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QBE Foreign WorkerMedical InsuranceGroup medical insurance
Introducing QBE Foreign Worker Medical InsuranceEmployers are required to purchase andmaintain minimum medical insurancecoverage of S 15,000 per year for eachWork Permit holder to provide inpatientcare, day surgery and outpatient clinicalcoverage, if needed.QBE’s Foreign Worker Medical InsurancePlan provides protection for foreign workers(excluding foreign maids) against the costsof hospitalisation, surgery and other relatedexpenses as a result of sickness or accident.With waiver of pre-existing medicalconditions, no minimum headcountrequirements and automatic extensionfor JB coverage, you can easily havethe peace of mind in safeguarding yourforeign worker’s medical liabilities.
The productWhat this plan gives youClaims can only be made for the treatment of a medical condition or injury while the Plan isvalid. This plan is specially designed to provide covers for S Pass Holders and Work PermitHolders issued by the Ministry of Manpower Singapore.BENEFITS (S )Hospital Room and Board Per DayIntensive Care Unit Per DaySurgery Charges inclusive of Theatre& Anaesthetist FeesHospital Miscellaneous Services & SuppliesPre-Hospitalisation/Surgery SpecialistConsultationPre-Hospitalisation/Surgery DiagnosticServicesIn-Hospital Physician’s VisitPost Hospitalisation / Surgery TreatmentOverall Maximum LimitEmergency Outpatient TreatmentPer policy Year (incurred within 31 daysof accident provided treatment issought within 24 hours of accident)Outpatient Kidney Dialysis & CancerTreatment Per policy YearRepatriation of Mortal RemainsPersonal Accidental (Due to non-work only)Special GrantGeographical scope of coverage(*Due to work reasons)Johor Bahru extensionCovers work/non-work relatedCovers in excess of WICACovers GST claim amountWaived 12 months waiting vernment, (Government, (Government,Restructured Restructured alCharges)50,000 (perdisability)30,000 (perdisability)20,000 (perdisability)15,000 esWP/S PassYesYesYesYesWP/S PassYesYesYesYesWP/S PassYesYesYesYesWP/S PassCo-insurance for admission to higher ward Upgrade to higher wards in government/restructured hospitals : 10% (Insured) Admission to private hospitals: 25% (Insured) Overseas treatment required while on a work assignment: 25% (Insured) All room and board, not exceeding S 200 per day for private hospitals
Clinical Outpatient (OP) benefitsPanel Consultation & Medicine(Includes basic Diagnostic test & X-ray)Government PolyclinicEmergency Treatment at A&EAnnual Limit Per InsuredAs charged 5 Co-payAs charged 5 Co-payAs chargedNo Co-pay600Note:Clinical Outpatient benefit is available for:- Group size with minimum 5 headcounts- Deluxe, Superior & Platinum Plans onlyOP Benefits and PremiumOP PREMIUM RATE5 to 50More than 50Premium (S ) above is based on per insured.Please add 7% GST to the total premiums 5 CO-PAY300250
Annual Premium Per EmployeePLAN TYPE/GROUP SIZE1-5051-100101-200Above 200 (Upon request from QBE)Premium (S ) above is based on per insured.Please add 7% GST to the total 000)CLASSIC(15,000)117113110969391878483807775
Important notes1. The limits of cover are subject to OverallMaximum Limit as stated in Benefits Table.2. Emergency Outpatient Treatment,Outpatient Kidney Dialysis andCancer Treatment, Special Grant andRepatriation of Mortal Remains areseparate benefits and do not formpart of the Overall Maximum Limit asstated in Benefits Table.3. The Policy covers all pre-existingconditions from inception for WorkPermit holders and S Pass holders.4. Information on disclosure of distributioncosts, charges and expenses are availableupon request.5. The premium payable for this cover arenot guaranteed and may be revised ateach renewal date, at the full discretion ofQBE.6. Enrolment requirements:a) Foreign Worker Medical InsuranceApplication Form to be completedb) Named basis only applicable for planswith Outpatient benefits7. This compulsory medical insurancerequirement was introduced in tandemwith the withdrawal of healthcare subsidiesfor foreigners in order to help employersmanage the potentially high medical billsof their foreign workers. This requirementis for basic coverage, but employers arestill responsible for any uninsured medicalexpenses of their foreign workers.8. The Policyholder and/or any InsuredPerson must disclose fully and truthfully toQBE all material facts and circumstancesthat may influence the cover providedunder this Policy up to the date of issue,commencement of cover in respect ofthe Policyholder and any Insured Person.Any non-disclosure or misrepresentationwill allow QBE to declare the Policy orcover for an Insured Person void from thestart and no benefits shall be payable byQBE under the Policy or in respect of thatInsured Person.
