Student Group Hospitalisation & Surgical (GHS) Insurance Need to stay in a hospital or have surgery? Apply for Letter of Guarantee (LOG). 1. Student should inform MYCG at least 5 working days (whenever possible) before the scheduled admission/surgery by submitting an online LOG Request Form at www.mycg.com.sg/sit. Please also upload the following documents: Who is covered? Registered full-time students of Singapore Institute of Technology (SIT) who have paid the insurance premium. For emergency admission, please contact MYCG as soon as possible. 2. If approved by the insurer, MYCG will issue the LOG and fax it to the hospital. A copy will be emailed to the student, copied to SIT. 3. With the LOG, the hospital will waive the deposit and payment of the hospital bill, up to the limits of the insurance and subject to the policy terms and conditions. The hospital will bill the insurer directly. 4. Student should submit to MYCG the documents required (refer to below section on “How to make a claim”) to process the claim as soon as possible but within 30 days after discharge from the hospital. What is covered? Coverage Overall Maximum Limit any one policy period and in total of any one claim or event, subject to the sub-limits as stated below Hospital Annual Limit S$30,000 Singapore Government/ Restructured Room and Board B1 Ward Hospital & Related Services (HRS) S$30,000 1 In-Hospital treatment, facilities & services including accommodation up to B1 ward in a Singapore Government/ Restructured Hospital including ICU, HDU and implants 2 Day Care Surgery 3 Pre-Hospital Specialist Consultation and Diagnostic Services within 90 days of hospital admission Specialist must be referred by a GP/A&E 4 Post-Hospital Follow-up Treatment up to 90 days after discharge 5 Casualty Ward Accident & Emergency Services including Dental (for bodily injury due to accident only) treatment must be sought within 24 hours of the accident follow-up treatment covered up to 31 days from the date of accident 6 Outpatient Kidney Dialysis 7 Outpatient Cancer Treatment 8 Ambulance Fee 9 Medical Report Fee (if required by the insurer) 10 Treatment in a Accident & Emergency (A&E) Department of a Government/Restructured Hospital for emergency treatment of illnesses (within Singapore only) As Charged Claims should be submitted as soon as possible but within 30 days of the date medical treatment. If more time is required, please submit the “Claim Notification” online form at www.mycg.com.sg/sit. 1. Prepare/obtain the following documents: S$70 per visit (a) (b) Outpatient treatment for Mental Illness in Singapore only (with referral from a Physician or School Counsellor/Appointed Psychologist) treatment in a Government/Restructured hospital/clinic or private Psychologist appointed by SIT S$500 13 Outpatient Extension for UOM students Covers consultation, outpatient laboratory tests (including vaccinations and check up) and medicine recommended by a Specialist/A&E in a Singapore Government/ Restructured Hospital due to accidental injury or illness contracted in the course of work or research (e.g. needle prick, blood/urine splash) Does not cover flu injections, which may or may not be required due to a flu outbreak, Hepatitis B injections and other similar preventive treatment Other illnesses and accidents are not covered under this extension S$750 S$10,000 (c) (d) (e) (f) (g) (h) Original Completed Reimbursement Request Form (Claim Form) - download from www.mycg.com.sg/sit Original Final Hospital Bill (the hospital will send this to the patient within 2 to 3 weeks after discharge) Original Pre and Post Hospitalisation/Surgery Bills Copy of Inpatient Discharge Summary) Copy of Test Reports, if any Original Completed Letter of Indemnity (if LOG is issued) Copy of Police Report (for traffic accidents) Original Medical Report (for emergency hospitalisation overseas) 2. The student should keep a photocopy for his/her own records. 3. Please send the documents by post to “MYCG, 3 Church Street, #25-00 Samsung Hub, Singapore 049483” for processing. 4. For follow-up claims, please send the original bills to MYCG with a note attached that states “Follow-up Claim”, “SIT” and the ”Student’s Full Name”. 5. Generally, medical expense claims will be processed within 30 days of receipt of complete claim documents and information. S$5,000 Territorial Limit – 24 hours worldwide for emergency treatment for accident or acute illness while overseas where immediate medical attention is required (does not cover non-emergency, elective and/or intentionally booked treatment overseas) Medical expenses incurred in an overseas hospital will be limited to similar treatment in a B1 ward at Singapore General Hospital Extensions Pre-existing conditions are covered from inception Mental Illness as stated in the table above Occupationally Acquired HIV (applicable to UOM students only) Prosthesis Covers all programs, activities and events organised by SIT and/or its Clubs or in which the student participates as a representative of SIT. This includes academic programs, work study programs, study trips, site visits, exchange programs, attachment, internship programs (including attachment or internship arranged personally by the students where SIT’s approval is not required), extra-curricular activities and all sports including competitions held locally or overseas. © MYCG 01042014 Please note that