Claims

Death Claim

What is the procedure for making a Death Claim?
Please click here to go to ‘make a claim’ for the procedure on making a Death Claim.
What is the Doctor’s Statement?
The Doctor’s Statement is a form provided by Great Eastern Life, to be completed by the doctor who attended to the deceased person for his last illness before his death. If death occurred in Singapore, the claimant can submit all the relevant documents except the Doctor’s Statement. Claims Department will review the claim and advise if the Doctor’s Statement is required. The Doctor’s Statement must be completed if death occurred abroad due to an illness.

How will the death claim proceeds be paid?
We pay to the trustee if the policy is under trust, the asssignee if the policy is assigned and the nominee if there is a nomination.

If there is no trust, assignment or nomination under the policy, the Company may pay to a "proper claimant" under Section 61 of the Insurance Act (on a case to case basis) for an amount up to S$150,000 without requiring the production of the Grant of Probate or Letters of Administration.

For submission of death claims for policies without trust, assignment or nomination, please advise the following claimants to come forward:

Scenario	Claimant to submit the death claim	Documents to submit
Deceased had left a will	Executor of Last Will	Copy of Last Will NRIC of Executor
Deceased did not leave a Last Will : -
Deceased is married	Spouse	NRIC of spouse Marriage certificate of deceased and spouse
Widowed / Divorced with adult children	Any adult child	NRIC of child Birth certificate of child Death certificate / divorce certificate of deceased's spouse
Single with surviving parents	Either parent	NRIC of parent Birth certificate of deceased
Single with no surviving parents	Any sibling	NRIC of sibling Birth certificates of sibling and deceased Death certificates of parents

Who is considered the Proper Claimant?
Proper Claimant refers to the executor, widower, widow, parent, child, brother, sister, nephew or niece of the deceased.

What is the Grant of Probate or Grant of Letters of Administration and how does the estate apply for it?
A Grant of Probate is issued by the Courts to confirm the appointment of the executor(s) named in the deceased’s will.

A Grant of Letters of Administration is issued by the Courts to name the legal representatives who are entitled to deal with the deceased’s estate.

Both can be applied through a lawyer or the Public Trustee, who will draw up and submit a petition to the High Court for approval. It may take up to six months for the court to grant an approval, depending on the complexities of the deceased’s estate.

Total and Permanent Disability (TPD) claim

What is the procedure for making a Total and Permanent Disability (TPD) claim?
Please click here to go to ‘make a claim’ for the procedure on making a Total and Permanent Disability Claim.
How will the Total and Permanent Disability (TPD) Benefits be paid?
Should the insured person become totally and permanently disabled while the policy is in force, the Company will waive the payment of all future basic life premiums and pay the Disability Benefit in 10, five or three annual instalments, or one lump sum, depending on the terms and conditions stated in the policy contract.

*Please refer to the policy contract for the instalment payments and the date of the instalments due as different contracts have different terms and conditions.
Why is a medical report required before payment of every TPD instalment?
A medical report is required before each TPD instalment is made because, under the contract for TPD, if the assured ceases to be totally and permanently disabled, the Company will discontinue all further annual payments. Therefore, there is a need to confirm that the policyholder is still totally and permanently disabled before each instalment is paid out.
For endowment policies, what happens when there are TPD instalments due after the policy maturity date?
On the maturity due date, the Company will pay in one lump sum to the policyholder the balance of the TPD instalments.
If the insured person passes away in the midst of his TPD instalments, what will happen to the rest of the unpaid TPD instalments?
The unpaid TPD instalments will be paid in one lump sum to the estate of the deceased.
What happens if the insured person recovers from his TPD before he has received the full TPD benefits?
It is stated in the contract that if the insured person ceases to be TPD, the Company will discontinue further TPD benefits payments and the policy shall continue under such terms and conditions as the company may decide.
If I have both DPS and Great Eastern Life policies, how should I submit the Permanent Incapacity (PI) and Total and Permanent Disability (TPD) claims respectively?
You may complete just one set of Claim form. Please use the DPS PI Claim form and submit all the required documents to us as stated on the claim form.

