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    Exclusion For Group Term Takaful

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    Nizam Shamat
    The document outlines exclusions for benefits payable under group term takaful and group personal accident (GPA) policies. Some key exclusions include death by suicide within 12 months, disability directly or indirectly caused by self-harm, alcohol/drug use, terrorism, criminal acts, pre-existing illnesses, and war or military service. No GPA benefits are payable for losses resulting from suicide, murder, war, military service, dangerous activities, or terrorism. The exclusions are intended to avoid paying out benefits for losses not covered under the intended scope of the policies.

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    © All Rights Reserved
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    Exclusion For Group Term Takaful

    Uploaded by

    Nizam Shamat
    66 views4 pages
    The document outlines exclusions for benefits payable under group term takaful and group personal accident (GPA) policies. Some key exclusions include death by suicide within 12 months, disability directly or indirectly caused by self-harm, alcohol/drug use, terrorism, criminal acts, pre-existing illnesses, and war or military service. No GPA benefits are payable for losses resulting from suicide, murder, war, military service, dangerous activities, or terrorism. The exclusions are intended to avoid paying out benefits for losses not covered under the intended scope of the policies.

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    1403056926_Exclusions_Clause

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    The document outlines exclusions for benefits payable under group term takaful and group personal accident (GPA) policies. Some key exclusions include death by suicide within 12 months, disability directly or indirectly caused by self-harm, alcohol/drug use, terrorism, criminal acts, pre-existing illnesses, and war or military service. No GPA benefits are payable for losses resulting from suicide, murder, war, military service, dangerous activities, or terrorism. The exclusions are intended to avoid paying out benefits for losses not covered under the intended scope of the policies.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    66 views4 pages

    Exclusion For Group Term Takaful

    Uploaded by

    Nizam Shamat
    The document outlines exclusions for benefits payable under group term takaful and group personal accident (GPA) policies. Some key exclusions include death by suicide within 12 months, disability directly or indirectly caused by self-harm, alcohol/drug use, terrorism, criminal acts, pre-existing illnesses, and war or military service. No GPA benefits are payable for losses resulting from suicide, murder, war, military service, dangerous activities, or terrorism. The exclusions are intended to avoid paying out benefits for losses not covered under the intended scope of the policies.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    You are on page 1of 4

    Exclusion / Pengecualian

    Exclusion for Group Term Takaful


    1. No benefit is payable if death is due to suicide, while sane or insane, within twelve (12) months from
    the original Covered Member Effective Date.
    2. No benefit is payable if such Total and Permanent Disability (TPD) is directly or indirectly caused by:
    (a) self-inflicted injury while sane or insane;
    (b) under the influence of any alcohol or drugs;
    (c) entering, operating, or servicing, ascending or descending, from or with any aerial device
    or conveyance except while the Covered Member is in an aircraft operated by a
    commercial passenger airline on a regular scheduled passenger trip over its established
    passenger route;
    (d) wartime service in the armed forces or participation in military manoeuvre or activities or
    in any acts of war (declared or undeclared) or terrorism;
    (e) by war (declared or undeclared), invasion, act of foreign enemy, hostilities, civil war,
    rebellion, revolution, insurrection, military or usurped power, riot or civil commotion;
    (f) by or arising from any act of Terrorism and any action taken in controlling, preventing,
    suppressing or any way relating to these activities. In the event the Company alleges that
    by reason of this exclusion, any loss, damage, cost or expense is not covered by the police,
    the Covered Member shall have the burden of proving that this exclusion does not apply.
    If any part of this exclusion is later found to be invalid or unenforceable in a Court of law
    or otherwise, the rest of the portions shall remain in effect;
    (g) from any criminal violation of the law;
    (h) any illness or disease as a result of or in any way associated with: any disability, illness or
    disease which is the direct or indirect result of, or in any way associated with sero-positive
    infection of Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome
    (AIDS) or any similar or AIDS-related syndrome; or
    (i) any disability, injury or illness which occur prior to the Covered Member Effective Date.
    Exclusion for Group PA (GPA)
    No benefit for GPA is payable for any loss resulting directly, indirectly or ultimately, wholly or partly,
    from any of the following instances:
    (a) suicide or attempted suicide or any self-inflicted injury while sane or insane, or any
    sickness;
    (b) murder, assault or any violation or attempted violation of any law or resistance to arrest;
    (c) war, invasion, act of foreign enemy, hostilities or warlike operations (whether war be
    declared or not), civil war, mutiny, rebellion, revolution, insurrection, military or usurped
    power, and civil commotion assuming the proportion of or amounting to a popular
    uprising;
    (d) service in or being attached to the armed forces or the police forces;