issuance of a LOG does not mean that the claim is approved. The LOG is a service extended for the convenience of the student during admission to the hospital. It is based on preliminary information available before the treatment. The insurer reserves the right to decline the claim after review of the complete claim documents if there should be difference in the actual information and subject to the policy terms and conditions. How to make a claim? Inpatient treatment for Mental Illness (a) If based on the information provided it is not clear if the claim is admissible, the insurer may decline to issue the LOG and the student would have to pay the medical bill first. The student can still submit the claim after the treatment for the insurer to review. (c) 12 Special Grant/Death Benefit Note: (b) Patient will have to sign the Medisave Authorisation Form on admission to the hospital, if the patient has a medisave account. When the claim is processed, the medisave account will be reimbursed according to the benefits payable under the insurance. 11 14 Copy of Completed Notification Form (Claim Form) Copy of Completed Letter of Indemnity Copy of Referral Letter, if any Copy of Financial Counselling Form/Day Surgery Authorisation Form (for admission to a Government/Restructured hospital) – the hospital will give these documents to the patient when the admission date is confirmed – the documents will contain an estimated bill, diagnosis and treatment information 6. Students will be notified of the claim result by email. For approved medical expense claims, the reimbursement will be credited into the student’s bank account. What is not covered? (Main Exceptions) Birth defects, congenital conditions Routine medical examination Higher risk/dangerous, professional sports War & Terrorism Please refer to the complete list at the end of this brochure. When does the cover end? When the student ceases to be a full-time student of SIT When the student goes on leave of absence (if the student goes on leave of absence due to medical reasons, he/she will be covered up to the end of the academic year for which premium and tuition fee has been paid) When the benefit limit has been reached If the policy has expired When the student attains the age of 65 If the student did not pay the insurance premium by your undertaking to indemnify the insurer and must settle all outstanding bills within 30 days of the request made for such payment. Student Group Hospitalisation & Surgical (GHS) Insurance 14. What should I do if I need to be admitted to the hospital urgently/immediately and it is after normal business hours? Please call MYCG at our 24hr emergency hotline 9336 0159 and provide us with your personal and admission details. We will try to arrange the LOG to the hospital. 15. How long does it take for the LOG to be issued and faxed to the hospital? Please inform MYCG at least 5 working days (whenever possible) before the scheduled admission/surgery, or as soon as possible for emergency admission. 16. How do I make a claim? What do I need to do after I am discharged from the hospital? I have paid the medical costs. How can I be reimbursed? Please visit the Claims section of www.mycg.com.sg/sit for the claim procedure and download the required forms. 17. When do I need to submit the claim? Claims should be submitted as soon as possible but within 30 days of the date medical treatment. If more time is required, please submit the “Claim Notification” form online. 18. I have submitted my claim earlier. I wish to submit follow-up treatment bills. What should I do? Please send the original bills to MYCG with a note attached that states “Followup Claim”, “SIT” and the ”Student’s Full Name”. 19. I am not sure if my claim falls under the Group Hospitalisation & Surgical (GHS) or Group Personal Accident (GPA) Insurance Scheme. How should I submit my claim? Please rest assured that we will help to review the claim documents to ensure that they are prepared correctly. If more documents or information are required, we will inform you by email. 20. How long does it usually take to process my claim? Upon receipt of all required documents and information, approved claims will generally be settled within 30 days. 21. How will I be notified of the result of my claim? You will be notified by email. Reimbursement for approved claims will be deposited into your bank account. 22. When will my insurance end? The insurance will end when one of the following occurs, whichever occurs first: When the student ceases to be a full-time student of SIT When the student goes on leave of absence (if the student goes on leave of absence due to medical reasons, he/she will be covered up to the end of the academic year for which premium and tuition fee has been paid) When the benefit limit has been reached If the policy has expired When the student attains the age of 65 If the student did not pay the insurance premium 23. If I have questions or need assistance, who should I contact? Please contact MYCG at [email protected] or call 6476 3829 / 9762 2062. For emergencies only after business hours, please call 9336 0159 (24hr Emergency Hotline). FAQ 1. Who is covered? All registered full-time students of SIT who have paid the premium. 