Programme Guideline

1. GENERAL INFORMATION

1.1. About Lyndung

1.2. About the Programme

1.2.1. The Programme serves as a trusted online-based platform that connects individuals who share the same interest in improving the community (“Lyndung Community”) by alleviating, supporting and caring for each other’s well-being, particularly health.

1.2.2. The Programme is built on the principles of mutual aid (Ta’awun), community support and responsibility among the Lyndung Community. The concept of the Programme is to share the medical expenses between the Lyndung Community, not for their convenience or cost savings but they are prompted by conscience to support, care and aid one another in times of distress.

1.2.3. The ultimate goal of the Programme is for every active member of the Lyndung Community to have access to a convenient health care.

Lyndung Programme Structure

1.3. Method Of The Programme

The Lyndung Community committed to contribute (Iltizam Bi Al-Tabarru’) their contribution ("Community Sharing") into a Sharing Contribution Pool ("Share Pool") to share the medical expenses of any active members in need of medical treatment equally among the community members by deducting their contribution from the Share Pool.

It is essential to understand that the Administrator does not own the Share Pool. Instead, the Trustee shall monitor and manage the disbursement and any reimbursement to the TPA.

1.4. Shariah Concept Applicable for the Programme

2. SIGNING UP AS A LYNDUNG COMMUNITY MEMBERS

A person may sign up for the Programme directly through the Lyndung website, or official referral link. Prior to signing up, a working SIM card with a phone number and an internet connection or data plan connected to a mobile device or personal computer is required. During the sign-up procedure, one must build a profile by supplying the following information:

1. Member details
2. Emergency contact details
3. Agree to the terms and conditions
4. Answer health screening questionnaire
5. Proceed with payment

The person is to confirm that he/she is healthy and does not suffer from any Pre-Existing Medical Condition, has read, understood and agreed to the Programme Guideline, the Terms of Use, Legal Disclaimer and the Privacy Policy and also authorising the Administrator to automatically debit the necessary amount that may be required from a person a source of payment described in the Programme Guideline.

3. MEMBERSHIP COST DURING SIGN UP

3.1. Upon signing up, a person may opt to pay an Annual Membership Fee of RM120.00 OR Monthly Membership Fees of RM10.00, and the Initial Sharing Contribution of RM100.00 and the payment gateway fee (if any). Append below are the breakdown of the details:

1. Annual Membership Fee of RM120.00 + Initial Sharing Contribution of RM100.00 + **Payment gateway Fees of RM5.50 = RM225.50; or
2. Monthly Membership Fee of RM10.00 + Initial Sharing Contribution of RM100.00 + **Payment gateway Fees of RM4.10 = RM114.10

**Payment Gateway Fees (if any) may vary based on the payment gateway provider engaged by the Administrator and the method of payment chosen by the member.

3.2 Annual Membership Renewal Fee

Members are required to pay the Annual Membership Fee to maintain an active member status. After the initial payment has been made, the membership fee will reoccur every 365 days and monthly mode will reoccur in the following month. The fee breakdown for a member who joins on January 3^rd 2022, is as follows:

1. Annual Membership Fee of RM120.00 + **Payment Gateway Fees of RM3.20 recurred on 3^rd January 2023 (After 365-days of initial payment); or
2. Monthly Membership Fee of RM10.00 + **Payment Gateway Fees of RM2.10 recurred on 3^rd February 2022 (after 1 month of initial payment)

**Payment Gateway Fees (if any) may vary based on the payment gateway provider engaged by the Administrator and the method of payment chosen by the member.

