What is a deductible?
A deductible is an amount that you must pay out of pocket for a claim, while the remaining is compensated by the takaful operators. According to your takaful certificate, you have either a 10% deductible or an RM100 deductible, whichever is higher, for every claim.
Understanding Single Condition Claim
Example 1:
Let’s say your cat, Comel, needs treatment that costs RM1,000.
Here’s what happens:
Cost of Treatment: RM1,000
10% Deductible: RM100
RM100 Deductible: RM100
Since the 10% deductible and the RM100 deductible are the same, you will pay RM100.
Claim Submitted: RM1,000
Deductible: RM100
Claim Reimbursement To You: RM900
Understanding Per-Condition Deductibles
The deductible is applied once per condition. If Comel has multiple treatments for the same condition, you only pay the deductible once* (unless the claim is more than RM1,000, then the deductible will be recalculated & you will pay for any excess).
Example 2:
If Comel has two visits for the same condition (for e.g. skin infection):
First Visit for Skin Infection: RM500
Total Claim Submitted: RM500
Deductible: RM100
Claim Reimbursement To You: RM400
Second visit for Skin Infection: RM700
Total Claim Submitted: RM1,200 (including first visit)
10% Deductible: RM120
Deductible: RM100
Claim Reimbursement To You: RM700 - RM20 (excess of deductible) = RM680
For Claims Below RM100
Example 3:
For a minor treatment costing RM80, the RM100 deductible is higher, so you pay the full bill amount.
Claim Submitted: RM80
10% Deductible: RM8
Deductible: RM100
Claim Reimbursement To You: RM0
For Claims Above RM1,000
Example 4:
For a treatment costing RM1,500, the 10% deductible is higher, so you are reimbursed RM1,350.
Claim Submitted: RM1,500
10% Deductible: RM150
Deductible: RM100
Claim Reimbursement To You: RM1,350
In the event of follow-ups, compile all receipts together to apply the deductible only once for the same illness within 60 days of your first visit.
If you need more help on this, you can WhatsApp us at +60162996840 or email us at care@oyen.my.
Certificate terms and conditions applies