PRUSimple Care on Pulse Heart Health Package

Plan Features

1. What is PRUSimple Care - Heart Health Package?
PRUSimple Care - Heart Health Package is an affordable non-participating group insurance plan where Prudential Assurance Malaysia Berhad (PAMB) is the Master Policyholder of the plan. This plan offers Death Benefit, Diagnosis of Stroke, Heart Attack or Serious Coronary Artery Disease Benefit and Daily Intensive Care Unit (ICU) Benefit to the Insured Member for a period of 12 months from Commencement Date of the Insured Member’s insurance certificate.

2. What benefit does PRUSimple Care - Heart Health Package provide?

Notes:
a) The Daily Intensive Care Unit (ICU) Benefit covers all disability and is NOT limited to hospitalisation which is related to the diagnosis of Stroke, Heart Attack or Serious Coronary Artery Disease.

3. Who is eligible to purchase PRUSimple Care - Heart Health Package?
You may purchase this plan if you are:
a) A user of Pulse by Prudential mobile application;
b) Malaysian citizen currently residing in Malaysia; and
c) Aged from 19 to 55 ANB (age next birthday).

4. How do I sign up?
Download latest Pulse by Prudential mobile application and create a Pulse account. Sign-in to your Pulse account and under ‘Home’ page -> Click the ‘PRUShoppe’ tab -> Click ‘PRUSimple Care - Heart Health Package’ to sign up.

5. How do I find out more about the features and benefits of PRUSimple Care - Heart Health Package?
Please refer to the Product Disclosure Sheet and Master Policy/Insurance Certificate for more details.

6. Is there a waiting period applicable for PRUSimple Care - Heart Health Package?
Yes, Daily Intensive Care Unit (ICU) Benefit is subject to waiting period of:
- 120 days for Specified Illnesses; and
- 30 days for all other covered illnesses.

Diagnosis of Stroke, Heart Attack or Serious Coronary Artery Disease Benefit is subject to waiting period of:
- 30 days for Stroke; and
- 60 days for Heart Attack and Serious Coronary Artery Disease.

This means that the eligibility for the benefits under the Insurance Certificate will only start after the waiting period of each benefit from the commencement of your coverage. Please refer to the Product Disclosure Sheet and Master Policy/Insurance Certificate for more details on Specified Illnesses.

7. What are the exclusions for PRUSimple Care - Heart Health Package?
Please refer to the Product Disclosure Sheet and Master Policy/Insurance Certificate for more details.

8. Can I buy PRUSimple Care - Heart Health Package from my Prudential agent
No, this product is an online-self-purchase product sold by Prudential Assurance Malaysia Berhad (PAMB).

Premium and Charges

9. How much premium do I need to pay?
Kindly refer to the Product Disclosure Sheet for the premium for each plan. The premium payable is subject to the Insured Member’s entry age and plan chosen.

10. How can I pay the premium for the plan?
You may pay the premium for the plan via credit card, debit card, online banking or promo/referral code.

11. Is Sales and Services Tax (SST) chargeable for PRUSimple Care - Heart Health Package?
SST is not chargeable for PRUSimple Care - Heart Health Package.

12. Are there any additional fees and charges for this plan?
There are no additional fees and charges other than the premium indicated in the Product Disclosure Sheet.

13. Can I claim for tax relief on the premium paid for this plan?
The premium substance for PRUSimple Care – Heart Health Package is 100% Medical-Life Insurance.

Whether the premium paid is eligible for tax relief is subject to Malaysian's tax authority/law. Please refer to the relevant guideline issued by the Inland Revenue Board of Malaysia or consult your tax advisor to determine your eligibility for any tax relief.

Underwriting

14. Do I need to undergo any medical, health or financial assessments to buy PRUSimple Care - Heart Health Package?
You need not undergo any medical or health assessments to buy PRUSimple Care - Heart Health Package. However, Anti-Money Laundering (AML) assessment will apply and will be conducted by PAMB.

15. What happens if I wrongly / mistakenly declare wrong information?
When answering any question asked by us, you must disclose all relevant facts correctly. We reserve the right to verify the information and declarations provided by you and may avoid this policy if incorrect information is provided. Kindly refer to the contract for more details on Anti-Money Laundering (AML), Anti-Terrorism Financing and Proceeds of Unlawful Activities.

16. Can I purchase multiple PRUSimple Care - Heart Health Package policies?
No. Only one PRUSimple Care - Heart Health Package policy is allowed per one customer.

Policy Servicing

17. After I have purchased my policy, who may I contact for policy servicing?
You may perform policy servicing such as change of contact details and cancellation of policy in ‘My Coverage’ in the Pulse by Prudential mobile application. Please refer to Questions 19 and 20 for more details.

18. How do I receive my insurance certificate after purchase?
Once your sign-up has been successful, you will receive instant confirmation and will be able to view the contract in ‘My Coverage’ in the Pulse by Prudential mobile application.

19. How can I change my contact details?
You may change and update the address and contact details in the ‘Update Contact Details’ page in the Pulse by Prudential mobile application.