2. When does my coverage start? Your coverage will start on the date advised by SIT. 3. What does the insurance cover? The insurance covers mainly (a) medical expenses incurred for hospitalisation &/or surgery due to accident or illness, including mental illness and (b) medical expenses incurred for outpatient treatment of mental illness. 4. Are outpatient services for illnesses covered? Emergency treatment at the Accident & Emergency (A&E) Department of a Government/Restructured Hospital is covered up to $70 per visit. Other outpatient services provided by a GP or Specialist for illnesses (e.g. for common cold or fever) are not covered. 5. Is dental treatment covered? Dental treatment is not covered except for treatment required to restore sound natural teeth lost or damaged in an accident. 6. Will I be covered during my overseas Exchange Program/Industrial Attachment? Yes, you are covered for emergency treatment for accident or acute illness while overseas where immediate medical attention is required. The insurance does not cover non-emergency, elective and/or intentionally booked treatment overseas. Medical expenses incurred in an overseas hospital will be capped to B1 ward charges in Singapore General Hospital 7. Will I be covered if I travel overseas or return vacation? Yes, please refer to answer for Q6. You are consecutive days while overseas. If you wish to country, please contact MYCG to obtain approval country for treatment. to my home country during covered up to maximum 90 seek treatment in your home before returning to your home 8. Are pre-existing conditions covered? Yes, pre-existing conditions are covered. 9. Do I have to pay the medical costs at the time of treatment? For hospitalisation and/or surgery, please visit www.mycg.com.sg/sit and submit an online request for a Letter of Guarantee (LOG). For outpatient treatment, please pay first and submit the claim for reimbursement. 10. What should I do if I need to stay in the hospital or have surgery? Please inform MYCG at least 5 working days (whenever possible) before the scheduled admission/surgery by submitting an online LOG Request Form at www.mycg.com.sg/sit. You will also need to upload the following documents: 11. 12. 13. Copy of Completed Reimbursement Request Form (Claim Form) Copy of Completed Letter of Indemnity Copy of Referral Letter, if any Copy of Financial Counselling Form/Day Surgery Authorisation Form (for admission to a Government/Restructured hospital) – the hospital will give these documents to the patient when the admission date is confirmed – the documents will contain an estimated bill, diagnosis and treatment information If a LOG is issued, does this mean that the medical expenses are covered? No, the issuance of the LOG does not mean that the insurer has approved the claim. The LOG is a service extended for the convenience of the student during admission to the hospital. It is based on preliminary information available before the treatment. The insurer reserves the right to decline the claim after review of the complete claim documents if there should be difference in the actual information and subject to the policy terms and conditions. After you have been discharged from the hospital, please submit the documents required to the insurer to process the claim. If the claim is payable, the insurer will pay directly to the hospital. If the claim is not admissible, you will have to reimburse the insurer or pay to the hospital. Will a LOG be issued for medical treatment that is not covered? No. For such cases, students will have to make payment directly to the hospital. Thus, they should ensure that they have the financial means before admission into the hospital. What is a Letter of Indemnity? If a LOG is issued, you will have to sign the Letter of Indemnity to indemnify the insurer in the event that: total medical cost exceeds the maximum limit of the coverage, or the treatment cost/medical condition is excluded under the policy, or there is interest charged by the hospital due to delay in settlement to the hospital caused by your delay in submitting the claim documents. In the event that the above situation should arise, the insurer will instruct you to settle the bill directly with the hospital or recover from you if payment has already been made by the insurer to the hospital. Your benefits under this insurance will be suspended pending settlement. Reinstatement will be granted as soon as full payment has been received by the insurer or the hospital. You are legally bound © MYCG 01042014 For all enquiries, please contact MYCG Pte Ltd Co. Reg. No. 200313024E Phone Fax Email Web : : : : Address : +65 6476 3829 / +65 9762 2062 +65 6474 0089 [email protected] www.mycg.com.sg/sit 3 Church Street, #25-00 Samsung Hub, Singapore 049483 24-hr Emergency Hotline +65 9336 0159 (for emergencies only after business hours) Underwritten by MSIG Insurance (Singapore) Pte. Ltd. Co. Reg. No. 200412212G This policy is 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 your insurer or visit the GIA / LIA or SDIC websites (www.gia.org.sg or www.lia.org.sg or www.sdic.org.sg). The information contained in this brochure is a summary only and is subject to the terms conditions and exceptions of MSIG’s policy. Any discrepancy between the information in this brochure and the policy is unintentional. Student Group Hospitalisation & Surgical (GHS) Insurance 26. Hotel or non-Hospital accommodation costs except as provided for in the Policy. 