MyBenefitsPlus FAQ

1. We will not pay any Term Life Benefits under this Policy if the claim is due to or arising directly or indirectly, wholly or partly, from any Pre-Existing Condition unless: 

• the Pre-Existing Condition was declared by the Insured Person and specifically accepted by Us in writing to be covered under this Policy; or
• the Pre-Existing Condition was not excluded from the Policy by Us in writing and the Insured Person has been insured under this Policy continuously for at least 18 months from the Effective Date.

2. Suicide is excluded for 12 months from the Effective Date.

We will not pay any Living Care benefit under this Policy for any Critical Illness caused directly or indirectly, wholly or partly, by any of the following:

• Pre-Existing Condition unless the Pre-Existing Condition was declared by the Insured Person and specifically accepted by Us in writing to be covered under this Policy; or
  • sexually transmitted diseases or viruses, Acquired Immune Deficiency Syndrome (AIDS), AIDS-related complexes and all illnesses or diseases associated with the human immunodeficiency virus (HIV), except AIDS due to blood transfusion as provided in this Policy;
  • invasion, riot, civil commotion or rebellion, any war (declared or undeclared) or act of war; violation or attempted violation of the law or resistance to arrest;
  • suicide or any attempted suicide or self-inflicted injury or illness, whether the Insured Person is sane or insane unless such suicide occurs 12 months after the Effective Date.
  • over-indulgence in alcohol;
  • drug-taking unless taken under the direction of a Registered Medical Practitioner.

This Policy does not cover any Accidental Injury caused directly or indirectly, wholly or partly, by any one of the following occurrences:

• Suicide or any attempted suicide or self-injury whether the Insured Person is sane or insane.
• War, any acts of terrorism involving, directly or indirectly, the use of nuclear radiation and/or biological and/or chemical agents, hostilities or any warlike operations (whether war be declared or not) or civil war; military or naval or airforce service while under orders for warlike operations.
• Participation in a riot; commission of an assault or criminal offence.
• Participation in competitive racing of any kind other than on foot; travelling in any type of aircraft other than as a fare-paying passenger on a regularly scheduled flight of a commercial airline.

Group Medical (Group Outpatient Medical, Group Basic Medical and Group Major Medical)

We will not pay any benefit under this Policy for any of the following occurrences:

• Pre-existing Conditions, the cause or pathology of which already existed prior to the Effective Date, whether the Insured Person was aware of it or not; unless he has already been insured continuously for 12 months
  • under this Policy; or
  • under any Group Hospital & Surgical Insurance Policy issued in Singapore immediately prior to the Effective Date. This waiver is not applicable if You have less than 11 Insured Persons at the Policy Commencement Date.

The above exclusion is not applicable to Group Outpatient Medical.

Pre existing Conditions which existed prior to the commencement of insurance coverage of the Insured Person under this Policy whether known or unknown to the Insured Person will be permanently excluded under Group Major Medical.

• Suicide or attempted suicide or intentional self-injury whether the Insured Person is sane or insane (including suicide or attempted suicide or intentional self-injury attributable to psychological, emotional or mental problems or conditions of the Insured Person; alcoholism or drug addiction of the Insured Person).
  
• Congenital anomalies or genetic defects, including hereditary conditions of the Insured Person present at or existing from the time of his birth irrespective of when the Insured Person discovered or underwent treatment or surgical procedure for the same.
  
• Treatment relating to birth control, infertility and impotency including treatment or surgical procedures done at fertility clinics, in-vitro fertilization clinics, reproductive medicine or assistance clinics or centres or any treatment or procedures occasioned by or resulting from pregnancy, childbirth and abortion including any complications arising from any of the above.
  
• Any dental work or treatment, oral surgery, orthodontics and orthognathic surgery or temporo-mandibular joint disorder unless it is due to an injury sustained in an Accident.
  
• Eye examination, surgical procedure for correction of eye refraction, procurement or use of contact lenses or eye glasses, (surgical procedure or treatment for correction of squint or other eye misalignment (unless the Insured Person is below 8 years old) and cosmetic or plastic surgery except to the extent that such surgery is necessary for the repair of damage caused solely by bodily injuries sustained in an Accident.
  
• Treatment of xanthelasma, syringoma, acne, alopecia, cosmetic skin surgeries, inguinal hernia, hydrocele (including any complications) unless treatment for inguinal hernia and hydrocele is for an Insured Person who is more than 5 years old.
  
• Services (irrespective of whether there is Hospital Confinement) for the primary purpose of diagnosis, medical check-up, genetic or health screening and Outpatient treatment and Rehabilitation Services (except for Post-Hospital Confinement / Surgery Follow-up Treatment), immunotherapy, alternative medicine including accupunture, chiropractice, osteppathy, herbal medicine, homeopathy and the like and other unconventional medical practices not normally practiced by a Registered Medical Practitioner.
• Rest cures, sanatoria care or special nursing care or any treatment or services that are not medically necessary or reasonably required for Illness or bodily injury caused by an Accident.
• Treatment for sleep apnea, obesity, weight reduction or weight improvement even if it is caused by a medical condition which is otherwise payable under this Policy.
  
• Circumcision (except where it is medically necessary) or treatment relating to the same.
  
• Sexually transmitted diseases, Acquired Immune Deficiency Syndrome (AIDS), AIDS related complexes and all illnesses or diseases associated with the human immunodeficiency virus (HIV).
  
• Injuries and disabilities sustained from direct participation in a strike, riot or civil commotion, insurrection, hostilities or any war-like operations (whether war be declared or not) or in the commission of any criminal offence.
  
• Implants (homograft, heterograft, artificial) and prosthesis (except as provided under PART III – BENEFIT PROVISIONS, Section 2 - Benefits, Clause 2A(xiv) under Hospital Miscellaneous Services); procurement or use of wheel-chair, dialysis machine and any other hospital-type equipment.
  
• Any expenses, administrative or other charges of a non-medical nature in the course of obtaining medical supplies or services.

No benefit shall be payable under this Supplementary Contract in respect of:

• Any treatment for corrective purposes (such as crowns and bridges) or for the replacement of any lost or stolen denture, unless the Insured Person is covered under Superior Plan 2 as specified in the Schedule of Dental Benefits and such treatment is specifically covered under Superior Plan 2.
  
• Any treatment provided before the commencement of insurance coverage for an Insured Person under this Supplementary Contract.
  
• Any treatment provided after the termination of insurance coverage for an Insured Person under this Supplementary Contract.
  
• Treatment or services not specified in the Schedule of Dental Benefits.