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Make a new medical and hospitalisation claim

Electronic filing submission (e-file)

The e-file facility was set up by the Ministry of Health to electronically submit your insurance claims. You are eligible for this if you are our GREAT SupremeHealth customer who is a Singapore citizen or permanent resident. The hospital will file the claim on your behalf and you will not need to do anything as we will receive your claim directly from the hospital.

With our SMS notification service, you will be notified once we receive your claim from the hospital. You will also be notified when your claim has been approved. To ensure that you receive these important updates through SMS notifications, please ensure that your contact information is up to date in our system. 

Should we need further documents, we will write to you directly.  

 

Great Eastern Claims Processing Duration

The following claims return rate table shows how long it takes Great Eastern to process Integrated Shield Plan (IP) claims with positive payouts. Please note that the durations below do not apply to rider claims.

Median Claims Processing Duration (days)  1 75th Percentile Claims Processing Duration (days) 2
0 (Same Day) 1

 Data period is from 1 - 31 Dec 2023

*The number of days that insurers take to process claims include the time it takes to obtain medical records from claimants or medical institutions.

Median Claims Processing Duration means that 50 out of 100 claims are processed by the insurer within the indicated number of days in the table.

2  75th Percentile Claims Processing Duration means that 75 out of 100 claims are processed by the insurer within the indicated number of days in the table.

Note: Our information is published on a monthly basis, whereas MOH website publishes on a quarterly basis.

Non-electronic filing submission (Non e-file)

You will need to submit your insurance claim directly to us if you were not eligible* for the electronic filing (e-file) submission process. Simply follow these steps after your treatment/discharge to make your claim.

 

Some incidences include:

  • Foreigners who are our life assured
  • If you are insured under our Premier Health Plan or Hospital and Surgical Protector plan
  • Bills that were incurred overseas
  • Pre and post hospitalisation bills

Step 1: Prepare the required documents

Download these documents:

  1. Claimant's Statement
    Complete this form for us to find out more details.
  2. Clinical Abstract Application
    This form provides us with your consent to attain your medical information from the hospital on your behalf.
  3. Doctor's Statement
    To be completed by your attending doctor, and applicable if your claim is more than $2,000 or your plan's deductible amount1

Step 2: Obtain these supporting documents

  • Original final hospital/medical bills and receipts2.
  • Hospital discharge summary report (if available).
  • A copy of the reimbursement letter/discharge voucher from the insurer/employer (if there was previous reimbursement from another insurer/employer).
  • If your Medisave was used to pay part of your hospital/ medical bills, please provide a copy of the "Medisave payment and claims" statement. This statement states the deduction details which we will need to process your claim. Go to www.cpf.gov.sg/healthcare with your Singpass and proceed to "latest healthcare payments and claims" to retrieve the statement.

Step 3: Submit your documents

a. Your Great Eastern Financial Representative
 
 
c. By post:
 
Attention to: Health Claim Services
 
The Great Eastern Life Assurance Company Limited

1 Pickering Street 
Great Eastern Centre #01-01
Singapore 048659

 

Note:  You will receive an SMS notification once your claim has been approved. 

Depending on the type of hospital, the process will be different and applicable after you have been diagnosed. Download and print the relevant Doctor's Statement document (as above) and bring it along with you to the hospital. The Doctor Statement is to be completed by the doctor who diagnosed you. You will be required to pay a fee for the application. 

For restructured hospital (public hospital), apply through the hospital's Medical Report Office (MRO). This may take approximately 6-8 weeks.

For private hospital, pass the doctor's statement to your attending doctor to complete during your visit.

For claims more than $2,000, the Doctor’s Statement must be completed by the attending doctor and submitted to us. For Great SupremeHealth/ MaxHealth / Premier Health Plan (with deductible) claim, the Doctor’s Statement is required only if the claim amount exceed the deductible amount. The Doctor’s Statement is furnished at the expense of the claimant.

For claims less than $2,000 or less than the deductible amount for Great SupremeHealth / MaxHealth / Premier Health Plan (with deductible), the Company may waive the medical report if there is sufficient documentary evidence to show the cause of hospitalisation / disability and period of disability. For example, Doctor’s Memo certifying the date of accident, the injuries sustained and diagnosis.

