HI Claims and Procedures 2

Question 1

What are the common exclusions in Singapore health insurance policies?

Accepted Answer

Cosmetic surgery, fertility treatments, pre-existing conditions (during waiting period), experimental treatments, and self-inflicted injuries

Answer

Nothing is excluded

Answer

Only dental is excluded

Answer

Only overseas treatment is excluded

Question 2

What is 'direct billing' (cashless hospitalisation) in Singapore health insurance?

Accepted Answer

An arrangement where the hospital bills the insurer directly, and the patient only pays the deductible, co-insurance, and any non-covered items

Answer

The patient pays nothing ever

Answer

Only available at public hospitals

Answer

A type of medical loan

Question 3

How are outpatient specialist visits covered under Singapore health insurance?

Accepted Answer

Coverage depends on the policy: MediShield Life covers selected costly outpatient treatments; IPs may offer outpatient coverage through riders at additional premium

Answer

All outpatient visits are fully covered

Answer

Outpatient visits are never covered

Answer

Only GP visits are covered

Question 4

What is the claims turnaround time standard for Singapore health insurers?

Accepted Answer

Insurers are expected to settle straightforward claims within 30 days of receiving complete documentation

Answer

No standard exists

Answer

Claims must be settled within 24 hours

Answer

Claims can take up to one year

Question 5

What documentation is typically required for a health insurance claim in Singapore?

Accepted Answer

Hospitalisation leave certificate, detailed hospital bill, medical report, claim form, NRIC copy, and any referral letters

Answer

Only the hospital bill

Answer

Only the claim form

Answer

Only verbal confirmation from the doctor

Question 6

What is the role of the Life Insurance Association (LIA) in health insurance disputes in Singapore?

Accepted Answer

LIA provides guidelines for the industry and facilitates resolution of complaints; unresolved disputes can be escalated to FIDReC

Answer

LIA sells insurance directly

Answer

LIA has no role in disputes

Answer

LIA only handles life insurance, not health