4. THE LYNDUNG COMMUNITY MEMBERS

4.1 Members

A member is a person who signs up and takes part in the Programme. The members shall deposit an Annual (RM120.00)/Monthly (RM10.00) membership fee and at least commit to contribute the Initial Sharing Contribution amount of RM 100.00 to share in the monthly medical expenses of other members

4.2 The Member’s Qualifications

To qualify and remain as the Lyndung Community members, a person must meet all the following requirements: -

5. REFERRAL INCENTIVE AND REWARDS FOR LYNDUNG COMMUNITY MEMBERS

RM10.00 incentive will be granted to each successful referral to encourage the Lyndung Community members to help promote the Programme to others. Lyndung Community members can transfer their incentive at any amount to their Pocket at any time. The incentive can also be withdrawn to a bank account with a minimum withdrawal value of RM100.00.

Pocket refers to the Initial Sharing Contribution that has been deposited by the Members. Members may check his/her Sharing Contribution balance in his/her Pocket on their profile page.

6. THE LYNDUNG COMMUNITY MEMBERS CONTINUED OBLIGATIONS

A member who wishes to remain as a member and continue to enjoy the benefits of this Programme, he/she must continue to comply with the following obligations:

1. To read, understand, agree, and abide with this Programme Guideline as revised, supplemented, or substituted from time to time;
2. To regularly check for and examine all revisions and information pertaining to the Programme Guideline that the Administrator may from time to time update and notify;
3. To pay the Annual or Monthly Membership Fee and any other fees that the Administrator may levy. As indicated in the Programme Guidelines, members must also add to the Sharing Contribution and pay the Actual Community Sharing Amount.
4. To provide all pertinent information and documents indeed, completely and accurately to the Administrator when requested (if necessary);
5. To notify the Administrator without delay if the Members becomes aware that he/she no longer meets the Programme's Requirements as outlined in Section 4.2 of this Programme Guideline;
6. To act with integrity and avoid the appearance of abuse, fraud and dishonesty towards other members and the Administrator particularly when submitting your medical expenses invoice/receipts for sharing;
7. To respectfully communicate his/her thoughts, opinions, or complaints to the appropriate person and resolve dispute according to the method stated in Section 17.3 of this Programme Guideline;
8. To courteously regard other members or the employees of the Administrator. For the benefit of all members and to reduce the total Eligible medical expenses shared in the Programme, each member is required to;
   1. To lead a healthy lifestyle, e.g. eat healthily, exercise regularly, and eliminate detrimental behaviours, stressors, and risk factors that are within one's control; and
   2. To seek medical advice when needed, to make the necessary efforts to comprehend the medical advice received and any diagnostic offered and to acquire the required medical treatment promptly.
9. To take personal charge of his/her medical care, and make responsible, informed and wise health care choices;
10. To enquire about costs before receiving medical care and make prudent decision whenever feasible;
11. To seek medical advice when needed, to make the necessary efforts to comprehend the medical advice received and any diagnostic offered, and to acquire the required medical treatment promptly;
12. To not abuse any legal or prescribed substance, completely abstain from illegal substances, and restrict alcohol and cigarette usage to moderate levels; and
13. To authorise the Administrator to have full access to all medical records if it is determined that the members had previously filed the medical expenses and/or claims with other organisations and/or insurance/takaful providers. The Administrator may terminate the members' involvement if it is determined that the members have failed to fulfil his/her responsibilities.

7. THE LYNDUNG COMMUNITY MEMBERS’S RIGHT

Under this Programme, each member is entitled to the following:

1. To appoint Lyndung as his Administrator to manage the contribution pool with the imposition of Membership fees (or known Wakalah fee) on behalf of the members.
2. To receive thoughtful and courteous service from all Administrator employees and representatives;
3. To receive accurate and latest information regarding this Programme from the Administrator;
4. To ensure that all medical records and personal information are treated with confidentiality and in accordance with the Privacy Policy;
5. To submit their medical expenses invoice/receipt(s) for processing and assessment by the TPA and the Administrator in accordance with this Programme Guideline;
6. To file a Dispute (as defined hereinafter) in accordance with this Programme Guideline and express his/her concern with the decision of his/her Dispute or file an appeal in accordance with this Programme Guideline, without fear of reprisal or prejudice.
7. To give the Administrator recommendations or criticism regarding this Programme Guideline; and
8. Members have the right to vote in any poll created by the Administrator.
9. To make aware that the remaining contribution pool may be allocated for investment purposes and it shall only be invested in Shariah Compliance Portfolio and abide by the Manner of Investment set up by the Administrator.

