Frequently Asked Questions about Re-Claim Personal Accident Insurance.

Re-Claim is specifically designed to cover you against injuries caused by sports.

Re-Claim has the following unique features which you can’t get anywhere else:-

  • Cashless Admission to some of the medical benefits
  • Reimbursement of Overseas Treatment
  • Emergency Medical Evacuation and Repatriation
  • Stem Cell Therapy Expenses (Performed at Kuala Lumpur Sports Medicine Centre "KLSMC" only)
  • Corrective dental, cosmetic surgery, reconstructive surgery and skin transplant surgery
  • Prescribed Orthopedic Equipment and Prosthetic Device
  • Physiotherapy and Rehabilitation Treatment
  • Sports Rehabilitation Treatment (Performed at KLSMC only)
  • Home Nursing Care
  • Second Medical Opinion via Best Doctors TM for Sports Related Injuries
  • Damage to Sports Equipment
  • Personal Liability caused by sports activity

NOTE: The complete coverage, terms and conditions applicable are set out in the policy document.

Most of the medical or personal accident policies do not cover ‘Hazardous Sports’. You may check your policy’s Exclusion section on whether the sports that you play are mentioned in the exclusion list.

Besides that, most insurers to do not inform you the type of sports that fall under the hazardous sports exclusion. Often than not, you can be caught in a situation that your sport is categorised as hazardous after you sustain sports injuries.

Re-Claim do not have ‘Hazardous Sports’ exclusion in our policy and the only sports that we do not provide insurance cover are mentioned clearly under “Excluded Sports”. In short, we got you covered in most hazardous sports.

(*Refer FAQ on Excluded Sports)

No worries . Re-Claim has high medical expenses limit ranging from as low as RM 50,000 to as high as RM 750,000.

Besides that, Re-Claim is also designed to ease you to a faster recovery path so that you can get back to your sports activities as soon as possible with our Stem Cell Therapy Expenses and Sports Rehabilitation Treatment at Kuala Lumpur Sports Medicine Centre (KLSMC); Malaysia’s leading sports medicine centre.

Yes, we can. With Re-Claim, you will have access to BestDoctors.

For starters, they have an independent team of medical specialists who are the leading experts in treating sports injury and for some, they provide world-leading medical advice to professional athletes in USA Major Leagues, NZ All-Blacks Rugby Team and many other professional sports. So rest assured, getting you back into action will be an easy tackle!

Re-Claim types of benefits can be categorised into 2 categories:-

  1. Non Top Up Cover benefits
    • Section 1: Accidental Death
    • Section 2 : Permanent Disablement
    • Section 3: Emergency Medical Evacuation & Repatriation
    • Section 4: Best Doctors Services
    • Section 5: Sports Equipment
    • Section 6: Personal Liability
  2. Top Up Cover benefits (Section 3 only)
    • Medical Expenses
    • Overseas Treatment
    • Stem Cell Therapy Expenses (Performed at KLSMC)
    • Reconstructive Surgical Expenses
    • Prescribed Orthopaedic Equipment and Prosthetic Device
    • Physiotherapy and Rehabilitation Treatment
    • Sports Rehabilitation Treatment (Performed at KLSMC)
    • Home Nursing Care
    • Hospital Admission Assistance

Top Up Cover means We will only pay You after You had exhausted all other avenue of compensation from Your "Other Insurances". This means that you must first claim from your “Other Insurances” up to the maximum limit that you are covered for or allowed by the policies and the Top Up Cover will pay the balance of the amount in excess of your “Other Insurances” combined limit up to the Re-Claim Personal Accident Insurance policy limit.

Example on Top Up Cover – Traffic accident:

You have one medical policy covering traffic accident up to a limit of RM 50,000

Your total hospital bill is RM 85,000

Re-Claim Personal Accident covers you the excess amount: RM 35,000 (up to the limit of the selected plan)

“Other Insurances” means all other insurances that provide medical/hospital and surgical benefits effected by You or on behalf of You insuring the same event(s) insured within Section 3 including insurances (whether insured or self-insured by Your employer or company) provided by Your employer or company. Insurances with Medical Expenses coverage below RM10,000 per Bodily Injury is not considered as Other Insurances and as such You shall be subjected to RM 10,000.00 Deductible Per Disability as stipulated in the Table of Benefits

A fixed “Deductible Per Disability” of RM 10,000 will be applied to each claim under the Top Up Cover benefits (Section 3 only) category.

