Insurance: Frequently Asked Questions

FAQs on Claims

1. How do I make a claim?

You will need to fill out a Claim Form and submit the completed form together with those documents that are relevant to the nature of your claims and coverage.

2. Are original medical bills/invoices required to support my claim for hospital income and medical expenses reimbursement?

Claims for medical expenses must always be supported with original bills/invoices. For the hospital income claims, you will only need to submit photocopies of the hospital bills indicating the dates of admission and discharge as evidence of the hospitalization period.

3. If my medical expenses are being paid by my employer or are being considered for payment by another insurance company, am I still entitled to seek reimbursement from my medical insurance policy purchased from your company?

As medical claims are always paid on a reimbursement basis, you cannot be paid for any medical expenses that you did not incur personally. If your employer or another insurance policy is paying you in full for the medical expenses incurred, you are not entitled to claim any reimbursement from your medical insurance policy purchased from ACE Jerneh.  

However, if there is any excess amount from the incurred medical expenses which is not paid by your employer or the other insurance policy, you are entitled to claim the excess amount from your medical insurance policy purchased from ACE Jerneh subject to the limits, terms and conditions of the policy.

4. Since medical expenses cover is on a reimbursement basis, why should I purchase another policy from your company when I am already insured with another insurance company or when my employer is paying for my medical expenses?

Besides medical expenses cover, ACE Jerneh’s insurance policies also provide other benefits such as hospital income, disability and death, depending on which policy you purchase. All these benefits are paid in addition to any other coverage that you may already have from your employer or policies you purchased from other insurance companies. Purchasing additional insurance with these benefits gives you additional protection.

5. Does ACE Jerneh provide a guarantee to hospitals for the payment of medical expenses incurred by your policyholders?

All policyholders are required to settle the hospitalization bill upon discharge and to submit the original invoices/bills to ACE Jerneh for reimbursement.

6. How fast does ACE Jerneh settle a claim for Accident and Health policies?

Our benchmark is to issue payment within 5 working days upon receipt of full documentation.

7. How is a death benefit paid under a PA insurance policy?

The death benefit is paid to the beneficiary nominated by the policy owner. In the case where no beneficiary is nominated, the death benefit will be paid to the legal representative of the deceased’s estate or alternatively to Amanah Raya Berhad (the corporatized government trustee) as provided by law.

8. Does your company pay for the cost of the medical report?

No. It is for the claimant to prove his claim with reasonable evidence and at his or her own expense.

9. Under what circumstances can I claim for hospital income?

Provided the reason for your hospitalization is one covered by the policy, a hospital income claim is only paid if the Insured Person is hospitalized for at least 24 hours as an inpatient in a licensed hospital.

10. How soon should a claim be notified?

Some policies may state a specific period to notify of a claim.You are advised to study your policy for the terms and conditions.

11. Does your company recognize traditional treatment?

Only from providers approved and licensed by the Health Ministry.

Auto Claims

1. How fast does ACE Jerneh settle damage repair claims?

Our benchmark is to approve damage repair claims within 3 days for non-severe damage upon receipt of the repair estimate/notification and within 5 days for extensive damage.

2. Can I send my car for repair at any PIAM authorized workshop?

No. you are required to send your car to ACE Jerneh’s appointed workshop or to the franchise workshop.

3. Does ACE Jerneh have panel workshops nationwide?

Yes. Please refer to the workshop panel list provided with your car insurance policy.

4. What is the time frame for notifying a claim?

Under condition 2(a) of the standard motor policy, you are required to notify in writing with full details as soon as possible.

5. What should I do when I am involved in an accident or if my car is stolen, and what documents do I need to submit?

Please refer to the claims guide attached to your motor policy.

6. Does ACE Jerneh pay for consequential loss or for hire of another car as a result of damage to my car in an accident?

No. Currently the standard comprehensive motor insurance policy will pay for the cost of repairs to your vehicle but not for any consequential losses as a result of damage to your car.

7. Does ACE Jerneh pay for the full sum insured in the event my car is rendered a total loss or stolen?

Payment for the total loss or theft of your car is on an indemnity basis. This means that we will pay you the market value prevailing at the time of the loss or up to the sum insured, whichever is lower.

FAQs on E-Payment

“WHY YOU SHOULD CHOOSE TO RECEIVE CLAIM PAYMENTS VIA DIRECT DEPOSIT INTO YOUR BANK ACCOUNT (i.e. “E-PAYMENT”)”?

1. Why should I choose to receive funds via e-payment?

Faster - funds should be available on the 2nd working from the day the payment was approved by the Company’s authorized personnel

Convenient - removes the need to travel and deposit the cheque at the bank as payments are credited directly into your bank account

Safer - misplaced, lost, fraud or expired cheques will no longer be an issue

2. Will there be any registration fee imposed if I want to use e-payment?

No, you can enjoy the service free of ANY charges.

