Under the Programme, each member is entitled to the following:
A member can freely withdraw from the Programme by clicking the ‘Retreat’ button in the Lyndung Portal. The member will receive a verification code through SMS that must be inserted into the Lyndung Portal to complete the withdrawal process. The member’s 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 member is still accountable for any Actual Community Sharing Amount for the period within the 26-day grace period from the remaining balance of his/her sharing contribution.
In terms of failure to make payment for Sharing Contribution top-up or payment for Annually/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 26 days (if any) from the remaining balance of his/her sharing contribution.
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 have been blacklisted, the refund process shall initiate immediately to refund any remaining balance of his/her Sharing Contribution Pool.
The Lyndung Community members shall be entitled to a refund of any unused portion of the 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.
The account of the Lyndung Community members who have already withdrawn/suspended/ blacklisted from the Programme will be terminated upon refunding the remaining unused Sharing Contribution.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.
7.1 Member’s Scheduled Benefits
The purpose of the Programme is to assist the members with their medical expenses through the Lyndung Community members sharing according to the Shariah Principle of Tabarru’.
The Administrator has developed a strategic agreement with a reputable Third-Party Administrator (“TPA”) to manage the entire hospitalisation and claims process for the Programme.
7.2 Hospitalisation Medical Expenses
Medical expenses that are eligible for sharing under the Programme shall be usual, customary and reasonable while hospitalised as an Inpatient ("Hospitalisation") for any medically necessary treatments of his/her sickness are provided by or under the direction of Panel Hospital.
7.3 Hospitalisation Medical Expenses Annual Sharing Limit
Every member’s maximum entitlement for an annual sharing of medical expenses shall not exceed RM1,000,000.
7.4 Accidental Injury Medical Expenses Sharing Limit
Members may seek emergency medical treatment for accident-related injury. The Lyndung Community permitted a maximum sharing limit of RM20,000 for all authorised cases of unintentional injury. This eligibility for sharing is subject to a Waiting Period. This benefit will be upgraded to Hospitalisation Medical Expenses Annual Sharing Limit upon expiration of the 60-day waiting period, as described in Section 7.3 herein above and Section 9 for further information on Waiting Period.
7.5 Outpatient Cancer Treatment and Kidney Dialysis
Chemotherapy, Radiotherapy, Electrotherapy and Kidney Dialysis are eligible for sharing up to RM100,000 per lifetime, excluding the RM1,000,000 Hospitalisation Medical expenses Annual Sharing Limit, for being considered Outpatient treatment.
7.6 Emergency Outpatient Accidental Treatment
Emergency Outpatient accidental treatment and/or accidental dental treatment are eligible for sharing up to RM3,000 per disability. However, only treatment within 24 hours after the accident and follow-up treatment up to 60-days are eligible for sharing.
7.7 Post Hospitalisation Treatment
Post-hospitalisation treatment consists of up to one follow-up visit within 60 days per disability following hospital discharge.
7.8 Organ Transplant
Organ transplant involving a member as a Donee is eligible for sharing up to RM20,000 per lifetime.
7.9 Eligible Hospitalisation Medical expenses for Sharing Contribution
7.9.A. Hospital Room and Board
Medical expenses for hospital room accommodation and meals during Hospitalisation, subject to a maximum of RM150 per day, not exceeding the maximum of 120 days for each Sharing Year. By default, a four-bedded room shall be chosen and subject to the cap of RM150 per night. Any amount exceeding the limit described herein is to be borne by the member him/herself. Members are not allowed to upgrade to another room type above a four-bedded one unless they are fully occupied or not available.
7.9.B. Intensive Care Unit
Medical expenses for actual room and board incurred in the Intensive Care Unit of the Hospital up to 120 days per Sharing Year.
7.9.C. Ambulance Fees
Medical expenses for ambulance services (inclusive of attendants) to and/or from the hospital are provided only for emergencies involving life-threatening situations for up to RM250.
7.9.D. Hospital Supplies and Services
7.9.E. Surgical Fees
Medical expenses for surgery performed by a Specialist.