Living Assurance/Early-Payout Critical Care (EPCC) Claim

What is the procedure for making a Living Assurance/EPCC claim?
Please click here to go to ‘make a claim’ for the procedure on making a Living Assurance Claim
Will the Living Assurance/EPCC claim be paid to the policyholder immediately?
There is a three-month waiting period for the following major illnesses/surgeries (i.e. the major illness or the illness for which surgery is required will be covered only three months after the date of issue of the policy/rider or reinstatement of the policy/rider):
- Cancer/Major Cancers
- Heart Attack
- Angioplasty & other Invasive Treatments for Coronary Artery
- Coronary Artery By-pass Surgery
If the claim is admitted, the payment of claims will be made to the policyholder.
What is a Doctor’s Statement?
The Doctor’s Statement is a form provided by Great Eastern Life, to be completed by the doctor who attended to the insured person for his illness. The policyholder has to request the attending doctor to complete the Doctor’s Statement and the fee for the completion of the Doctor’s Statement will be borne by the policyholder. Should the Claims Department require additional medical reports, the medical report fee will be borne by the Company. In addition, all relevant laboratory and test results need to be submitted.
If an existing insured person is planning to reside overseas, how will the Living Assurance be affected?
The Living Assurance benefits provide a worldwide cover. However, the insured person’s condition must be certified by a qualified physician practising Western medicine. The Company reserves the right to ask the insured person to be reviewed by an appointed physician.

If a special endorsement (Endorsement No. 100) is included in the insured person's policy, eg. for foreigners and PRs, the insured person is required to be diagnosed in Singapore, Malaysia or Brunei. However, the Company will still consider the medical evidence if the illness is diagnosed in other countries. If the medical evidence is sufficient, the Company may choose to pay the claim on goodwill basis without admitting liability. Otherwise, the Company reserves the right to ask the insured person to be reviewed by an appointed physician.
What should the policyholder do if he does not know which Major Illness to claim under?
If the policyholder does not know the exact diagnosis of his condition or does not know which Major Illness it falls under, the policyholder may show the policy with the Major Illnesses’ definitions to his attending doctor and seek the doctor’s opinion whether the condition fulfils any of the Major Illnesses. If it does, the policyholder should request the attending doctor to complete the Doctor’s Statement of that particular Major Illness.

Personal Accident Claim

What is the procedure for making a Personal Accident Claim?
Please click here to go to ‘make a claim’ for the procedure on making a Personal Accident Claim.
Do I need to submit a medical report?
For claims of more than S$1,500, the Doctor’s Statement must be completed by the attending doctor and submitted to us. The Doctor’s Statement is furnished at the expense of the claimant.

For claims of less than S$1,500, the Doctor’s Statement need not be submitted. The Company may waive the
1. medical report if there is sufficient documentary evidence, e.g. a Doctor’s Memo or Inpatient Discharge
2. summary report to show the cause of hospitalisation/disability and period of disability

Medical/ Hospitalisation claim

What is an Integrated GREAT SupremeHealth Plan?

GREAT SupremeHealth, which is an Integrated Shield Plan, consists of 2 parts:
- MediShield Life (Basic component) which is compulsory and administered by CPF Board &
- 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.
How do I check if my GREAT SupremeHealth is an Integrated Shield Plan?
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.
What is Deductible and Co-insurance?
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.
Which benefits are NOT subjected to the Deductible under GREAT SupremeHealth?

Benefits listed below are not subject to Deductible:
1. Outpatient Kidney Dialysis Treatment
2. Outpatient Cancer Treatment (Radiotherapy, Chemotherapy, Immunotherapy, Stereotactic Radiotherapy)
3. Erythropoietin
4. Immunosuppressant drugs prescribed for treatment of organ transplants
  
  However, the Co-insurance of 10% shall apply.
What is Short-Stay Ward?

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.
What is Day Surgery?

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.
What is Room & Board?

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.
What is Final Expenses Benefit?

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.
How to submit claim under GREAT SupremeHealth?