    Page 1 of 4
    Exclusion / Pengecualian

    (e) participation in any fight or brawl by the Covered Member; or assault or death with
    provocation from the Covered Member;
    (f) any violation or attempted violation of the law or resistance to arrest;
    (g) Accident caused by the effect of alcohol or any un-prescribed drug on the Covered
    Member;
    (h) any bodily or mental infirmity, disease or sickness, or infection other than infection
    occurring at the same time with or because of an accidental cut or wound;
    (i) poison, gas or fumes voluntarily taken or atomic explosion, nuclear fission or radioactive
    matter, chemical or biological contamination;
    (j) entering, leaving, operating, servicing, or being in, on or about any aerial or submarine
    device or conveyance except as a passenger in an aircraft provided by a commercial
    passenger airline;
    (k) involvement in any dangerous sports or hobbies such as racing on wheels, glider flying,
    sailing or other hobbies which are comparably dangerous and risky unless covered under
    special endorsement;
    (l) cosmetic or plastic surgery, any dental work, treatment or surgery, eye or ear
    examination, except to the extent that any of them is necessary for the repair or
    alleviation of damage to the Covered Member caused solely by Accident; or
    (m) any Act of Terrorism or any action taken in controlling, preventing, suppressing, or in any
    way relating to, any act of terrorism. For the purpose of this exclusion, an “Act of
    Terrorism” means an act, including but not limited to, the use of force or violence, atomic/
    biological/ chemical weapons, weapons of mass destruction, disruption or subversion of
    communication and information systems infrastructure and/or the contents thereof,
    sabotage or any other means to cause or intended to cause harm of whatever nature
    and/or the threat of any of the aforementioned acts, of any person or group(s), whether
    acting alone or in behalf of or in connection with any organization(s) or government(s),
    committed for political, religious, ideological or similar purposes including the intention to
    influence any government and/or to put the public, or any section of the public, in fear.

    Page 2 of 4
    Exclusion / Pengecualian

    Pengecualian Group Term Takaful


    1. Tiada manfaat akan dibayar jika kematian disebabkan bunuh diri semasa siuman atau tidak siuman,
    dalam tempoh dua belas (12) bulan dari Tarikh Kuatkuasa Ahli yang Dilindungi yang asal.
    2. Tiada manfaat akan dibayar jika hilang upaya tersebut berlaku secara langsung atau tidak langsung
    disebabkan:
    a) kecederaan yang dilakukan sendiri semasa siuman atau tidak siuman;
    b) di bawah pengaruh alkohol atau dadah;
    c) memasuki, mengendali, atau menyelenggara, naik atau turun, daripada atau dengan sebarang
    peranti atau pengangkutan udara kecuali semasa Ahli yang Dilindungi berada di dalam pesawat
    yang dikendalikan oleh penerbangan penumpang komersial pada perjalanan penumpang
    berjadual tetap melalui laluan penumpang yang ditetapkan;
    d) perkhidmatan semasa perang dalam angkatan tentera atau penyertaan dalam manuver atau
    aktiviti ketenteraan atau dalam apa-apa tindakan perang (diisytiharkan atau tidak
    diisytiharkan) atau keganasan;
    e) dengan peperangan (perang diisytiharkan atau tidak), penaklukan, tindakan keganasan musuh,
    permusuhan, perang saudara, pemberontakan, revolusi, kebangkitan kuasa, ketenteraan atau
    rampasan kuasa, rusuhan, mogok atau kekacauan awam.
    f) oleh atau yang timbul daripada apa-apa perbuatan Keganasan dan apa-apa tindakan diambil
    dalam mengawal, mencegah, membenteras atau apa-apa cara yang berkaitan dengan aktiviti-
    aktiviti ini. Sekiranya Syarikat mengatakan bahawa oleh sebab pengecualian ini, mana-mana
    kerugian, kerosakan, kos atau perbelanjaan tidak dilindungi oleh polis, Ahli yang Dilindungi
    hendaklah mempunyai beban membuktikan bahawa pengecualian ini tidak terpakai. Jika mana-
    mana bahagian pengecualian ini kemudiannya didapati tidak sah atau tidak boleh
    dikuatkuasakan di Mahkamah undang-undang atau sebaliknya, seluruh bahagian hendaklah
    terus berkuat kuasa;
    g) daripada pelanggaran mana-mana undang-undang jenayah;
    h) Sebarang hilang upaya atau penyakit disebabkan secara langsung atau tidak langsung oleh,
    dengan mana-mana cara berkaitan dengan jangkitan positif sero Virus Human
    Immunodeficiency (HIV), Sindrom Kurang Daya Tahan Penyakit (AIDS) atau sebarang sindrom
    berkaitan AIDS yang serupa; atau
    i) Sebarang hilang upaya, kecederaan atau penyakit yang berlaku dahulu sebelum Tarikh
    Kuatkuasa Ahli yang Dilindungi.