7.9.F. Operating Theatre Fees
Medical expenses for the use of the operating room and equipment incidental to the surgical procedure.
7.9.G. Anesthetist Fees
Medical expenses for the administration of anaesthesia by an anaesthetist.
7.9.H. In-Hospital Doctor Visit
Medical expenses for Doctor’s visit to an Inpatient subject to a maximum of 1 visit per day not exceeding the maximum of 120 visits per Sharing Year.
7.9.I. Day Care and Day Surgery
As charged subject to Annual Sharing Limit.
7.9.J. Second Surgical Opinion
One time, as charged for advice received 60-days preceding confinement/admission.
7.9.K. Malaysian Goods and Services Tax or Sales and Service Tax
The prevailing Malaysian Goods and Services Tax or Sales and Service Tax as charged on the Medical expenses set out in Section 7.9.
7.9.L. Medical Report Fee Reimbursement
Medical Report Fee reimbursement or retrieval of medical report up to RM100.00 per disability
7.10 The Administrator reserves the right to review admission requests and invoices submitted by the Panel Hospital or member for sharing, and with the assistance from the TPA to accept or decline payment of medical expenses deemed not eligible under the Programme Guideline.
7.11 Death Beneficiaries Support (Khairat Kematian)
In the event of a member's death, the member's next of kin are eligible to receive RM5,000 as death beneficiaries support (Khairat Kematian) from the Programme. This amount will be shared equally among the members to help the deceased member's beneficiaries. Before the Programme provides the beneficiaries with khairat support, the next of kin must inform and provide the Administrator with the certificate of death and any other necessary documents. Once the death and identity as well as legal standing of the beneficiaries are verified, the beneficiaries will receive RM5,000 khairat support from the Programme.
8.1 Pre-existing conditions. Medical expenses for Pre-existing conditions incurred. See Section 11 herein below for further details
8.2 Pre-Hospital Diagnostic Test.
8.3 Pre-Hospital Specialist Consultation.
8.4 Abortion. Treatments in connection with an abortion unless the physical life of the mother is endangered by the continued pregnancy and that treatment via a Caesarean Section has been determined to be inadvisable by a neonatologist.
8.5 Air Travel. Treatments for Disability sustained during air travel except as a fare paying passenger on a recognized airline operating on scheduled air routes and air travel by any chartered aircraft duly licensed as a recognized air carrier and flown by professional crews between properly established and maintained airports.
8.6 Alcohol/Drugs. Treatments for a Disability occurred due to the member’s abuse and/or use of alcohol or drugs/pharmaceuticals, including drug and/or alcohol rehabilitation treatment.
8.7 Alternative Treatments. Acupuncture, acupressure, aromatherapy, bone setting, chiropractic, herbalist treatment, hyperbaric oxygen therapy, massage, osteopathy, reflexology and other alternative treatment.
8.8 Any Types of Implants.
8.9 Circumcision. Any circumcision.
8.10 Cosmetic Surgery. Cosmetic or plastic surgery includes, but not limited to, breast augmentation or reduction (exceptions for breast reconstruction after breast cancer for the affected breast and the non-affected breast if recommended for purposes of symmetry), double eyelids, acne, keloids etc.
8.11 Complication of Non-Eligible Treatment. Treatments required as a result of complications from a Treatment or a Disability are not eligible for sharing.
8.12 Congenital or Hereditary Disease. Treatments for congenital or hereditary diseases, deformities and disabilities e.g. childhood hernias, clubfoot, VSD, ASD, Thalassemia etc.
8.13 Custodial Care. Treatments provided mainly as a rest cure, maintenance, custodial and recuperative care, or other care that does not treat a Disability e.g. private nursing or house calls by Doctors etc.
8.14 Covid-19 Test. Any medical expenses for Covid-19 test prior to hospitalisation.
8.15 Dental. Dental Treatments, including periodontics, orthodontics, Temporomandibular Joint (TMJ) disorder or orthognathic surgery, Hospital charges for dental work done under general anesthesiology except necessitated by injury to sound natural teeth.
