MPI Generali

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HOSPITALISATION PROCEDURES FOR ALL MEDICAL POLICYHOLDERS

Step 1. At the time of admission, please present your

  1. Membership Card
  2. Original Identity Card
  3. Referral letter (for referred cases) from your doctor, if any.

Step 2. After identifying yourself,

  1. The Hospital will request you to fill in your personal details and sign the Hospital Admission Form.
  2. Your attending doctor will complete the Admission Form regarding your medical condition and treatment plan.
  3. The hospital admission staff will then arrange to notify our appointed third-party administrator (TPA) on your admission.

Step 3. TPA will then process your admission by:

  1. Verifying your Membership status against their records
  2. Checking the treatment procedures against the policy coverage.

Step 4. If your medical condition is within your policy coverage,

  1. TPA will provide an initial admission guarantee of up to RM2,500 to the hospital.
  2. After admission, TPA will monitor your hospitalisation until discharge and will issue a superseding guarantee (if required) if the treatment expenses exceed the initial admission guarantee.

    At discharge, but before you leave for home,

  3. The hospital will fax the bill to TPA for them to calculate the amount payable under the Policy.
  4. TPA will then notify the hospital the amount payable under the Policy and any item which is not payable under the Policy.
  5. Any cost that is not payable under the Policy MUST be paid by you.

Step 5. If your medical condition is NOT within the policy coverage,

  1. TPA will inform the hospital that your medical condition is not within the policy coverage and will not issue a Letter of Guarantee to the hospital.
  2. TPA will inform us accordingly

    At the time of discharge,

  3. You will have to settle the hospital bill in full yourself.
  4. You may request for your medical report and submit this together with your original bill(s) to us for further review if you are not satisfied with the findings of TPA.

HOW TO PROTECT YOUR PREMISES AGAINST BURGLARY

The physical controls you need

  • Instal and maintain perimeter protection of premises (fences, lighting, alarms, guards, cleared space around premises).
  • Use appropriate locks, vaults/safes and exterior doors.
  • Install surveillance cameras linked to off-site videotape recorders.
  • Place "marked" cash and other property in vaults/safes to help trace and identify burglars.
  • Eliminate places of possible concealment for burglars.

Some procedural controls

  • Train personnel to watch for potential burglars go or near the premises to learn about the premises.
  • Adopt premises and safe/vault opening and closing procedures that should frustrate and trap burglars.
  • Develop and practise procedures for notifying and cooperating with police.
  • Caution employees against sharing information about premises with outsiders.
  • Check premises for unauthorised persons just before closing and just before opening.
  • Control access to combinations to vaults/safes and change combinations frequently (especially when a senior employee leaves the organisation).

Other special managerial controls

  • Inform employees about burglary peril and hazards.
  • Keep records of burglary losses.
  • Include burglary loss control in managerial performance standards.

HOW TO PROTECT YOUR PREMISES AGAINST ROBBERY

The physical controls you need

  • Instal physical barriers inside premises to shield personnel from potential robbers.
  • Install safes and vaults with time lock that only a few employees know how to open.
  • Place surveillance cameras in vulnerable locations.
  • Employ guards and/or plainclothes security personnel.
  • Instal silent alarm or panic button that signals police or a private security service.

Some procedural controls

  • Decrease the amount of cash and other valuables at any one vulnerable location.
  • Make effective use of vaults or safes (do not leave them unlocked and do not leave valuable property in the open).
  • Run bank errands involving cash deposits or withdrawals at random times, and travel by varying routes to and from bank so that robbers cannot predict bank visits and wait in ambush.
  • Train personnel in surreptitiously sounding silent alarms.
  • Train personnel in dealing with robbers for their and others' safety (remember features, speech, name and other details that can help track robbers and delay their departure until police arrives, provided delay does not endanger others).
  • Post in public areas prominent signs indicating that employees cannot open safes/vaults.

Other special managerial controls

  • Screen present employees and job applicants for records of past crimes.
  • Educate employees about general precautions the organization has taken against robbery.
  • Assist law enforcement personnel in apprehending and prosecuting burglary suspects.