20. Can I cancel the policy after purchasing it?
You may choose to cancel your policy in ‘My Coverage’ in the Pulse by Prudential mobile application during the Free Look Period. If you choose to cancel your Policy after the Free Look Period, you will only be covered under the Policy until the Policy terminates. No cash value will be payable, and no premium paid will be refunded.

21. What is Free Look Period?
You may cancel your Policy in ‘My Coverage’ in the Pulse by Prudential mobile application within 15 days after the Policy has been delivered to you. We will refund you the premiums that you have paid in the payment method that you have selected during sign-up.

Nomination

22. Why is it important to nominate a beneficiary?
It is important to ensure that your loved ones will receive the benefit as intended by you and that the monies payable under the policy (and related campaign, if any) can be paid out by PAMB without any delay. Without a nomination, the contract benefits will be paid out to your lawful executor or administrator to distribute it in accordance to the applicable laws of distribution. The process will take a while.

It is important for you to inform the beneficiary about the insurance benefits and nomination.

23. Who can I nominate as the beneficiary for my policy?
The person you can nominate is limited to your parent, sibling, spouse, child, grandparent, and grandchild. The beneficiary must be at least 18 years old and above.

24. How can I nominate a beneficiary for my policy?
You have the option to nominate a beneficiary during sign-up, otherwise you can update your Beneficiary in the ‘Update Beneficiary’ page in the Pulse by Prudential mobile application after sign-up.

Claims

25. How do I submit claims?
For a claim on Death Benefit:
You may submit the completed Claim form(s) along with the supporting documents to your nearest Prudential branch.

For a claim on Diagnosis of Stroke, Heart Attack or Serious Coronary Artery Disease Benefit or Daily Intensive Care Unit (ICU) Benefit:
You may register a claim in the ‘Register Claim’ page in the Pulse by Prudential mobile application along with the supporting documents in ‘My Coverage’ page in the Pulse by Prudential mobile application.

26. What are the documents required when submitting a claim?
For a claim on Death Benefit:
Claimant is required to submit the following:
1) Death Claim Form - signed by the claimant (person who is making the claim)
2) Medical Report pertaining to the cause of death - signed by the doctor who last treated the deceased
3) Certified true copy of Death Certificate - to be certified by Prudential branch staff / Business Development Executive
4) Copy of Claimant's MyKad
5) Copy of Deceased's MyKad
6) Proof of Relationship between claimant and deceased where there is a nomination made in the policy:
- if claim is made by spouse - marriage certificate is required
- if claim is made by children - child birth certificate is required
- if claim is made by parent - Deceased birth certificate is required
- if claim is made by sibling - sibling and deceased’s birth certificates are required
7) Other supporting test/Laboratory Report: Biopsy, MRI, scan and investigation results (where applicable)

For a claim on Diagnosis of Stroke, Heart Attack or Coronary Artery Disease Benefit:
You are required to submit the following via Pulse by Prudential mobile application:
1) Front and back of NRIC image;
2) Portrait or Selfie image holding ID/NRIC verification;
3) Copy of Critical Illness Claim (Doctor’s Statement for critical illness) - completed and signed by doctor who treated the Insured Member;
4) Laboratory Report: Histopathology Examination Report, Biopsy, MRI, scan and investigation results (where applicable)

For a claim on Daily Intensive Care Unit (ICU) Benefit:
You are required to submit the following via Pulse by Prudential mobile application:
1) Front and back of NRIC image;
2) Selfie image holding ID/NRIC verification;
3) Duly completed Medical Claim Form
4) Medical Claim (Doctor’s Statement) - completed and signed by doctor who treated the customer to be assured
5) Original final bills/tax invoices with itemized breakdown details
6) Original receipts including deposit receipts
7) Other supporting test/Laboratory Report: Biopsy, MRI, scan and investigation results (where applicable)

Prudential Assurance Malaysia Berhad (PAMB) reserves the right to request for other relevant supporting documents, information or to view the original of the copied documents whenever necessary.

You can get the relevant claim forms from our corporate website at www.prudential.com.my, any Prudential branch near you, email your request to customer.mys@prudential.com.my or contact our Customer Service Hotline at 03 - 2116 0228 (Monday to Friday, 8.30am - 5.15pm)

27. How long will it take to process the claim?
Upon receiving the complete documents, the claim payment will be processed within 14 working days.

My Feedback

28. How can I provide my feedback on Pulse app?
Under “Account” page -> Click “My Feedback”.

Termination

29. Under what circumstances will my policy terminate?
Your insurance certificate terminates automatically:
a) when the Insured Member dies;
b) when the insurance coverage of the Insured Member is cancelled, voided or terminated; or
c) on the last day of the Coverage Period of the Insured Member’s insurance certificate;
whichever happens first.

30. Will my policy terminate after I have submitted a claim?
Your policy will only terminate upon a death claim under Death Benefit has been made during the policy term.

Coverage for Diagnosis of Stroke, Heart Attack or Serious Coronary Artery Disease Benefit will cease if the benefit amount stated in your insurance certificate has been fully paid out.

Coverage for Daily Intensive Care Unit (ICU) Benefit will cease if the claim amount has exceeded the benefit amount stated in your insurance certificate.

Please refer to the Product Disclosure Sheet and Master Policy/Insurance Certificate for more details.