8. RETREAT FROM PROGRAMME

A member can freely withdraw from the Programme by clicking the ‘Retreat’ button in the Lyndung Portal. The members will receive a verification code through SMS that must be inserted into the Lyndung Portal to complete the withdrawal process. The members’ status will remain “Active” for 26 days after completion. After 26-days, the Trustee shall proceed to refund any available balance in his/her Sharing Contribution. However, the members are still accountable for any Actual Community Sharing Amount for the period within the 26-day grace period.

9. DISQUALIFICATION FROM PROGRAMME

In terms of failure to make payment for Sharing Contribution top-up or payment for Annual/Monthly Membership Fee, a member will be suspended for 26 days. Member’s status will be immediately reinstated if payment is made within the time frame (suspended period). If no payment is received within the time frame, the member will be permanently disqualified and no longer be eligible for any Lyndung Community Programme benefits. The Trustee shall process the refund of whatsoever remaining balance of his/her Sharing Contribution. However, the member is still responsible for the Actual Community Sharing Amount within the 26 days (if any) from the remaining balance of his/her sharing contribution.

10. BLACKLIST FROM PROGRAMME

The Administrator has full authority to blacklist a member(s) from the Programme if in any event found a member willfully concealed his/her previous medical history or any relevant facts regarding his/her health. This action is deemed as fraud or abuse against the Lyndung Community member.

If any of the Lyndung Community members has been blacklisted, the refund process shall initiate immediately to refund any remaining balance of his/her Sharing Contribution.

11. REFUND POLICY

The Lyndung Community members shall be entitled to a refund of any unused portion of the Initial Sharing Contribution as determined by the Administrator. The Administrator will require up to 60-days to refund whatsoever sum to the members. Please note that the Annual/Monthly Membership Fee is strictly non-refundable save and except in the case of duplicate charges. The Administrator may require up to 30-days to refund the members for any duplicate charges.

12. REINSTATEMENT AS LYNDUNG COMMUNITY MEMBERS

The account of the Lyndung Community members who have already withdrawn/suspended/ blacklisted from the Programme will be terminated upon refunding the remaining unused Sharing Contribution. A member may re-enroll or reinstate his/her membership through the Lyndung Portal if they wish to do so. Nevertheless, all rewards and incentives previously attained will be reset to zero. However, the reinstatement is subject to the Administrator’s approval.

13. SHARING CONTRIBUTION AND OTHER FEES

13.1 Monthly Community Sharing Limit

13.2 Actual Community Sharing Amount

13.3 Manner of Investment

14. THE PROGRAMME IS AN ALTERNATIVE TO HEALTH INSURANCE/TAKAFUL

The Programme is an alternative healthcare option that is convenient, affordable and fully funded by members of the Lyndung Community. It is the most cost-effective and innovative solution to the challenges of rising healthcare and medical costs, as well as prohibitively high health insurance premiums/takaful contributions. The Programme which makes extensive use of technology, also enables rapid and uncomplicated access to healthcare. As opposed to the time-consuming and restrictive procedure of obtaining a standard health insurance/takaful coverage. The following are many reasons why the Monthly Community Sharing Limit under the Programme is maintained low:

14.1 It is a profit controlled oriented Programme

The Administrator does not profit from the members’ Community Sharing on medical expenditures. The total amount of allowable medical expenses certified by TPA is conveyed to all Lyndung Community members. Under the Programme, no contribution or any other fees shall be received from the Lyndung Community members. The Lyndung Community members shall only pay for their part of the eligible medical expenses and the Annual/Monthly Membership Fee.

