Insuran Kemalangan Diri Berkelompok AJK Rukun

Tetangga (RT), Mediator Komuniti (MK) & Ahli

Peronda Skim Rondaan Sukarela (SRS) Bagi 2
tahun 2020-2021

Jabatan Perpaduan Negara

Dan Integrasi Nasional

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 Manfaat-manfaat
Jumlah Perlindungan
Manfaat
seorang (RM)

1 Kematian Kemalangan (Semasa Waktu Bekerja) 40,000.00

2 Kematian Kemalangan (Selepas Waktu Bekerja) 20,000.00

3 Keilatan Kekal Menyeluruh (Semasa Waktu Bekerja) 20,000.00

4 Elaun Harian Hospital (Semasa Waktu Bekerja – Mak. 60 hari setahun) 50.00 / sehari
50.00 / sehari
5 Keilatan Kekal Sementara (Semasa Waktu Bekerja – Mak. 60 hari setahun)

6 Perbelanjaan Perubatan (Semasa Waktu Bekerja – Mak. setiap insiden) 1,500.00

7 Khairat Kematian (Semua Sebab) 1,500.00

Terma Dan Syarat Tahun 2020 & 2021

1 Had Umur 18 - 70 tahun
2 Skop Perlindungan 24 jam
3 Kawasan Perlindungan (Termasuk Brunei semasa ahli membuat Domestik
perjalanan pintasan diantara Daerah Limbang dan Daerah Lawas) (Dalam Malaysia Sahaja)

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Keterangan Manfaat (Benefits)

Manfaat-Manfaat Diskripsi
Accidental Kematian Apa-apa kematian yang disebabkan oleh
Death Kemalangan kemalangan

Total Permanent Keilatan Kekal Hilang keupayaan Menyeluruh mengikut skala

Disablement Menyeluruh kontinental

Daily Hospital Elaun Harian Bayaran elaun harian sekiranya dimasukkan ke

Allowance Hospital hospital

Temporary Total Keilatan Kekal Bayaran elaun mingguan atau harian sekiranya
Disablement Sementara cuti sakit yang diberikan oleh doktor kerana
tidak dapat melaksanakan tugas seperti biasa.
Medical Perbelanjaan Kos perbelanjaan perubatan sebagai pesakit
Expenses Perubatan luar di klinik-klinik, pusat perubatan, hospital

Funeral Perbelanjaan Kos menguruskan jenazah dan pengkebumian

Expenses Pengurusan
Jenazah

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 Tuntutan – Apa perlu dilakukan oleh ahli……..
No Perkara Butiran
1 Pemberitahuan Ahli memaklumkan segera tuntutan yang hendak dibuat
(Notification within 30 days) kepada pihak Perpaduan Daerah. Seterusnya makluman
segera pihak Perpaduan Daerah kepada Etiqa.
2 Borang Tuntutan Ahli dapatkan borang tuntutan daripada pihak Perpaduan
(Claim form) Daerah.
3 Dokumen sokongan Ahli sediakan dokumen-dokumen sokongan seperti Surat
(Supporting documents) Pengesahan Ahli oleh pihak Perpaduan Daerah, salinan
KP, Kad Ahli, Sijil Kematian, Lapuran Doktor, Lapuran
polis, surat “Admission/Discharge” hospital dsbnya
mengikut keperluan syarat tuntutan yang dinyatakan.
4 Hantar Tuntutan Ahli kemukakan borang tuntutan yang telah dilengkapkan
(Claim submission) bersama dokumen sokongan kepada pihak Perpaduan
Daerah dengan kadar segera.

Pihak Perpaduan Daerah mengemukakan tuntutan yang

lengkap kepada Etiqa terus menerusi “scan email”.

Nota : Sila rujuk pada senarai dokumen-dokumen sokongan yang di perlukan.