HOW TO PREVENT FRAUD

The physical controls you need

  • Control access to premises to ensure only legitimate persons can enter.
  • Use videotape cameras to record the activities in the premises

Some procedural controls

  • Confirm identity of persons entering premises and their reasons for entering.
  • Conduct frequent, unannounced audits to detect any unusual transaction.
  • Verify the background of persons and firms with which organisation deals either as a buyer or a seller of good and services.
  • Keep complete, accurate, detailed business records to discourage fraud, detect fraud when it occurs, and identify and trace perpetrators.
  • Transfer or rotate employees among positions to prevent collusion among them or with outsiders.

Some special managerial controls

  • Keep managers and employees who deal with the public informed of many possibilities of fraud.
  • Stay informed of new varieties of fraud, especially those new to the organisation's industry or activities.
  • Bring criminal and civil charges against persons who commit fraud.

CONTROLS AGAINST EMBEZZLEMENT/FIDELITY

The physical controls you need

  • Keep under lock and key all documents used in making or recording all the organisation's incoming or outgoing cash or credit transactions (checks, receipts, purchase orders, bills of lading, vouchers, and customers' records) so that embezzlers cannot use them to drain funds from the organization.
  • Use locked doors, guards, cameras or other barriers to control physical access to areas or operations where vulnerable property and records are kept or processed, especially computer operations.
  • Instal and use vaults and safes, keeping valuable property under lock and key except when it is being used or processed.
  • Monitor employees who are handling cash, jewellery, or highly vulnerable property or performing other sensitive tasks with video cameras on a continuous or random basis.
  • Implement physical controls for computer crimes, since much embezzlement is done through computers.

Some procedural controls

  • Number consecutively all documents related to incoming or outgoing cash or credit transactions so that any misuse of these documents to embezzle funds can be readily recognised and traced.
  • Divide among several employees responsibility for performing and documenting all tasks related to incoming or outgoing cash and credit transactions so that no employee has complete control over both doing and recording any activity related to cash.
  • Require all employees to take vacations so that one employee's control over any task is not continuous for long periods.
  • Rotate employees among tasks.
  • Conduct regular, unannounced audits by both internal and external auditors.
  • Conduct independent checks of payroll and other payment records to ensure that those records accurately reflect payments to actual persons or organisations that have provided the organisation with the goods or services for which the payments have been made.
  • Verify records of sales, deliveries, and purchases of goods and services to confirm that these records reflect real transactions and do not mask embezzlements.
  • Maintain strict controls of inventories of goods in process, merchandise and supplies to counter embezzlement of property.
  • Inspect incoming and outgoing shipments of goods, supplies and raw materials to detect shortages or defects through which employees alone or through collusion with outsiders may embezzle.
  • Implement procedural controls to prevent computer crime losses.
  • Screen the background of job applications or present employees seeking job transfers for records of past embezzlement convictions or attempts.

Other special managerial controls

  • Educate employees about the threat of embezzlement, its effects on the organisation's profit (and therefore employees' compensation), and the organisation's efforts to prevent it.
  • Encourage supervisors and other managers to counsel, or bring to management's attention, any employee who is under such financial or other personal pressure that he or she may be tempted to embezzle.
  • Prosecute or dismiss suspected embezzlers or, if this is impractical, transfer them to positions that offer less opportunity for embezzlement.
  • Remain alert to changes in operating procedures or technology that might offer new opportunities for embezzlers.

HOW TO PREVENT ARSON (BY PERSON OTHER THAN OWNER OR EMPLOYER)

The physical controls you need

  1. Adopt measures for preventing or reducing accidental fires so that property will not burn and any fires can be quickly extinguished.
  2. Instal locks in vulnerable areas, especially storage areas where arsonists might find flammable liquids and combustibles with which to set fire.
  3. Apply physical controls for combating vandalism (arson being an extreme form of vandalism).

Some procedural controls

  • Frequently inspect premises, especially storage areas.
  • Screen present employees and job applicants for past arson activities or tendencies toward pyromania.
  • Post guard, especially when the organisation is closed for several days (e.g. during holidays or labour union disputes).
  • Work with police and fire departments on arson control procedures.
  • Implement fire emergency response plans to reduce damage and the time operations are interrupted after any fire (including arson).

Other special managerial controls

  • Identify and counsel or terminate relationships with any employees, customers, suppliers or other persons who may be so hostile to the organisation that they may be tempted to commit arson against it.
  • Avoid, or be very careful in undertaking, activities so controversial that they may trigger political activists to commit arson against the organisation.
  • Alert employees regarding arson threat and keep them informed of measures the organisation is taking to counter that threat