14.2 The administrative cost of this Programme

The Administrator charged a minimal Annual Membership Fee of RM120.00 or a Monthly Membership Fee of RM10.00 to those interested to join the Lyndung Community Programme. Expenses such as hiring TPA shall be utilised from the said membership fees.

14.3 Members’ share in actual Medical Expenses not projection value

The Programme nor the Administrator are not in the position to forecast the expected medical expenses of the members. The members agreed to share only the actual medical expenses incurred. The more members joining the Programme resulting in lower value of each member's share.

14.4 Lifetime community sharing and benefits

The Lyndung Community members shall remain as “Active” members upon joining as long as they continue their contribution sharing even though they have exceeded the age eligibility stated in Section 4.2.1.

14.5 Members are committed to live healthy lifestyle

To ensure the sustainability of the Programme, The Lyndung Community members are encouraged to lead a healthy lifestyle, mental health and create a socially responsible community. The Lyndung Community members have to be accountable for their own actions throughout the Programme.

14.6 Members are committed to be honest about their declaration

Members are required to thoroughly comprehend the Programme's concepts as outlined in the Programme Guideline and make a list of declarations regarding their health and lifestyle. False declarations will result in immediate disqualification. The Administrator shall have full access to all the Lyndung Community members medical reports, pertinent tests and previous medical claim records (if any) before joining the Programme.

14.7 Hospital Admission and Medical Treatment are examined upfront and effectively managed for the best possible outcome

To administer the Programme’s hospitalisation and claims processes, the Administrator has formed a strategic partnership with established and professional TPA which guarantees an effective management of the Medical Expenses for the Lyndung Community. The Lyndung Community members are also provided with continuous education on managing health and medical expenditures throughout the Programme.

15. CLAIM PROCESS

15.1 RM100.00 will be set aside as the Share Pool by every member who joins the Programme. The amount of this contribution will be reflected in the members’ Pocket Balance (“Pocket”). The Share Pool will be utilised to settle the medical cost of the other active Lyndung Community. Contribution can be made through an agreed payment method, i.e. by debiting his/her credit/debit card.

15.2 The Share Pool will be deposited into a trust account of the Trustee (“Trust Account”) established exclusively for this medical cost-sharing to match the Lyndung Community’s actual sharing amount. The Trust Account shall be administered by the Trustee where the Share Pool shall be held within a Shariah compliant financial instrument.

The Trust Account is owned by the Lyndung Community and managed by the Trustee under the direction of the Administrator. The Surplus, if any, will be determined and declared from the Trust Account at the end of every financial year by the Administrator. Based on the Shariah Principle of Jualah, the surplus may be distributed between the Administrator as Jualah (performance fees) for Lyndung achievement in managing the pool effectively and the balance shall be directly placed into the active Lyndung Community’s Pocket.

15.3 By contributing a sum for the Initial Sharing Contribution, the Lyndung Community is considered to have granted the Administrator permission to use the amount to cover the Eligible Medical Expenses following the Programme Guidelines.

15.4 The Lyndung Community members must adhere to two types of deferment periods of 60 days and 180 days ("Waiting Period") from the date of the signing up subject to all payments in Section 15.1 hereinabove of this Programme Guideline have been made. The Lyndung Community members are not eligible to receive from the Community Sharing any charges for medical assistance charged by the Panel Hospital ("Panel Hospital") under the Programme, save and except for accidental injury within the 60 days deferment period. During this Waiting Period, a new Lyndung Community member is required to contribute to the Actual Community Sharing Amount if any critical case arises for other active Lyndung Community members.

15.5 During the 60 days Waiting Period, the Lyndung Community Members are allowed to seek community sharing for medical assistance due to accidental injury up to a total of RM20,000 and receive death beneficiary support (Khairat Kematian) amounting to RM5,000. Following the expiration of the 60 days Waiting Period, the Lyndung Community members may begin to seek Community Sharing of any expenses incurred while receiving medical care from the Panel Hospital under the Programme, with the exception of cases falling under Specific Illnesses under Section 10 of the Members’ Manual.