27. Cost of medical reports unless agreed by the Company. What is not covered? GENERAL EXCEPTIONS (which apply to the whole Policy) The following tests, investigations, treatments, items, conditions, activities and their related or consequential expenses are excluded from the Policy and the Company shall not be liable for: 1. Pre-Existing Conditions as defined, including any treatment and complication arising from the Pre-existing Conditions. For the avoidance of any doubt, the Pre-Existing Conditions exclusion, including any treatment and complication arising from the Pre-Existing Conditions, shall always apply unless specifically waived or limited by the Company in writing in the Schedule or official endorsement thereto. 2. Routine medical examinations or check-ups; routine eye or ear examinations; or any form where there is no objective indication of impairment of normal health or any treatment or investigation of a preventive nature; or any treatment which is not medically necessary; vaccinations; cosmetic surgery or plastic surgery; treatment for obesity or weight reduction (including liposuction); weight improvement programs; alopecia; breast reduction or enlargement (regardless whether it is medically necessary or not); treatment for all forms of acne; rest cures and services or treatment in any home, spa hydro-clinic, sanatorium or long term care facility that is not a Hospital as defined. 3. Infertility; contraception; sterilization (or its reversal); impotence; erectile dysfunction; sexual dysfunction; treatment relating to sex change; sexually transmitted diseases; Human Immunodeficiency Virus (HIV), including Acquired Immune Deficiency Syndrome (AIDS) or any HIV/AIDS related conditions or diseases. 4. Birth defects, congenital Illness. 5. Pregnancy or childbirth except as defined under the Maternity Benefit when this Benefit is stated on the Schedule as being covered by the Policy. 6. Circumcision operations unless medically necessary. 7. All types of Sleep Disorders including Sleep Apnoea unless this leads to treatment through surgery. 8. Behavioural or Developmental Delay and/or learning disabilities. 9. Prosthesis; corrective devices; medical appliances which are not surgically required; or any other that is not scientifically recognised by Western European or North American Standards. 10. All costs relating to cornea, muscular, skeletal, human organ or tissue transplant from a donor to a recipient and all expenses directly or indirectly related to organ transplantation (except as defined under the Organ Transplantation Benefit but only when this Benefit is stated on the Schedule as being covered by the Policy). 11. Mental illness; self-inflicted injury; misuse or over dosage or excessive use of drugs/medicine; alcoholism; abuse of alcohol; drug abuse; drug addiction; suicide or attempted suicide. 28. Expenses, administrative or other charges of a non-medical nature in connection with the provision and/or performance of medical supplies and/or services. 29. Non-prescription drugs, medicines and other items. 30. Diving unless the person concerned has been duly qualified and certified as a diver by an internationally recognised diving organisation or unless such person is at the time of the happening of the event giving rise to a claim actually receiving diving instruction from a duly qualified and certified diving instructor, Rock climbing Caving, Pot-holing, Mountaineering, Skydiving, Parachuting, Hang-gliding, Para-sailing, Bungee Jumping, racing of any kind other than on foot, or any other type of competitive sports other than those in which the Insured Person participates purely as an amateur, all professional or inherently dangerous sports unless declared to and accepted by the Company in writing prior to the event giving rise to a claim. 31. Any Flying Activity or Air Travel other than as a fare-paying passenger in a commercially licensed passenger carrying aircraft. 32. Costs or treatment after an annual renewal date (Due Date) arising from Injury, Illness or death occurring during the previous Period of Insurance. 33. Costs or benefits payable under the Work Injury Compensation Act or similar or subsequent Act or legislation, or corresponding insurance cover relating to occupational death, Injury, Illness or disease. 34. Costs arising under any legislation which seeks to increase the cost of medical treatment and services actually received above charge levels which would be considered Reasonable and Customary in the absence of such legislation or action for compensation under this Policy brought in any jurisdiction outside Singapore. 35. Any treatment or expense in respect of persons less than 15 (fifteen) days old or more than 70 (seventy) years old for Employee or 65 (sixty-five) years old for Dependant at the date of the onset of the event giving rise to a claim, unless agreed otherwise by the Company prior to the inception of the Policy. 36. The cost of transporting an Insured Person by means of his employer's owned or leased watercraft or aircraft or the cost of medical treatment rendered by the employer's personnel or at the employer-provided medical facilities unless agreed otherwise in writing by the Company prior to the inception of the Policy. This exclusion shall also apply to transportation and medical treatment which an Insured Person is entitled to receive by virtue of a contract between his employer. 