PRODUCT SUMMARY

FOR
GROUP HOSPITAL & SURGICAL INSURANCE

PRODUCT INFORMATION

Group Hospital & Surgical Plan is a medical expense insurance plan that seeks to reimburse the expenses
incurred by an employee and his specified dependants as a result of hospitalisation. Through this insurance
scheme, the employee would be able to protect himself against exorbitant and escalating hospital bills.

This cover is extended 24 hours a day on worldwide basis and you will begin to receive benefit when you are :-

(i) hospitalised for at least 6 consecutive hours and room and board charges made
(ii) undergoing a surgical intervention

BENEFITS & PREMIUM TABLE

(Please refer to Schedule of Benefits attached).

1. Hospital Confinement Benefits

A. Daily Room and Board Benefit

The daily room and board charges incurred by an Insured Person while in Hospital Confinement
shall be payable up to the maximum amount and for a maximum no. of days per Disability specified
in the Benefit Schedule.

B. Intensive Care Unit Benefit

In the event that an Insured Person is confined to the Intensive Care Unit of the Hospital, the
scheme will reimburse up to a maximum amount per Disability specified in the benefit schedule.

C. Hospital Miscellaneous Services

Reimbursement will be made for expenses such as the use of operating room, drugs and medicine,
laboratory examination, anaesthesia and oxygen and their administration, ambulance service and
other eligible miscellaneous expenses.

D. Surgical Benefit

A surgical benefit equal to the sum actually charged for any operation performed by one or more
Registered Medical Practitioners shall be payable, provided that the maximum benefit for all
surgical operations performed per Disability shall not exceed the aggregate amount obtained by
multiplying the respective percentages shown for the operations listed in the Surgical Schedule of
Fees by the maximum Surgical Benefit shown in the Benefit Schedule.

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 E. In-Hospital Doctor Consultation

Fees charged by the Registered Medical Practitioner for consultation while an Insured Person is in
Hospital Confinement shall be payable up to the maximum daily limit shown in the Benefit
Schedule. If a surgery has been performed, the consultation fee shall be payable under the Surgical
Benefit instead.

2. Outpatient Benefits

A. Pre-Hospital Confinement/Surgery Diagnostic X-ray and Laboratory Test

Reimbursement will be made for such diagnostic/laboratory tests following referral by a Registered
Medical Practitioner provided consequent hospitalisation or surgery occurs within 90 days.

B. Pre-Hospital Confinement/Surgery Specialist Consultation

Reimbursement will be made for expenses incurred (excluding medication) following referral by a
Registered Medical Practitioner to a specialist and provided consequent hospitalisation or surgery
occurs within 90 days.

C. Emergency Outpatient Treatment Benefit (Bodily Injury Caused by Accident)

Reimbursement will be made for emergency outpatient treatment of bodily injuries arising from an
accident and not by sickness, disease or gradual physical or mental deterioration received within 24
hours of the accident.

D. Post-Hospital Confinement/Surgery Follow-up Treatment

Upon discharge, expenses incurred for follow-up treatment by the same Registered Medical
Practitioner will be reimbursed up to a maximum no. of days specified in the Benefit Schedule.

3. Miscarriage Benefit

Expenses incurred for Miscarriage that require in-hospital or outpatient treatment by a Registered Medical
Practitioner shall be payable up to the maximum limit specified in the Benefit Schedule.

4. Death Benefit

Upon receipt of due proof, in the form specified by the Company, of death of an Insured Person, an
amount determined in accordance with the Benefit Schedule shall be payable.

Outpatient Kidney and Cancer Treatment (if applicable)

The cover may be extended to reimburse expenses incurred for outpatient kidney and/or cancer treatments
received at institutions or premises approved by government health authorities according to the benefit limits
specified in the policy.

WHO ARE ELIGIBLE?

(i) All full-time active employees below the age of 65, renewable up to age 70.
(ii) Spouse of eligible employee who is below the age of 65, renewable up to age 70 and not divorced or
legally separated from eligible employee
(iii) An unmarried and unemployed child of the eligible employee who is between the age of 15 days and 19
years or up to age 25 years if the child is a full-time student in an institution of higher learning.

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KEY PRODUCT PROVISIONS

1) EXCLUSIONS

The following are some key provisions found in the policy contract of this plan. This is only a brief summary
and you are advised to refer to the actual terms and conditions in the policy contract. Please consult your
financial advisor or insurance intermediary should you require further explanation.

(i) Pre-existing conditions which have existed at any time prior to the commencement of insurance
coverage, unless the Insured Person has already been insured continuously for 12 months under this
policy or under any GHS issued in Singapore immediately prior to the commencement of his insurance
coverage under this policy.
(ii) Congenital anomalies or genetic defects.
(iii) Non-medical expenses.
(iv) Treatments which are not medically necessary (eg. cosmetic, fertility related etc.), routine medical
check-ups.
(v) Childbirth including abortion, birth control, infertility, impotency.
(vi) Implants, dental treatments, HIV and all other sexually transmitted diseases.
(vii) Treatment of mental illness, self-inflicted injury, suicide, abuse of alcohol, drug addiction.
(viii) Disabilities resulting from direct participation in a strike, riot or civil commotion, insurrection, or any act
of war (whether declared or undeclared).
(ix) When an Insured Person is entitled to benefits payable under any employees’ compensation
legislation, government or public programme of medical benefits, or other group or individual
insurance, the benefits payable under this Policy shall be limited to the balance of expenses not
covered by benefits payable under such legislation, programme or other insurances, or that computed
in accordance with the Benefit Schedule of this Policy, whichever is lesser.

(You are advised to read the policy contract for the full list of exclusions)

2) NON GUARANTEED PREMIUM

Premiums payable for this plan are not guaranteed and may be increased at Policy Renewal Date at the full
discretion of the Company.

3) TERMS OF RENEWAL

Coverage may be renewed on the Policy Anniversary Date by payment of the annual premium, we can vary
the premium and any other terms, conditions or exclusions in this policy by giving you written notice of such
change, if you continue to pay premiums after we give such notice, it means you accept the change.

4) CANCELLATION CLAUSE

We may terminate this Policy on any Renewal Date by giving you at least 30 days’ prior written notice of
termination. Whenever such cancellation occurs, the Company shall return the unearned portion of
premiums paid. The termination of coverage shall be without prejudice to payment of claims arising prior to
the date of termination.

5) WAITING PERIOD

Not applicable.

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6) MISSTATEMENT

A. If the age or date of birth or other relevant facts relating to any Insured Person is misstated and this
affects the scale of benefits or other terms and conditions of this Policy, then we will use the true age
and facts to determine whether insurance coverage is in force and the benefits payable under this
Policy and if, in our opinion is necessary, an equitable adjustment of premiums will be made and
notice of the adjustment will be given to you.

B. Where a misstatement of age or other relevant facts has caused a person to be insured under this
Policy when he is otherwise ineligible for any insurance, or where such statement has caused a
person to remain insured when he would otherwise be disqualified in accordance with the provisions
of this Policy, his entire insurance coverage shall be void and there shall be a refund of premiums
paid. However, if there is a fraud on the part of the Insured Person, premiums paid shall not be
refunded.

IMPORTANT NOTICE

This is only product information provided by us and is designed to serve as a guide only. In the event of
clarification or dispute, the prevailing terms and conditions of the Group Insurance contract with your
employer shall apply.

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