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Reap the benefits of staying healthy with Claims-Adjusted Pricing

Claims-Adjusted Pricing

Be rewarded with more premium savings when you lead a healthy lifestyle and continue to be in the pink of health. 

What is Claims-Adjusted Pricing

Claims-Adjusted Pricing (CAP) framework is an equitable and sustainable framework that allows you to decide on your preferred treatment option based on your circumstances.

It is applicable to policyholders with GREAT TotalCare (Elite-P) and GREAT TotalCare (Classic-P). The yearly renewal premium for your supplementary plan will be determined by your personal claims experience during the Assessment Period1

Learn more about CAP and how it benefits you

Watch our video

How does it work?

With CAP, you will start at the Standard Premium Level. At each policy renewal, your Premium Level will be determined by any previous claims2 you have made during the Assessment Period1.

If you remain healthy and did not make any claim, you will enjoy being in the Preferred Premium Level, with 20% savings off the Standard Premium Level at your next policy renewal.

Claims-Adjusted Pricing Diagram 1
Claims-Adjusted Pricing Movement table

How Claims-Adjusted Pricing works

How Claims-Adjusted Pricing works
Claims-Adjusted Pricing Diagram 2

For a Life Assured who is age 64 moving to age 65 at next policy renewal:

Claims-Adjusted Pricing Table 2

Should there be occurrences of Private Hospital and Restructured Hospital claims within the same Assessment Period1, only the claims under Private Hospitals will be added together to determine the movement on premium level for the next policy renewal. 

How to maintain affordable premiums in the long run?

We understand that you may require hospitalisation and/or medical treatments and may be concerned on the possibility of increased premium in the following year. Here are some options which can help you decide better:

  • Consider if there is a need for in-hospitalisation stay for minor medical attention. 
  • Consider if your employer has additional health coverage that enables claims or reimbursement from your company’s group insurance employee benefits plan.
  • Consider having your medical treatment supported through Singapore's Restructured Hospitals.

You may also consult our Health Connect team to get a Pre-Approval of your Eligible Medical Expenses with a panel specialist via our Health Connect.

You may ask your panel specialist to request a pre-approval on your behalf when you are at the clinic. Check out the list of specialists.

Our Online Form
Download the online form and email it back to us at pre-authorisation@healthconnect.com.sg . Once approved, you will be notified through email.

How to maximise benefits from your other insurance plans?

By reducing the claim amount made under your Integrated Shield policy and supplementary plan, you can better manage future premium increments. One way to do this is to recover the cost of your medical claims from other insurance plans that you are insured under, such as your company’s group insurance employee benefits plan. By doing so, you can reduce the claim amount made under your Integrated Shield policy and help us keep your premiums more affordable in the long term.

Under the Claims-Adjusted Pricing framework, you will also benefit by staying at the Standard Premium Level at the next policy renewal if you manage to recover your medical claims from other insurance plans such that your total claim amount for your Integrated Shield policy is S$2,000 and below.

For instructions on how to recover the cost of your medical claims from a third party, please refer to the “GREAT SupremeHealth Integrated Shield Claim Recovery” section here.

 

For more information, contact your Great Eastern Financial Representative today.

All ages refer to age next birthday of the Life Assured.

If it is the first policy year that your policy is subject to CAP, the Assessment Period refers to a 9-month period starting on the Commencement Date of your policy or the first renewal date that your policy is renewed into CAP (where applicable). Otherwise, the Assessment Period refers to a 12-month period starting 3 months immediately preceding the last renewal date, and ending 3 months immediately preceding the relevant renewal date for which the premium level is to be assessed.

2 Refers to all claims paid by us from your GREAT SupremeHealth, GREAT TotalCare and GREAT TotalCare Plus (where applicable).

These policies are protected under the Policy Owners’ Protection Scheme which is administered by the Singapore Deposit Insurance Corporation (SDIC). Coverage for your policy is automatic and no further action is required from you. For more information on the types of benefits that are covered under the scheme as well as the limits of coverage, where applicable, please contact us or visit the Life Insurance Association (LIA) or SDIC websites (www.lia.org.sg or www.sdic.org.sg).

Information correct as at 1 March 2021.