# embeddings_queue

created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: e70f2c12-5742-4eac-8ce2-a4b986e055b9
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{"_node_content": "{\"id_\": \"e70f2c12-5742-4eac-8ce2-a4b986e055b9\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"ad5dcddb-d5cf-425f-a5d4-c25df4a32bba\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"2d10aca5129350ed92e06cef74e05bb1907c9a2d3b04e93038ee77242b4e2f39\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"26d71781-5304-4720-851a-17c93d8a17b3\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"b1e6f49feb507f2fd3a86dee07d7239cd48cef5104645f3e5dfbce09fdb8809e\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 844293, \"end_char_idx\": 848650, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "\u2022 Participation incentives of up to $2,500 for Singapore Citizens, if they join \nCareShield Life by 31 December 2023, to encourage those born in 1979 or \nearlier to join CareShield Life.\n\u2022 Additional participation incentives of $1,500 for Merdeka and Pioneer \nGeneration citizens if they join CareShield Life by 31 December 2023.\n\u2022 Additional Premium Support for Singaporeans who are unable to pay their \nCareShield Life premiums even after premium subsidies, so that no one will lose \ncoverage under CareShield Life due to genuine inability to pay premiums.\nEnhanced benefits under \nCareShield LifeCareShield Life features higher payouts that increase over time with no cap on \npayout duration, to provide better protection against the uncertainty of long-term \ncare costs in the event of severe disability. \n\u2022 Lifetime cash payouts for as long as the policyholder is severely disabled.\n\u2022 Payouts increase until age 67 or when a claim is made, whichever is earlier, with \npayouts starting at S$600 per month in 2020.\nCareShield Life Premiums \u2022 The CareShield Life scheme makes use of pre-funded premiums i.e. the insured \nCPF members pay more than the cost of their health risk, while they are \nyounger, to cover for the higher risk in their later years.\n\u2022 For Singapore Residents born 1980 or later (future cohorts),  premiums are paid \nfrom the age of enrolment until age 67. Premiums will increase over time, to \nsupport payout increases.\n\u2022 Singapore Residents born in 1979 or earlier (existing cohorts) will pay a base \npremium.\n\u2022 Fully payable by MediSave.\n\n35\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nEligibility Criteria for \nPayment of CareShield Life \nBenefitsSimilar to that of ElderShield.\nOther key features of \nCareShield Life\u2022 Guaranteed renewable on an annual basis.\n\u2022 Worldwide coverage.\n\u2022 Minimum entry age of 30 years old, but no maximum entry age.\n\u2022 CareShield Life policy will be terminated if the insured is no longer a Singapore \nCitizen or SPR.\n\u2022 No cash surrender value.\nOther healthcare financing \nschemes set up by the \nSingapore government\u2022 Pioneer Generation Package;\n\u2022 Merdeka Generation Package;\n\u2022 Interim Disability Assistance Programme For The Elderly (IDAPE);\n\u2022 ElderFund and\n\u2022 Medifund.\n\u2022 COVID-19 Medical Bills\nInterim Disability \nAssistance Programme For \nThe Elderly (IDAPE)\u2022 IDAPE was launched by the Government to take care of Singaporeans who were \nnot eligible to join the ElderShield scheme, when it was launched in September \n2002, either because they exceeded the maximum entry age or they had a pre-\nexisting disability.\nSingaporean will qualify for IDAPE if:\n\u2022 He is unable to perform three or more of the 6 Activities of Daily Living (ADL) - \nwashing, feeding, dressing, toileting, mobility and transferring.\n\u2022 He is a Singapore citizen born before 30 September 1932 OR born between \n1 October 1932 and 30 September 1962 (both dates inclusive) but with pre-\nexisting disabilities as at 30 September 2002.\n\u2022 His per capita household monthly income is $2,800 or less OR he has no \nhousehold income and is living in a residence with Annual Value of $13,000 and \nbelow.\nIDAPE Payout\n*An IDAPE applicant from a household with no income will qualify for the S$250 \nmonthly payout if the annual value of his place of residence is S$13,000 or lower.\nElderFund ElderFund is a discretionary assistance scheme launched on 31 January 2020. It is \ntargeted at severely disabled lower-income Singapore Citizens aged 30 and older, \nwho are not able to benefit from CareShield Life, ElderShield, and the Interim \nDisability Assistance Programme for the Elderly (IDAPE), have low MediSave \nbalances and have inadequate personal savings to meet their long-term care needs.\nMediFund MediFund is an endowment fund set up by the Government. It provides a safety net \nfor needy Singaporeans who face difficulties paying for their remaining healthcare \nbills after Government subsidies, insurance and MediSave.Per Capita Household Income*IDAPE Payout\n(With Effect From 1 July 2013)\n(a) S$0 to S$2,000 (a) S$250 per month for up to 72 \nmonths\n(b) S$2,001 to S$2,800 (b) S$150 per month for up to 72 \nmonths\n\n10.Common Policy Provisions\nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]  221  CHAPTER 10  \nCOMMON POLICY PROVISIONS \nCHAPTER OUTLINE  \n1. Introduction\n2. Sections Of A Policy Contract\n3."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 26d71781-5304-4720-851a-17c93d8a17b3
encoding: FLOAT32
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{"_node_content": "{\"id_\": \"26d71781-5304-4720-851a-17c93d8a17b3\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"e70f2c12-5742-4eac-8ce2-a4b986e055b9\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"0c3fa46555e4c5c3939872f955cea536beb0f39c2cbee8315d3fa9eb2db52cc4\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"c1dcd128-dd4b-458d-ae44-53867d64895c\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"0e6686a347540cec1d102e6a27e0999fd798e4ca3369b60fcd6b32d3e9eb426c\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 848533, \"end_char_idx\": 853887, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "4]  221  CHAPTER 10  \nCOMMON POLICY PROVISIONS \nCHAPTER OUTLINE  \n1. Introduction\n2. Sections Of A Policy Contract\n3. Policy Schedule\n4. Insuring Clause & Definitions\n5. General Conditions\n6. Benefit Provisions\n7. Exclusions\n8. Claim Conditions\n9. Endorsements\n10. Conclusion\nAppendix 10A \u2013 Policy Schedule\nLEARNING OUTCOMES  \nAfter studying this chapter, you should be able to:  \n\u25aalist the sections of a Health Insurance policy contract\n\u25aaknow the information contained in a Health Insurance policy schedule\n\u25aaoutline what an insuring clause is\n\u25aadefine the following common terms under a Health Insurance policy:\n-dependant\n-insured /insured person\n-accident\n-hospital\n-any one disability\n-covered charges\n-day of hospital confinement\n-registered medical practitioner /physician\n-medically necessary service, supply or day of hospital confinement\n-period of hospital confinement\n-pre-existing condition\n-policyholder/policy owner\n-usual, customary and reasonable\n-waiting period\n-illness\n-pre-hospitalisation benefits\n-per policy year limit\n-lifetime limit\n-deductible and co -insurance\n-pro-ration factor\n\nHealth Insurance  \n222 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] \u25aaexplain the general conditions sections that outline the rights of the policy owner and\nthe insurer:\n-entire contract clause\n-effective date of cover\n-premium clauses\n-free-look period\n-actively at work\n-termination of cover\n-cover abroad\n-renewal\n-mis-statement of age or gender\n-grace period\n-reinstatement\n-incontestability\n-change of occupation\n-co-ordination of benefits\n-cancellation\n-change of plan\n-currency\n-last payer status\n-nomination of beneficiaries\n-Policy Owners\u2019 Protection Scheme\n\u25aaexplain the various bases upon which Health Insurance policies can be issued:\n-cancellable\n-optionally renewable\n-conditionally renewable\n-guaranteed renewable\n-non-renewable\n\u25aaunderstand the purposes a nd functions of the benefit provisions section of the Health\nInsurance policy\n\u25aalist the common exclusions that are found in Health Insurance policies\n\u25aaexplain some of the important general claim conditions commonly found in Health\nInsurance policies:\n-notifi cation of claim condition\n-physical examination provision\n-mediation/arbitration and legal action s provision\n\u25aaexplain what an endorsement  is\n\n10. Common Policy Provisions  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   223  \nContents  \nCHAPTER OUTLINE  ................................ ................................ ................................ .........  221 \nLEARNING OUTCOME S ................................ ................................ ................................ .. 221 \n1. INTRODUCTION  ................................ ................................ ................................ ..... 225 \n2. SECTIONS OF A POLICY CONTRACT  ................................ ................................ ... 225 \n3. POLICY SCHEDULE  ................................ ................................ ................................  225 \n4. INSURING CLAUSE & DEFINITIONS  ................................ ................................ ..... 226 \nA. Insuring Clause  ................................ ................................ ................................  226 \nB. Definitions  ................................ ................................ ................................ ........  226 \n5. GENERAL CONDITIONS  ................................ ................................ ........................  231 \nA. Entire Contract Clause ................................ ................................ .....................  231 \nB. Effective Date Of Cover  ................................ ................................ ...................  231 \nC. Premium Clauses  ................................ ................................ ............................  231 \nD. Free-look Period  ................................ ................................ ..............................  232 \nE. Actively At Work  ................................ ................................ ..............................  232 \nF. Terminati on Of Cover ................................ ................................ ......................  233 \nG. Cover Abroad  ................................ ................................ ................................ .. 233 \nH. Renewal  ................................ ................................ ................................ ...........  234 \nH1. Cancellable Policy  ................................ ................................ .....................  234 \nH2. Optionally & Conditionally Renewable Policies  ................................ ...... 234 \nH3. Guaranteed Renewable Policy  ................................ ................................ . 235 \nH4. Non-renewable  ................................ ................................ .........................  236 \nI. Mis-statement Of Age Or Gender  ................................ ................................ ... 236 \nJ. Grace Period  ................................ ................................ ................................ .... 236 \nK. Reinstatement  ................................ ................................ ................................ ."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: c1dcd128-dd4b-458d-ae44-53867d64895c
