Commercial Claims

For work related injuries or illness, employers may make a claim under their Work Injury Compensation Insurance policy. For non- work related conditions, this is when Foreign Worker Medical insurance may be activated.

Ministry of Manpower has compulsory requirements for employers to maintain minimum insurance coverage of $15,000 per year for every work permit and s pass holder. There is no compulsory requirement to maintain coverage for employment pass holders however we highly recommend employers to do so.

Most standard plans are limited to government and/or restructured hospitals only. (E.g. TTSH, SGH, CGH, NUH, NTFGH)

Further, the $15,000 coverage would sometimes be insufficient and many employers would left with out of pocket expenses. If you have other requirements, you may wish to discuss this with us.

In order for the policy liability to respond, the following conditions have to be met:

• Hospitalisation (Government/Restructured Hospitals.) • Day surgery • Do not fall within policy exclusions (E.g. Work-related, congenital, etc.)

In addition, we require the following standard documents to be submitted:

• Original Completed Claim Form • Work Pass Copy • Inpatient Discharge Summary / Day Surgery Discharge Summary • Original FINAL Admission Tax Invoice • Original Medical Bills related to the admission (Pre-Hospitalisation Specialist Consultation/Diagnostic Expenses & Post-Hospitalisation follow-up expenses 90 days, at the same hospital)

• The documents required is not exhaustive and should more clarification / documentation be required in the course of the insurer’s claims assessment, we seek your understanding to furnish them to us.

Written notice of claim must be provided to the Insurance Company within 30 days after the occurrence of any event which may give rise to a claim under the Policy.

Claim Reporting refers to:

1)    either upon full submission the required documents (Claim Form, Invoices, Incident Report, etc.)

OR

2)    instruct us to report the claim to the Insurer with the incident information (Date of Admission/Surgery, Diagnosis, Copy of Work Pass, Copy of Inpatient/Day Surgery Discharge Summary).

The assessment by insurer will only commence upon full receipt of claims documents.

In order for the policy liability to respond, the following conditions have to be met:

• Hospitalisation • Day surgery • Not fall within policy exclusions

• A E (to ensure that there is such benefit provided under the policy)

In addition, we require the following standard documents to be submitted:

• Original completed claim form • Inpatient discharge summary / day surgery discharge form, or

• Medical report (private hospital)

• Original FINAL hospital bills (summary detailed)

• Original medical bills related to the admission (pre post 90 days)

• The documents required is not exhaustive and should more clarification / documentation be required in the course of the insurer’s claims assessment, we seek your understanding to furnish them to us.

Written notice of claim must be provided to the Insurance Company within 30 days after the occurrence of any event which may give rise to a claim under the Policy.

Claim Reporting refers to:

1) either upon full submission the required documents (Claim Form, Invoices, Incident Report, etc.)

OR

2) instruct us to report the claim to the Insurer with the incident information (Date of Admission/Surgery, Diagnosis, Copy of Work Pass, Copy of Inpatient/Day Surgery Discharge Summary).

The assessment by insurer will only commence upon full receipt of claims documents.

It is important that you notify us of the incident immediately upon having news of it.

Do not admit liability, sign any promissory note agreeing to pay for damages, settle or negotiate settlement without the Insurer’s approval. The claim will be based on a without prejudice basis.

Please do not compensate the third party without Insurer’s written consent as you would have prejudiced your/Insurer’s legal position.

Please complete the claim form and forward related photographs for our onward submission to the insurer.

Kindly ensure that the claim form is completed with policy number, date of loss/damage, incident location, brief description of the accident, extent of damages, loss amount and etc so that the insurer can better assess the situation to respond to the case.

The contact details of the onsite contact person should also be provided in case further clarification is required.

A surveyor may or may not be appointed.

For cases where surveyor is involved, the surveyor will request for a survey/meeting and request for list of documents to be submitted and the process may be a bit longer due to the thorough investigation required.

For cases where surveyor is not involved (Decided by the Insurer), the insurer will then decide on the list of documents to be submitted. You are likely be required to present three quotations for the insurer’s consideration of the repair work (if there are repair works to be done).

The insurer will only assess upon full receipt of claims documents.

Written notice of claim must be provided to the Insurance Company ASAP after the occurrence of any event which may give rise to a claim under the Policy.

The documents required is not exhaustive and should more clarification / documentation be required in the course of the insurer’s claims assessment, we seek your understanding to furnish them to us.

Claim Reporting refers to:

1)either upon full submission the required documents (Claim Form, Invoices, Incident Report, etc.)

OR

2) instruct us to report the claim to the Insurer with the incident information (Date of Admission/Surgery, Diagnosis, Copy of Work Pass, Copy of Inpatient/Day Surgery Discharge Summary).

The assessment by insurer will only commence upon full receipt of claims documents.

CONVID-19: https://www.mom.gov.sg/covid-19/frequently-asked-questions

To understand more about Ministry of Manpower’s position on Work Injury related claims: https://www.mom.gov.sg/workplace-safety-and-health/work-injury-compensation

While the worker is injured in course of employment and unfit for work, please kindly ensure that you continue to pay medical leave wages and medical expenses to the injured worker. Thereafter seek reimbursement from the insurer (We will assist you in this).

Employers will be required to do:  Report the accident to MOM (https://www.mom.gov.sg/eservices/services/wsh-incident-reporting using Corp Pass) and us (the insurance agent)/Insurer (In Writing via completed claim form) within the legislated limit.

It is compulsory to report to MOM within 10days from the incident if any of the following applies:

• Work Injury resulting in the death of an employee.
• The employee was hospitalised for at least 24 hours.

• From 1 September 2020, employers must report all work-related medical leave or light duties to MOM.

In addition, the following standard documents are to be submitted:

•ted claim form • Ireport, if applicable • Police report / internal incident report, if applicable • NRIC/work permit • Payslips for the past 12 months before the accident (e.g. if the accident happened in May 2019, insured has to submit the payslips from May 2018 to April 2019) •Inpatient discharge summary/medical report/doctor’s memo/referral letter/radiology report, whichever applicable • Original medical bills • Original medical certificate • Contract agreement between the main-con and sub-con (for project-related accident) • Toolbox meeting record/attendance sheet/punch card on the accident date (for project- related accident)

• The documents required is not exhaustive and should more clarification / documentation be required in the course of the insurer’s claims assessment, we seek your understanding to furnish them to us.

Written notice of claim must be provided to the Insurance Company within 10 days as per legislation after the occurrence of any event which may give rise to a claim under the Policy.

Claim Reporting refers to:

1)    either upon full submission the required documents (Claim Form, Invoices, Incident Report, etc.)

OR

2)    instruct us to report the claim to the Insurer with the incident information (Date of Admission/Surgery, Diagnosis, Copy of Work Pass, Copy of Inpatient/Day Surgery Discharge Summary).

The assessment by insurer will only commence upon full receipt of claims documents.