8.16 Durable Medical Equipment (DME). Medical Expenses arising from the purchase, rental or replacement of durable or reusable equipment or devices, including, but not limited to, prosthetics, artificial limbs, orthotics, hearing aids, tubing, aero chambers, masks, exercise equipment, locomotion equipment (bed, wheelchair, walking aid etc.), maintenance treatment and their associated expenses.
8.17 Emergency Room Charges for Non-Emergencies. Treatment at an emergency room that does not deem to be an emergency according to the usual standards of medical care.
8.18 Exercise Programs. Exercise programmes as a Treatment of any Disability except for Doctor supervised cardiac rehabilitation and or Inpatient physical therapy.
8.19 Experimental, Investigational, Unproven or Unapproved Treatments. Treatments that are experimental, investigational or unproven or that are not according to accepted professional standards and/or that are illegal under the Malaysian Law.
8.20 Eye Care. Eye exercise therapy, radial keratotomy or other eye surgery to correct near-sightedness, far-sightedness or visual acuity. Also, routine eye examinations, including refractions, lenses, corrective glasses for the eyes and examinations for their fitting.
8.21 Gross Negligent Acts. Treatments for a Disability as to which the member has acted with gross negligence or with reckless disregard to safety, as evidenced by medical records and as determined by the Administrator in its absolute discretion.
8.22 Hair Loss. Treatments for hair loss, hair transplants or any drug that promises hair growth, whether or not prescribed by a Doctor.
8.23 Hearing Aids and Exams. Charges for services or supplies in connection with routine hearing exams, hearing aids, or exams for their fitting.
8.24 Hazardous Hobbies. Treatments of a Disability that results from engaging in a hazardous hobby. A hobby is hazardous if it is an activity which is characterised by a constant or recurring threat of danger or risk of bodily harm. Examples of hazardous hobbies include, but are not limited to, rock/cliff climbing, spelunking, skydiving, or bungee jumping.
8.25 Illegal Acts. Treatments received as a result of a Disability caused by engaging in an illegal act or occupation; by committing or attempting to commit any crime, criminal act, assault or other felonious behaviour; including but not limited to illegal drug activity, crimes against persons, crimes against property and gun offences, while sane or insane.
8.26 Impotence. Treatments for impotence.
8.27 Infertility. Diagnostic, surgical repair, non-surgical repair, surgical impregnation and prescription drugs for the treatment of infertility.
8.28 Mental Health Treatments Psychiatric or psychological counselling, mental or nervous disability, learning disability, bereavement counselling, biofeedback therapy, psychological testing, treatment, medication and hospitalisation.
8.29 Miscellaneous Treatments. Treatments for sleep and snoring disorders, hyperhidrosis treatment, hormone replacement therapy, stem cell therapy and treatment for symptoms not related to a specifically diagnosable Disability, such as ongoing fatigue and malaise.
8.30 No Obligation to Pay. Medical expenses for which the member has no legal obligation to pay.
8.31 Non-Prescribed Medical Supplies and Equipment. Non-prescribed medical supplies and equipment including, but not limited to, over-the-counter drugs, first-aid supplies and treatments, vitamins, food supplements, herbal cures, soap, anti-obesity or weight reducing agents, elastic stockings, tubings, masks, ostomy supplies, insulin infusion pumps, ace bandages, gauze, syringes, diabetic test strips and similar supplies.
8.32 Non-Panel Hospital. Treatment provided by or under the direction of a Non-Panel Hospital.
8.33 Non-Medically Necessary Treatments. Treatments that do not meet the criteria of a Medically Necessary Treatment or is not specified as a Medically Necessary Treatment, or Treatments that are not recommended and approved by a Doctor; or Treatments received when the member is not under the regular care of a Doctor.
8.34 Non-Reasonable and Customary Charges. Charges for Treatments that are in excess of the Fair and Reasonable Charges based upon the determination of the Administrator in accordance with the Programme Guideline.