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.
Does Short Stay Ward require to be E-filed for claim under GREAT SupremeHealth?

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.
If I did not E-file my claim under GREAT SupremeHealth upon discharge, what should I do?

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.
If I had claimed my hospitalisation bills under another medical plan/my employment benefits first but I was not fully reimbursed, can I still submit the claim under my GREAT SupremeHealth?

Yes, but you will need to bring the 3rd party insurer’s claim settlement letter to the hospital/day surgery centre and request them to E-file the claim inclusive of the 3rd party’s claim settlement amount to us.

Please note that some hospitals/day surgery centre will charge an administrative fee for such request, which will be borne by policyholder.
What Claims are to be Manually Submitted to Great Eastern?
1. For Life Assured who is a foreigner, your GREAT SupremeHealth is not integrated with MediShield Life. Hence, E-filing submission is not applicable
2. For Life Assured who is insured under Premier Health Plan or Hospital & Surgical Protector Plan
3. Claim for all Pre and Post-Hospitalisation Treatments
4. Claim for Overseas Bills
  
  For the above claims, policyholder needs to submit claim manually to Great Eastern.
  
  For instructions on manual claim submission and downloading of claims forms, please visit our website under Home > Personal Insurance > Get Help > Make a Claim > Medical/Hospitalisation Claim.
If I had claimed my Pre/Post-Hospitalisation bills under another medical plan/my employment benefits first but I was not fully reimbursed, can I still submit the claim under my GREAT SupremeHealth?

You may submit a copy of the 3rd party insurer’s claim settlement letter and a copy of the bills for us to process the balance unclaimed portion of the bill. If your bills reflect full payment by the 3rd party (e.g. MCPS – medical claims proration system for civil servants, other statutory bodies, etc.) where co-payment of the bill may be deducted from the salary, please provide a copy of the payslip reflecting the co-payment deducted for each corresponding bill.
How approved claims are reimbursed to me?

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.
If I have consulted the A&E Dept in a Hospital due to an illness (acute or otherwise) but was not hospitalised, will the claim be payable?

No. Our hospitalisation plans do not cover for outpatient treatment at A&E Dept due to an illness.
If I have consulted the A&E Dept in a Hospital due to an accidental injuries but was not hospitalised, will the claim be payable?

Yes. Emergency outpatient treatment covers accidental injuries and this is only applicable to Hospitalisation Plans that have a benefit on Emergency Outpatient Treatment due to Accident.
Can I claim under my GREAT SupremeHealth if I am hospitalised overseas?

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.
If I have a GREAT TotalCare Plus coverage attached to my GREAT TotalCare, when do the Reasonable and Customary Charges come in for expenses incurred outside of Singapore?

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.
If the insured person underwent day surgery, can he/she claim under Hospital & Surgical Protector (HSP)/Premier Health Plan (PHP)/GREAT SupremeHealth/Maxhealth?

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.
If the insured person has consulted the A&E department of a hospital due to an illness (acute or otherwise) but was not hospitalised, will the claim be payable?

No. HSP/PHP/GREAT SupremeHealth/Maxhealth claim is only payable if the insured person is hospitalised or has undergone a surgery in a specialist clinic or hospital due to an illness/accident. However, A&E consultations without hospitalisation will be payable if it is due to an accident/injury and must be treated by a qualified Western-trained physician (Please refer to policy contract for the definition of ‘physician’).
If the insured person goes to the A&E department of a hospital due to an illness, e.g. high fever or food poisoning, can he/she claim under the Hospital & Surgical Protector (HSP)/Premier Health Plan (PHP)?

No. Emergency outpatient treatment only covers accidental injuries (Please refer to policy contract for the definition of ‘Emergency Outpatient Treatment’).
My surgery or treatment has been rescheduled because of the Covid-19 situation. As such, my pre and post hospitalisation visits have also been affected. Can I still submit bills to make claims?

Yes, you can still submit the bills to make claims if your pre and post hospitalisation visits are related to your surgery or treatment.

