I am advised to go for a surgery?
The CTF will cover COVID-19 test done during emergency and semi-emergency surgeries.
are exposed to the COVID-19 virus. LIAM COVID-19 testing. The definition for eligible cases will be based on the Emergency Severity Index from the
The CTF is only applicable for insurance policyholders/ takaful certificate holders who have
Agency for Healthcare Research and Quality (an agency of the US Department of Health
been referred by registered doctors for COVID-19 testing at recognised private labs as listed
and Human Services):
• Emergency means a situation where a patient requires immediate and life-saving
contributed RM5 million towards the CTF certificates. intervention.
Your insurance policy/takaful certificate must be in force as of 27 March 2020 and at the
2. Who is eligible to claim from the CTF?
• Semi-Emergency means a high-risk patient whose condition could easily deteriorate
or who presents with symptoms of a condition requiring time-sensitive treatment.
which is open to individual and Group on the MoH COVID-19 website. Effective 23 December 2020, the CTF eligibility criteria has been broadened to include
The CTF will cover COVID-19 test done during emergency and semi-emergency surgeries.
3. Am I entitled to claim from the CTF if I am advised to go for a surgery?
hospital admissions for Non-emergency and Non Semi-Emergency Surgery.
The definition for eligible cases will be based on the Emergency Severity Index from the
medical and health insurance policyholders time the COVID-19 test is conducted. Under the newly expanded CTF eligibility, below are the Reimbursement Rates for the
respective categories:
CTF Reimbursement
Category
Rate (RM)
who are at risk or who fall under the Person Agency for Healthcare Research and Quality (an agency of the US Department of Health A Persons Under Investigation (PUI) Up to RM300 per test for Reverse Transcriptase
• Semi-Emergency means a high-risk patient whose condition could easily
deteriorate or who presents with symptoms of a condition requiring time
– Polymerase Chain Reaction (RT-PCR))
and Human Services):
4. Am I entitled to claim for the CTF if I am advised to be hospitalised but my condition
Under Investigation (PUI) category. • Emergency means a situation where a patient requires immediate and Note: For Persons Under Investigation (PUI) (those who are at risk or referred by doctors to go for the COVID-19 test as defined by the MOH)
Emergency / Semi-Emergency
Up to RM300 per test for RT-PCR
B
life-saving intervention.
Surgery
You are not entitled to claim from the CTF if your hospitalisation does not require you to
C
Asymptomatic Individuals
undergo an Emergency or Semi-Emergency surgery. You are also not entitled to claim from
i.All Individual MHIT policy/certificate
-sensitive treatment.
Up to RM100 per
Up to RM50 per test
holders
for Rapid Test Antigen
test for RT-PCR
(RTK-Ag)
5. If I have a medical card, will the cost of the COVID-19 test be covered by way of Letter
Up to RM50 per test
i. All Group MHIT policy/certificate
Up to RM50 per
holders (limit to 50 employees per
does not require a surgery?
test for RT-PCR
for Rapid Test Antigen
policy)
the CTF if you are undergoing an Elective Surgery.
You have to pay for the COVID-19 test and seek reimbursement later. The cost will not be
(RTK-Ag)
Up to RM50 per test
Up to RM100 per
Hospital Admissions
D
for Rapid Test Antigen
test for RT-PCR
(for Non Emergency/Non Semi-
(RTK-Ag)
Emergency Surgery)
covered by way of Letter of Guarantee.
i.e up to a maximum of RM300 per test per individual
Life Insurance Association of Malaysia of Guarantee? and tests performed due to Hospital Admission for Emergency and Semi Emergency cases, the reimbursement rate remains unchanged