8.35 Organ Transplant. Medical expenses for donation of any body organ as donor.
8.36 Outpatient Treatments. Any Treatment received by an Outpatient that is not related to an Inpatient treatment.
8.37 Personal Comfort Items. Personal comfort items or similar facilities, such as, but not limited to, television, telephone, fax, radio, air conditioners, air purification units, humidifiers, electric heating units, non-hospital adjustable beds, orthopaedic mattresses, blood pressure instruments, scales, elastic bandages or stockings and, admission kit/pack.
8.38 Pregnancy and Maternity. Treatments relating to pregnancy including childbirth, miscarriage, surrogacy, pre and post-natal care and surgical except for miscarriage due to Accident.
8.39 Professional Racing or Competitive Events. Treatments of Disability while racing or competing as a professional. Professional racing means that such activity is one’s primary vocation and means of financial support. Professional racing and competitive events include, but are not limited to, automobile, motorcycle, watercraft, ski or rodeo races or competitions.
8.40 Radiation. Treatments for effects from radiation or contamination by radioactivity from any source.
8.41 Replacement Braces. Replacement of braces of the leg, arm, back, neck, unless there is sufficient change in the Member’s physical condition to make the original device no longer functional.
8.42 Routine and Preventive Care – including, but not limited to, all well-patient care and screening test and procedures, such as:
8.43 Self-Inflicted Injuries. Treatments due to suicide, attempted suicide or intentionally self-inflicted Disability, while sane or insane.
8.44 Sex Changes. Treatments for non-congenital transsexualism, gender dysphoria or sexual reassignment or change. This includes medications, implants, hormone therapy, surgery, or medical or psychiatric treatment.
8.45 Speech and Occupational Therapy.
8.46 Surgical Sterilisation or Reversal. Treatments for, or reversal of, surgical sterilisation, including vasectomy and tubal ligation or contraceptive medications and devices.
8.47 Transportation. Charges resulting from transportation by ambulance for Disability that will not seriously jeopardise the member's health or life are not eligible for sharing. The additional expenses for transportation to a Panel Hospital that is not the nearest Panel Hospital that is capable of providing Medically Necessary Treatment is also not eligible for sharing.
8.48 Travel or Accommodations. Charges for travel or accommodations, whether or not recommended by a Doctor.
8.49 Treatment by Relatives. Treatments performed by a person who ordinarily resides in the member’s home or is related to the member as a spouse, parent, child, sibling, whether the relationship is by blood or exists in law.
8.50 Venereal Disease, AIDS, and AIDS Related Complex, HIV Related Disability. Exceptions include innocent transmission via transfusion, rape, work-related needle stick or sex within marriage.
8.51 Waiting Period. Medical expenses Incurred during the Waiting Period. See Section 9 for further information as to the Waiting Period.
8.52 War. Any Medical expenses incurred that is due to any declared or undeclared act of war, military activity, riot, rebellion, insurrection, civil commotion, explosion of war weapons, terrorism related activity, nuclear war, biological and chemical warfare/activity
8.53 Shariah Non-compliant Medical Procedure. Any Medical expenses incurred that are deemed non-compliant according to the Shariah principle.
9.1 Before the end of 60-days Waiting Period
Members may seek emergency medical help due to personal accident injury. The Lyndung Community allowed a maximum of RM20,000 sharing limit for any approved accidental injury case and to receive death beneficiaries supporting (Khairat Kematian) amounting to RM5,000. This sharing eligibility is not bound by any Waiting Period.
9.2 After the end of the 60-Days Waiting Period (General Illnesses Unlock)
Upon expiry of 60-days from initial payment, a member is entitled to the Hospitalisation Medical Expenses Annual Sharing Limit, with an exception of the treatment/surgery resulting from Specific Illnesses.
9.3 After the end of the 180-Days Waiting Period (Specific Illnesses Unlock)
Upon expiry of 180-days from initial payment, a member is entitled to the Hospitalisation Medical expenses Annual Sharing Limit, including treatment/surgery resulting from Specific Illnesses.