For the documents mentioned in item (4) above, copies of the hospital bills will be accepted for Hospitalisation Benefit, Lifetime Hospital Benefit claim, stand-alone Hospital Cash Protector (HCP) claim, Premier Medicash claim and Hospital Income Benefit Rider. Original final hospital bill is required for all Hospital & Surgical Benefit claim for the reimbursement of Surgeon’s fee, Anaesthetist’s fee, stand-alone Hospital & Surgical Protector (HSP) , Premier Health Plan (PHP) claim, Great Supreme Health claim and Max Health claim.

*To authorise a Great Eastern Financial Representative (other than your designated Financial Representative for this policy) to handle the claim, please download this authorisation letter and submit it together. 

Frequently asked questions

GREAT SupremeHealth, which is an Integrated Shield Plan, consists of 2 parts:

  1. MediShield Life (Basic component) which is compulsory and administered by CPF Board, and
  2. An additional private insurance coverage portion provided by Great Eastern.

The final payout from the integrated GREAT SupremeHealth will comprise of the MediShield Life payout and the GREAT SupremeHealth’s additional insurance coverage payout.

If you are a Singapore Citizen or Permanent Resident who has MediShield Life and uses Medisave to pay for the GREAT SupremeHealth premium, you will be covered under the integrated GREAT SupremeHealth.

Expenses incurred are subject to deductible and co-insurance, where applicable.

Deductible is the initial amount Life Assured need to pay in Period of Insurance (policy year) before any payout from the GREAT SupremeHealth can be made.

Co-insurance is proportion of the claim that Life Assured need to pay after the deduction of the Deductible. It is expressed as a percentage of the total claimable amount.

Benefits listed below are not subject to Deductible:

  • Outpatient Kidney Dialysis Treatment
  • Outpatient Cancer Treatment (Radiotherapy, Chemotherapy, Immunotherapy, Stereotactic Radiotherapy
  • Erythropoietin
  • Immunosuppressant drugs prescribed for treatment of organ transplants

However, the Co-insurance of 10% shall apply.

Confinement in the short-stay ward of an accident-and-emergency department of a  Government Restructured Hospitals with short stay ward charges incurred. There must be a short-stay ward charge.

Day surgery refers to the situation where a patient undergoes an operation in a hospital or a day surgery centre which is MediShield Life-accredited medical institution, performed by a duly qualified Medical Doctor and involving local or general anesthesia. The surgical expenses include the fees and charges for anesthetics and oxygen and their administration, and use of operating theatre and facilities. Surgery excludes Accidental Dental Treatment. Day surgery done in a clinic or polyclinic which is not participating in MediShield Life Scheme is not covered.

Room & Board refers to accommodation in a hospital, including meals and general nursing, during confinement as a bed-paying patient. Deluxe rooms, luxury suites or other special rooms that cost more than a standard single room are excluded.

High Dependency Ward is not classified under ICU. It is recognized as within the Standard Room & Board charges.

This is a waiver of Deductible and Co-insurance (D&C). This benefit will come into effect upon the insured person’s death during hospitalisation or after discharge from the hospital. The D&C, which must be incurred during the same period of insurance in which death occurs, will be reimbursed up to the limits for the plan type insured, provided that death is a result of the cause of the hospitalisation. If the insured person’s death is a result of self-inflicted injuries, suicide or attempted suicide, whether sane or insane, the Final Expenses benefit will not be claimable.

If you are a Singapore Citizen or Permanent Resident, you need to inform the hospital/day surgery centre staff that you are covered under GREAT SupremeHealth upon your admission. You will need to complete a Claim Form for Medisave-Approved Integrated Plan in order for the hospital/day surgery centre to submit the claim electronically i.e. via E-filing to us.

Claim incurred for Inpatient treatment and/or Day Surgery and/or Outpatient Benefits namely, Erythropoietin, Immunosuppressant Drugs Prescribed for Treatment of Organ Transplants, Kidney Dialysis treatment and Cancer treatment will be submitted by Hospitals via E-filing through Central Claims Processing System (CCPS).

All major hospitals/day surgery centres that are accredited under the MediShield Life scheme are linked-up to the electronic claim submission system. You may visit CPF Board’s website for an updated list.

Hospitals can only E-file the claim if confinement in the short stay ward is more than 8 hours. If the confinement is less than 8 hours, please submit the claim with the Hospital Claim Form and original final bill.

You will need to go back to the hospital/day surgery centre to ask for E-filing to be done. Please note that some hospitals/day surgery centre will charge an administrative fee for such requests, which will be borne by policyholder.

