Allianz Shield Plus

Policy Details (Personal Accident):

Insurance Provider: Allianz General Insurance Company (Malaysia) Berhad

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1. Main Coverage Areas & Limits

Accidental Death & Permanent Disablement

• Sum Insured: RM60,000
• What’s Covered: Provides payment if the insured dies or becomes permanently disabled due to an accident. Includes coverage for loss of limbs, sight, and severe permanent injuries (full table below)

Claimable Scenario:

• During a car accident, the insured loses both limbs, which results in a 100% payout of the insured sum.

Non-Claimable Scenario:

• Death due to a heart attack or illness, unrelated to any accident, is not covered.

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2. Medical Expenses

Limit: Up to RM3,500

What’s Covered: Reimburses the cost of medical treatments due to accidents, including hospital, clinical, and surgical treatments. This also includes coverage for specific viral infections like Dengue and Zika Virus.

Claimable Scenario:

• If the insured sustains a fracture from a fall and requires hospital treatment, the expenses up to RM3,500 would be covered.

Non-Claimable Scenario:

• A routine outpatient visit for flu or fever is not covered, as it does not arise from an accident.

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3. Hospital Income

Limit: RM85/day, up to 180 days

What’s Covered: Provides a daily payment for hospitalisation due to an accident.

Claimable Scenario:

• An insured person is hospitalized for three days due to a workplace accident. They will receive RM85/day for each day spent in the hospital.

Non-Claimable Scenario:

• Hospitalization due to food poisoning or illness (not related to an accident) would not be eligible for hospital income.

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4. Alternative Medicine

Limit: RM350

What’s Covered: Covers the cost of alternative treatments such as acupuncture or chiropractic care, provided the treatment follows an accident.

Claimable Scenario:

• If the insured seeks chiropractic treatment for back pain following a car accident, the costs would be reimbursed up to RM 350.

Non-Claimable Scenario:

• General wellness treatments or therapies unrelated to accidents are not covered.

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5. Funeral Expenses

Limit: RM5,000

What’s Covered: Provides a lump sum for funeral expenses in the event of accidental death.

Claimable Scenario:

• If the insured dies in a road accident, the policy will pay RM 5,000 to the family for funeral costs.

Non-Claimable Scenario:

• Death caused by natural illness or disease, such as cancer, would not qualify for funeral expense coverage.

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6. Double Indemnity

• Limit: RM 60,000 (doubles to RM 120,000 in specific cases)
• What’s Covered: Pays double the insured sum if the insured dies or is permanently disabled while traveling on public transport or overseas.
• Claimable Scenario: If the insured person dies while traveling on public transport, the death benefit will double to RM 120,000.

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7. Snatch Theft / Attempted Snatch Theft

• Limit: RM 600
• What’s Covered: Provides compensation for snatch theft or attempted snatch theft. A police report must be made within 24 hours.
• Claimable Scenario: If the insured is a victim of a snatch theft, RM 600 is paid as compensation.
• Non-Claimable Scenario: If the theft is not reported to the police within 24 hours, the benefit is not claimable.

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Additional Coverage:

• Coma Benefit
• What’s Covered: If the insured remains in a coma for at least 1 year due to an accident, 100% of the insured sum (RM 60,000) is payable. If the insured regains consciousness, a deduction of 10% is applied for each year in a coma.
• Disappearance
• What’s Covered: If the insured disappears and is presumed dead after 1 year, the death benefit is payable (RM 60,000). If the insured is found alive, the amount must be refunded.
• Corrective Dental / Cosmetic Surgery
• Limit: RM 12,000
• What’s Covered: Provides coverage for dental correction or cosmetic surgery resulting from injuries sustained in an accident.
• Ambulance Fee
• Limit: RM 500
• What’s Covered: Reimburses ambulance charges for transportation due to an accident.
• Blood Transfusion
• Limit: 20% of the sum insured (RM 12,000)
• What’s Covered: Pays if the insured contracts HIV due to a blood transfusion while receiving treatment for an injury.
• Mobility Expenses
• Limit: RM 2,000
• What’s Covered: Covers the cost of medical equipment needed due to permanent disablement following an accident.
• Repatriation Expenses
• Limit: RM 20,000
• What’s Covered: Pays for repatriation of remains if the insured dies in an accident while overseas.
• Personal Liability
• Limit: RM 180,000
• What’s Covered: Covers legal liabilities for injuries caused to third parties or damage to their property due to the insured’s actions..

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Key Exclusions (What’s Not Covered):

1. Illness or Disease: Medical conditions not related to accidents, such as heart attacks or flu, are not covered.
2. Self-Inflicted Injuries: Injuries caused intentionally, including suicide attempts, are excluded.
3. Professional Sports: Injuries sustained while engaging in professional sports are not covered.
4. War & Civil Unrest: Any injury or death resulting from war or civil disturbances is excluded.