Specific illnesses shall mean the following Disabilities and its related complications:
10.1 Hypertension, diabetes mellitus or cardiovascular disease;
10.2 Growths of any kind including tumours, cancers, cysts, nodules, polyps;
10.3 Stones of the urinary system and biliary system;
10.4 All ear, nose (including sinuses) and throat conditions;
10.5 Hernias, haemorrhoids, fistulae, hydrocele or varicocele;
10.6 Any disease of the reproductive system including endometriosis;
10.7 Vertebro-spinal disorders (including disc) or any knee conditions and;
10.8 Critical Illnesses:
10.8.2 Heart Attack;
10.8.3 Kidney Failure;
10.8.5 Coronary Artery By-Pass Surgery;
10.8.6 Serious Coronary Artery Disease;
10.8.7 Angioplasty and other Invasive Treatments for Coronary Artery Disease;
10.8.8 End-Stage Liver Failure;
10.8.9 Fulminant Viral Hepatitis;
10.8.11 Benign Brain Tumour;
10.8.12 Paralysis of Limbs;
10.8.15 Third Degree Burns;
10.8.16 HIV Infection Due to Blood Transfusion;
10.8.17 Occupationally Acquired Human Immunodeficiency Virus (HIV) Infection;
10.8.18 Full-blown AIDS;
10.8.19 End-Stage Lung Disease;
10.8.21 Major Organ / Bone Marrow Transplant;
10.8.22 Loss of Speech;
10.8.23 Brain Surgery;
10.8.24 Heart Valve Surgery;
10.8.25 Terminal Illness;
10.8.26 Loss of Independent Existence;
10.8.27 Bacterial Meningitis;
10.8.28 Major Head Trauma;
10.8.29 Chronic Aplastic Anaemia;
10.8.30 Motor Neuron Disease;
10.8.31 Parkinson’s Disease;
10.8.32 Alzheimer’s Disease / Severe Dementia;
10.8.33 Muscular Dystrophy;
10.8.34 Surgery to Aorta;
10.8.35 Multiple Sclerosis;
10.8.36 Primary Pulmonary Arterial Hypertension;
10.8.37 Medullary Cystic Disease;
10.8.39 Systemic Lupus Erythematosus with Severe Kidney Complications; and
10.8.40 All types of newly defined critical illnesses.
11.1. Pursuant to Section 14.6 of the Programme Guideline, the Lyndung Community members are required to disclose all Pre-Existing Conditions to the Administrator during the signing up process. Failure to fully comply and disclose all 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 member and blacklisted from the Programme pursuant to Section 10 of the Programme Guideline.
11.2. If the Lyndung Community member is admitted for hospitalisation or seeks treatment on the basis of his/her Pre-Existing Condition, or otherwise is found to possess any Pre-Existing Condition, the said member shall lose his/her eligibility as The Lyndung Community member and shall be terminated. All deposits of the said member shall be forfeited and be used towards the Community Sharing.
11.3. 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.
Medical Expenses incurred at any non-Panel Hospital are not eligible for sharing. Please refer to the list of Panel Hospitals on our web page.
13.1. If the Medical Expenses of a member are simultaneously covered or under the responsibility of another insurance/takaful type or arrangement, or a third-party liability (party responsible for causing the Disability), the member is encouraged to claim his/her Medical Expenses from such insurer or third-party (“Primary Responsible Party”) rather than submitting the Medical Expenses to the Programme for sharing. Conditions may be imposed by the Administrator on the sharing of Medical Expenses in such circumstances.
13.2. If any of the Lyndung Community members suffer an injury and a Primary Responsible Party refuses to pay unless legal remedies are pursued, the members must pursue his/her legal remedies. The Administrator, on behalf and for the benefit of all members, will be subrogated to any and all rights and remedies that a member has against any Primary Responsible Party to the extent of such shared Medical Expenses and shall be entitled to sue on behalf of such member to recover the shared medical expenses from the Primary Responsible Party. The member shall give or cause to be given to the Administrator all such cooperation and assistance as required by the Administrator to determine whether such shared Medical expenses are payable by the Primary Responsible Party and to secure the rights and remedies. The member shall also at the Administrator’s request, execute or cause to be executed all documents necessary to enable the Administrator to effectively bring the suit. If the member does not fully cooperate and assist the Administrator, the medical expenses will not be eligible for sharing under the Programme and shall refund all shared Medical Expenses paid for the members.
