MyShield

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Key Product Provisions

The following are some key provisions found in the Policy contract of MyShield Medical Insurance. 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 insurance adviser should You require further explanation.

  1. Exclusions
    There are certain conditions under which no benefit will be payable. These are stated as General Exclusions in the policy contract. You are advised to read the Policy contract for the precise terms and conditions of all exclusions. The following is a simplified list of some of the exclusions applicable under MyShield. It is not exhaustive.
    • Pre-existing Condition
      means any Injury, Illness, condition or symptom that existed prior to the Effective Date, the date of Upgrade or the date of the last reinstatement, whichever is later,:

      • for which treatment or medication or advice or diagnosis has been sought or received or was foreseeable by You or the Insured Person, or
      • for which an ordinary and prudent person with such Injury, Illness, condition or symptom would have sought advice or treatment in connection with his/her health, or
      • for which You or the Insured Person knew existed, whether or not treatment or medication or advice or diagnosis was sought or received.
      Pre-Existing Conditions are excluded under this Policy unless:
      1. if You have chosen the Full Medical Underwriting Option, the Pre-Existing Condition has been declared by You and specifically accepted by Aviva in writing to be covered under the Policy; or
      2. if You have chosen the Moratorium Underwriting Option, during the period of 5 years' continuous insurance from the date of commencement of cover or the date of reinstatement or the date of Upgrade, whichever is later, under the Policy, the Insured Person has not, in relation to a Pre-Existing Condition,:
        1. experienced symptoms or
        2. sought advice or tests from a Physician, a Specialist or Alternative Medicine provider (including checkups for that Pre-Existing Condition) or
        3. required treatment or medication or
        4. received treatment or medication

        in which case, Aviva will cover that Pre-Existing Condition under the Policy. This 5 year period is known as the Moratorium. If an insured person has experienced any of the above during the Moratorium period, then that particular Pre-Existing Condition shall be permanently excluded from the Policy.

        For the avoidance of doubt, the Moratorium will not apply to the following list of Pre-Existing Conditions and these Pre-Existing Conditions shall be permanently excluded under the Policy if You have selected the Moratorium Underwriting:

        • Heart attack, heart bypass, angioplasty
        • Chronic obstructive lung disease, chronic cor pulmonale, pulmonary hypertension
        • Stroke
        • Liver cirrhosis
        • Paralysis
        • Osteoporosis
        • AIDS or HIV infection
        • Thalassaemia Intermediate/ major
        • Diabetes with complications such as protein in urine or eye problem
        • Kidney failure
        • Organ transplantation
        • Systemic lupus erythematosus (SLE)
        • Muscular dystrophy
        • Multiple sclerosis
        • Alzheimer's disease
        • Dementia
        • Any form of Cancer (other than skin cancer)
        • Autism
    • Entire period of hospitalisation if admission to Hospital is before the Policy Commencement Date;
    • Overseas medical treatment other than Inpatient Medical Complaint as outside Singapore covered under MyShield;
    • Any transport trips to obtain medical treatment;
    • Private nursing charges/services
    • Routine medical examination or check-ups, elective cosmetic treatments, vaccination;
    • Congenital anomalies or birth defects, hereditary conditions except as provided for and covered under Inpatient Congenital Anomalies benefit under MyShield;
    • Pregnancy or childbirth, except as provided for and covered under Inpatient Pregnancy Complications benefit under MyShield; self- inflicted injuries, suicide, abuse of alcohol, drug addiction;
    • Sexually transmitted diseases and any treatment or test in connection with Human Immunodeficiency Virus (HIV) Infection and all HIV infection-related conditions or diseases, except HIV infection acquired through blood transfusion in Singapore or HIV acquired while performing regular professional duties in a medical profession in Singapore.;
    • engagement/involvement in any sports in a professional or competitive pursuit on a full-time, part–time, contractual and/or ad hoc basis other than those undertaken in leisure or as a hobby
    • War and terrorism;
    • Mental Illness or personality disorder except as provided for and covered under Inpatient Psychiatric Treatment benefit under MyShield;
    • Experimental or pioneering medical and surgical techniques not commonly available or not approved by MOH.
  2. Pro-ration Factor, Annual Deductible and Co-Insurance
    The actual benefit payable will be subjected to the following factors as specified in the Benefit Schedule:
    • Pro-ration Factor: If an Insured Person is admitted to a ward higher than what he/she is entitled to under the plan he/she has chosen, or received Inpatient treatment outside Singapore, the Pro-ration Factor (if applicable), which is expressed as a percentage, will be applied to the actual charges incurred and covered under the Policy, including charges in respect of Pre-Hospital and Post-Hospital Treatment received in connection with hospitalization, or the Reasonable and Customary Charges for equivalent medical treatment in any Singapore private Hospital or at the Singapore General Hospital, depending on the Plan covered, whichever is lower.
    • Annual Deductible: Before a claim is payable by Aviva Ltd., an Insured Person has to pay the Annual Deductible which is the accumulative total amount of covered expenses incurred by him/her during any one Policy Year. Any covered expenses incurred under Outpatient Catastrophic Treatment are not subject to the Annual Deductible.
    • Co-insurance: In the event a claim is payable by Aviva Ltd., an Insured Person has to pay the amount of Co-Insurance up to the maximum amount as stated in the Benefits Schedule. The amount payable by him/her is obtained by multiplying the benefit payable in excess of Annual Deductible with a fixed percentage as stated in the Benefits Schedule.
  3. Non-Guaranteed Premium
    Premium rates payable under MyShield are not guaranteed and may be increased on the Policy renewal date based on the claims experience of the portfolio.
  4. Renewal
    MyShield is guaranteed renewable for a further period of 12 months by payment of the renewal premium before the Renewal Date. Aviva Ltd. may vary the benefits, cover, premium, clauses and conditions to all the policies under this class of insurance by giving You 30 days' advance notice in writing but will not cancel any individual policy.
  5. Termination Clause
    An Insured Person's cover under MyShield will automatically terminate on the date any one of the following events first occurs:
    1. upon his/her death;
    2. on the expiry of the 30-day notice following Your request for cancellation;
    3. non payment of premium after the Grace Period;
    4. failure to refund Aviva Ltd. money due to/owing to Aviva Ltd. for any prior payment made by Aviva Ltd. (if any)
    5. upon successful commencement of another Medisave-approved Integrated Shield Plan issued by another insurance company covering the Insured Person.
  6. Reinstatement
    If MyShield terminates due to non-payment of premium, You may apply to reinstate MyShield within 30 days of the date of notice of Termination by providing Aviva Ltd. with satisfactory evidence of insurability at Your expense. All Insured Persons must be 75 years old or below at age next birthday at the date of reinstatement. All outstanding premiums must be received by Aviva Ltd. before MyShield can be reinstated. Treatment provided to the Insured Person after the date of Termination and within 30 days of the date of notice of reinstatement will not be covered unless the treatment received as an Inpatient is for Injuries caused by an Accident occurring after the date of notice of reinstatement.
  7. Cancellation Clause
    You may cancel MyShield by giving Aviva Ltd. thirty (30) days' notice in writing. There will be a pro-rated refund based on the number of unused days for the rest of the Policy Year. The cover under MyShield will cease at the requested date of Termination. Cover under the MediShield will continue to remain in force as long as he/she still satisfies the eligibility criteria under MediShield. If You wish to terminate the cover under MediShield, you will have to notify the Central Provident Fund Board separately.
  8. Change of Plan
    You may change the plan of an Insured Person, subject to Aviva Ltd approval in writing, by giving Aviva Ltd. A written notice at least 30 days prior to the Renewal Date of the Policy. This is subject to satisfactory evidence of insurability for each Insured Person at Your Expense for any upgrading of plan before the change can be effected on the Renewal Date.