You will have to present a 3rd party Letter of Guarantee (LOG) to the hospital and request the hospital to bill the 3rd  party LOG as 1st payer, followed by GREAT SupremeHealth (2nd payer) during the financial counselling session with the hospital of how the bill may be covered by 3rd party LOG under employee benefits, an Integrated Shield plan, Medisave and government subsidies (where applicable). A 3rd party LOG is provided to you by the other insurer under your employer's Group Hospital & Surgical policy if you are eligible. You can check with your company's human resource on your eligibility.

Yes, you will need to bring the other insurer's claim settlement letter to the hospital/ Day Surgery Centre and request them to submit the claim electronically (e-file), inclusive of the claim settlement amount paid by Group Hospital & Surgical under GREAT Supremehealth. At the same time, you will need to notify Claims Department by submitting a copy of the Group Hospital & Surgical claim settlement letter to us.

He/ She needs to submit the original final hospital bill to his/ her company insurer together with a copy of our settlement letter to claim the balance of the hospital bill not covered under the integrated plan.

  • For Life Assured who is a foreigner, your GREAT SupremeHealth is not integrated with MediShield Life. Hence, E-filing submission is not applicable.
  • For Life Assured who is insured under Premier Health Plan or Hospital & Surgical Protector Plan.
  • Pre and post hospitalisation treatments.
  • Overseas bills.

Policyholder needs to submit the above claims manually to Great Eastern. Read more on the instructions on manual claim submission and downloading of claims forms.

For claims under GREAT SupremeHealth that are notifed via E-filing, the payment will be made directly to the hospital/ day surgery centre. The hospital/ day surgery centre will finalize the bills and process the refund (if any) according to the patient.

For claims that are notified via manual submission, the reimbursement protocol is to first reimburse the policyholder for any cash payment, followed by the reimbursement to the CPF Medisave Account and then followed by the reimbursement to MediShield Life or Medisave-approved Integrated Shield Plan.

Please be informed for the cash payment, reimbursement will be via PayNow. Read more on PayNow.

Please submit a copy of the "Medisave payment and claims" statement together with your final medical bills. You can follow the steps outlined below to download your " CPF Medisave Transaction" statement.

  1. Log in to my cpf online services with your Singpass at www.cpf.gov.sg/healthcare
  2. Click on "My Statement" at the sidebar.
  3. Scoll to Section B and select "Medisave and Healthcare Insurance Claims and Reimbursement".
  4. Select the relevant dates and click "Proceed".
  5. Click on the amount at "Medisave Payment" or "Medishield Life/ Integrated Shield Plan Payment" to view the claim details.

No. Our hospitalisation plans do not cover for outpatient treatment at A&E Department of a Hospital due to an illness. Where applicable, you should claim from your employee benefits for outpatient treatment.

Yes. Emergency outpatient treatment covers accidental injuries and is only applicable to hospitalisation plans that provide benefit for Emergency Outpatient Treatment to bodily injuries due to an accident. Please refer to the terms and conditions of your respective hospitalisation plan for eligibility.

If the medical or surgical treatment is medically necessary as a result of an Emergency while overseas, GREAT SupremeHealth shall reimburse the eligible expenses incurred up to the limits stated in the GREAT SupremeHealth Benefit Schedule, subjected to Reasonable & Customary charges in Singapore.

Emergency is contractually defined as a serious Injury or illness or the onset of a serious medical condition which, in the opinion of the Company, requires urgent remedial treatment within 24 hours from the discovery of the Injury or illness or experiencing an onset of the serious medical condition to avoid death or serious impairment to the Life Assured’s immediate or long-term health.

Under GREAT TotalCare Plus (ESSENTIAL)

The coverage for expenses incurred outside the ASEAN* countries will be limited to Reasonable and Customary Charges in Singapore.
 

Under GREAT TotalCare Plus (ADVANCE) 

If you have resided outside Singapore for more than 90 days, whether continuously or otherwise during the Period of Insurance, any Eligible Expenses incurred outside of the ASEAN* countries will be limited to Reasonable and Customary Charges in Singapore.

Note: The 1st 90 days start from the date of departure from the country of residence

*Singapore, Malaysia, Indonesia, Philippines, Thailand, Brunei, Vietnam, Myanmar, Cambodia, and Laos.

Day surgery performed in a specialist clinic or hospital may be paid after assessment of the claim. However, day surgery performed by a General Practitioner is not payable.

How to check your claim status


View our FAQs for Medical / Hospitalisation Claims.

 

For General Insurance claims, visit our General Insurance claims page.