Health Status

• Health status must be FE (Fit Everywhere).
• Need to make declaration in the proposal form.
• Healthy than persistent or recurrent illnesses and *exception diseases when signing the application.
  
  *exception diseases – please refer to the STBATM Guidebook.

Spouse

• Spouse can participate in the scheme provided that the Eligible Member must participate in the scheme.
• Spouse’s unit coverage and/or Sum Covered should not exceed the Eligible Member’s unit coverage and/or Sum Covered.
• The spouse may continue in the scheme after the death of the Eligible Member provided the payment of the contribution shall continue to be made 6 months or 12 months.

Death

Permanent Disability

**Limited to 1 child only during the period of scheme.

Exclusion for Death, Total and Permanent Disability Benefit, Occupational Incapacity, Partial and Permanent Disability and Additional Accidental Benefit arising from directly or indirectly associated with the following situations/events:

• The benefit prescribed in this Certificate shall not be payable in respect of any death which is directly or indirectly caused by or in connection with suicide within one (1) year after the Effective Date stated in the Takaful Certificate issued by the Takaful Operator whether attempted/ inflicted while sane or insane; or
• Pre-existing illness which also includes the Chronic Illness as defined hereinbefore (This is applicable for new members only); or
• Being under the influence of intoxicating liquor or any narcotic or drug; or
• Injuries and/or residual disablement or Degenerative Disease /Conditions arising out of injuries, sustained by Person Covered in an accident prior to the Effective Date/event date; or
• While participating in unlawful activities or in organisation, societies, movements, clubs banned by the Government of Malaysia; or
• Declared or undeclared war; or
• Acquired Immune Deficiency Syndrome (AIDS), AIDS related complication, infection by Human Immunodeficiency Virus (HIV), except AIDS due to blood transfusion; or
• Engaging in any riot, civil commotion, strike, rebellion, unless performing his duties as a member of the Armed Forces to protect the national interest and not as a participant to the strike, riot and commotion or terrorist activities or any act of terrorism; or
• Self-inflicted injuries which are intentional; or
• Total and Permanent Disability or Occupational Incapacity or Partial and Permanent Disability not due to the accidental injury; or
• Total and Permanent Disability or Occupational Incapacity or Partial and Permanent Disability not due to the accident arising from deterioration cerebrovascular accident; or
• Loss of hearing or loss of vision due to exposure while on working or training activities not due to the accidental injury; or
• Ordered by Court of Law or while serving a sentence pronounced by a Court of Law or after legal arrest or while resisting arrest by a lawful authority; or
• Any involvement in assault and battery, brawls, demonstration and riots committed in the Person Covered’s personal capacity; or
• Total and Permanent Disability or Occupational Incapacity or Partial and Permanent Disability as a result of injury not due to accident which is related to loss of sense or taste or smell, permanent cosmetic abnormality, sexual dysfunction, emotional disturbance, sleep disorder, station and gait, sensory, pain, power/motor, muscle atrophy shall also be excluded.
• Epidemic or outbreak; or
• War, invasion, acts of foreign enemies, hostilities or warlike operations (whether war be declared or not), civil war, rebellion, revolution riot, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power; or
• Any act of Nuclear, Biologicial or Chemical (NBC); or
• Loss, damage, cost or expense of whatsoever nature directly or indirectly cause by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to any act of terrorism; or
• Claims arising directly or indirectly from results of nuclear fission or fusion or radioactivity or in connection with biological chemical or nuclear explosion, pollution and contamination.
• No monthly contribution payment received by Insurance Unit, KATMB for three (3) consecutive months.

1. A notice of claim must be given to Insurance Unit KATMB within thirty (30) days from the date on which claim/incident event occurs.

2. To submit the following initial documents to Insurance Unit KATMB

For claim processing, full documents are still required by Takaful Operator.

3. The member shall obtain an injury assessment from a legally qualified and registered ATM Physicians after one (1) year from the date of accident.

4. Full documentation of claim must be submitted to Insurance Unit, KATMB within two (2) years from the date of accident.

5. Insurance Unit, KATMB will notify member if any additional documents are required.

6. Claim Forms can be obtained from KATMB’s website or at any nearest KATMB’s branch.