13.3. Any amount paid by the Primary Responsibility Party will not be shared. If the medical expenses are shared in the Programme and later voluntarily reimbursed by a Primary Responsible Party or compensated by Primary Responsible Party in settlement, judgement or other award or recovery, such reimbursement or compensation (to the extent they fairly represent compensation for the shared Medical expenses) must be returned by the member to the Share Pool immediately for future sharing.
14.1. Programme Guideline
The Programme is governed and regulated by the Programme Guideline. The Administrator is responsible to formulate and enforce the Programme Guideline according to the Applicable Law including Shariah Law. By becoming a member of the Program, a member agrees to adhere to the Programme Guideline. The Programme Guideline as of current at the time of service shall govern the Programme, not the Programme Guideline as it was when the member signed up for the Programme. The Programme Guideline is final and will overrule any verbal statement made by employees or representatives of the Administrator. The Administrator shall notify members against the amendment made in the Programme Guideline and members may indicate their acceptance of the amendment.
14.2. 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 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 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.
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's responsibility to notify members against the amendment made in the Programme Guideline.
14.3. 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. Such a shared responsible Programme may not be successfully implemented without its members' understanding and adhering strictly to the 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 Lyndung Community Programme or the Programme Guideline (particularly on the interpretation of any provision of the Programme Guideline) (“Dispute”) occurs, a methodology for determining and addressing the Dispute must be made available. By agreeing to participate in the Programme, a member agrees that any Dispute he/she may have with or against one another, the Programme, the Administrators and/or its directors, employees, representatives, and associates, will be settled using the following procedures, and only as a course of last resort.
14.4. Determining the Dispute
Any Dispute shall be referred to the Administrator for determination. Lyndung Community members may contact the Administrator’s service representatives. However, the oral opinions offered by the service representatives do not constitute binding decisions of the Administrator. Formal inquiries by the Lyndung Community members shall be in writing explaining circumstances and specifically seeking a binding decision from the Administrator (“Decision”). The Administrator shall reply in writing to the Decision and will explicitly indicate if it is a decision that will bind the Administrator and the Programme.
14.5. Review by Appeal Committee
If a Lyndung Community member is not satisfied with the Decision (“the Appellant”) and has logical reasons to believe that the Decision is incorrectly made, the appellant may file an appeal for review and reconsideration to the Programme’s appeal committee (“Appeal Committee”). The appeal for a review must be made within 30 days from the day the Decision was made and must be in writing, stating the elements of the Dispute and all the relevant facts.
If required, the Internal Appeal Committee may call for a meeting with the Appellant to discuss and/or require the Appellant to furnish further documents or commence further investigation.
Within 30 days from the appeal or such other longer time as shall be required, the Appeal Committee will deliberate on the Dispute and initial Decision and render a written decision to the Participant. The Appeal Committee’s decision is final and binding on both the Administrator and the Appellant.
The Administrator reserves the right to impose an appeal fee payable by the Appellant.
14.6. Decision made by the Appeal Committee is Final and Binding
In the interest of the Programme, Members agree that the above methods of resolving Dispute shall be the sole remedy for any Dispute and expressly waive his right to file a lawsuit in any civil court against one another, the Administrator and/or its directors, employees, associates or representatives, for such Dispute.
14.7. Applicable Law
For all matters of procedure and substance regarding any Dispute that comes within these above requirements, the laws of Malaysia and laws of Shariah shall govern.
15.1.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.
If the Members believe the Administrator is misinterpreting this Programme Guideline or his/her circumstances, the aggrieved member 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 Members can be sure that the Administrator is reconsidering the sharing of the medical expenses according to this Programme Guideline.
Referral Incentive and Rewards for Member
RM10.00 incentive will be granted to each successful referral to encourage the Members to help promote the Programme to others. The 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.