Simply provide us with your doctor's memo with the following details:
(1) A statement that your surgery or treatment has been rescheduled because of the COVID-19 situation.
(2) Details of both the original and rescheduled dates, for example, from 16 March 2020 rescheduled to 16 June 2020.

Submit your medical bills with the doctor's memo to us to make your claims.

As your pre and post hospitalisation claims are valid for 120 and 180 days respectively, they may no longer be valid due to your rescheduled surgery or treatment. Please be assured that we'll still process your claims as long as these expenses are eligible based on your policy coverage. You may refer to your policy contract or contact your financial representative to find out the details of your eligible claimable expenses.

Find out how you can make a claim.

GREAT SupremeHealth Recovery

Why does Great Eastern need to recover claims paid out from my GREAT 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. GREAT SupremeHealth).
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 GREAT SupremeHealth policy will be preserved as much as possible for future claimable events. By recovering the GREAT SupremeHealth claims payout from other parties, GREAT SupremeHealth premiums can be kept affordable in the long run.
I would like to claim from my employer or other insurer first. Could I inform the hospital and then re-submit the claim for GREAT 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. GREAT SupremeHealth will pay any outstanding eligible expenses not reimbursed under your employer or other insurer's insurance policy.
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.
Why should I make my employer or other medical insurance plans refund the paid medical expenses back to GREAT SupremeHealth?
When we successfully claim back from your employer or other medical insurance plans, you will preserve the annual benefit limit under your GREAT SupremeHealth, keeping your premiums affordable in the long run.

Instructions for Recovery

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 GREAT SupremeHealth policy. Please follow the steps below for making recovery from the other insurance policy:

Step 1:
Complete the Integrated Shield Claims Recovery Authorisation Form and email to MedicalClaims-SG@greateasternlife.com.

Step 2:
Submit original bills/ receipts and claim forms to your employee's benefits insurer or other insurance policy by another insurer

Incentive

What will I receive upon a successful recovery?
As a token of our appreciation, you will be rewarded with 5000 UPGREAT Points* in your UPGREAT account and you can redeem shopping, dining and lifestyle e-vouchers from your favourite merchants. We will inform you upon successful claim recovery from the other insurer. The UPGREAT Points will be credited within two weeks from the date we receive the payment from the other insurer.

*We reserves the right to replace the credits with an item of similar value at any time and without notice in its absolute discretion.

UPGREAT, your all-in-one rewards platform that makes any day GREAT with shopping, dining and lifestyle rewards. If you are new to UPGREAT app, please visit our website for more details. You can also learn more about UPGREAT in our FAQs.

Letter of Guarantee (LOG)

What is a Letter of Guarantee (LOG)?
A LOG* is a facility Great Eastern extends to our GREAT SupremeHealth Lives Assured. When you are admitted to a hospital, a LOG can be obtained at the hospital to waive the pre-admission deposit amount of up to S$30,000 for Restructured Hospital and S$10,000 for Private Hospital.

*Note: Applicable only when GREAT SupremeHealth Life Assured does not use Health Connect.
How does the LOG work?
LOG is available only at the participating Restructured hospitals and Private hospitals in Singapore. You may request for a LOG in the event that you are unable to settle the pre-admission deposit. The LOG can be used to waive the deposit up to S$30,000 for Restructured Hospital and S$10,000 for Private Hospital, thus alleviating your financial burden.
Who is eligible for a LOG?
LOG will be issued if the pre-set rules are fulfilled. Great Eastern reserves the right and at its discretion, to decline the request for a LOG in other circumstances which may not be listed below.

a)         Only for GREAT SupremeHealth’s Life Assured
b)         Must be accompanied with Medical Claims Authorisation Form (MCAF)
c)         Only applicable for Singapore Citizen or Singapore Permanent Resident
d)         Policy is in-force at the date of hospital admission
e)         Life Assured was accepted for cover at standard risk
f)         The medical conditions and treatments are not excluded from the policy

Instructions for Request of LOG

How can I request for a LOG?
You can inform the hospital staff at point of admission that you are a GREAT SupremeHealth Life Assured. Hospital staff would be able to assess if you are eligible and generate the LOG. You would need to sign the Medical Claims Authorisation Form (MCAF) before the LOG can take effect.
Should I request for a LOG from Great Eastern prior to a scheduled admission?
No, you do not need to request for a LOG in advance from Great Eastern. Hospitals will self-administer the LOG.