Re-Claim do not impose a fixed “Deductible Per disability” on Non Top Up Cover benefits.

Deductible Per Disability means the amount You have to bear when You incur expenses for the treatment of Bodily Injury. We will only pay the amount exceeding this Deductible Per Disability.

Example on Deductible Per Disability – Traffic accident: You do not have any other medical policy.

Your total hospital bill is RM 85,000

Re-Claim Personal Accident covers you the excess amount: RM 75,000 (RM 85,000 – RM 10,000) (up to the limit of the selected plan)

Re-Claim will not impose the Deductible Per Disability of RM 10,000.00.

Rest assured, we will pay You from ground up if the Sports Accident is not covered by Your Other Insurances and not excluded in Re-Claim Personal Accident.

Example on payment from ground up – Sky Diving accident

You have one medical policy with a limit of RM 50,000

But Sky Diving is NOT COVERED by your medical policy

Your total hospital bill is RM 85,000

Re-Claim Personal Accident covers you the full amount: RM 85,000 (up to the limit of the selected plan)

NO

Re-Claim Personal Accident Insurance is designed to cover for medical expenses arising from accidents where the injuries require you to be hospitalised.

Yes, it does cover.

However, if it is a non-sport accident, you cannot claim the following benefits:-

  • Section 1: Stem Cell Therapy Expenses (Performed at KLSMC)
  • Section 2: Prescribed Orthopaedic Equipment and Prosthetic Device
  • Section 3: Sports Rehabilitation Treatment (Performed at KLSMC)
  • Section 4: Best Doctors Services
  • Section 5: Sports Equipment
  • Section 6: Personal Liability

*Non-Sports Accident means accidents which are not caused by Sports subject to policy exclusions.

YES. If you participate in the competition or race as an amateur for those sports which are covered by the policy.

Motorcycling and driving a motorcar is not covered whether it is an amateur race or professional race

Re-Claim Personal Accident Insurance covers the costs of replacing the sports equipment which belong to you in the event that you sustain a sport accident which requires you to be hospitalised and the sports equipment is damaged at the same time.

The basis of the replacement costs is subject to the age, technological advancement for any applicable betterment and estimated wear and tear of the sports equipment or its components. A 10% policy excess is applicable on the replacement costs.

The sports equipment covered under this benefit are objects which are being used solely to equip you to perform the sports and form the core function of the sports. Vehicles or equipment licensed for road use, any form of Sports apparels, bags or items used to store or carry the sports equipment, all form of balls including golf balls and shuttle cocks, global positioning devices, watches, speed or fitness tracking devices, cameras and the likes are not considered as sports equipment.

NO.

You do not need more than one Re-Claim Personal Accident Insurance

You must be:

  1. Between 15 to 60 years old. For those below 18 years old, your parent or legal guardian must purchase the insurance policy on your behalf.
  2. A Malaysian
  3. A non Malaysian who resides or work in Malaysia with a valid visa or working permit
  4. Not a Professional Sports Person
  5. Not a Sports Coach

NO if you fall within the Professional Sports Person definition.

Professional Sports Person means a person who earns more than RM 30,000 per annum from sports and/or endorsement and/or engages in government sponsored or private sports development program and/or classified as a national or state athlete and/or competes in sports on a professional level.

NO.

You do not need more than one Re-Claim Personal Accident Insurance

NO if you provide training for professional or national or state competitions players. Personal trainers or instructors are not considered as Sports Coach.

YES

You must be a qualified scuba diver unless you are accompanied by a qualified scuba diving instructor to dive up to the depth of (18) eighteen metres.

If you are a qualified scuba diver you must always dive in accordance to the depth limits of your qualification and diving not exceeding the depth of (50) fifty metres.

Re-Claim Personal Accident Insurance does not cover you whilst you are diving as a commercial diver, dive instructor and/or dive master.

NO.