Description of coverThe amount payable will not exceed the actual costsof medically necessary services. The maximumliability of QBE shall not exceed the limits of cover lessany deductible that is for the account of the InsuredPerson. The limits of cover and the deductibles (ifany) are shown in the Benefits Table and are basedon a single policy year.Pre -hospitalisation / surger y specialistconsultation – QBE will repay specialist consultationand referral fee including the cost of a second opinionprior to hospitalisation provided such consultationwas recommended in writing by the attendingphysician and incurred within 90 days prior toinpatient treatment or surgery.Hospital room & board – QBE will repay the dailycharges for room and board accommodation,general nursing services and meals for each day ofconfinement in a hospital, subject to daily maximumlimit not exceeding the entitled ward entitlement,stated in the Benefits Table, in Singapore Governmentor Restructured hospitals.Pre-hospitalisation/surgery diagnostic services– QBE will repay charges for diagnostic proceduresand laboratory examinations prior to hospitalisationprovided incurred within 90 days prior to inpatienttreatment or surgery.Intensive care unit/high dependency ward/critical care unit – QBE will repay charges for anintensive care unit/high dependency/critical care unit,provided it is certified medically necessary by theattending physician or surgeon.Surgery charges, theatre and anaesthetist fees –QBE will repay the fees charged by the surgeon forthe operation, theatre and anaesthetist charges.Hospital miscellaneous services & supplies –QBE will repay charges incurred during a hospitalconfinement for medically necessary hospitalsupplies and services which shall include prescribedmedicines, dressing, supplies, blood transfusions,rental of appliances, implants, treatment fees, therapyfees, laboratory fees, X-rays, and oxygen and itsadministration. QBE will also pay for ambulanceservices for transporting an Insured Person to ahospital, which results in an inpatient treatment orsurgery.In-hospital physician’s visit – QBE will repay feescharged by the attending physician for visiting a bedpaying patient, limited to one visit per day.Post hospitalisation/surgery treatment – QBE willrepay expenses incurred for follow-up treatmentsafter hospitalisation or surgery, by the same physician,within 90 days immediately following discharge fromhospital or surgery.Emergency outpatient treatment – QBE will repayexpenses incurred as a result of an accidental injuryfor treatment as an outpatient at any registered clinicor hospital within 24 hours of the accident causing theinjury. Charges for follow-up treatment by the samephysician up to 31 days from the date of the accidentwill also be covered (if the benefits is applicable).
Description of cover (continued)Outpatient kidney dialysis & cancer treatment– QBE will reimburse charges for kidney dialysis at aregistered dialysis centre or unit and cancer treatment(chemotherapy and radiotherapy) at an outpatientdepartment of a hospital or registered cancertreatment centre on recommendation of a registeredmedical practitioner (if the benefit is applicable).Special grant – QBE will pay to the Policyholder orlegal representative, the stated sum in the event ofdeath of the Insured Person in connection with a claimresulting from:a) An injuryb) A sickness during or after treatment for suchsickness at hospital or in a day surgery ward.Repatriation of mortal remains – QBE will pay thesum stated in the Policy schedule to the Policyholderor his legal representative in the event of death ofthe Insured Person for the transportation of mortalremains to the airport in Singapore or burial overseas.Personal Accident – QBE will pay a lump sumpayment stated on the benefit schedule upon lossof life or permanent disablement arising solely anddirectly from a non-work related accidental injury onaccident death, total paralysis, permanent bedridden,total and irremediable lost of sight of one eye,complete and incurable insanity.