LOG Amount

How much pre-admission deposit is the LOG able to waive?
The LOG is able to waive up to S$10,000 deposit for private hospitals and S$30,000 for restructured hospitals per hospital admission.

Can I appeal for a higher LOG amount?
We regret to inform that Great Eastern would not be able to accede to requests of more than the stipulated amount stated above. You would need to bear the outstanding amount using cash or funds from your own or a family member’s Medisave account.

Alternatively, if you call in to Health Connect, you can get pre-authorisation for your proposed medical and/or surgical expenses. Once the pre-authorisation is completed, a Certificate of Pre-authorisation will be issued. This Certificate of Pre-authorisation waives off the deposit requirement upon admission and also enable for Great Eastern to settle the medical and/or surgical expenses directly with the hospital after discharge.

Please refer to FAQ on Health Connect for more information.

Issuance of LOG

Is the issuance of LOG guaranteed?
The issuance of a LOG is not guaranteed. In some circumstances, your request for a LOG may be declined. This includes, but is not limited to, not fulfilling the pre-set rules for LOG eligibility. Great Eastern reserves the right, at its discretion, to decline the request for a LOG in circumstances not listed under the pre-set rules.
Would I still need to settle the pre-admission deposit or hospitalisation bill upon presenting the LOG?
The issuance of a LOG does not guarantee a full or partial waiver of the pre-admission deposit. The LOG is still subjected to acceptance by the hospital. The hospital may still, at its discretion, require you to fully settle the hospitalisation/day surgery bill upon discharge, despite the submission of a LOG.
Does the issuance of a LOG suggest a full admittance of my claim?
The issuance of a LOG does not indicate an approval on any claim or claim amount in respect to the cause of admission payable under your GREAT SupremeHealth. A claim would still need to be submitted and assessed by Great Eastern.

The LOG amount may not be the actual sum that you are entitled to claim under the policy. The final amount of claim paid upon a claim settlement may deviate from the LOG amount.
Are there any other documents that I need to submit together with the LOG?
You need to sign the Medical Claims Authorisation Form (MCAF) before the LOG can take effect. The hospital staff will pass the form to you at point of admission.
If I have a LOG from my employer or other insurer, can I request for a LOG from Great Eastern?
We regret to inform that Great Eastern would not be able to issue another LOG.
If I do not have a GREAT SupremeHealth policy but am insured under Premier Health Plan/Hospital & Surgical Protector, am I eligible for LOG?
No, LOG is only available to eligible Lives Assured covered under GREAT SupremeHealth.

LOG Availability

Which are the participating hospitals in Singapore?
LOG is only available at the following participating Restructured hospitals and Private hospitals.

List of Participating Restructured Hospitals
- Singapore General Hospital
- Tan Tock Seng Hospital
- National University Hospital
- Changi General Hospital
- KK Women's & Children's Hospital
- Khoo Teck Puat Hospital
- Ng Teng Fong General Hospital
- Alexandra Hospital
- Sengkang General Hospital
- Singapore National Eye Centre
- Jurong Medical Centre
List of Participating Private Hospitals
- Raffles Hospital
- Mount Elizabeth Hospital
- Parkway East Hospital
- Gleneagles Hospital
- Thomson Medical Centre
- Concord International Hospital
- Mount Elizabeth Novena Hospital
- Mount Alvernia Hospital
- Farrer Park Hospital
Can I request for a LOG for all hospital treatments?
LOG would only be issued for day surgery and inpatient hospital treatments. It is not applicable for outpatient treatments such as kidney dialysis, cancer treatment and consultation.
Can I request for a LOG for medical treatments, emergency or non-emergency, when overseas?
No, this facility is currently only available to local participating hospitals and private hospitals.

