Generali Malaysia Triumphed at the Insurance Asia Awards 2024

The interim measures on recent medical re-pricing were introduced to ease financial burden to policy owners and preserve their medical coverage. The following are the interim measures announced by BNM:

1. For policy owners affected by the premium adjustments, the changes in premium/insurance charge will be spread over a minimum of three years. With this measure, at least 80% of policy owners are expected to experience yearly premium adjustments due to medical claims inflation of less than 10%.
   (Note: This measure is not applicable to premium/insurance charge increase due to change in age band.)
2. Special provisions for policy owners aged 60-year-old and above. One year deferment of premium/insurance charge adjustment due to medical claims inflation for those aged 60 and above who are covered under the minimum plan of the medical product.
3. Policy owners who have surrendered their policies or whose medical policies have lapsed due to re-pricing in 2024 will be eligible for reinstatement without additional underwriting requirements. This option will be available upon request from policy owners.
4. Insurers will offer appropriate alternative MHIT products at the same or lower premium/insurance charge for policy owners who do not wish to continue their existing medical plans that have been repriced within the next one-year.
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For more general information on the interim measures, you may refer to the following press statements and FAQ:

• Press Statement by Bank Negara Malaysia
• Press Statement by Life Insurance Association of Malaysia‍
• FAQ by Life Insurance Association of Malaysia

Healthcare costs in Malaysia have increased significantly, with medical cost inflation reaching 15% in 2024, which is higher than the global and Asia Pacific average of 10%.

This rise is driven by factors such as new advancements in medical technology and increasing prevalence of non-communicable diseases such as diabetes, heart disease, and cancer, which has led to greater demand for healthcare services.

As a result, the claims paid out by insurers and takaful operators (ITOs) have grown faster than the premiums collected, creating a financial imbalance. The medical re-pricing helps to ensure policy owners have continued medical coverage throughout the policy tenure, balancing affordability and rising medical costs.

If you have any questions or concerns about your medical policy or the interim measures, please contact our Customer Service Centre hotline at 1 300 13 2121 or +603 3007 2121 (oversea) or email us at [email protected]

These interim measures will apply to policy owners with medical plans that are undergoing our medical re-pricing. Please refer to the following segregation of policy owners based on the affected medical plans below:

Block A: Policy owners of the following products with policy commencement date before 1st December 2024 and undergoing the medical re-pricing between 1st December 2024 to 30th November 2025 (hereinafter referred to as “2024 Medical Re-pricing”) :

• Medical Care
• Medical Care Plus
• Medic Essential Rider
• Medic Essential
• HOPE Medic
• HOPE Medic+
• HOPE Medic 2
• HOPE Medic 3
• Medic Assure
• OneMedic
• eMedic

Block B: Policy owners of the following products with policy commencement date that falls in between 1st December 2024 to 30th November 2025:

• OneMedic
• Medic Essential Rider

It is our commitment to our customers to provide sustainable and quality medical coverage. With that, we have introduced an additional layer of re-pricing to ensure that we are able to maintain our medical coverage to our customers.

Under the interim measure, any changes in premium or insurance charges introduced for 2024, 2025 and 2026, are required to be staggered over a minimum period of 3 years and the total yearly increase after staggering shall not exceed 10%. This clause will also apply to the additional layer of re-pricing and will be reflected accordingly in the full staggered re-pricing notification letter.

a. For the 2024 Medical Re-pricing staggered quantum:‍

Effective from 1st March 2025, the 2024 Medical Re-pricing staggered quantum has already been implemented in our systems. Any premiums or insurance charges deducted from this date onwards has correctly reflected with the 2024 Medical Re-pricing staggered quantum. This applies to all medical policies with policy anniversaries falling on and after 1st March 2025.

Additionally, the staggered quantum also applies to all medical policies under the initial 2024 Medical Re-pricing exercise, with policy anniversaries fall between 1st December 2024 and 28th February 2025.

‍b. For the Additional Layer of Re-pricing staggered quantum:

‍The Additional Layer of Re-pricing quantum will take effect from the first medical policy anniversary after 1st December 2025. We are committed to keeping you informed of the adjustments, and we shall notify you in writing of any changes at least 90 days before the new re-pricing quantum takes effect. Such notice will be incorporated together with the revised letter reflected with the full staggered re-pricing quantum that will be sent out starting from 1st September 2025.

a. If your policy anniversary falls between 1st December 2024 to 28th February 2025:‍

Your initial medical re-pricing notification letter has not been reflected with the interim measures. We will send you a revised letter with the full staggered re-pricing quantum starting from September 2025. Any excess premium/insurance charge deducted between 1st December 2024 to 28th February 2025 will be credited back to your policy in August 2025.