Key provisionsAge limits – subject to insurability for a Group Memberwhose age at entry is below 65 years old, cover will berenewable until the Insured Person reaches the ageof 72.Cancellation – The Policyholder may cancel the Policyat any time by notifying us in writing and by registeredpost stating the effective date of cancellation of thesaid Policy. QBE shall charge premiums for that periodof insurance coverage based on the Short PeriodRates as stipulated in the Policy contract provided noclaim has been paid or is payable under the Policy.PERIODOF COVERSHORT PERIODRATES% OF PREMIUMPAYABLEFor a period notexceeding 1 week1/8 AnnualPremium12%For a period notexceeding 1 month1/4 AnnualPremium25%For a period notexceeding 2 months3/8 AnnualPremium37%For a period notexceeding 3 months1/2 AnnualPremium50%For a period notexceeding 4 months5/8 AnnualPremium62%For a period notexceeding 6 months3/4 AnnualPremium75%For a period notexceeding 8 months7/8 AnnualPremium87%For a periodexceeding 8 monthsFullPremium100%Other insurance – The Plan will indemnify on aproportionate basis if the applicant has any otherinsurance in force (excluding any health insurancecover/policy provided as part of his employmentcontract) in respect of the same injury or sickness,disease or illness.Eligibility – All present full time employees shall beeligible to join on the commencement date of thePlan. If an employee is not actively at work on thedate that he or she would otherwise be eligible inaccordance with the above, then the eligibility dateshall be deferred to the first working day of activeemployment.Group member – A foreign employee who is not acitizen or Permanent Resident of Singapore who seeksor is offered employment in Singapore, holds a validWork Permit or S Pass, and is actively at work for anorganisation including its subdivisions as defined onthe Application form.Geographical Scope – Worldwide as stated in PolicySchedule is applicable to Group members who workoverseas on assignment for the Policyholder only.Residence Requirement – The Insured Personmust be a resident of Singapore or Johor Bahru.Resident include all foreigners who hold valis S-Passor Work Permit and must have a residential addressin Singapore or Johor Bahru. The Policy will not coveryou if you reside or travel for more than 90 daysunless the Company has been informed and you havepaid the additional premium, if any.Restoration of cover for the same disability(applicable for benefits based on a per disabilitybasis only)In the event the Hospitalisation and surgery benefit isexhausted in respect of any in-patient hospitalisationand surgery benefits (including day surgery) only, anyillness, sickness or injury arising from the same medicalcondition or cause including any and all complicationsarising therefrom or closely related thereto shall beconsidered as a new disability provided always:(a) the Policy remains in force;(b) the Group Member is in active service at the timeof the claim and(c) the first consultation with a registered medicalpractitioner for the recurrence or relapse ismade 14 days after the latest discharge from thehospital.
Key provisions (continued)Non-guaranteed premium – Premiums payable forthis cover are not guaranteed and may be increasedon the policy renewal date, at the discretion of QBE.Policy administration – The administration foremployees (without outpatient benefits) will be onheadcount basis as described below:Reasonable & customary charges – Benefits payableare limited to reasonable and customary charges forthe treatment provided and to the limits of the plantype you choose.a)Upgraded clause – If the cover to an InsuredPerson is increased while it is in force or at the timeof renewal and if the Insured Person is afflicted witha disability at the time the cover was increased, thelimits of cover payable in respect of such pre-existingconditions shall not exceed the limits of cover prior tothe date of the upgrade. This limit will remain in placefor 12 months following the date on which the coverwas increased. Any upgrading of Plan shall take effectat each renewal only.Example of calculation:Annual premium:Adjustments (new list) :Difference:Credit note:Premium payment warranty – The Plan is subjectto premium payment warranty clause, which requiresthe premium due to be paid in full within 60 days fromthe inception date of the coverage under the Policy orthe effective date of each Endorsement. Failing which,QBE will not be liable under the Policy.Where terms cannot be finalised by the 21st day fromthe commencement of the Policy due to the absenceof or inadequate policy information, QBE will proceedto issue a provisional Policy based on expiring termsor terms quoted.The Plan applied for had not been in whole or in partterminated by another insurer due to non-payment ofthe premium in the last 12 months.Data required – You will furnish to QBE full particularsof all Group Member’s name, gender, work permitnumber/passport number, date of birth, medical plan,effective date, date, occupation details, and any otherpertinent information as is necessary to carry out theterms of this Policy.Administration – ‘Headcount Basis’ This applies to all foreign workers medicalinsurance application. You must furnish such information of allforeign workers who are covered under a‘Headcount Basis’ at commencement dateof the Policy and at each renewal date or atsuch times as required. The adjustments of additions and deletionsof foreign workers for the year will be billedat the end of the policy year: b)S 1,000S 800S 200 divided by 2S 100No premium refund if total claim experienceis above 60%.No premium refund if final adjustment,insured headcount is less than 5.Administration – ‘Named Basis’ This only applies to plans with outpatientbenefits. You must furnish such information of allforeign workers who are covered under a‘Named Basis’ at commencement date of thePolicy, at each time that is required and ateach renewal date. For new foreign workers, you must notify usin writing within 30 days after each foreignworker is employed and actively at work andpay the premium for new foreign workersfrom the effective date to the renewal date ofthe Policy. Premium will be pro-rated for additions anddeletions.