3. What do I have to do to receive funds via e-payment?

You need to complete the Fund Transfer Authorisation Form (“the Form”) and provide your bank account information as stated in the Form when you submit your claims form.

4. What are the required supporting documents if I choose to receive e-payment?

The following original documents are required for verification:

i. National Registration Identity Card (“NRIC”),  passport, or other acceptable identification documents; and

ii. A (a) Beneficiary’s bank statement; OR (b) Relevant page of the bank account showing beneficiary’s name and account number; OR (c) Details of beneficiary’s bank account printed from bank’s website; OR (d) Written confirmation from bank on your bank account details.

5. Is there any restriction on the type of bank account that can be assigned for e-payment?

You can assign any of your existing active saving or current account held under your name or in the case of a joint account that has your name as one of the accountholders. The saving or current account must be maintained with one of the financial institutions offering MEPS Inter-Bank GIRO (IBG) service.

Please refer to the following website for a current list of IBG members http://www.myclear.org.my/faqs/interbank-giro-faqs/

6. Can I change my bank account information?

Yes, you are allowed to change your bank account details by submitting a fresh Fund Transfer Authorisation Form together with the required supporting documents. No cost will be charged for this purpose.

7. When will my bank account be credited?

Payment will be made electronically into your bank account by your insurance company as soon as your claim has been approved. Generally, funds will be made available in your bank account within the same day of payment.  However, depending on the processes adopted by your bank, you may receive the payment on the same day or a day after.  

8. Will I be notified once the insurance company has made the payment?

Yes, our bank will send you an email notification to your email address as provided by you in the Form. Therefore it is important that you provide us with a valid email address in the Form.

9. How will my bank account information be used and will it remain confidential?

Your bank account details and other related information:

Will be used solely for the purpose of enabling payments to be credited directly into your bank account; and

Is protected under the Personal Data Protection Act 2010 (“PDPA”) that strictly prohibits the disclosure of such information to any person unless customer or his personal representative has consented or in situation that we are permitted to do so, in line with the requirements under the PDPA. It should be noted that by signing the Form to provide your bank account information, you will be authorising the disclosure of your bank account information to parties’ necessary to affect a payment to you e.g. insurance company, financial institutions, service providers

10. What will happen to funds that cannot be credited into my bank account?

If funds cannot be credited into your bank account due to, for example, incorrect bank account number, closed or inactive bank account, inconsistency of NRIC/Passport number or Business Registration number, you will be contacted by us or our agent to validate your bank account details. However, this may lead to unnecessary delay to the payment process. To avoid this issue, please ensure that your bank account details are correct and active upon providing such information to us. Otherwise, we will remit the payment to you via cheque.

11. Do I need to provide my bank account information separately for e-payment for each of my policy if I have more than one policy?

If you want all your payments to be paid to the same bank account, you need to indicate so to your insurance company at the point of submitting your claim form.   

Alternately, you can opt to assign different bank accounts for each of your policy maintained with the same insurance company. To do so, you will need to provide your insurance company with the details of the bank accounts for each of your policy.

If you have more than one insurance company, you will need to inform every insurance company separately as bank account information is not shared with other insurance companies.

12. What if I die before the insurer pays out my claims proceeds and the bank has frozen my account. Where does the money go then?

All monies due to a policyholder in the event of his death will go to the administrators of his estate or to the nominees named in the policy.

13. I have previously claimed from an insurer and already provided my bank details. Do I need to re-submit all the bank supporting details to insurer every time I submit a claim?

It is recommended that you provide your bank details each time you submit a claim. This will ensure that your insurer is provided with the up to date bank details as there is always the possibility that you may overlooked informing your insurer of a change in your bank account.

14. Is it compulsory for a claimant/applicant to fill up the bank a/c section of the claim form? What If I do not wish to reveal my banking details – how do I get paid?

E-payment is the most efficient and safest mode of payment.  However, in the event you do not wish to receive payments directly to your bank account, you need not provide us with your bank account details.

15. I am a foreign worker. I do not have bank account. Can I authorize payment to my employer’s bank account?

It is always advisable for an employee, either a Malaysian or a foreign worker to open a bank account.  However, if a foreign worker does not have a bank account, he can authorize the payment to the employer’s bank account.  This, however, is a private arrangement between the foreign worker and the employer.  The insurance company will not be liable in the event the payment is not paid out by the employer to the employee.

16. I have been adjudicated a bankrupt and unable to open a bank account.  How do I get paid?

If you have been adjudicated a bankrupt, then you would have to obtain Insolvency Office’s consent for your insurer to make the claim payment to the party approved by the Insolvency Office.

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