Key Learning Outcome:
At the end of the course, participants will be able to:
- Explain key terminologies and definitions,
and calculate the various elements of
the Hospital & Surgical Insurance benefit
structure.
- Match the various expense items to
their respective benefit category and
calculate the amount of admissible and
nonadmissible claims.
- Explain the situation where an upgrading of
room becomes medically necessary.
- Explain the meaning of specialist, customary
and reasonable charges.
- Explain M&H claims procedures and
assessment.
- State the various warning signs relating to
possible fraud.
- Identify and state the responsibilities of the
various parties involved in using, delivering
and financing healthcare.
Course Content:
Day 1
-
Session 1: Medical Jargons and
Abbreviations
Day 2- Session 2: What is Sickness and
Injuries?
- Session 3: Congenital Conditions
- Session 4: Pre-existing and
Long- standing Conditions
- Session 5: Waiting Period
- Session 6: Medically Necessary
- Session 7: Customary and
Reasonable Charges
Target Audience
Underwriters, claims assessors, sales intermediaries, customer service officers, trainers, product designers
and those involved in pricing, healthcare professionals, software programmers, employee benefit
professionals and third party administrators and those who are managing medical insurance claims.
Speaker Profile
TAN ENG BEE
SRN, ANZII (Senior Assoc), ACS, FLMI, FLHC, FAHM,
MBA (UK), CFP
Ms Tan has more than 15 years of experienced in the life insurance industry.
She was an experience staff nurse and clinical instructor before she
started her career as a Medical Assistant and Life Insurance Underwriter.
Ms Tan is a Senior Associate of The Australian and New Zealand Institute of Insurance and Finance
(ANZIIF), Fellow in Life & Health Claims, Associate in Customer Services, Fellow of Life Management
Institute, Fellow in Academy of Health Management, holds a Masters in Business Administration, and
is a Certified Financial Planner.
Throughout her career in insurance, she held the roles of Manager of the Medical and Group Insurance
Department and Vice President of New Business and Claims in a leading multinational insurance
company.
Currently, Ms Tan is the Technical Adviser in a leading assistance company.
Date and Time
Date: 27 - 28 June 2022
Time: 9.00 a.m. - 4.00 p.m.
Registration Closing Date: 20 June 2022
Price
Early Bird (Register before 13 June 2022)
MII Member:
RM880 (Single), RM830 (Group)
Non Member:
RM1,050 (Single), RM1,000 (Group)
International:
USD250 (Single), USD230 (Group)
Normal Fee
MII Member:
RM950 (Single), RM900 (Group)
Non Member:
RM1,100 (Single), RM1,050 (Group)
International:
USD280 (Single), USD260 (Group)
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