b. If your policy anniversary falls between 1st March 2025 to 31st May 2025:‍

Your initial medical re-pricing notification letter has not been reflected with the interim measures. However, the staggered quantum has been charged correctly to this batch of policies, and therefore, no refund of excess premium/insurance charge is required. We target to send you a revised letter with the full staggered re-pricing quantum starting from September 2025.

c. If your policy anniversary falls between 1st June 2025 to 30th November 2025:

Your medical re-pricing notification letter has been reflected with the staggered re-pricing quantum pursuant the interim measures. However, you may receive a letter that only shows the effect of the interim measures for the next one-year only. We target to send you a revised letter with the full staggered re-pricing quantum starting from September 2025.

a. For Unit Deducting Rider and Premium Paying Rider attached to the Investment-linked policies:‍

If your policy has been charged with the higher revised insurance charge, the excess insurance charge (i.e.: total revised insurance charge minus staggered insurance charge) deducted between 1st December 2024 to 28th February 2025 will be converted to units and deposited in your policy account value. We will notify you of the adjustments made in the revised letter. Should you wish to withdraw the excess of units, you may submit a Fund Investment Instruction form to any of our branches or via email at [email protected].

b. For Premium Paying Rider attached to the traditional policies and standalone plan:‍

If you have been charged the higher revised premium, the excess premium charged (total revised premium minus staggered premium) between 1st December 2024 to 28th February 2025 will be utilised for future insurance premium. We will notify you of the adjustments made in the revised letter. Should you wish to withdraw the overpaid premium, you may submit a Service Request Form to any of our branches or via email at [email protected] provided that the excess premium has not been utilised for the next premium due.

If the existing payment method of your policy falls under any of the following options and you have not made any changes to your premium payment amount, we would encourage you to adjust your premium accordingly to the revised letter with the full staggered re-pricing quantum:

• Bank Standing Instruction
• Biro ANGKASA
• Private Salary Deduction
• Cheque
• Electronic Funds Transfer
• Bank Counter Payment

If you have paid an excess of premium and wish to withdraw the overpaid premium, you may submit a Service Request Form to any of our branches or via email at [email protected] provided that the excess premium has not been utilised for the next premium due.

You may reinstate your medical policy without underwriting, within 1 year from the date of lapse or surrender. Please take note that upon reinstatement, the revised medical premium/insurance charge will still be applied as per the interim measures.

You may reinstate your policy subject to our reinstatement practices and underwriting that may apply. Upon successful reinstatement, please take note that the revised premium/insurance charge of your medical plan will still be applied from your next policy anniversary of the medical plan after the new rate effective date.

Due to the rising cost of healthcare driven by various factors such as aging population and advancement in medical technology, which have raised the cost of medical coverage. To ensure the sustainability of your medical plans and continued access to quality healthcare, periodic adjustments to the medical rates are necessary. Rest assured, the medical re-pricing exercise is aligned with the interim measures, any adjustments to the premium or insurance charge will be staggered over a minimum period of 3 years and the total yearly increase shall not exceed 10%.

The insurance charges or premium rates reflecting this re-pricing quantum will be applied starting from your medical policy’s anniversary date that falls on and after 1st December 2025.

We target to send you a letter with the full staggered re-pricing quantum following the schedule below:

If you are 60 years old and above and covered under the minimum plan of your current medical plan, the medical premium/insurance charge revision will be automatically deferred for a 1-year period.

Please note that this 1-year re-pricing deferment does not apply to the medical premium/insurance charge increase due to the insured reaching a higher age band.

After the 1-year temporary deferment, your medical plan premium/insurance charge will be revised as per the interim measures. This illustration will automatically be reflected in the letter with the full staggered re-pricing quantum.

95% of regular top-up premium will be allocated to your investment-linked policy account value to promote policy sustainability. Should you wish to reduce the regular top-up premium, you are advised to first review your policy sustainability to avoid your policy lapsing earlier than expected. You can proceed to reduce your premium by contacting your servicing agent, sales representative or our Customer Service Centre.

You may choose other plans with the following options to lower your medical coverage for lower premium/insurance charge, including but not limited to:

• Downgrade your current medical plan (if applicable); or
• Convert to another on-shelf medical plan; or
• Opt for deductible/co-insurance (if any) on your current medical plan or new on-shelf medical plan.

Alternatively, you may alter other benefits under your policy to suit your affordability, if applicable:

• Reduce the coverage amount of the basic plan or any other optional rider(s); or
• Cancel any other optional rider(s).

Any changes made shall be subject to the terms and conditions of your policy. You may consult your servicing agent, sales representative or our Customer Service to choose options which meet your protection and financial needs.