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 Tuntutan - Dokumen yang diperlukan…..
a. Accidental Death
(Kematian Kemalangan)
1) Death Certificate
2) Burial Permit
3) Police Report
4) Driving Licence (if death was due to
road traffic accident)
5) Post mortem Report
6) Confirmation Letter from Pegawai
Perpaduan on the membership and
also whether the accident happened
outside or within working hours
7) For payment purposes :
a) Copy of IC and marriage
certificate for married covered
person + bank details
b) Copy of IC of parents and
deceased birth cert for single
covered person + bank details
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b. Total Permanent Disability
(Keilatan Kekal Menyeluruh)
1) Medical Report certifying the extent
of permanent disability sustained
2) Police Report (if injury sustained in
road traffic accident)
3) Driving Licence (if injury sustained in
road traffic accident)
4) Photos of the amputated limbs (for
amputation cases only)
5) Confirmation Letter from Pegawai
Perpaduan on the membership and
also whether the accident happened
outside or within working hours
 Tuntutan - Dokumen yang diperlukan…..
c. Temporary Total Disablement
(Keilatan Kekal Sementara)
1) Medical Report
2) Police Report (if injury sustained in
road traffic accident)
3) Driving Licence (if injury sustained in
road traffic accident)
4) Copy of the Medical Certificate
5) Confirmation Letter from Pegawai
Perpaduan on the membership and
also whether the accident happened
outside or within working hours
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d. Hospital Allowance
(Elaun Harian Hospital)
1) Medical Report/Discharge Summary
2) Police Report (if injury sustained in
road traffic accident)
3) Driving Licence (if injury sustained in
road traffic accident)
4) Confirmation Letter from Pegawai
Perpaduan on the membership and
also whether the accident happened
outside or within working hours
 Tuntutan - Dokumen yang diperlukan…..
e. Medical Expenses
(Perbelanjaan Perubatan)
1) Medical Report/Discharge Summary
2) Police Report (if injury sustained in
road traffic accident)
3) Driving Licence (if injury sustained
in road traffic accident)
4) Original Receipt and Bill for the
expenses incurred
5) Confirmation Letter from Pegawai
Perpaduan on the membership and
also whether the accident happened
outside or within working hours
Bayaran tuntutan: Di kreditkan kedalam akaun bank ahli diantara 21 hari bekerja
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f. Khairat Kematian
(Perbelanjaan Pengurusan Jenazah)
1) Death Certificate
2) Burial Permit
3) Police Report
4) Confirmation Letter from Pegawai
Perpaduan on the membership
5) For payment purposes :
a) Copy of IC and marriage
certificate for married covered
person + bank details
b) Copy of IC of parents and
deceased birth cert for single
covered person + bank details
 Carta aliran tuntutan

Komuniti Perpaduan
1. AJK RT
2. Mediator Komuniti
3. Anggota SRS
Ahli

Bayaran tuntutan secara Perpaduan Daerah 116 Pusat Penerimaan Tuntutan

“electronic transfer”

Emel kepada:
1. Etiqa GPA Claim Submission
Etiqa GPA Claim
Submission CC kepada
1. Etiqa Process Centre 1
2. Etiqa Process Centre 2
3. Etiqa Process Centre 3
4. Perpaduan Negeri
5. Perpaduan Pusat

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 Rangkaian Komunikasi
Etiqa
Etiqa GPA Claim Submission (TO: )
1. nm.paclaims@etiqa.com.my
2. mahpuzah.m@etiqa.com.my
3. nurulaqila.mo@etiqa.com.my
4. fauzana.na@etiqa.com.my

Etiqa Process Centre (C.C ) - *** Wajib

1. zuletiqa@yahoo.com
2. aniyah.mn@etiqa.com.my ***
3. syazanareena.shalizam@etiqa.com.my *** Etiqa Claims Careline
4. zulkeffly.j@etiqa.com.my *** 1-300-88-1007
5. khairull.ml@etiqa.com.my
6. Emel Perpaduan Negeri
7. Emel Perpaduan Pusat

Inquiry Contact Centre

1. Zulkaplly Sulaiman (019-757 3445)
2. Aniyah Mohd Noh (06-284 1558)
3. Syaza Nareena (014-665 7008)
4. Zulkeffly Jaffar (016-215 6069)
5. Khairull Azim (012-210 8603)
6. Rosli Taib (016-442 8675)

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 Lain-lain Aktiviti Pengendalian Skim

1. Contoh menghantar emel tuntutan

From : roslan@perpaduan.gov.my
To : zuletiqa@yahoo.com
Cc : rosli.t@etiqa.com.my
Subject : PERPADUAN/Jasin/Melaka/No Sijil C04567/Pemberitahuan atau Hantar
Tuntutan: Kematian Bagi Allahyarham Ali Bin Ahmad

Dimaklumkan…………………………..
…………………………………………………………………………………..
…………………………………………………………………………………..

Yang benar,

Roslan
Perpaduan Jasin, Melaka
No tel:

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