15.6 Upon the expiration of the 180 days Waiting Period, the Lyndung Community members may seek and receive medical assistance through the Community Sharing for all types of medical treatment, except for all the items listed under Exclusions and Non-covered Items for Sharing in Section 8 of the Members’ Manual.

15.7 For pre-authorization purposes, the TPA identification card and TPA admission card must be presented to the Panel hospital admission counter. Memberships are required to present their card from their user portal profile (“Lyndung Portal”) before proceeding with the intended treatment.

15.8 In any case which requires hospital admission, the Panel hospital will seek an approval from TPA and make admission appointments upon permission is obtained. The Lyndung Community members may call the TPA hotline number 03-2779 0012 or via Whatsapp to +6018-788 3627 if they have any questions or issues regarding the admission.

15.9 TPA will notify the Panel Hospital following the approval of the member’s admission application and the hospital will advise the member immediately of the status.

15.10 Once approved, the TPA will issue an initial guarantee letter (“GL”) and Top-Up guarantee letter (“Top-Up GL”) if necessary.

15.11 Prior to the discharge, the Panel Hospital will send the bill of the medical expenses directly to the TPA.

15.12 The TPA receives and processes the medical expenses for sharing eligibility.

15.13 When a Member is discharge, TPA will issue a Final Guarantee Letter ("FGL") to the Panel Hospital on behalf of the Lyndung Community members and the aggregate of the FGLs will be calculated as at the monthly cut-off date (every 25^th of the month). Then only the sharing amount for that particular month shall be determined.

15.14 The exact amount committed must be reported to the Trustee by the Administrator. The Actual Community Sharing Amount shall be deducted from each Lyndung Community members’ Pocket. If the Pocket balance is less than or equal to RM50.00, the Lyndung Community members' debit/credit card will be charged the amount required to get the Pocket balance to RM100.00.

15.15 Panel Hospital

Medical expenses incurred at any non-Panel Hospital are not eligible for sharing.

15.16 Pre-Existing Condition

15.16.1 Pursuant to Section 14.6 hereinabove, a Lyndung Community member is required to disclose all Pre-Existing Conditions to the Administrator during the signing up process. Failure to fully disclose information pertaining to his/her Pre-existing Condition at the time of signing up is a material violation of the shared trust between the Lyndung Community members and may subject to the disqualification of the said members from the Programme pursuant to Section 10 of this Programme Guideline.

15.16.2 If the Lyndung Community members is admitted for hospitalisation or seeks treatment on the basis of his/her Pre-Existing Conditions, or otherwise is found to possess any Pre-existing Condition, the said members shall lose his/her eligibility as Lyndung Community members and shall be terminated. All deposits of the said members shall be forfeited and be used towards the Community Sharing.

15.16.3 Medical expenses incurred and submitted for sharing within the first 90-days from the Eligibility Date may be subject to a Pre-Existing Condition review by the Administrator, including, but not limited to, request for medical notes/records, hospital charts, surgical records, tests result or other relevant medical history information.

16. DISCLAIMER

16.1 The Programme is administered on behalf of the Lyndung Community members as principal (muwakkil) by the Administrator as agent (Wakil) and as a platform for the Lyndung Community members to share their healthcare and medical burden in accordance with the Programme Guideline. Neither the Administrator nor the Lyndung Community members guarantee or promise that the Eligible Medical Expenses will be shared by the other Lyndung Community members of the Programme due to the payment of the Sharing Contribution are not totally under the Administrator nor the other Lyndung Community members’ control. The Administrator as the agent appointed by the members may utilise the sharing contribution pool for Shariah-compliance investment purposes whenever the Administrator deems appropriate.

16.2 Neither the Lyndung Community members nor the Administrator will be compelled by law to make such a sharing contribution. However, a members’ failure to contribute will result in disqualification from the Programme.

16.3 The Administrator encourages the Lyndung Community members to consult a health insurance/takaful professional for advice on the difference between regulated health insurance/takaful and community sharing programmes such as this Programme.

