1. Why does Great Eastern need to recover claims paid out from my SupremeHealth policy?
From the requirement set out in the CPF (Private Medical Insurance Scheme) Regulations, parties offering similar medical coverage to Medisave-approved Integrated Shield Plans are required to refund the amounts paid out under your Medisave-approved Integrated Shield Plan (i.e. SupremeHealth).
2. What are the benefits of seeking a recovery?
We encourage you to seek a recovery as this will ensure that the annual benefit limits under your SupremeHealth policy will be preserved as much as possible for future claimable events. By recovering the SupremeHealth claims payout from other parties, SupremeHealth premiums can be kept affordable in the long run.
3. Why is Great Eastern processing my claim first when I have other medical insurance plans?
For all Medisave-approved Integrated Shield Plans, hospitals/clinics are equipped with the MediClaim system (administered by CPF) to directly get in touch with insurers on claims for your medical expenses. Hence, Great Eastern will be the first party to process your claim.
Great Eastern will then proceed to get in touch with your employer or the other insurer with your assistance / approval to recover the claim paid out from your SupremeHealth plan.Please note that prior to Great Eastern getting in touch with your employer or the other insurer, you need to make a claim with your employer's insurer or the other insurer and return us the SHP CLAIMS RECOVERY AUTHORISATION FORM.
4. I would like to claim from my employer or other insurer first. Could I inform the hospital and then re-submit the claim for SupremeHealth if there are still amounts not paid by my employer or other insurer?
Should your employer or other insurer also provide an LOG, you may claim from your employer or other insurer first. SupremeHealth will pay any outstanding eligible expenses not reimbursed under your employer or other insurer's insurance policy.
Otherwise, you are encouraged to e-file your SupremeHealth claim with the hospital first and seek a recovery of the claim paid out under SupremeHealth from your employer or the other insurer.
5. How can I find out which insurer covers my employer for medical benefits?
You may check with your employer on details of the medical insurance policy offered by your company. Details useful for the recovery are the insurer's name, contact person, policy details and type of coverage. If your employer is self-insured, just pass us the contact person's details and we will get in touch with him/her directly.
Instructions for Recovery
6. My company does not provide me with any hospitalisation benefit, but I have a personal medical insurance policy. Should I claim from my personal medical insurance policy too?
Yes, you should claim from your personal medical insurance policy too. You can proceed to make the recovery after you receive from us a letter informing you that your medical expenses have been successfully reimbursed under your SupremeHealth policy. Please follow the below steps for making recovery from the other insurance policy:
Submit a claim to the insurer of the insurance policy which you are seeking recovery (if this has not been already done). Please refer to the respective insurer for submission procedures. If the insurance policy is one that is provided by the employer, you may need to submit the claim via the employer.
Complete "SHP CLAIMS RECOVERY AUTHORISATION FORM".
Return the following items to us using the self-addressed envelope provided.
- Completed "SHP CLAIMS RECOVERY AUTHORISATION FORM"; and
- Duplicated copy of all documents submitted in Step 1 which will include the claim form and hospital bills.
7. Could Great Eastern obtain information of my employer or other insurer directly from the hospital and help me to submit the claim?
Your personal information with the hospital only includes basic information on the hospitalisation and the bill incurred. It does not include any information on your employer or the other insurer. The hospital is also not in the position to release such information to a third party. As such, Great Eastern would not be able to submit a medical claim directly to your employer or other insurer on your behalf.
8. The other insurer requires a medical report to assess the claim. Will the medical report fees be payable from Great Eastern?
No, Great Eastern will not be able to reimburse you for your medical report fees.
9. What will I receive upon a successful recovery?
As a token of our appreciation, you will receive a $50 Robinson's gift voucher from us if we have made a successful claim recovery from the other insurer for the medical expenses incurred. The voucher will be sent to you approximately a month from the date Great Eastern receives the reimbursement amount from the other insurer.