What insurance policy only requires a payment of premium at its inception?

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The information provided is based on what was provided to us at the date of Publication. We are not responsible for 

• the correctness of the information, or
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You are strongly advised to seek the professional advice of insurance professionals before making any decision with regard to any of the Medisave-Approved Integrated Shield Plans.

Summary: List of Integrated Shield Plans (IPs) and their targeted level of coverage (As at 1 Sep 2022)

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Basic Plans

Standard Integrated Shield Plan (for Public Hospital Class B1 coverage)

Comparison of Standard IPs (for Class B1 coverage)

1. AIA HealthShield Gold Max Standard Plan
2. Singlife with Aviva Singlife Shield Standard Plan
3. AXA Shield Standard Plan
4. Great Eastern GREAT SupremeHealth STANDARD
5. Income IncomeShield Standard Plan
6. Prudential PRUShield Standard Plan
7. Raffles Shield Standard Plan

Class B1 Plans

Comparison of Class B1 IPs

1. AIA HealthShield Gold Max C*
2. AIA HealthShield Gold Max B Lite
3. Singlife with Aviva Singlife Shield Plan 3
4. Great Eastern GREAT SupremeHealth B*
5. Great Eastern GREAT SupremeHealth B Plus
6. Income Enhanced IncomeShield Basic
7. Prudential PRUShield B*
8. Raffles Shield B

Class A Plans

Comparison of Class A IPs

1. AIA HealthShield Gold Max B
2. Singlife with Aviva Singlife Shield Plan 2
3. AXA Shield Plan B
4. Great Eastern GREAT SupremeHealth A*
5. Great Eastern GREAT SupremeHealth A Plus
6. Income Enhanced IncomeShield Advantage
7. Income IncomeShield Plan A*
8. Prudential PRUShield Plus
9. Prudential PRUShield A*
10. Raffles Shield A

Private Hospitals Plans

Comparison of Private Hospital IPs

1. AIA HealthShield Gold Max A
2. Singlife with Aviva Singlife Shield Plan 1
3. AXA Shield Plan A
4. Great Eastern GREAT SupremeHealth P Plus
5. Income Enhanced IncomeShield Preferred
6. Income IncomeShield Plan P*
7. Prudential PRUShield Premier
8. Raffles Shield Private

* These plans are no longer offered to new members. Existing members may continue to renew their policies.

Sample Policy Contracts of Integrated Shield Plans (As at 1 Sep 2022)

• Income's IncomeShield and Enhanced IncomeShield
• AIA Singapore Private Limited's HealthShield Gold
  
• Great Eastern Life Assurance Co's SupremeHealth
  
• Singlife with Aviva's Singlife Shield
  
• Prudential Assurance Company Singapore's PRUShield
  

• AXA Singapore’s AXA Shield

• Raffles Health Insurance's Raffles Shield

Service Indicators

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

Insurer

Median Claims Processing Duration (days)1

75th Percentile Claims Processing Duration (days)2

AIA

0 (Same Day)

1

Singlife with Aviva

0 (Same Day)

1

AXA

1

1

Great Eastern

0 (Same Day)

2

Income

1

1

Prudential

0 (Same Day)

1

(1 July to 30 September 2022)^
1 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 75 out of 100 claims are processed by the insurer within the indicated number of days in the table.
* As RHI was approved to provide IPs from 16 July 2018 onwards, the number of claims processed by RHI is currently insufficient for analysis.
^ For Q3 2022, insurers' performance could have been affected by 1 week of intermittent system downtime in the month of July. 

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

Common reasons why insurers may reject or not pay for claims made

Having an insurance policy does not always mean that you will receive a payout for your claim. The table below shows some common reasons why your insurer may reject your claim or not provide a payout for your claim. For more information regarding your claim and insurance coverage, please check with your insurer.

• Claim amount is below the deductible
• Medical condition is excluded from the policy
• General exclusions, such as pregnancy and maternity expenses

(II) Letter of Guarantee

When you are hospitalised, if your hospital can obtain a Letter of Guarantee (LOG) from your insurer, you can reduce the upfront cash deposit amount that you have to make with the hospital. An LOG is a letter issued by insurers to selected hospitals to fully or partially waive the hospital upfront cash deposit for hospitalisations or surgeries, based on the estimated portion of the bill covered by the insurance. LOGs are provided by insurers as an additional service, according to their respective terms of service. 

All IP insurers provide LOGs and you may check with your IP insurer for more information.

Following the hospital discharge, you may still be required by your hospital to settle your hospital bill, while your insurer assesses your claim according to your insurance coverage. You will be reimbursed by the hospital, after your insurer makes payment to your hospital.

Common reasons why insurers do not provide a Letter of Guarantee in specific cases

Having an IP does not mean that your insurer will always provide an LOG when you need treatment at a hospital. Your insurance coverage may differ from other policyholders, and your insurer may be unable to ascertain at the start of your treatment  whether your treatment is claimable under your insurance coverage.

The table below shows some common reasons why insurers may not provide policyholders with a LOG. For more information regarding LOGs and your insurance coverage, please check with your insurer.

• Estimated bill size is below the deductible
• Duration between policy inception and LOG application is shorter than insurer's stipulated minimum duration for LOG eligibility
• Medical condition is a pre-existing medical condition that the policyholder had before the commencement of the policy
• Medical condition is excluded from the policy
• General exclusions, such as pregnancy and maternity expenses

(III) Medical Record Costs

To process claims, insurers may require your medical records. Either you as a claimant, or your insurer, can request medical records from medical institutions. This request, however, usually comes at a cost of between $75 to $250. IP insurers may not absorb the cost of obtaining medical records. 

What if I have a claim dispute with my insurer? 

For claim disputes of a contractual nature
Financial Industry Disputes Resolution Centre (FIDReC) is an independent and impartial institution that helps to resolve consumer financial disputes through mediation and adjudication. It is an accessible and affordable alternative to legal proceedings. FIDReC's services are available to consumers who are either individuals or sole proprietors for claims against licensed financial institutions who are subscribers of FIDReC.

Before filing a dispute at FIDReC, the consumer must first approach the financial institution. If the financial institution has not been able to resolve the dispute satisfactorily, the consumer can then proceed to file a claim at FIDReC. The consumer must file the claim within six months of receiving a final reply from the financial institution.

FIDReC can handle disputes of a contractual nature, this includes disputes involving disagreements over the interpretation of contractual terms. FIDReC also handles disputes involving issues of misrepresentation, service lapses and mis-selling.

Further information on FIDReC and its dispute resolution process can be found at www.fidrec.com.sg

For claim disputes of a clinical nature
From 9 November 2021, a Clinical Claims Resolution Process (CCRP) was established to resolve claim disputes of a clinical nature between private Integrated Shield Plan (IP) policyholders, IP insurers, medical practitioners and medical institutions.

The CCRP will help to facilitate the resolution of clinically related IP claim disputes, including concerns on unfair rejection of claims for medically appropriate treatment or procedures, concerns on over-charging by medical practitioners and medical institutions, and concerns on over-servicing by medical practitioners.

The CCRP is a voluntary process. The parties must mutually agree to participate in the CCRP, and enter into a contractual agreement to abide by the CCRP Panel's decision. Parties should, however, attempt to resolve the disputes amongst themselves at the first instance.

The CCRP is administered by a secretariat from the Academy of Medicine, Singapore. Complainants can file their disputes online via the CCRP website.

Further information on the CCRP and the CCRP agreement form can be obtained from the CCRP website at www.ccrp.com.sg

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