16.4 The Programme is not provided by an insurance/takaful provider, nor considered as an insurance/takaful contract. The Programme is also not a substitute for any insurance/takaful policy authorised by law. No risk transferred from the members to the Administrator or from among the Lyndung Community members. No indemnity or guarantee contract exists between the Administrator and any of the Lyndung Community members or among the members themselves.

16.5 Neither the Administrator nor the Lyndung Community members are considered insurers under the Malaysian Law. The Programme is not subject to the country's insurance/takaful regulatory standards or consumers’ rights.

17. GOVERNING AND DECISION MAKING

17.1 Programme Guideline

The Programme is governed and regulated by this Programme Guideline. The Administrator is responsible to formulate and enforce this Programme Guideline according to the Applicable Law including Shariah Law. By becoming a member of the Programme, a member agrees to adhere to this Programme Guideline. The Programme Guideline shall vary from time to time or the Administrator shall notify members against the amendment made in the Programme Guideline and members may indicate their acceptance towards the amendment. The Programme Guideline is final and will overrule any verbal statement made by employees or representatives of the Administrator.

17.2 Amending the Programme Guideline

The Programme Guideline may be amended from time to time as circumstances require and as determined to be appropriate by the Administrator. The Administrator has the obligation to ensure that the amendment made to the Programme Guideline shall abide by the Shariah Principle at all times. The Administrator has the option, at its full discretion, of first taking an advisory vote among, or feedback and recommendations from the Lyndung Community members prior to making such amendments. Amendments to the Programme Guideline will go into effect as soon as is administratively practical or as otherwise designated by the Administrator (“Effective Date”) and such amended Programme Guideline shall supersede all previous editions of the Programme Guideline and any other communication, written or verbal. communication, written or verbal.

For the avoidance of doubt, Medical Expenses submitted to the Administrator for sharing after the Effective Date will be subject to the new amendments of the Programme Guideline regardless of when the Medical Expenses are incurred.

The latest Programme Guideline can be accessed via the link in the Lyndung Portal and website. It is the Administrator responsibility to notify members against the amendment made in the Programme Guideline.

17.3 Dispute Resolutions and Appeal

The Programme is a community-based effort where its members voluntarily come together to support, care, and assist each other in a mutually beneficial way. The Programme may not be successfully implemented without its members’ understanding and adhering strictly to this Programme Guideline. As such, it is important that in the event any question, issue, complaint, claim, dispute, or disagreement arising out of, or related to, this Programme Guideline or the Programme (“Dispute”) occurs, a methodology for determining and addressing the Dispute must be made available. By agreeing to participate in the Programme, the Lyndung Community members agrees that any Dispute arise, the Programme, the Administrators and/or its directors, employees, representatives, and associates, will be settled using the following procedures: -

17.4 Applicable Law

For all matters of procedure and substance regarding any Dispute that comes within these above requirements, the laws of Malaysia shall govern.

18. ALTERNATIVE AVENUE TO PRESENT NON-ELIGIBLE MEDICAL EXPENSES

18.1 Nearly all medical expenses can be determined to be eligible for sharing as provided in this Programme Guideline and the Lyndung Members’ Manual. However, in matters where this Programme Guideline or the Members’ Manual may not provide absolute clarity, the Administrator has the absolute discretion to determine whether the medical expenses should be shared according to the procedure and precedent the Administrator deems fit.

18.2 If the Lyndung Community members believe the Administrator is misinterpreting this Programme Guideline or his/her circumstances, the aggrieved members may seek reconsideration through the appeal procedure outlined above. Regardless of the appeal’s outcome, the existence of this appeal procedure should not be interpreted as creating any expectation of sharing or a legally enforceable right since there are no contractual rights of sharing under this Programme Guideline. Rather, the procedure is an alternate method by which the Lyndung Community members can be sure that the Administrator is reconsidering the sharing of the medical expenses according to this Programme Guideline.