37. Costs arising out of any litigation or dispute between the Insured Person and any medical person or establishment from whom treatment has been sought or given, or any other costs not specifically related to the payment of the medical expenses covered by the Policy. Additionally, the following apply: 38. Institute Radioactive Contamination, Chemical, Electromagnetic Weapons Exclusion Clause (a) 13. Refractive defects of the eye, such as nearsightedness and astigmatism. (b) 14. Spectacles; monocles or contact lenses, Lasik, hearing aids. (c) 15. All dental treatment or oral surgery related to teeth (unless within the terms of the Accident Dental Benefit). (d) 16. Robotic Surgery; Use of Stem Cell Transplants; Cryopreservation; implantation or reimplantation of living cells or living tissue, whether authologous or provided by a donor. 18. Experimental or pioneering medical and surgical techniques not commonly available and elected by the Insured Person to be received elsewhere in the world in lieu of t treatment usually and customarily provided for the medical condition. 19. Second Opinions in respect of medical conditions which have already been diagnosed and/or treated at the date such Second Opinions are obtained unless considered by the Company's medical advisers to be reasonable and necessary having regard to the medical facts and circumstances. (e) 39. death, disability, loss, damage, destruction, any legal liabilities, cost or expense including consequential loss of whatsoever nature, directly or indirectly caused by, resulting from or in connection with any of the following regardless of any other cause or event contributing concurrently or in any other sequence to the loss; (a) war, invasion, acts of foreign enemies, hostilities or warlike operations (whether war be declared or not), civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power; or (b) any act of terrorism including but not limited to i. the use or threat of force, violence and/or ii. (ii) harm or damage to life or to property (or the threat of such harm or damage) including, but not limited to, nuclear radiation and/or contamination by chemical and/or biological agents, by any person(s) or group(s) of persons, committed for political, religious, ideological or similar purposes, express or otherwise, and/or to put the public or any section of the public in fear; or (c) any action taken in controlling, preventing, suppressing or in any way relating to (a) or (b) above 22. Injury or Illness while serving as a full-time member of a police or military unit and treatment resulting from participation in war, riot, civil commotion or any illegal act including resistance to lawful arrest or resultant imprisonment. 25. Travel costs in respect of trips made specifically for the purpose of obtaining medical treatment unless in the course of an approved Overseas Emergency Medical Evacuation, and all Overseas Emergency Medical Evacuation and Repatriation costs not approved in advance by the Company or MSIG Assist. © MYCG 01042014 ionising radiations from or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel the radioactive, toxic, explosive or other hazardous or contaminating properties of any nuclear installation, reactor or other nuclear assembly or nuclear component thereof any weapon or device employing atomic or nuclear fission and/or fusion or other like reaction or radioactive force or matter the radioactive, toxic, explosive or other hazardous or contaminating properties of any radioactive matter. The exclusion in this subclause does not extend to radioactive isotopes, other than nuclear fuel, when such isotopes are being prepared, carried, stored, or used for commercial, agricultural, medical, scientific, or other similar peaceful purposes any chemical, biological, bio-chemical, or electromagnetic weapon. The insurance by this policy excludes: 21. Continuance of fees from a referring Doctor after the date on which an Insured Person has been referred to another Doctor or Specialist. 24. Hospital Inpatient treatment for conditions which can be properly treated as an outpatient. and War and Terrorism Exclusion 20. Costs of treatment rendered and drugs or medicine prescribed by a Doctor or Specialist which are not related to the treatment provided to the Insured Person in respect of a condition that is covered under this Policy. 23. Outpatient Services except as defined under the Outpatient Services Benefit and then only to the extent such Benefits are stated on the Schedule as being covered by the Policy. Biochemical In no case shall this insurance cover loss damage liability or expense directly or indirectly caused by or contributed to by or arising from 12. Elective overseas treatment for non-emergency or chronic medical conditions where covered treatment can reasonably be postponed until the Insured Person returns to the Usual Country of Residence. 17. Treatment provided to an Insured Person by the Insured or Insured Person or a family member of the Insured or Insured Person, self treatment by the Insured Person, including the dispensation of medication and/or any medical tests/procedures carried out. Biological, If the Company says that any loss, damage, cost or expense is not covered by this insurance by reason of any of these General Exceptions, then the burden of proving the contrary shall be upon the Insured and/or the Insured Person.
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