You do not need more than one Re-Claim Personal Accident Insurance

YES when you are diving for leisure purpose i.e.: not for commercial or work reason

YES if you are recommended by the attending Doctor in Malaysia to be transferred to a Hospital outside of Malaysia because the specialised nature of the treatment, aid, information or decision required can neither be rendered nor furnished nor taken in Malaysia.

We will cover you only after we had reviewed and approved the necessity of the recommended overseas treatment. The transportation cost is not covered by the policy.

YES if you need to be hospitalised because the treatment cannot be reasonably postponed until you return to Malaysia.

Yes.

Re-Claim Personal Accident Insurance is designed to cover you even when you are playing sports outside Malaysia.

However, if you reside outside Malaysia for more than 90 consecutive days, we will only pay you for the benefits under Accidental Death and Permanent Disablement.

All occupations are qualified to purchase Re-Claim Personal Accident Insurance except for Professional Sports Person and Sports Coach.

However, we will not cover you if you sustain the accident while you are involved in the following list of occupations. We will still cover you if you are injured when you participate in the sports as an amateur excluding motorcycling and driving a motorcar whether it is an amateur or professional race.

Occupations:

  1. While performing work as a manual workers, engaging in manual labour or using hazardous machineries
  2. Wood working machinists - using wood working machinery driven by mechanical power
  3. Aircraft testers and aircraft crews (not applicable when You are not engaging in any trade or technical operation in the aircraft)
  4. Armed forces personnel including police, army/military and law enforcement officers
  5. Commercial divers, dive instructors and dive masters (not applicable when You are diving for leisure)
  6. Racing drivers
  7. Seamen and Fishermen
  8. Oil rig workers including Off-shore workers
  9. Circus Performers
  10. Stuntman
  11. Whilst engaged in demolition of buildings
  12. Firemen
  13. Jockeys
  14. Whilst engaged in underground mining and tunnelling
  15. Explosive handlers
  16. Quarrymen
  17. Security personnel using firearms
  18. Stevedores
  19. Sawyers, logging workers and tree fellers
  20. Window cleaners (High rise building exceeding 9m)/ Painters (High rise building exceeding 9m)
  21. War correspondents

This insurance covers a comprehensive list of sports and leisure activities including those that might be considered hazardous in other insurance policies, for example sky diving, hang gliding, scuba diving, snowboarding, skiing, paragliding, white water rafting, parachuting... Basically all sports type except the following “Excluded Sports”:

  1. All forms of martial arts not limited to boxing, wrestling, karate and the likes when You participate in competitions whether as an amateur or professional
  2. Aerobatics flying, Sky surfing, Wing suit flying
  3. Base jumping
  4. Cliff jumping, cliff diving and/or coasteering
  5. Expeditions. For the purpose of this exclusion, “Expeditions” means a planned journey for exploration and/or for specific and/or scientific purposes in remote polar regions.
  6. American football, all forms of rugby, Aussie Rules and the likes
  7. Heli-skiing
  8. Rock/ Snow/ Ice/ Alpine climbing performed solo, freestyle or climb without ropes and all forms of solo climbs
  9. Sailing and/or yachting offshore
  10. Speed or reliability trials or racing with a motorcycle, motorcar, powerboat or bobsleigh regardless whether the race is amateur or not
  1. Pre-existing injuries, illness and/or degenerative conditions regardless whether it is aggravated by an Accident or not
  2. Act of Terrorism
  3. War, invasion, act of foreign enemy, hostilities
  4. Ionization, radiation or contamination
  5. Whilst you are on active duty in the armed forces whether during peace or war
  6. Any form of disease
  7. Childbirth, miscarriage, pregnancy or related complications
  8. Suicide, attempted suicide or self-inflicted injury
  9. Intoxication by alcohol or drugs
  10. Provoked murder or assault
  11. Whilst committing in unlawful act

More details are available in the Policy Wording.

NO.

You must perform the Sports with a valid qualification and you comply with the age, safety and/or fitness requirements which are required by the related Sports’ qualification, if the particular sport requires you to have a valid qualification,

You must be deemed as fit to perform the Sports or you do not perform the Sports against a Doctor’s advice.

Change of plan is only allowed upon renewal of your policy.