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{"_node_content": "{\"id_\": \"c1dcd128-dd4b-458d-ae44-53867d64895c\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"26d71781-5304-4720-851a-17c93d8a17b3\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"b1e6f49feb507f2fd3a86dee07d7239cd48cef5104645f3e5dfbce09fdb8809e\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"92c25908-b9a0-41d5-914e-66d42f29ab57\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"409a93d1837ef403af6f95ff43d43c68ce5a8d048898bdfb9cc39418ccfbb6d5\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 853888, \"end_char_idx\": 859366, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "236 \nL. Incontestability  ................................ ................................ ................................  237 \nM. Change Of Occupation  ................................ ................................ ....................  237 \nN. Co-ordination Of Benefits  ................................ ................................ ...............  237 \nO. Cancellation  ................................ ................................ ................................ ..... 237 \nP. Change Of Plan  ................................ ................................ ................................  238 \nQ. Currency  ................................ ................................ ................................ ..........  238 \nR.  Last Payer Status  ................................ ................................ .............................  238 \nS. Nomination Of Beneficiaries  ................................ ................................ ...........  238 \nT. Policy Owners\u2019 Protection Scheme  ................................ ................................  239 \n6. BENEFIT PROVISIONS  ................................ ................................ ...........................  239 \n7. EXCLUSIONS  ................................ ................................ ................................ .........  241 \n8. CLAIM CONDITION S ................................ ................................ ..............................  242 \n\nHealth Insurance   \n \n224 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] A. Notification Of Claim Condition  ................................ ................................ ..... 242 \nB. Submission Of Claim  ................................ ................................ ......................  243 \nC. Physica l Examination Provision  ................................ ................................ ..... 243 \nD. Mediation/Arbitration & Legal Action Provision  ................................ ............  243 \n9. ENDORSEMENTS  ................................ ................................ ................................ ... 244 \n10. CONCLUSION  ................................ ................................ ................................ .........  244 \nAppendix 10A  ................................ ................................ ................................ ..................  245 \n \n \n\n10. Common Policy Provisions  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   225  \n1. INTRODUCTION  \n \n1.1 A Health Insurance policy is the written evidence of a contract between the \ninsurer and the policy owner who can be an individual or a corporation. It \nspecifies the precise terms of the agreement between the two parties to the \ncontract. The details of the contract terms are clearly laid out in various policy \nprovisions. This chapter will describe the common and important provisions of \nIndividual and Group Health Insurance contracts.  \n \n1.2 It is very important to fully understand the various policy provisions to avoid \nany dispute later on.  \n \n \n2. SECTIONS OF A POLICY CONTRACT  \n \n2.1 There are basically seven sections in a Health Insurance policy contract.  \n \n2.2 The sequence  or header  of the sections in a policy document may vary among \nthe different insurers.   \n \n \n3. POLICY SCHEDULE  \n \n3.1 The schedule contains details of the policy  owner , insured person(s), as well as \nthe insurance coverage , coverage limits and sum insured . The schedule is not \na stand -alone document and must always be read together with the policy \nwording \u201c as one contract\u201d . The schedule will also outline additional clauses or \nexclusions specific to the policy owner\u2019s own circumstances.   \n \n3.2 The schedule will include  information as follow s: \n\u25aa policy number;  \n\u25aa effective date of cover;  \n\u25aa expiry date of cover;  \n\u25aa date at which the policy is issued;  \n\u25aa contract currency;  \n\u25aa name and identity number of the policy owner ; \n\u25aa name, age, gender and identity number of the insured  person ; \n\u25aa name of insurance plan;  \n\u25aa types of riders and the coverage limits  (if any);  \n\u25aa premium s for the insurance plan and riders;  \n\u25aa coverage details on  benefits  limits or sum insured ; and \n\u25aa special  provisions/endorsements indicating the types of endorsements \nattached to the policy.  \n \n \n \n \nHealth Insurance \nPolicy   \n1. Policy Schedule  \n2. Insuring Clause & \nDefinitions  \n3. General Conditions  \n4. Benefit Provisions  \n5. Exclusions  \n6. Claim Conditions  \n7. Endorsements  \n\nHealth Insurance   \n \n226 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] 3.3 The policy schedule gives the specific details of the policy contract (refer to \nAppendix 10A of this chapter for a sample copy of the  first page of a policy \nschedule . For a detailed schedule of benefits, refer to Appendix 2A  of Chapter \n2 of this Study Guide ). When you promptly deliver the policy to the policy \nowner, you need to go through this schedule with the policy owner thoroughly , \nto ensure that there is no typographical error , and that the insurance coverage \ntallies with what the policy owner has agreed to purchase.  \n \n \n4. INSURING CLAUSE & DEFINITIONS  \n \nA. Insuring Clause  \n \n4.1 The insuring clause also known as the operative clause states the purpose of \nthe policy and outlines the conditions under which the policy will pay."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 92c25908-b9a0-41d5-914e-66d42f29ab57
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{"_node_content": "{\"id_\": \"92c25908-b9a0-41d5-914e-66d42f29ab57\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"c1dcd128-dd4b-458d-ae44-53867d64895c\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"0e6686a347540cec1d102e6a27e0999fd798e4ca3369b60fcd6b32d3e9eb426c\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"fbc0af64-5278-4179-8aed-5f23b24f9a78\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"ae46d7dd79611b5c2bf64755b9341c97157c768f58364fb3f2765552c73b9366\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 859156, \"end_char_idx\": 863764, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "INSURING CLAUSE & DEFINITIONS  \n \nA. Insuring Clause  \n \n4.1 The insuring clause also known as the operative clause states the purpose of \nthe policy and outlines the conditions under which the policy will pay. The \ninsuring clause serves to:  \n\u25aa describe the general scope of coverage;  \n\u25aa provide any definitions required;  and \n\u25aa set forth the cond itions under which the benefits are payable . \n \n4.2 This clause is often viewed as the foundation of a Health Insurance policy in \nterms of the insurer\u2019s general agreement to provide the coverage.  \n \nB. Definitions  \n \n4.3 To ensure a common understanding for both parties , the policy contains \ndefinitions of key words used in  the policy.  In this section, we highlight the \nimportant terms in a Health Insurance policy and their sample definitions (note \nthat the actual definition s vary from insurer to insurer).  \n(a) Dependant  \nSome Health Insurance policies provide coverage to the dependants \n(spouse and children) of the policy owner (or of the employee in the case \nof Group Insurance) and the definitions are important.  \n \nA spouse is typically defined as the person to whom the policy owner is \nlegally married  under the laws of the country.  \n \nA spouse is no longer considered a dependant in the case of legal \nseparation. As for a child, he must typically be unmarried, under the age \nof 18 years , and principally dependent on the insured for support. This \ndefinition also includes the legally adopted children and stepchildren of \nthe insured. Most insurers will extend the cover up to age of 18 or 25  years  \nif the child is pursuing a tertiary education.  \n \n(b) Insured /Insured Person  \nThe insured person is the person covered by the insurance. The insured  \nperson, more often than not, is the policy owner. At times, the policy \nowner opts to cover his dependant s (spouse and children)  under the  \npolic y, and in such instance, the dependants will be  the insured  persons .  \n\n10. Common Policy Provisions  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   227  \nA policy will specify that the insured person may include the policy owner , \nor any one of his insured dependants as defined in the policy.  \n \n(c) Accident  \nIt means an incident caused by accidental, violent, external and v isible \nmeans.  \nNote that some insurers may not have the \u201cviolent\u201d requirement in their \ndefinition of \u201caccident\u201d.  \n \n(d) Hospital  \nIt is defined as any lawfully operating institution which \nhas 24 -hour a day nursing services by registered \ngraduate nurses, one or more physicians available at all times and \norganised facilities for diagnosis and major surgery . It is not primarily a \nclinic, a place for alcoholics or drug addicts, nursing, rest or convalescent \nhome , or home for the aged , or simil ar establishment.  \n \n(e) Any One Disability  \nIt means disabilities resulting from illness or bodily injury and their \ncomplications arising from the same cause.  However, if any subsequent \ndisability arising after a specified number of days (e.g. 45 or 90 days, \ndepending on the policy wording  of the insurer ) has lapsed following the \nlatest discharge from hospital, then it shall be considered a new disability , \nregardless of the cause.  \n \n(f) Covered Charges  \nThey refer to the charges incurred by the insured person, while t he policy \nis in force, for a service, supply or period of confinement, which has been \nordered or prescribed by a physician.   \n \nA covered charge is deemed to be incurred at the time the service or \nsupply is received or rendered. The covered charges for a period of \nhospital confinement are deemed to be incurred at the time of admission \nto a hospital. However, some insurers take into  account the actual date of \nprovision of service.  \n \n(g) Day Of Hospital Confinement  \nIt refers to a full 24 hours during a period of hospital confinement. The first \nday of confinement will commence at the time of admission to the hospital \nand each subsequent day  will commence 24 hours after the \ncommencement of the previous day of confinement, and the day of \ndischarge will also be regarded as a day of confinement.  \n \n(h) Registered Medical Practitioner/Physician  \nIt means a qualified medical practitioner registered with the Singapore \nMedical Council to render medical and surgical services. It excludes a \nphysician who is the policy owner, insured person himself or his spouse \nor any of his lineal relatives1.  \n \n \n1 Lineal relatives refer to people who are descendants from the same ancestor.  \n HOSPITAL"}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"fbc0af64-5278-4179-8aed-5f23b24f9a78\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"92c25908-b9a0-41d5-914e-66d42f29ab57\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"409a93d1837ef403af6f95ff43d43c68ce5a8d048898bdfb9cc39418ccfbb6d5\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"7748d5bf-7649-4e0a-86c2-dc40a10bb6fc\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"07f42bf381ed879b5049abaf45ac91e22ff5663259da40d60be1ba0855b36aa4\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 863674, \"end_char_idx\": 866749, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "1 Lineal relatives refer to people who are descendants from the same ancestor.  \n HOSPITAL  \n \n\n\nHealth Insurance   \n \n228 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] (i) Medically Necessary Service, Supply Or Day Of Hospital Confinement  \nIt means a service, supply or day of hospital confinement, which is \nordered by a physician and which is:  \n\u25aa provided for the diagnosis or direct treatment of a disability;  \n\u25aa appropriate and consistent with the symptoms and findings or \ndiagnosis and treatment of the insured person\u2019s disability;  \n\u25aa provided in accordance with generally accepted medical practices on \na national basis;  \n\u25aa the most appropriate supply or level of service which can be provided \non a cost effective basis; and  \n\u25aa not of an experimental or investigative nature, or research purposes.  \n \nThe fact that the insured person\u2019s physician prescribes a service, supply \nor day of hospital confinement does not automatically mean that such \nservice, supply or day of hospital confinement is medically neces sary.  \n \n(j) Period Of Hospital Confinement   \nIt means a continual period of time where  an insured person is confined \nto a hospital as a registered inpatient. Two or more periods of  hospital  \nconfinement resulting from  the same or related causes, are considered as \nthe same period of hospital confinement, unless the break between the \ndate of discharge of the earlier period of hospital confinement and the \ndate of admission of the following period of  hospital  confinement  is more \nthan a specified number of days (e.g. 45 days) . Insurers normally require \npatients to stay in a hospital for 6 to 24 hours , before being  considered to \nbe \u201chospitalised\u201d.  \n \n(k) Pre-existing Condition  \nIt is usually defined as a condition which has existed and:  \n\u25aa for which the insured  person  received treatment or medical advice;  \n\u25aa in respect of which the insured  person  showed symptoms;  \n\u25aa of which the insured  person was aware;  and \n\u25aa of which the insured  person  should reasonably have been aware;  \n \nbefore the date of policy issue or the date that the cover was reinstated.  \n \nNote that insurers may adopt one or more of the above -mentioned  \nconditions in their definition of the term \u201cpre -existing condition\u201d.   \n \nAlmost all insurers require the insured  person  to declare any known pre -\nexisting condition. These  pre-existing condition s may be excluded from \ncoverage , and the policy  being  put in  force with the required exclusions. \nIn recent years , some insurers use a moratorium underwriting  method . \nThis means  that the  insured  person  does not need to make any medical \ndeclaration  when he applies for coverage . Pre-existing conditions can be \ncovered after a continuous period (e.g. five years) from the effective date \nof coverage,  reinstatement, or upgrade of plan, whichever is the later. For \nthe specified number of years, the insured  person  must not have \nexperienced any symptom, seek consultati on, or receive treatment or \nmedication for the condition."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 7748d5bf-7649-4e0a-86c2-dc40a10bb6fc
encoding: FLOAT32
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{"_node_content": "{\"id_\": \"7748d5bf-7649-4e0a-86c2-dc40a10bb6fc\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"fbc0af64-5278-4179-8aed-5f23b24f9a78\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"ae46d7dd79611b5c2bf64755b9341c97157c768f58364fb3f2765552c73b9366\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"2a98d458-8d17-4fad-a30e-b484361f70c0\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"d80e7c5ae3d668c48958e44e79795751dd261b1d2dbc20a49e76d615ce22e7db\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 866756, \"end_char_idx\": 871198, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "10. Common Policy Provisions  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   229  \nIn addition , the insurer may also have a list of pre -existing conditions that \nare permanently excluded from coverage , e.g. cancer, stroke, heart attack, \nkidney failure , etc. \n \n(l) Policyholder/ Policy Owner  \nThe policy owner owns the policy and is responsible for the payment of \npremiums and receipt of claims and benefits under the policy.  He has the \nright to make changes to the contract and receive all payments due under \nthe policy.  \n \n(m) Usual, Customary & Reasonable  \nIt means the charges for a specific service, supply or period of hospital \nconfinement:  \n\u25aa is within standard charge for the specific provider; and  \n\u25aa must not be more than the general level of charges of other medical \ncare providers with similar standing in the same geographical area, for \nan equivalent treatment, services or supplies to individuals of the same \ngender, of comparable age, for a similar illness or injury.  \n \n(n) Waiting Period   \nFor Medical Expense Insurance , it refe rs to the period of time  starting from \nthe date of policy issue  or reinstatement date , where  the insured  person 's \nmedical expenses are not covered by the policy. Waiting period  differs \nfrom insurer to insurer and appl ies only to medical expenses arising from  \nan illness , not from an accident.  \n \nFor Disability Income Insurance , it refers to a specified period of time , \nbeginning with the onset of the disability, where  benefits are not payable. \nThe waiting period in a Disabili ty Income Insurance policy is sometimes \ncalled the \u201celimination period\u201d or the \u201cprobationary period\u201d.  \n \nFor Long -Term Care (LTC) Insurance , it refers to a period  of time beginning \nfrom the first day the insured person is unable to perform the specified \nActivities of Daily Living (ADLs) , during which no LTC Insurance benefit \nwill be payable.  For LTC Insurance, this may also be known as the deferred \nperiod.  \n \n(o) Illness  \nIllness refers to a physical condition marked by a pathological deviation \nfrom the normal healthy state.  \n \n(p) Pre-hospitalisation Benefits  \nThis refers to the diagnostic X -ray, laboratory tests and specialist \nconsultation for an illness or injury which occurred within a specified \nnumber of days prior to hospitalisation. The insurer will pay only for such \noutpatient treatments  if they lead to hospitalisation or surgical operation , \nwithin the time  frame  as specified in the policy.  \n \n  \n\n\nHealth Insurance   \n \n230 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] (q) Per Policy Year Limit  \nThis is the maximum amount that a Medical Expense Insurance (MEI) \npolicy will pay for all the eligible medical expenses that an insured person \nincurs within each policy year.  \n \n(r) Lifetime Limit  \nThis is the maximum amount that a MEI policy will pay for all the  eligible \nmedical expenses that an insured person incurs under the policy.  \n \n(s) Deductible & Co-insurance  \nA deductible  is a flat amount of covered medical expenses that an insured \nperson must first incur , before  the insurer will make any benefit payment \nunder a MEI policy. This amount will have to be borne by the insured  \nperson . \nCo-insurance , on the other hand, is a percentage of all eligible medical \nexpenses, in excess of the deductible, that the insured person must \npersonally pay under a MEI policy.  \n \n(t) Pro-ration Factor  \nThis is the percentage that the insurer will use to pro -rate the hospital bills \nbefore it compute s the claim payout , if the insured person is admitted to \na ward/hospital higher than what he is entitled to under the policy. The \npercentage is applied on the actual charges incurred and covered under \nthe policy, including charges of pre-hospital and post-hospital treatment s \nreceived in connection wi th the hospitalisation. Therefore, t he benefit \npayable is reduced to take into account the difference in Government \nsubsidies applicable to the ward type of the selected plan.  \n \nIf the life assured receives inpatient treatment in a luxury or deluxe suite \nor any other special room of a hospital, the room charge benefit will be \npro-rated to the actual charges which the life assured has to pay for each \ntype of plan.  \n \nHere is an example of how an insurer would  pro-rate the room charges."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 2a98d458-8d17-4fad-a30e-b484361f70c0