Exclusionsequipment, machines and other devices such aswheelchair, bed, walking or home aids of any kindand any other hospital-type equipment.For full list of exclusions, please refer to the actualpolicy wordings. A copy is available on request.This Policy does not cover situations listed below orexpenses for any disability incurred as a result of:GeneralWar or any act of war, terrorism or act of terrorism,direct involvement in strikes, civil commotion etc.,nuclear fall-out, naval, military or air force services(except peacetime reservist duty for the Republic ofSingapore), self-inflicted injuries, provoked assault,intoxication and the use of drugs, injuries arising fromracing of any kind (except foot racing), sky-diving,winter, water and professional sports, attemptedsuicide or suicide, and illegal activities.Medical1.Congenital or neo-natal physical abnormalitiesdeveloping within 6 months of birth, birth defects,hereditary conditions and disorders, or conditionsarising therefrom.2.Treatment pertaining to sexually transmitteddiseases, AIDS or AIDS-related complex or anysequelae.3.Cosmetic treatments, eyes glasses or refractionand hearing aids except as necessitated byinjuries.4.Treatment for obesity, weight reduction orimprovement regardless of whether causeddirectly or indirectly by a medical condition; studyand treatment of sleep apnoea.5.Prostheses of any kind; purchase or home oroutpatient use of special braces, appliances,6.Psychological, psychotic, mental or nervousdisorders, neuroses, depression, personalitydisorders, drug addiction, alcohol dependenceand gambling addiction.7.Work-related treatment payable to the InsuredPerson under the Work Injury Compensation Actor similar legislation except for any excess limitsnot payable under the Work Injury CompensationAct or similar legislation provided the costs oftreatment constitute a valid and payable claimunder the Work Injury Compensation Policy.8.In the event the Insured Person is inadequatelycovered or not covered under an insurancescheme required under the Work InjuryCompensation Act, this Policy shall pay only theamount in excess of the benefits payable underthe Work Injury Compensation Act.9.Pregnancy (except miscarriage due to an accidentas specified in Section III (9) of Employmentof Foreign Manpower Act – Chapter 91A), anycomplications arising from pregnancy, child birth(including surgical delivery), abortion, pre-natal orpost-natal care, surgical, mechanical or chemicalcontraceptive methods of birth control and anyresulting complications or treatment or testspertaining to varicocele, fertility or impotency,the use of Viagra and/or similar drugs includingany adverse effects of taking the drug or itscomplications.Other exclusions are stated in the Policy.Policy owners’ protection scheme (effective 01 January 2012)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 arecovered 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).This product summary provides only a brief description of the Policy. For full details, please refer to the actual policy wordings. When switchingfrom one health insurance product to another please ensure that such a switch is not detrimental to the prospective application/membership.QBE shall not undertake any liability until this application has been accepted in writing.
QBE Insurance (Singapore) Pte LtdPart of QBE Insurance Group Unique Entity No. 198401363C1 Wallich Street, #35-01,Guoco Tower, Singapore 078881Tel : (65) 6224 6633www.qbe.com/sgDISCLAIMER. QBE Insurance (Singapore) Pte Ltd 2021. This document is for information purpose only.While QBE has taken reasonable care in the production of this document, it does not warrant the accuracy orcompleteness of the information. Not all products are available to all markets and policy wording should berequested for full details on a particular product. QBE reserves the right to amend any information containedin this document at any point in time.FWMI/NOV20
maintain minimum medical insurance coverage of S 15,000 per year for each Work Permit holder to provide inpatient care, day surgery and outpatient clinical coverage, if needed. QBE's Foreign Worker Medical Insurance Plan provides protection for foreign workers (excluding foreign maids) against the costs
