Hong Leong Assurance Berhad 198201014849 (94613-X)

Medical Card Services

How to enquire the Guarantee Letter status and decision?

Contact our Third Party Administrator (TPA) by calling the phone number on your medical card. They operate 24 hours a day, 7 days a week.

Why is deposit required for some panel hospitals?

Some hospitals require deposit upon admission; however, this is refundable by the hospital upon deducting the deductible, co-insurance amount and non-covered charges.

What are the reasons causing Life Assured having to wait for a long time prior to be admitted?

The delay is normally caused by the doctor as he needs to perform several diagnostic examinations to determine the condition of the Life Assured before deciding if admission is required. The doctor is also required to complete a medical report with details of Life Assured’s condition before the hospital staff could fax it over to Third Party Administrator for issuance of initial Guarantee Letter.

Can Life Assured admit to non-panel hospital?

Guarantee Letter is only applicable to HLA’s panel hospitals. Life Assured is required to pay and file claim with us, subject to the terms and conditions of the policy. If Life Assured insists to admit to non-panel hospitals, he/she has to obtain the approval from Company via TPA.

Can Life Assured stay in a room that charges higher than his/her room and board limit?

Yes, however Life Assured will need to pay the difference (excess room and board) if he/she choose to stay in a room that charges higher than the room and board limit.

Can Life Assured utilise the Guarantee Letter without presenting the medical card to hospital?

Yes. Present Life Assured’s NRIC and Referral Letter (if any) at the Hospital’s Front Admission Counter. The hospital will arrange with HLA’s TPA for issuance of Guarantee Letter.

What are the circumstances whereby Guarantee Letter will be declined and Life Assured will need to settle own hospital bill?

The common reasons/scenarios when Life Assured will need to settle own hospital bill are when:
  1. Condition falls under policy exclusion/ personal exclusion.
  2. Suspect of pre-existing conditions which were not declared during insurance application.
  3. Policy has lapsed or terminated.
  4. Admission is for investigation purposes only.
  5. It is for outpatient visit, pre-admission or post-hospitalisation visit.

What is the next course of action for Pay & File claim after the Guarantee Letter is declined?

Submit the relevant claim documents to our branches, front desk or head office and the claim will be reassessed by the Company.

What are the common non-payable items?

  1. Admission fees
  2. Telephone charges
  3. Excess room and board
  4. Excess policy limit
  5. Co-Insurance / deductibles

Why Life Assured has to wait for a minimum of 4-5 hours for discharge?

Once Life Assured is advised for discharge, the doctor will continue with his ward visits to other patients before completing the medical report. The Billing Department also needs time to prepare and summarize the admission bill and subsequently gather other documents i.e. diagnostic test / lab reports from Radiology/Lab Department to be faxed over to TPA. TPA will review and assess the hospital bill thoroughly to justify if the charges are consistent with the treatment required for the admitting diagnosis of the Life Assured. In the event there is inconsistency found, TPA shall send medical enquiry to the hospital for further clarification on the matter before issuing the final Guarantee Letter to hospital.

Can Life Assured pay the admission bill before final Guarantee Letter is issued?

Yes. In the case where Life Assured wishes to submit for reimbursement, he/she may file a claim with us.

Can Life Assured enjoy the Guarantee Letter overseas?

No, the Guarantee Letter is only applicable to HLA’s panel hospitals in Malaysia. Life Assured may file a claim with us once he/she is back and the claim will be assessed in accordance with terms and conditions of the policy contract.

What is Emergency Evacuation & Repatriation service?

Emergency Evacuation
Emergency evacuation is a service provided via emergency assistance agency who will arrange for the air and/or surface transportation and communication for moving Life Assured when in a serious medical condition to the nearest Hospital where appropriate medical care is available and not necessarily to Malaysia. The emergency assistance agency shall pay for the medically necessary expense of such transportation and communications and all usual ancillary charges incurred in such services so arranged by the emergency assistance agency.

The emergency assistance agency retains absolute right to decide whether the Life Assured’s medical condition is sufficiently serious to warrant emergency medical evacuation. The emergency assistance agency further reserves the right to decide the place to which the Life Assured shall be evacuated and the means or method by which such evacuation will be carried out having regard to all the assessed facts and circumstances of which the emergency assistance agency is aware at the relevant time.
 
Emergency Repatriation
Emergency repatriation is a service provided via emergency assistance agency who will arrange for the return of Life Assured to Malaysia following an emergency medical evacuation for subsequent hospitalisation outside Malaysia. The emergency assistance agency shall pay for the expenses necessarily and unavoidably incurred in the services arranged by the emergency assistance agency.

The emergency assistance agency reserves the right to decide the means or method by which such repatriation will be carried out having regard to all the assessed facts and circumstances of which the emergency assistance agency is aware at the relevant time.

How to file Emergency Evacuation & Repatriation claim?

Call our emergency assistance agency by calling the phone number on your medical card.