ElderShield

What is the definition of disability?
Disability shall mean the inability of the policyholder to perform at least three out of the six Activities of Daily Living (ADL), even with the aid of special equipment; the physical assistance of another person is always required throughout the entire activity. Cases whereby substantial assistance is needed to do the ADLs will also be considered.
What are the ADL?
The six Activities of Daily Living are washing, dressing, feeding, toileting, mobility and transferring.
Does ElderShield give worldwide coverage?
Yes.
Can I claim after I reach 65 years of age (Regular Premium Plan) since I will no longer be paying premiums?
The premium payment term of the policy is up to age 65. However, the policy provides lifetime coverage. Hence, you will still be eligible to claim under the policy after you have stopped your paying your premiums at age 65.
Should I recover from my disability after a period of time, will I have to continue paying the premiums?
Should you recover from your disability, benefit payments will cease and you have to resume paying the premiums to continue the coverage. However, if you have exceeded the premium paying age by then, no more premium payments will be required, but you will continue to be covered under the policy.
Will there be any claim payable upon death?
ElderShield covers disability only, so no claim will be payable should death occur. There will also be no refund of premiums. The policy will be terminated upon the death of the policyholder. However, if the policyholder has purchased our Supplementary Plan, the estate of the policyholder will be eligible to claim for the death benefit should death occur during the disability claim. However, if there is no disability claim at the time of death, there will not be any death benefits payable.

Benefit

How much is the monthly benefit?
For policies that commenced before 30 September 2007, the monthly benefit shall be S$300. For policies that commenced after 30 September 2007 or have been successfully upgraded, the monthly benefit shall be S$400.
For how long will I receive the monthly benefit?
The benefit shall be payable up to a maximum of 60 months per lifetime for policies that commenced before 30 September 2007. For policies that commenced after 30 September 2007 or have been upgraded to the new ElderShield plan, the benefit is payable up to a maximum of 72 months. It shall cease immediately on the earliest of the following dates:
1. the date of recovery from disability
2. the date of death of the policyholder
3. after the maximum benefit payout period has been reached (i.e. 60 months or 72 months)
How will the monthly payments be made to me?
For your convenience, the payments can be directly credited into your bank account specified in the Claim Form. Alternatively, cheque payments can be arranged.
Can payments be made to my caregiver?
All payments will be made to the policyholder. However, we will consider your request on a case-by-case basis.
I am going overseas for my treatment. Can you send the monthly benefit to my overseas address?
Arrangement for bank drafts to be sent to your overseas address or telegraphic transmission to your overseas account can be made. However, any charges involved will be deducted from the benefit payments.
With the treatment received, I can now perform the ADLs, which I was unable to do so previously. Must I inform your company?
Yes. Since the benefit is only payable when you are not able to perform at least three ADLs, we will have to review your case when there is an improvement in your condition.

Procedure

Can I stop my premium payment once I file for a claim?
You are required to continue paying the premiums to keep the policy in force till the admission of the claim. Subsequently, any premiums paid after the date of the medical assessment will be refunded.
I am disabled but I do not stay in Singapore and am unable to go back. How should I file my claim?
You would be required to obtain the Claim Form from the insurer’s website, or contact the insurer’s Customer Service Centre to request for a copy to be mailed to you.

You will then have to submit the completed statement, together with any available medical reports (from registered practitioners in Western medicine), and provide the name, address and clinic of the doctor certifying your medical condition.

Upon receipt of the information, the insurer will send the Assessor’s Statement to the doctor, who will assess the severity of your disability and send the completed statement back to the insurer.

The insurer will assess the claim and, where necessary, request your disability to be assessed by a specialist in your country of residence, to be appointed by the insurer.

For claims made from overseas, the insurer shall make every reasonable effort to assess the disability and make claim payments. Under these circumstances, the insurer may commute the benefit payments to a single payment reflecting the present value of future benefit payments.