    In the event of an Upgrade whereby the Insured Person fails to satisfy the Moratorium of the upgraded plan, any claim arising from a Pre-Existing Condition after the Upgrade will be assessed under the terms and conditions of the plan prior to the Upgrade. 

    If such a claim is admissible after having satisfied the Moratorium of the plan prior to the Upgrade, any benefit payout would be limited to the benefits under the plan prior to the Upgrade. 

    Any Pre-Existing Condition which has been permanently excluded under the Policy as provided in the General Conditions clause of the Policy Contract will remain permanently excluded under the upgraded plan.
  9. Last Payer Status
    If the insured has other medical insurance, including medical benefits under any employment contract which makes provision for reimbursement of medical expenses, Aviva Ltd. shall be the last payer reimbursing the claim. If benefits payable under this Policy has been made to You first before a claim is made under any other medical insurance policies or employee benefits, the other medical insurers or employer will need to reimburse Aviva their share. You shall provide Aviva with the full details of such other insurance policies or employee benefits and all relevant documentary proof necessary to make a claim. 

    For every claim, the total reimbursement to be made should not exceed the expenses actually incurred.
  10. Waiting Period
    This is applicable to specific benefits under the Policy as set out under the relevant benefit provisions, starting from:
    1. the date which the benefit first becomes effective under the Policy;
    2. the Policy Commencement Date of the Policy;
    3. the date of last reinstatement; or
    4. the date of Upgrade (applicable to any increased or additional benefit(s)),
    Whichever is the latest, during which this Policy will not provide for those specific benefits regardless of treatment made necessary by any cause.
  11. Full Disclosure
    You are required to disclose fully and truthfully all material facts and circumstances to Aviva Ltd. up to the date full cover is provided in respect of any Insured Person. Otherwise, Aviva Ltd. can declare the Policy void and avoid all liabilities existing under the Policy contract. If You were previously covered under MediShield or a Medisave-Approved Plan offered by another insurer, only Your cover under MediShield will be reinstated. Aviva Ltd. will refund You all premiums paid provided You have not made any claim under the plan.
  12. Free Coverage for Child(ren)
    Aviva Ltd. will cover Your children (up to a maximum of 4 children) up to 20 years old at age next birthday for free under Plan 2 if Aviva Ltd. accept their application in writing and both parents are insured under Plan 1 or 2. You only need to start paying premiums at renewal when Your children reach 21 years old at age next birthday in order to let them enjoy continuous coverage.
  13. Aviva's Promise of Service
    MyShield which is issued to You will contain Aviva Ltd's promise of service. You can contact Aviva Ltd if You have any concern about the terms of Your policy or any claim You may make. Information on the distribution costs will be available at Your request.

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 Aviva Ltd or visit the Life Insurance Association (LIA) or SDIC websites (www.lia.org.sg or www.sdic.org.sg).

Note:
This is only product information provided by Aviva Ltd. Full details of the terms, conditions and exceptions of this insurance are provided in MyShield and will be sent to You upon acceptance by Aviva Ltd. You have a "Free Look" period of two (2) calendar months from the Policy Commencement Date or fourteen (14) days from the date of receipt of MyShield Policy, whichever is the later. You are assumed to have received the MyShield Policy within seven (7) days after We have sent it by post. Please inform Aviva Ltd within the "Free Look" period if You do not want the MyShield Policy. It will be cancelled from Policy Commencement Date and any premium that You may have paid will be refunded in full after deducting any expenses incurred in assessing the risk under the Policy, as long as no claim has been admitted under the Policy. MyShield is governed by and shall be construed according to the laws of Singapore.