    Pengecualian Group PA (GPA)


    Tiada manfaat GPA akan dibayar bagi kematian atau sebarang kecederaan atau hilang upaya atau
    sebarang kerugian yang lain berlaku secara langsung atau tidak langsung disebabkan:
    (a) membunuh diri atau cubaan membunuh diri atau sebarang kecederaan yang dilakukan
    sendiri semasa siuman atau tidak siuman, atau sebarang penyakit;

    Page 3 of 4
    Exclusion / Pengecualian

    (b) pembunuhan, serangan atau sebarang cubaan ancaman cubaan melakukan sebarang
    perbuatan yang di luar batas undang-undang termasuk menentang daripada ditahan;
    (c) peperangan, penaklukan, tindakan keganasan musuh, permusuhan atau operasi seakan-
    akan peperangan (sama ada perang diisytiharkan atau tidak), perang saudara,
    pemberontakan, revolusi, kebangkitan kuasa, ketenteraan atau rampasan kuasa dan
    kekacauan awam dengan mengandaikan sebahagian daripada atau menjumlahkan
    kepada pemberontakan yang diketahui. Pengecualian ini tidak terkesan oleh sebarang
    endorsan, yang tidak merujuk secara terperinci kepadanya secara penuh atau
    sebahagian;
    (d) berkhidmat dalam atau terikat dengan angkatan tentera atau angkatan polis;
    (e) penyertaan dalam sebarang perjuangan atau pergaduhan oleh Ahli yang Dilindungi; atau
    serangan atau kematian dengan provokasi daripada Ahli yang Dilindungi;
    (f) semasa melakukan atau cubaan melakukan sebarang perbuatan yang di luar batas
    undang-undang termasuk menentang daripada ditahan;
    (g) Kemalangan yang disebabkan oleh kesan alkohol atau apa-apa dadah tidak ditetapkan
    pada Ahli yang Dilindungi;
    (h) sebarang kelemahan badan atau mental, penyakit atau penyakit, atau jangkitan lain
    daripada jangkitan yang berlaku pada masa yang sama dengan atau kerana suatu luka
    kemalangan atau luka;
    (i) racun, gas atau wasap diambil dengan sukarela atau letupan atom, pembelahan nuklear
    atau bahan radioaktif, bahan kimia atau pencemaran biologi;
    (j) memasuki, meninggalkan, mengendali, menyelenggara, atau berada di dalam, pada atau
    kira-kira mana-mana peranti udara atau kapal selam atau kenderaan kecuali sebagai
    penumpang dalam pesawat yang disediakan oleh syarikat penerbangan penumpang
    komersial;
    (k) penglibatan dalam sebarang sukan atau hobi merbahaya seperti berlumba di atas roda,
    terbang luncur, belayar atau hobi-hobi lain yang sama merbahaya dan berisiko kecuali
    dilindungi di bawah endorsan khas;
    (l) pembedahan kosmetik atau plastik, apa-apa kerja pergigian, rawatan atau pembedahan,
    mata atau pemeriksaan telinga, kecuali setakat bahawa mana-mana daripada mereka
    adalah perlu untuk membaiki atau pembasmian kerosakan kepada Ahli yang Dilindungi
    yang disebabkan semata-mata oleh kemalangan; atau
    (m) apa-apa perbuatan Keganasan dan apa-apa tindakan diambil dalam mengawal,
    mencegah, membenteras atau dalam apa-apa cara yang berkaitan dengan perbuatan
    Keganasan ini. Bagi tujuan pengecualian ini, sesuatu ‘Perlakuan Keganasan’ bermakna
    sesuatu perlakuan, termasuk tetapi tidak terhad kepada penggunaan secara paksaan
    atau keganasan dan/atau ugutan daripada seseorang atau secara berkumpulan, sama
    ada secara bersendirian atau mewakili atau berkaitan dengan sebarang organisasi atau
    kerajaan, dilakukan untuk politik, agama, ideologi atau tujuan seumpamanya termasuk
    niat untuk mempengaruhi mana-mana kerajaan dan/atau untuk membuat orang awam,
    atau sebahagian daripada orang awam, berada di dalam ketakutan.

    Page 4 of 4

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