Medical Assessment

Can I see my own doctor or therapist to be assessed for ElderShield eligibility?
Severely disabled individuals who wish to apply Eldershield will need to undergo a severe disability assessment by a MOH-accredited severe disability assessor. We have expanded the list of accredited assessors to include therapists and nurses who have been trained to assess whether the applicant meet Eldershield criteria of being unable to perform three or more of the six Activities of Daily Living (ADLs).
I am a housebound patient and cannot go to your panel assessor for the medical assessment. Can the assessor come to my house or institution?
You may make arrangement with the panel assessors located nearest to your house or institution for a house call. For disability assessment, applicant will need to pay $100 for a clinic-based assessment or $250 for non-clinic based assessment with effect from 31 Jan 2020.
Which panel assessor is nearest to my house/institution?
Click here for the panel assessor list.
Should I recover from my disability and subsequently become disabled again, would I need to go for another medical assessment?
Yes, you would need to go for another medical assessment.
Will I get a reimbursement for the assessment fees?
Yes, you will be be fully reimburse for the fees upon admission of the claim .
Will cognitive impairments be better recognised under revised disability assessment framework?
Yes, assessors will be guided more explicitly on the aspects to take into consideration if an insured is suspected to be cognitively impaired.
If my General Practitioner (GP) / my nursing home has assessed that I am disabled, why do I still need to visit an accredited assessor for assessment?
Not all GPs would have undergone the rigorous training programme to learn how to assess disability. You would still required to undergo disability assessment which performed by an accredited assessor. If you are staying in a nursing home, you may approach your nursing home for assistance to submit the Resident Assessment Form in place of the severe disability assessment.

Periodic Review

Will there be any reviews of my disability?
Yes, you may be required to go to our panel assessor for periodic examination. We shall keep you informed when such requirements arise.
Will there be any charges for the reviews? Who will bear those charges?
Yes, there will be charges for reviews. However, the insurer shall bear the charges for the reviews.

GREAT CareShield Advantage / GREAT CareShield Enhanced

1. What is disability?

Disability refers to the inability of the Life Assured as certified in an Assessor's Statement, to perform any of the 6 Activities of Daily Living (ADLs). This means requiring significant assistance from another person throughout the entire activity.

2. What are the 6 Activities of Daily Living (ADLs)?
The 6 Activities of Daily Living are:

(a) Washing
The ability to wash in the bath of shower (including getting into and out of the bath of shower) or wash by other means.

(b) Dressing
The ability to put on, take off, secure and unfasten all garments and, as appropriate, any braces, artificial limbs or other surgical or medical appliances.

(c) Feeding
The ability to feed oneself food after it has been prepared and made available.

(d) Toileting
The ability to use the lavatory or manage bowel and bladder function through the use of protective undergarments or surgical appliances if appropriate.

(e) Walking or Moving Around
The ability to move indoors from room to room on level surfaces.

(f) Transferring
The ability to move from a bed to an upright chair or wheelchair, and vice versa.

3. Does GREAT CareShield Advantage / GREAT CareShield Enhanced provide worldwide coverage?
Yes

4. To be insured under GREAT CareShield Advantage / GREAT CareShield Enhanced, I would already have a basic ElderShield or CareShield Life policy. In the event of a Disability, do I need to be assessed twice to make claims for both policies?
No, you will only be required to complete a single claim form and assessment for your both policies.

5. Can I see my own doctor or specialist to be assessed?
You are only able to use your own doctor for the assessment if they are already on the list of MOH Accredited Assessors for Severe Disability Schemes.

6. Should I fully recover from my disability, will I have to continue paying the premiums?
Should you recover from your disability, you will have to resume paying the premiums to continue your coverage. However, if you have exceeded the premium payment age (chosen by you when you first purchased the policy) when you have fully recovered from your disability, no more premium payments will be required and you will continue to enjoy coverage under the policy.

Benefit

1. How much is the monthly payout that I will receive?
The monthly payout that you will receive depends on your chosen monthly benefit when you had purchased the policy and whether you had purchased GREAT CareShield Advantage or GREAT CareShield Enhanced.

For GREAT CareShield Advantage, if you are still unable to perform 2 or more ADLs after the Deferment Period, you will receive 100% of your chosen monthly benefit amount for as long as you are unable to perform 2 or more ADLs.