While the current interim measures aim to spread the premium increase over a minimum three-year period to ease the adjustment process for our customers, any further premium changes will depend on various factors. These factors may include changes in healthcare costs, advancements in medical technology, claims trends, and economic conditions. We are committed to keeping you informed and will provide advance notice of any future changes to premium rates. Our goal is to ensure transparency and continue providing you with reliable and comprehensive coverage.

The cost of healthcare in Malaysia has grown significantly over the years, with medical cost inflation reaching 15% in 2024 – well above the global and Asia Pacific average of 10%. This rise is driven by factors such as advancements in medical technology and the increasing prevalence of non-communicable diseases, which have led to greater demand for healthcare services.  

On 20^th December 2024, Bank Negara Malaysia announced interim measures to assist policyholders who are impacted by medical repricing on their Medical and Health Insurance/Takaful (MHIT) plans. 

These interim measures serve to provide temporary financial assistance, while the industry collaborates with regulators, healthcare providers and the government to develop sustainable long-term initiatives to address the rising medical cost in Malaysia and ensure that MHIT products continue to be accessible, affordable and sustainable for all Malaysians.  

Please refer to the following for more details on the announcement:  

• Press Release from Bank Negara Malaysia ‍
• Press Release (ENG) from Life Insurance Association of Malaysia (LIAM), the Malaysian Takaful Association (MTA) and Persatuan Insurans Am Malaysia (PIAM) ‍
• Press Release (BM) from Life Insurance Association of Malaysia (LIAM), the Malaysian Takaful Association (MTA) and Persatuan Insurans Am Malaysia (PIAM) ‍
• FAQs On Medical Insurance Premium/Contribution Repricing

At Generali Malaysia, we fully support Bank Negara Malaysia’s interim measures and the joint effort from the insurance and takaful industry in addressing this matter. We are committed towards supporting our valued customers and implementing these changes fairly, responsibly and transparently, in line with the framework provided by Bank Negara Malaysia.  

Effective 15^th January 2025, SmartCare Optimum and SmartCare Optimum Plus (SCO and SCO+) policyholders that meet the interim measure’s eligibility criteria can apply for access to the initiatives. We hope that these initiatives will help mitigate the impact of rising premiums and allow our policyholders to continue the benefits of quality medical care and protection during difficult times.
 

For SCO and SCO+ policyholders whose premium has been revised effective 1^st March 2024 to 28^th February 2025,
There will be no change to your current policy and premium rates.  Should you need further assistance for a more affordable option, please reach out to our authorised intermediary or Customer Service Centre from 15^th January 2025.  
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For SCO and SCO+ policyholders who are facing financial difficulties with the premium increase
Our priority is to ensure our policyholders continue to receive the protection that fit their needs. We offer several options that can be considered, including:

• Opting for a higher deductible plan (where available)
• Switching to a non-cashless (reimbursement) plan
• Review and convert to lower premium plans and products

Please reach out to our authorised intermediary or Customer Service Centre for further advice and assistance.  
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Policy Reinstatement for SCO and SCO+ policyholders
Reinstatement options with staggered pricing will be available for SCO and SCO+ policies that were surrendered/ lapsed between 1^st March 2024 to 15^th January 2025 and the lapsation was due to the repricing exercise.

A fresh application form is required for the request to reinstate and for our validation on the reasons for lapsation. No additional medical underwriting will be required.

If accepted, your coverage will be reinstated to the original renewal date for continuous coverage.  

Kindly provide relevant documentation to our authorised intermediary or Customer Service Centre to facilitate the reinstatement process.

The interim measures are applicable to policyholders aged 60 years old and above and covered under the minimum plan of SCO (Plan 4), or SCO+ (Plan 5).  

If you meet these criteria, you are entitled to a one-year deferment (“deferment period”) of the next premium adjustment/ increment. This deferment does not apply to premium increase due to age.

As part of interim measure, after the deferment period, policyholders will be subject to premium increments. However, this will be spread over a minimum period of three years commencing from the end of the deferment period.

Please be assured that there will be no changes to the coverage under your policy and we will continue to honour all benefits detailed in your contract, despite the interim measures taking place.

Medical or health insurance is a vital safety net, protecting you from any potential financial burden during unexpected emergencies. Hence, maintaining continuous coverage is important to ensure peace of mind.

While staggering or spreading the increase premiums over a minimum period of three years can provide you with immediate relief in paying for your plan, the reality is that the premium rates will require material adjustments in the near future unless systematic changes are implemented across the healthcare eco-system.  

As the current premium rates are inadequate, insurance providers may have to step up cost containment initiatives, as part of the industry’s commitment to provide accessible, affordable, and effective healthcare. We therefore urge you to use your health/medical insurance responsibly.

Please contact your Servicing Agent or our Customer Service Centre by email at [email protected] or call us at +603 2170 8282, Monday to Friday from 8:30am to 5:30pm (excluding public holidays).