You may cancel your policy at any time by giving a written notice to customerservice@lonpac.com

If you cancel your policy with more than 6 months remaining period of insurance, we will refund 50% of the premium to you provided that you have not make any claim on the policy.

There will be no refund of premium if you cancel your policy with less than 6 months remaining period of insurance.

We accept credit and debit card (Visa or Mastercard). All payment must be made via the website (www.bestsportsdoctors.com) at the end of the purchasing process.

Yes. You will be able to spread the cost of your premium if you pay by monthly instalments through debit from your credit card(Visa or Mastercard). Debit card is not allows for monthly instalment.

  1. There is an additional charge of approximately 5% on the yearly premium plans if you choose to pay in monthly instalments.
  2. You will be charged the same amount of premium every month except for the month 1 where there is an additional RM 10.00 for the stamp duty.
  3. Kindly ensure there is enough credit for the next monthly instalment payment attempt failure which you will have a grace period of seven (7) days from the monthly due date to update your credit card details.
  4. After the grace period of seven (7) days, we will conduct second attempt of charging your credit card. If the transaction fails again, your policy will be automatically terminate from the monthly premium due date

The total insurance premium that you have to pay varies depending on the plan selected at the time of purchase and the frequency of payment (Annual or Monthly instalment) selected.

For emergency cases where you require cashless hospital admission or emergency evacuation or repatriation when you are overseas, please call the 24 hours hotline numbers as stated on your medical card.

For non-emergency cases, just notify us within 10 days from the accident date at customerservice@lonpac.com or call us at 1300-889-899 and submit the original claim form, original itemised bills, receipts and other relevant documents as required by us.

As soon as reasonably possible and in any case not later than 10 days from the accident date

You must seek for treatment within 60 days from the date of your accident

You must first show the medical card or the medical guarantee letter issued by your Other Insurances to the hospital that you are admitting to. If the amount covered by your Other Insurances is not sufficient to pay for the medical bills, please show the Re-Claim Personal Accident Insurance hospital admission card to the hospital to cover for the excess amount.

Once we had verified the amount which is guaranteed by your Other Insurances, we will liaise with the hospital to provide the cashless admission service to you for the amount in excess of the Other Insurances’ coverage up to the amount covered by Re-Claim Personal Accident Insurance subject to the policy terms and conditions.

If we are not able to verify the amount which is guaranteed by your Other Insurances, you need to pay the claim first and then seek reimbursement from Lonpac Insurance Bhd.

Please show the Re-Claim Personal Accident Insurance hospital admission card to the hospital and we will liaise with the hospital to provide the cashless admission service to you for the amount in excess of RM 10,000 up to the amount covered by the Re-Claim Personal Accident Insurance subject to the policy terms and conditions.

You must first show the medical card or the medical guarantee letter issued by your Other Insurances to the hospital that you are admitting to. If your Other Insurances are not covering you for the particular sports accident, please show Re-Claim Personal Accident Insurance hospital admission card to the hospital to arrange for cashless admission.

Once we had verified that the particular sports accident is not covered by your Other Insurances, we will liaise with the hospital to provide the cashless admission service to you up to the amount covered by Re-Claim Personal Accident Insurance subject to the policy terms and conditions.

If we are not able to verify that the particular sports accident is not covered by your Other Insurances, you need to pay the claim first and then seek reimbursement from Lonpac Insurance Bhd.

You must keep the original medical bills and medical report and submit to us when you had returned to Malaysia. We will assess the claim as per the policy terms and conditions and reimburse the covered medical expenses to you.

You will not be able to use the medical card if you seek treatment outside Malaysia. You will have to pay first and seek reimbursement from Lonpac Insurance Bhd.

You must keep the original medical bills and medical report and submit to us within the required claims notification period. We will assess the claim as per the policy terms and conditions and reimburse the covered medical expenses to you.

You can claim this benefit if you are certified by the attending doctor at the Kuala Lumpur Sports Medicine Centre (“KLSMC”) that you are suitable to be treated with Stem Cell Therapy in connection with the surgery performed at KLSMC due to sports accident.

You must refer and is agreed by us in writing before you can proceed with the Stem Cell Therapy.

The Stem Cell Therapy can only be performed at KLSMC.