For GREAT CareShield Enhanced, if you are still unable to perform 2 ADLs after the Deferment Period, you will receive 50% of your chosen monthly benefit amount for as long as you are unable to perform 2 ADLs. If you are still unable to perform 3 or more ADLs after the Deferment Period, you will receive 100% of your chosen monthly benefit amount for as long as you are unable to perform 3 or more ADLs and any monthly benefit payments under 2 ADLs will cease.

2. How long will I receive the monthly payout?
You will receive the monthly payout for as long as you are unable to perform the applicable number of ADLs.

3. How will the payouts be made to me?
You will receive the payouts as you have indicated in your claim form. You are encourage to choose PayNow or Direct Credit into your bank account for greater convenience.

4. Can the payouts be made to my caregiver?
All payouts will be made to the Policyholder. However, we will consider your request on a case by case basis.

Procedure

1. Can I stop my premium payment once I file for a claim?
You are required to continue paying the premiums to keep the policy inforce until the admission of the claim. Subsequently, any premiums paid after the Deferment Period will be refunded.

2. I am disabled but I do not stay in Singapore and am unable to go back. How should I file my claim?
You would be required to obtain the Claim Form from the insurer’s website, or contact the insurer’s Customer Service Centre to request for a copy to be mailed to you.

You will then have to submit the completed statement, together with any available medical reports (from registered practitioners in Western medicine), and provide the name, address and clinic of the doctor certifying your medical condition.

Upon receipt of the information, the insurer will send the Assessor’s Statement to the doctor, who will assess the severity of your disability and send the completed statement back to the insurer. The insurer will assess the claim and, where necessary, request your disability to be assessed by a specialist in your country of residence, to be appointed by the insurer.

For claims made from overseas, the insurer shall make every reasonable effort to assess the disability and make claim payments. Under these circumstances, the insurer may commute the benefit payments to a single payment reflecting the present value of future benefit payments.

Medical Assessment

1. It is not convenient for me to go to any doctor in the panel for my medical assessment. Can the doctor perform the assessment at a location that is convenient for me?
You may make an arrangement for a house call assessment. Do note that the cost of a clinic-based assessment is $100 and house call assessment is $250.
If you are residing in a nursing home, your nursing home can help to submit a Resident’s Assessment Form instead of the disability assessment. Please approach your nursing home for more assistance.

2. Which panel assessor is nearest to my house/institution?
Click here for the Panel Assessor list.

3. Should I recover from my disability and subsequently become disabled again, would I need to go for another medical assessment?
Yes, you would need to go for another medical assessment.

4. Will I get a reimbursement for the assessment fees?
If your claim is successful, we will reimburse the full cost of your assessment.

If your claim is denied, you will be responsible for the cost of the assessment unless waived as part of the first time assessment fee waiver for CareShield Life.

5. Will cognitive impairments be better recognised under revised disability assessment framework?
Yes, assessors will be better equipped and guided more explicitly on the aspects to consider if an insured is suspected to be cognitively impaired.

6. If my General Practitioner (GP) / my nursing home has assessed that I am disabled, why do I still need to visit an accredited assessor for assessment?
Not all GPs would have undergone the rigorous training programme to learn how to assess disability. You would still required to undergo disability assessment which performed by an accredited assessor. If you are staying in a nursing home, you may approach your nursing home for assistance to submit the Resident Assessment Form in place of the severe disability assessment.

Periodic Review

1. Will there be any reviews of my disability?
Yes, you may be required to go for periodic reviews on your disability. This will help us to assess if you have recovered or if your disability has worsened. We shall keep you informed when such requirements arise.

2. If my condition has been assessed to have worsened from the inability to perform 1 ADL to the inability to perform 2 or more ADLs, will I have to undergo another assessment to be eligible for the monthly payouts from my plan?
No. If we have assessed during the periodic review that your disability has worsened to the inability to perform 2 or more ADLs, the monthly payout from your plan will start after the Deferment Period.

3. Will I have to pay for these periodic reviews?
Rest assured, we will bear the charges for the periodic reviews regardless of the outcome of the assessment.