encoding: FLOAT32
metadata:
{"_node_content": "{\"id_\": \"2a98d458-8d17-4fad-a30e-b484361f70c0\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"7748d5bf-7649-4e0a-86c2-dc40a10bb6fc\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"07f42bf381ed879b5049abaf45ac91e22ff5663259da40d60be1ba0855b36aa4\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"3b546870-8a17-4b12-baa8-972168072d5f\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"454184648d22bd2b64da5779db50e4653f4f234c243ba2a7217b80d02a6b4c7f\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 871128, \"end_char_idx\": 872371, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Here is an example of how an insurer would  pro-rate the room charges.  \n \nInsured\u2019s Plan \nEntitlem ent Pro-ration formulae  \nPrivate \nHospital \u2013 any  \nstandard ward   \n\ud835\udc36\u210e\ud835\udc4e\ud835\udc5f\ud835\udc54\ud835\udc52  \ud835\udc53\ud835\udc5c\ud835\udc5f  \ud835\udc4e \ud835\udc60\ud835\udc56\ud835\udc5b\ud835\udc54\ud835\udc59\ud835\udc52 \u2212\ud835\udc4f\ud835\udc52\ud835\udc51\ud835\udc51\ud835\udc52\ud835\udc51  \ud835\udc341 \ud835\udc64\ud835\udc4e\ud835\udc5f\ud835\udc51  \ud835\udc56\ud835\udc5b \ud835\udc40\ud835\udc5c\ud835\udc62\ud835\udc5b\ud835\udc61  \ud835\udc38\ud835\udc59\ud835\udc56\ud835\udc67\ud835\udc4e\ud835\udc4f\ud835\udc52\ud835\udc61 \u210e \ud835\udc42\ud835\udc5f\ud835\udc50 \u210e\ud835\udc4e\ud835\udc5f\ud835\udc51  \ud835\udc3b\ud835\udc5c\ud835\udc60\ud835\udc5d\ud835\udc56\ud835\udc61\ud835\udc4e\ud835\udc59\n\ud835\udc45\ud835\udc5c\ud835\udc5c\ud835\udc5a  \ud835\udc50\u210e\ud835\udc4e\ud835\udc5f\ud835\udc54\ud835\udc52  \ud835\udc64\u210e\ud835\udc56\ud835\udc50\u210e \ud835\udc61\u210e\ud835\udc52 \ud835\udc8d\ud835\udc8a\ud835\udc87\ud835\udc86  \ud835\udc82\ud835\udc94\ud835\udc94\ud835\udc96\ud835\udc93\ud835\udc86\ud835\udc85  \u210e\ud835\udc4e\ud835\udc51 \ud835\udc61\ud835\udc5c \ud835\udc5d\ud835\udc4e\ud835\udc66    \n \nx total bill  \n \nRestructured \nHospital \u2013 any  \nstand ard ward   \n\ud835\udc36\u210e\ud835\udc4e\ud835\udc5f\ud835\udc54\ud835\udc52  \ud835\udc53\ud835\udc5c\ud835\udc5f  \ud835\udc4e \ud835\udc60\ud835\udc61\ud835\udc4e\ud835\udc5b\ud835\udc51\ud835\udc4e\ud835\udc5f\ud835\udc51  \ud835\udc341 \ud835\udc64\ud835\udc4e\ud835\udc5f\ud835\udc51  \ud835\udc56\ud835\udc5b \ud835\udc46\ud835\udc56\ud835\udc5b\ud835\udc54\ud835\udc4e\ud835\udc5d\ud835\udc5c\ud835\udc5f\ud835\udc52  \ud835\udc3a\ud835\udc52\ud835\udc5b\ud835\udc52\ud835\udc5f\ud835\udc4e\ud835\udc59  \ud835\udc3b\ud835\udc5c\ud835\udc60\ud835\udc5d\ud835\udc56\ud835\udc61\ud835\udc4e\ud835\udc59\n\ud835\udc45\ud835\udc5c\ud835\udc5c\ud835\udc5a  \ud835\udc50\u210e\ud835\udc4e\ud835\udc5f\ud835\udc54\ud835\udc52  \ud835\udc64\u210e\ud835\udc56\ud835\udc50\u210e \ud835\udc61\u210e\ud835\udc52 \ud835\udc8d\ud835\udc8a\ud835\udc87\ud835\udc86  \ud835\udc82\ud835\udc94\ud835\udc94\ud835\udc96\ud835\udc93\ud835\udc86\ud835\udc85  \u210e\ud835\udc4e\ud835\udc51 \ud835\udc61\ud835\udc5c \ud835\udc5d\ud835\udc4e\ud835\udc66  x total bill  \n \nRestructured \nHospital \u2013 any  \nstandard B1 \nWard   \n\ud835\udc36\u210e\ud835\udc4e\ud835\udc5f\ud835\udc54\ud835\udc52  \ud835\udc53\ud835\udc5c\ud835\udc5f  \ud835\udc4e \ud835\udc60\ud835\udc61\ud835\udc4e\ud835\udc5b\ud835\udc51\ud835\udc4e\ud835\udc5f\ud835\udc51  \ud835\udc351 \ud835\udc64\ud835\udc4e\ud835\udc5f\ud835\udc51  \ud835\udc56\ud835\udc5b \ud835\udc46\ud835\udc56\ud835\udc5b\ud835\udc54\ud835\udc4e\ud835\udc5d\ud835\udc5c\ud835\udc5f\ud835\udc52  \ud835\udc3a\ud835\udc52\ud835\udc5b\ud835\udc52\ud835\udc5f\ud835\udc4e\ud835\udc59  \ud835\udc3b\ud835\udc5c\ud835\udc60\ud835\udc5d\ud835\udc56\ud835\udc61\ud835\udc4e\ud835\udc59\n\ud835\udc45\ud835\udc5c\ud835\udc5c\ud835\udc5a  \ud835\udc50\u210e\ud835\udc4e\ud835\udc5f\ud835\udc54\ud835\udc52  \ud835\udc64\u210e\ud835\udc56\ud835\udc50\u210e \ud835\udc61\u210e\ud835\udc52 \ud835\udc8d\ud835\udc8a\ud835\udc87\ud835\udc86  \ud835\udc82\ud835\udc94\ud835\udc94\ud835\udc96\ud835\udc93\ud835\udc86\ud835\udc85  \u210e\ud835\udc4e\ud835\udc51 \ud835\udc61\ud835\udc5c \ud835\udc5d\ud835\udc4e\ud835\udc66  x total bill  \n \n\n10. Common Policy Provisions  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   231  \n5. GENERAL CONDITIONS  \n \n5.1 The general conditions section outlines the rights of both the policy owner and \nthe insurer. In this section, we highlight some of the important conditions as \nfound in a typical Health Insurance policy.  \n \nA. Entire Contract Clause  \n \n5.2 All insurance contracts have an \u201cEntire Contract Clause\u201d. In some policies, it is \nreferred to as \u201cThe Policy Contract Clause\u201d."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 3b546870-8a17-4b12-baa8-972168072d5f
encoding: FLOAT32
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Entire Contract Clause  \n \n5.2 All insurance contracts have an \u201cEntire Contract Clause\u201d. In some policies, it is \nreferred to as \u201cThe Policy Contract Clause\u201d. This clause states that the present \ncontract, together with any specified attachments/endorsements, make up the \nentire contract , and no other documents f orm another part of the contract. In a \nHealth Insurance contract, the policy document and the proposal form  (as well \nas proposal forms  of the insured  persons , if required in the case of a family or \ngroup polic y) are the entire contract between the insured and the insurer.  \n \n5.3 This clause also states that , in consideration of the first premium being received \nin full, the insurer will start providing benefits as set out in the policy.   \n \nB. Effective Date Of Cover  \n \n5.4 The effective date of cover is established in the policy by agreement between \nthe insurer and the  policy owner . It is the date on which the insured person \nbegins to be covered under the Health Insurance policy.   \n \n5.5 Usually, the effective date of cover applies to all types of cover s under  the \npolicy , unless there is a special arrangement to have one or more of the covers \nto become effective at some later date.  \n \n5.6 For instance, the effective date of cover for an accident  or illne ss may be  \ndifferent. For an accident , cover will commence as at the effective date of the  \ninsurance. For  an illness , the cover can commence  only after the waiting period  \nis over.     \n \nC. Premium Clauses  \n \n5.7 Health Insurance policies are issued by life insurers. Policies such as medical \nexpense insurance can also be issued by general insurers.  \n \n5.8 As far as individual Health Insurance policies issued by life insurers are \nconcerned, when the policy is first incepted, the premiums must be paid before \ninceptio n of cover. When the policy is renewed during the second year onwards, \nit is subject to a Grace Period whereby the premium must be paid within 30 \ndays from inception of cover.  \n \n5.9 For Group Health insurance policies issued by life insurers, there is a Grace \nPeriod  provision within such policies which states that the premium has to be \npaid within 30 days from the commencement date or renewal date (whichever \nis applicable); or the date of the insurer\u2019s premium tax invoice, whichever is \nlater . \n \n \n\n\nHealth Insurance   \n \n232 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] 5.10 We now turn to Hea lth Insurance policies issued by general insurers. For \nindividual health insurance policies issued by general insurers, they are subject \nto the Payment Before Cover Warranty  which states that the policy shall not be \nin force, unless the premium is paid to the insurer or intermediary on or before \nthe date of inception of the policy. In the event that the total premium due is not \npaid to the insurer or the intermediary on or before the inception date or the \nrenewal date of the policy or Bond, then no benefits  whatsoever shall be \npayable by the insurer.  \n \n5.11 As for Group Health insurance policies (e.g. Group Medical Insurance or Group \nHospital and Surgical Insurance) issued by general insurers, they are subject to \nthe Premium Payment Warranty  which states that if t he period of insurance is \nmore than 60 days, the policyholder is required to pay the premium due under \nthe policy in full, within 60 days from the date of inception of the policy. If this \nwarranty is not complied with, then the policy is automatically term inated from \nthe expiry of the 60 -day period, and the insurer will be entitled to a pro -rata \npremium for the 60 -day period that the insurer has been on risk. If the period of \ninsurance is less than 60 days, then the insured is required to pay the premium \ndue under the policy in full, within the period of insurance.  \n \nD. Free-look Period  \n \n5.12 The free -look period is the period of time after delivery of the policy document \nduring which the policy owner may review the policy and return it for a refund \nof the premium paid to the insurer  (less any medical fees incurred). Full \ncoverage is in force during this period. This can vary from 14 to 30 days from \nthe date of receipt of the policy document. The policy  document is deemed to \nhave been received by the policy owner within seven days after the insurer has \ndespatched it.  \n \nE. Actively At Work  \n \n5.13 This provision is usually found in Group Insurance , as well as Disability Income \nInsurance."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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Actively At Work  \n \n5.13 This provision is usually found in Group Insurance , as well as Disability Income \nInsurance. When applied to Group Ins urance, it provides that an employee is \nnot eligible for coverage , if he is absent from work because of an illness , injury \nand other reasons on the effective date of his coverage. However, in Disability \nIncome Insurance, it provides that the cover will aut omatically terminate , when \nthe person is not working owing to illness or termination of service.  \n \n  \n\n10. Common Policy Provisions  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   233  \nF. Termination Of Cover  \n \n5.14 This clause lists the situations , whereby the cover for Health Insurance will \ncease:  \n\u25aa when the insured  person  dies;  \n\u25aa when the policy owner fails to pay the renewal premium at the end of the \ngrace period;  \n\u25aa when the total amount of claims paid by the insurer has reached the limit of \nindemnity ; or \n\u25aa when the insured  person  reaches the specified maximum age during  which \nthe insurer is not willing to offer cover.  \n \n5.15 It also states that the termination of a policy will not prejudice or affect the \npayment of any claim that has arisen before the termination , and that there will \nbe no refund of premium if the policy is terminated before the expiry of the \ncover.  \n \nG. Cover Abroad  \n \n5.16 This clause is applicable only to the covered charges incurred in the \u201cCountry\u201d \nas specified in the policy schedule. It is also applicable under the following \ncircumstances:  \n\u25aa the insured  person , travelling abroad for a reason other than for medical \ntreatmen t, needs to be confined to a hospital outside the \u201cCountry\u201d as a \nconsequence of a medical emergency occurring within 90 days of leaving the \n\u201cCountry\u201d; or  \n\u25aa the insured  person , upon recommendation of a physician and with the prior \nwritten approval of the chief medical officer of the insurer, has to be \ntransferred to a hospital outside the \u201cCountry\u201d because the specialised \nnature of the treatment, aid, information or decision required can neither be \nrendered, nor furnished, nor taken, in  that \u201cCountry\u201d.  \n \n5.17 All co vered charges incurred during the period of confinement will be subject \nto the exclusions, limitations and conditions as specified in the policy , and all \nbenefits will be payable in the \u201cCurrency\u201d2 based on  the \u201cExchange Rate\u201d3 on \nthe last day of the period of confinement.  \n \n5.18 The purpose of this clause is to restrict the Health Insurance coverage to the \ncountry where the policy is issued; except when the insured person is travelling \nabroad and, at the time of an emergency, the cha rges for an overseas hospital \ntreatment will be covered. As the cost of healthcare varies from country to \ncountry, pricing of the product does not usually take into account any foreign \ncountry\u2019s claim costs. Furthermore , it complicates claim administration  and \nadjudication.  \n \n \n2  \u201cCurrency\u201d refers to any currency other than Singapore dollars.  \n3  \u201cExchange Rate\u201d refers to the rate of exchange used for the settlement of a claim.   \n\n\nHealth Insurance   \n \n234 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] H. Renewal  \n \n5.19 The Renewal Provision describes:  \n\u25aa the circumstances under which the insurer has the right to refuse to renew \nor the right to cancel the coverage; and  \n\u25aa the insurer\u2019s right to increase the amount of premium payable on the polic y. \n \n5.20 Health Insurance policies can be issued on any of the following bases:  \n\u25aa cancellable;  \n\u25aa optionally renewable;  \n\u25aa conditionally renewable;  \n\u25aa guaranteed renewable ; or \n\u25aa non-renewable.   \n \n5.21 Let us look at each of the five types of Health Insurance policies in turn.  \n \nH1. Cancellable Policy  \n \n5.22 The Renewal Provision included in a cancellable policy (e.g. some Medical \nExpense Insurance policies) grants the insurer the right to terminate the policy \nat any time, for any reason, si mply by notifying the policy owner in writing that \nthe policy is cancelled , and by refunding any advance premium that has been \npaid for the policy.   \n \n5.23 All things being equal, cancellable policies are generally cheaper than other \ntypes of policies.  \n \nH2."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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Optionally & Conditionally Renewable Policies  \n \n5.24 To remain in force, Health Insurance policies must be renewed periodically; that \nis, the coverage remains in force only for the length of time for which the \npremiums have been paid.  When the premium is due again, the policy may be \nrenewed , or it may expire . Both the policy owner and the insurer have a role to \nplay in the renewal process.  \n \n5.25 The policy owner has the option to cancel the policy at any time by notifying \nthe insurer  within a specified period during the currency of the policy , or by  \nallowing it to lapse at a premium due date by not paying the premium.  \n \n5.26 Health Insurance policies also include specific provisions that will determine \nwhether the insurer may refuse to rene w a policy.  When the insurer has the \noption to refuse to renew, the policy may be one of two types:  \n\u25aa Optionally Renewable Policy  \nThe insurer has the right to refuse to renew an optionally renewable policy \non certain dates as specified in the policy , usually either on the policy \nanniversary date or on any premium due date.  The insurer is also allowed to \nincrease its premium rate and to add coverage limitations, such as \neliminating coverage for injuries to certain parts of the body, or limiting the \n\n10. Common Policy Provisions  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   235  \nextent of coverage for certain occurrences.  \n\u25aa Conditionally  Renewable Policy  \nThe insurer may elect not to renew only under conditions  as specified in the \npolicy. These conditions cannot be related to the insured  person \u2019s health.  \nProvided that the insurer is still selling this line of business, the age and \nemployment status of the insured  person  are often listed as reasons for \npossible non -rene wal. For example, an individual Disability Income \nInsurance policy may state that the insurer will renew the policy until the \ninsured  person  reaches a certain age  (e.g. 65 years) , or until the insured  \nperson  retires from gainful employment. A conditionally renewable policy \nalso gives the insurer the right to increase the premium rate.  \nTo protect the insured  person  when a valid claim is being paid or is eligible \nfor payment at the time when the premium is due , the insurer may not \nprejudice that claim. That is, the claim will be paid if the insurer elects not to \nrenew the policy.  \n \nH3. Guaranteed Renewable Policy  \n \n5.27 In some  policies, the insurer relinquishes the rights to cancel the policy at any \ntime, as well as  to refuse renewal at a premium due date. This type of policy is \nsaid to be guaranteed renewable , and it includes several important features , \nsuch as : \n\u25aa renewal is guaranteed , as long as the policy owner pays the premium;  \n\u25aa the insurer may not cancel the policy , unless the policy owner fails to pay the \npremium;  \n\u25aa premiums may be increased on the basis of an entire classification, such as \noccupation or sub -plan;  and \n\u25aa guarantee d policy renewal until the specified age, such as 60 , 65, 70 or 75 \nyears , depending o n the insurer\u2019s policy . \n \n5.28 Non-payment of premium is the only r eason that an insurer may cancel or \nrefuse to renew a guaranteed renewable policy.   \n \n5.29 However, it may increase the premiums based on a class  basis. One common \nclassification, for example, is by o ccupational groups. Based on experience, the \ninsurer know s that certain occupations are subject to a higher risk of accidental \ninjury or death than other occupations. For example, compare the different risks \nfaced by a n office administrator and by a construction worker.   \n \n5.30 With a guaranteed renewable policy, the insurer must  renew the policy when it \nis due. However, based on new experience ratings within the insured  person \u2019s \noccupational class, the insurer may increase th e premiums for all insured  \npersons  in that class of risk.  \n \n5.31 The guaranteed renewable feature is often limited . In some policies, the insurer \nregains the right to cancel and to refuse to renew , when the insured  person  \nreaches a specified age.  Commonly, the p olicy will stipulate this right , when the \ninsured  person  reaches a normally accepted retirement age, such as 60, 65 , 70 \nor 75 years ."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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Non-renewable  \n \n5.33 In some situations, an individual may need Health Insurance for a fixed, limited \nperiod of time. Coverage that extends only for a specified length of time is called \nTerm Insurance. Such a policy cannot be renewed at all. When it expires, the \ninsured person  must purchase another policy.  \n5.34 Travel Insurance is a  typical  example of a form of Term Insurance. It essentially \ncovers from the start to the end of the trip . Student Personal Accident  Insurance  \npolicy is another example, beginning when the school term starts and ending \nwhen the school term is over.  \n \nI. Mis-stateme nt Of Age Or Gender  \n \n5.35 The provision specifies that , in the case of an insured person mis-stating his \nage or gender, the insurer will adjust the premium based on his correct age and \ngender. Any excess premium paid will be refunded  by the insurer , and any \nshortfall in premium will have to be made up by the policy owner . However, if \nat the correct age, an insured person would not have been eligible for coverage \nunder the policy, then no benefit would be payable  by the insurer . \n \nJ. Grace Period  \n \n5.36 Individual Health Insurance policies contain a Grace Period provision  that \nallows the policy owner to pay a renewal premium , within a stated grace period , \nfollowing the premium due date. The length of the grace period may vary \ndepending on how frequently the renewal premium is payable. The grace \nperiod is usually 30 days for most policies.  Coverage remains in force during \nthe grace period.  \n \nK. Reinstatement  \n \n5.37 An i ndividual Health Insurance polic y typically include s a Reinstatement \nprovision  stating that , if certain conditions are met, the insurer will reinstate a \npolicy that has lapsed for non -payment of premiums. The policy owner must \npay any overdue premium  (with or without interest as determined by the \ninsurer)  and the insured person must complete a reinstatement \napplication /health warranty . The insurer has the right to evaluate the \nreinstatement application , and to decline to reinstate the policy on the basis of \nstatements made in that application. Coverage under a reinstated policy can be \nlimited to  any accident or illness that will occur only after the effective date of \nreinstatement.  \n \n5.38 Thus, the insurer ca n protect against anti -selection by excluding from cover, \nthose losses that occur  only after the lapse of the policy and before it is being \nreinstated.  \n   \n \n \n \n\n\n10. Common Policy Provisions  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   237  \nL. Incontestability  \n \n5.39 Health Insurance riders attached to Life Insurance policies will be subject to the  \nIncontestability Clause. The Incontestability provision makes Life Insurance \npolicies indisputable after they have been in force for a certain minimum  period \n(usually one year) , with the exception of fraud.  In other words, this provision \nstops the insurer  from repudiating liability under a policy purely on grounds of \nbreach of utmost good faith , except when fraud has been proven.  \n \nM. Change Of Occupation  \n  \n5.40 Many individual Disability Income Insurance policies contain a Change Of \nOccupation provision  that pe rmits the insurer to adjust the premium rate or the \namount of benefits payable under the policy if the insured  person  changes \noccupation. The insured  person \u2019s occupation has a direct effect on his morbidity \nrisk. The Change Of Occupation provision typicall y permits the insurer to reduce \nthe maximum benefit amount payable under the policy should the insured \nperson change to a more hazardous occupation. Should the insured  person  \nchange to a less hazardous occupation, th is provision would also permit the \ninsurer to reduce the premium rate  of the policy.  \n \nN. Co-ordination Of Benefits  \n \n5.41 Many individual Health Insurance policies contain a Co -ordination of Benefits  \nprovision  (may also be known as Over -insurance provision  or Contribution \nprovision ) that is intended to prevent the insured person from profiting from a \nclaim ."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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Should there be \nover -insurance, the insurer would reduce the amou nt of benefits that would \notherwise be payable under the policy. In case s, whereby the insurer realises \nthat the insured  person  has also received benefits from other sources only after \nit has paid out the benefits, the insurer may, at its discretion, demand a return \nof all or part of the benefits previously paid  under the policy .  \n \nO. Cancellation  \n \n5.43 A Health Insurance policy may have a provision that allows the policy owner to \ncancel the policy by giving written notice to the insurer  within a certain period \nof time (e.g. seven days) . In such  a case , the policy owner is usually entitled to \na return of the excess premium paid less an y administrative cost as determined \nby the insurer. The policy owner must also state  when  such cancellation shall  \nbecome effective , usually not less than 30 days thereafter . \n \n5.44 After such return of premium, the insurer will not be liable for any benefits in \nrespect of covered charges incurred during the policy year in which the \ncancellation becomes effective.  \n \n \n\nHealth Insurance   \n \n238 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] 5.45 This pr ovision often goes hand -in-hand with the renewal provision of a \ncancellable policy , such that the insurer also has the right to terminate the policy \nat any time, simply by notifying the policy owner in writing , and by refunding \nany advance premium that has  been paid for the policy. This applies  not only  \nto an Individual Health Insurance polic y, but also  to a Group Health Insurance \npolicy (where the policy owner is usually the employer).  \n \nP. Change Of Plan  \n \n5.46 A Medical Expense Insurance policy has a provision to allow the insured  person  \nto upgrade or downgrade  the coverage plan. Any upgrading of plan is  subject \nto satisfactory evidence of insurability at the policy owner\u2019s expense . He may \nrequest for a change of plan either at the next policy renewal date or the next \npremium due date.  An a pplication for change of plan should be submitted by \nthe insured  person  to the insurer at least 30 days , before the policy renewal date \nor premium due date . However, the insurer may refuse to accept such an \napplication.  \n \n5.47 Any medical condition that is covered under the plan  immediately before the \nplan change  will continue to be covered , and claims on such condition will be \npayable  according to the limits of the plan before  its change.  \n \nQ. Currency  \n \n5.48 Where payment of claims is on reimbursement bas is, the policy will state the \ncurrency for the benefits payable. Generally, payment of all claims and benefits \nwill be made in Singapore currency. Charges incurred in any other currency \noutside Singapore shall be payable in Singapore currency on the basis of the \nexchange rate used by the insurer on  the date of processing the claims.  \n \nR.  Last Payer Status  \n \n5.49 This clause  appears  in the MediShield Life and Private Integrated Shield Plans. \nIt states that , if the insured  person  has any other Medical Insurance, including \nmedical benefits (such as from Work Injury Compensation Insurance) under any \nemployment contract, which makes provision for reimbursement of medical \nexpenses, the insurer shall be the last payer reimbursing the claim. If benefits \npayabl e under the policy have  been made to the insured person first, before a \nclaim is made under such other Medical Insurance policies or employee \nbenefits, the other medical insurers or the employer will need to reimburse the \nexisting insurer its share. The insured  person  shall provide the insurer with the \nfull details of such other insurance policies or employee benefits , and all \nrelevant documentary proof necessary to make a claim.  \n \nS. Nomination Of Beneficiaries  \n \n5.50 The introduction  of the Nomination Of Benef iciaries (NOB) under Part 3C of the \nInsurance Act 1966  as from 1 September 2009 gives policyowners of Life \nInsurance policies or A&H Insurance policies with death benefits, a clear and \naffordable legal means to distribute the policy benefits to their nomin ees. \n \n\n10. Common Policy Provisions  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1."}


created_at: 2024-03-15 18:52:31
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{"_node_content": "{\"id_\": \"81b8f3a8-5151-4abe-853c-9c772eeeab6f\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"d4f20ad3-0d20-479b-b36e-abde31bf67e6\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"6b7398b91b710c58a3ee7acebe1049cd995d5823f24b565ade759c66505bc6ee\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"e807fa8d-83d9-480f-8b39-b2cbcaa294c3\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"c7ae719608fdb7fdf03362de01782324d4e18d20e990ee4d92da8ad35a3a5766\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 894236, \"end_char_idx\": 898655, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "10. Common Policy Provisions  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   239  \n5.51 Since CI Insurance policies usually have built -in death benefits payable, they \nwill come under the NOB framework. Hence, the insured who is the policyowner \ncan make a nomination as long as he has attained the age of 18 years. Two \noptions of nominatio n as briefly described below are available:  \n\u25aa Trust or Irrevocable Nomination ( Section 132 of the Act ) \u2013 The insured loses \nall rights to the ownership of the policy. To revoke this trust nomination, \nthe insured needs the written consent of all the nominees.  \n\u25aa Revocable Nomination ( Section 133 of the Act ) \u2013 The insured retains the \nownership of the policy and is free to change, add or remove nominees, \nwithout their consent.  \n \nT. Policy Owners\u2019 Protection Scheme  \n \n5.52 Singapore  consumers enjoy the benefits of a sound fi nancial system. Insurers \nlicensed in Singapore are supervised by the Monetary Authority of Singapore \n(MAS) whose aim is to ensure the stability of the financial system in Singapore , \nand to require financial institutions to have sound risk management systems \nand adequate internal controls. However, MAS does not guarantee the \nsoundness of individual financial institutions. Therefore, the Policy Owners\u2019 \nProtection Scheme (PPF Scheme) ha s been set up  to protect the policy owners \nin the event of failure of a life or general insurer which is a PPF Scheme member.  \n \n5.53 The scope of PPF Scheme includes (but not limited to) individual and group \nshort -term or long -term accident and health (A&H) policies (e.g. Hospital  \nIncome , Medical Expense, Personal Accident, Disability Income, Long -Term \nCare  Insurance ).  \n \n5.54 The PPF Scheme is administered by the Singapore Deposit Insurance \nCorporation (SDIC). Coverage under the PPF Scheme is automatic , and no \nfurther action is required from  the policy owner s. For more information on the \ntypes of benefits that are covered under the scheme , as well as the limits of \ncoverage, where applicable, just refer to the SDIC Website at : www.sdic.org.sg   \n \n \n6. BENEFIT PROVISIONS  \n \n6.1 The benefit provisions section is the essence of any insurance  policy. The \nbenefit provisions set forth the insurer\u2019s promises. Each benefit provided by the \ninsurance policy is explained in detail, indicating what will be paid, the \nconditions that establish the insurer\u2019s liability to make payment, the conditions \nunder which p ayment will be made, the nature and extent of benefits payable, \nand the applicable benefit limitations.  \n \n6.2 Benefit provisions are written with utmost care. They must be clear and precise, \nbut at the same time broad enough to cover virtually any claim situati on that \ncan conceivably arise.  \n \n6.3 Let us take a look at some of the benefit provisions of a Medical Expense \nInsurance policy as an example.  \n  \n\nHealth Insurance   \n \n240 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4]  \nBENEFIT PROVISIONS  \n \nA. Hospital And Surgical Benefits  \n \n\u201cThe Company agrees that if any disease, illness or injury necessitates the \nInsured  Person  to be confined to a Hospital as an Inpatient or for day surgery \nwhile he  or she is covered under this Policy, the Company will pay the \nappropriate benefit stated below, su bject to the limits set out in the Schedule \nof Benefits. Provided that the Insured  Person  has actually incurred the \ncharges , the Company shall pay an amount equivalent to the actual charges \nincurred or the reasonable and customary charges or the maximum su m as \nspecified in the Policy Schedule in respect of the incident concerned, \nwhichever is the lowest.  \n \n1. Daily Hospital Room and Board  \nCharges for room accommodation, meals  and general nursing services \nfor the insured  person . \n \n2. Intensive Care Unit  \nCharges incurred during confinement as an Inpatient in the Intensive Care \nUnit of the Hospital.  \n \n3. Hospital Miscellaneous Expenses  \n(a) Prescription of Drugs  \nCharges for drugs prescribed which are medically necessary and \ndirectly in connection with the I nsured  Person \u2019s disability , provided \nthat such drugs are listed in the Singapore Index Medical Supplies \n(SIMS) and excluding charges for drugs prescribed for us e beyond \nsixty (60) days after discharge from the Hospital."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"e807fa8d-83d9-480f-8b39-b2cbcaa294c3\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"81b8f3a8-5151-4abe-853c-9c772eeeab6f\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"ee8b8401ec6fdad57b89796941784af295d1d301a2cbf2314a670d8b16e90f4f\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"0795d190-4de0-44bb-9f1e-30d9d40b342e\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"f5fe45fa6634d95a963e4b9d10e9d603f8e88444bf672882e4d2e16fc8ab4a7c\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 898660, \"end_char_idx\": 903112, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "(b)  Inpatient Diagnostic Procedures and Inpatient Physiotherapy  \nCharges for Inpatient Diagnostic Procedures or Inpatient Physiotherapy \nthat relates directly to the Disability and is medically ne cessary for \nwhich the Insured Person receives treatment as an inpatient.  \n \n(c) Ambulance Charges  \nCharges incurred for necessary domestic ambulance service (inclusive \nof attendance) to and/or from the Hospital , provided that the Insured  \nPerson  is admitted as an Inpatient.  \n \n \n \n6.4 Note: \u201cThe Company\u201d means the insurance company named in the policy \nschedule.  \n \n \n \n \n \n\n10. Common Policy Provisions  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   241  \n7. EXCLUSIONS  \n \n7.1 Exclusions refer to the circumstances under which the insurer will not pay. In \nthis section, we will highlight some important exclusions commonly found in a \ntypical Health Insurance policy.  \n \n7.2 No benefits will be paid for charges which are in excess of the usual, customary \nand reasonable charges . Illness contracted within the waiting period, pre -\nexisting conditions and the following  categories will also not be covered  by the \npolicy : \n \n(a) Surgical Procedures Or Examinations  \n(i) routine physical, pre -emplo yment or premarital examination, \nimmunisation or circumcision ; \n(ii) refraction, eye glasses or contact lenses , including fittings and \nexaminations, or surgical correction of near -sightedness (such as, \nbut not limited to, radial keratotomy and keratectomy);  \n(iii) exam ination, treatment or surgery of the teeth, gums or direct \nsupporting structure, except as necessitated by an injury to sound \nnatural teeth occurring while the cover for the insured person under \nthis contract is in force;  \n(iv) aesthetic or cosmetic surgery, exc ept for charges for treatment \nresulting from  an injury which occurs while the cover for the insured \nperson under the contract is in force. Such treatment must take place \nwithin 12 months of the injury , and while the cover for the insured \nperson under this contract is in force;  \n(v) pregnancy, childbirth (including surgical delivery), abortion or \nmiscarriage (except as a result of an injury) and pre -natal or post -\nnatal care;  \n(vi) prosthesis, corrective devices or medical appliances which are not \nmedically necessary;  \n(vii) donation of any body organ by the insured  person ; and \n(viii) gender changes . \n \n(b) Treatments  \n(i) test or treatment related to impotence, infertility, contraception or \nsterilisation;  \n(ii) treatment owing  to birth defect, hereditary or congenital condition;  \n(iii) treatment of any diagnosed emotional, mental or nervous disability , \nincluding any condition caused by or resulting from such disability;  \n(iv) treatment which is in any way related to sexually transmitted \ndisease, Acquired Immun e Deficiency Syndrome (AIDS) , or any \ninfection from a human immunodeficiency virus (HIV) , as well as \ntheir related complications ; \n(v) treatment resulting from suicide, attempted suicide,  self-inflicted \ninjury, narcotic or alcohol abuse, or participation in hazardous \npursuit;  \n(vi) treatment of a disability that results from participation in any assault, \ncriminal or unlawful act, strike, civil disorder or riot;  \n(vii) treatment directly or indirectly associated with invasion, act of \nforeign enem y, hostili ty or any act of war, whether or not declared, \n\nHealth Insurance   \n \n242 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] civil war , rebellion, revolution, insurrection or military or usurped \npower , or full -time service in any of the armed forces , except for \npeacetime reservist training or mobilisation exercise in accordance \nwith the Enlistment Act 1970 ; \n(viii) treatment of a disability resulting from the use of nuclear weapon or \nfrom contact with nuclear material;  \n(ix) treatment of morbid obesity or related conditions;  and \n(x) treatment arising from the insured  person \u2019s failure to act on proper \nmedical advice . \n \n(c) Confinement  \n(i) services, supplies or confinement days , which are not medically \nnecessary;  \n(ii) period of confinement resulting from  a disability not requiring \nsurgery , unless the period of confinement is more than a specified \nperiod of time (e.g.12 or 18 hours ); and \n(iii) convalescent care, rest care, hospice care, rehabilitation or similar \ntreatment."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"0795d190-4de0-44bb-9f1e-30d9d40b342e\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"e807fa8d-83d9-480f-8b39-b2cbcaa294c3\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"c7ae719608fdb7fdf03362de01782324d4e18d20e990ee4d92da8ad35a3a5766\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"fc2cbaa7-c716-4d33-9d7c-d02e4e3b5f9d\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"1c9672bed3ebe2c682396553550b4f1e0b696b8388aa14044de03ffbfd6e387e\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 903117, \"end_char_idx\": 907770, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "(d) Other  Services  \n(i) service performed by a person who ordinarily resides in the  insured \nperson\u2019s home or is a close relative;  \n(ii) transportation, other than ambulance transfer in the event of a \nmedical emergency;  and \n(iii) ancillary expenses , such as (but not limited to ) television, telephone, \nvideo, newspaper and family accommodation  charges . \n \n7.3 The list of exclusions changes from time to time , as new technologies surface \nwhich in turn affect medical cost.  \n \n \n8. CLAIM CONDITIONS  \n \n8.1 In this section, we highlight some important general claim conditions \ncommonly found in a Health Insurance policy.  \n \nA. Notification Of Claim Condition  \n \n8.2 A typical Health Insurance polic y include s provisions that define the insured\u2019s \nobligation to provide t imely notification of loss to the insurer . \n \n8.3 The period of time given to the policy owner to notify the insurer varies from \npolicy to policy. For instance, instead of the usual 30 days, a Medical Expense \nInsurance policy may require the insured to notify the insurer , within 14 or 21 \ndays from the date of hospital confinement.  \n \n  \nCLAIM  \n\n10. Common Policy Provisions  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   243  \nB. Submission Of Claim  \n \n8.4 The policy owner must (at his own expense) give the insurer all certificates , \nforms, bills , receipts , information and evidence as required by the insurer . The \npolicy owner must submit only original bills, invoices, receipts , discharge \nsummary  and other documents required to support a claim  lodged with the \ninsurer , unless such evidence and documents are electronically submitted on \nbehalf of the insur ed person  by a hospital or medical clinic or other medical \nestablishment through the electronic submission system , MediClaim.   \n \nC. Physical Examination Provision  \n \n8.5 The Physical Examination provision included in most individual and group \nDisability Income policies is similar. After the policy owner  submits a claim, the \ninsurer has the right to have the insured person examined by  a doctor of the \ninsurer\u2019s choice, at the insurer\u2019s expense. Therefore, t he insurer  has the \nopportunity to verify the validity of any Disability Income claim  submitted by \nthe insured or claimant .  \n      \nD. Mediation/Arbitration & Legal Action Provision  \n \n8.6 An individual Health Insurance policy will usually include a Dispute Resolution \nClause. It specifies that any dispute or matter arising under the policy should be \nreferred to the Financial Industry Disputes Resolution Centre Ltd (FIDReC) to be \ndealt with accordingly.  The policy owner should refer such dispute or matter to \nFIDReC within six months from the date of failure to reach an agreement with \nthe insurer.  \n \n8.7 If the dispute cannot be referred to or dealt with by FIDReC, the dispute will be \nreferred to and decided using arbitration . This will be according to the \nArbitration Rules of the Singapore International Arbitration Centre applicable  at \nthat point of time. The policy also states that the insurer will not be legally \nresponsible under the policy, unless the policy owner has first received an \naward under arbitration.  \n \n8.8 Where both mediation and arbitration fail to settle the dispute, the policy owner \nmay seek legal action against the insurer. The Legal Action Provision limits the \ntime during which the policy owner who disagrees with the insurer\u2019s claim \ndecision has the right to sue the insurer , to collect the amount which he believes \nis owe d under the policy. The policy may state that no action in law or equity \nwill be brought under the policy until after the expiration of 60 days from the \ndate a satisfactory proof of claim has been furnished to the insurance company \nin accord ance with  the t erms and conditions of the policy.  \n \n8.9 A policy issued by an insurer in Singapore will be construed according to and \ngoverned by the laws of the Republic of Singapore. These laws will apply in the \nevent of any conflict or dispute under the policy, and the parties to the conflict \nor dispute must agree to submit themselves to the exclusiv e venue and \njurisdiction of the Courts of the Republic of Singapore for the resolution of any \nconflict or dispute.  \n \n \n\nHealth Insurance   \n \n244 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] 9. ENDORSEMENTS  \n \n9.1 An endorsement is a separate document that modifies the policy to which it is \nattached. There are several types of endorsements concerning the policy \nwording, benefits or exclusions, etc."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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There are several types of endorsements concerning the policy \nwording, benefits or exclusions, etc.  \n \n9.2 Endorsements can be passed to amend or  include additional terms to the policy , \nso that the policy conforms to the legislative requirements.   \n \n9.3 Endorsements can also serve as supplementary agreements that provide \noptional benefits not previously contained in the basic policy. Such benefits \nrequire a separate additional pre mium. Examples of such supplementary \nbenefits are maternity benefits for attachment to a Hospital & Surgical \nInsurance polic y. Endorsements pertaining to supplementary benefits may be \nattached to the policy , when they are issued or they may be added at a l ater \ndate. When added, they become part of the  policy . \n \n9.4 Endorsements on exclusions restrict the scope of coverage , by excluding a \nspecific pre-existing condition or certain activities or avocations. The i nsurer \nmay require this form of endorsement as a pre -condition for issuing a policy. \nThis is one type of counter -offer. If the insured signs the endorsement and \naccepts the policy as offered, there is a binding contract. A copy of the signed \nendorsement remains attached to the policy.  \n \n \n10. CONCLUSION  \n \n10.1 As an insurance representative , you should help your prospective clients to \nunderstand the standard policy provisions  and terms , as well as to explain to \nthem the endorsements attach ing to the ir polic ies. \n\n10. Common Policy Provisions  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   245  \nAPPENDIX 10A \n \nPOLICY SCHEDULE  \n \n \nABC Insurance Company  (Singapore)  Limited  \n \n21 Any Street, ABC Centre, Singapore 654321  \nTel: (65) 6789 8181   Fax: (65) 6789 8282  \n \n \nPolicy Issue Date :                      POLICY SCHEDULE  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n TERRITORIAL  :   \nLIMITS     \n \n \n \n \nDETAILS OF POLICY  \nPolicy Number:  \nType  Of Plan:  \nSum insured/ Benefits:  \nPolicy Commencement Date:  \nPolicy Expiry Date:  \nPremium:  S$ \nEndorsements: Nil  \n \n \n \n \n THIS SCHEDULE REFLECTS THE TERMS, CONDITIONS AND COVERAGE OF Y OUR INSURANCE POLICY, \nSUBJECT OTHERWISE TO THE STANDARD POLICY WORDING AND/OR ANY OTHER AMENDMENTS AS \nSPECIFIED IN THIS SCHEDULE.  \n \n \n      NAME OF POLICY OWNER : \n      NRIC OF POLICY OWNER:  \n      ADDRESS:  \n \nAnywhere in the Republic of  Singapore, and \nelsewhere in the world for the purpose of \ntravel, but not for any intended or booked \nmedical  treatment overseas by the Insured \nPerson.  NAME OF INSURED PERSON:  \nNRIC OF INSURED PERSON : \n \nADDRESS:  \n  \n    \n\n\n36\nCOMMON POLICY PROVISIONS\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nSections of a Health \nInsurance policy contract\u2022 Policy Schedule.\n\u2022 Insuring Clause & Definitions.\n\u2022 General Conditions.\n\u2022 Benefit Provisions.\n\u2022 Exclusions.\n\u2022 Claim Conditions.\n\u2022 Endorsements.\nInformation contained in \na Health Insurance policy \nscheduleThe policy schedule gives the specific details of the policy contract.\n\u2022 Policy number;\n\u2022 Effective date of cover;\n\u2022 Expiry date of cover;\n\u2022 Date at which the policy is issued;\n\u2022 Contract currency;\n\u2022 Name and identity number of the policy owner;\n\u2022 Name, age, gender and identity number of the insured person;\n\u2022 Name of insurance plan;\n\u2022 Types of riders and the coverage limits (if any);\n\u2022 Premiums for the insurance plan and riders;\n\u2022 Coverage details on benefits limits or sum insured; and\n\u2022 Special provisions/endorsements indicating the types of endorsements \nattached to the policy.\nInsuring clause The insuring clause also known as the operative clause states the purpose of the \npolicy and outlines the conditions under which the policy will pay. The insuring \nclause serves to:\n\u2022 Describe the general scope of coverage;\n\u2022 Provide any definitions required; and\n\u2022 Set forth the conditions under which the benefits are payable.CHAPTER\n10\nCommon terms under a Health Insurance policy\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nDependant \u2022 Spouse and children of the policy owner (or of the employee in the case of \nGroup Insurance). \n\u2022 A spouse is typically defined as the person to whom the policy owner is legally \nmarried under the laws of the country. A spouse is no longer considered a \ndependant in the case of legal separation."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"ce7eae62-2ed9-4e66-9442-6131b7628e9e\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"fc2cbaa7-c716-4d33-9d7c-d02e4e3b5f9d\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"1c9672bed3ebe2c682396553550b4f1e0b696b8388aa14044de03ffbfd6e387e\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"5eb365ea-013f-477e-8ea3-408ecd380695\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"3447635b436cf143ae400e9dfc40dc7292ce37e8633b661e8ab3c4c48d65d85c\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 911764, \"end_char_idx\": 916629, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "\u2022 A spouse is typically defined as the person to whom the policy owner is legally \nmarried under the laws of the country. A spouse is no longer considered a \ndependant in the case of legal separation. \n\u2022 As for a child, he must typically be unmarried, under the age of 18 years, and \nprincipally dependent on the insured for support. This definition also includes \nthe legally adopted children and stepchildren of the insured. Most insurers will \nextend the cover up to age of 18 or 25 years if the child is pursuing a tertiary \neducation.\nInsured/insured person \u2022 The insured person is the person covered by the insurance. The insured person, \nmore often than not, is the policy owner.\nAccident \u2022 An incident caused by accidental, violent, external and visible means. Note that \nsome insurers may not have the \u201cviolent\u201d requirement in their definition of \n\u201caccident\u201d\nHospital \u2022 Any lawfully operating institution which has 24-hour a day nursing services by \nregistered graduate nurses, one or more physicians available at all times and \norganised facilities for diagnosis and major surgery.\n\n37\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nAny one disability \u2022 Disabilities resulting from illness or bodily injury and their complications arising \nfrom the same cause. However, if any subsequent disability arising after a \nspecified number of days (e.g. 45 or 90 days, depending on the policy wording \nof the insurer) has lapsed following the latest discharge from hospital, then it \nshall be considered a new disability, regardless of the cause.\nCovered charges \u2022 Charges incurred by the insured person, while the policy is in force, for a \nservice, supply or period of confinement, which has been ordered or prescribed \nby a physician.  \nDay of hospital \nconfinement\u2022 Refers to a full 24 hours during a period of hospital confinement.\nRegistered medical \npractitioner/physician\u2022 Qualified medical practitioner registered with the Singapore Medical Council to \nrender medical and surgical services. It excludes a physician who is the policy \nowner, insured person himself or his spouse or any of his lineal relatives.\nMedically necessary \nservice, supply or day of \nhospital confinementA service, supply or day of hospital confinement, which is ordered by a physician \nand which is:\n\u2022 Provided for the diagnosis or direct treatment of a disability;\n\u2022 Appropriate and consistent with the symptoms and findings or diagnosis and \ntreatment of the insured person\u2019s disability;\n\u2022 Provided in accordance with generally accepted medical practices on a national \nbasis;\n\u2022 Most appropriate supply or level of service which can be provided on a cost \neffective basis; and\n\u2022 Not of an experimental or investigative nature, or research purposes.\nPeriod of hospital \nconfinement\u2022 Continual period of time where an insured person is confined to a hospital as a \nregistered inpatient.\n\u2022 Two or more periods of hospital confinement resulting from the same or \nrelated causes, are considered as the same period of hospital confinement, \nunless the break between the date of discharge of the earlier period of hospital \nconfinement and the date of admission of the following period of hospital \nconfinement is more than a specified number of days (e.g. 45 days).\nPre-existing condition It is usually defined as a condition which has existed and:\n\u2022 For which the insured person received treatment or medical advice;\n\u2022 In respect of which the insured person showed symptoms;\n\u2022 Of which the insured person was aware; and\n\u2022 Of which the insured person should reasonably have been aware; \nbefore the date of policy issue or the date that the cover was reinstated.\nPolicyholder/policy owner \u2022 The policy owner owns the policy and is responsible for the payment of \npremiums and receipt of claims and benefits under the policy.  He has the right \nto make changes to the contract and receive all payments due under the policy.\nUsual, customary and \nreasonableIt means the charges for a specific service, supply or period of hospital confinement:\n\u2022 Is within standard charge for the specific provider; and\n\u2022 Must not be more than the general level of charges of other medical care \nproviders with similar standing in the same geographical area, for an \nequivalent treatment, services or supplies to individuals of the same gender, of \ncomparable age, for a similar illness or injury.\nWaiting period \u2022  For Medical Expense Insurance , it refers to the period of time starting from the \ndate of policy issue or reinstatement date, where the insured person's medical \nexpenses are not covered by the policy. Waiting period differs from insurer to \ninsurer and applies only to medical expenses arising from an illness, not from \nan accident.\n\u2022 For Disability Income Insurance , it refers to a specified period of time, \nbeginning with the onset of the disability, where benefits are not payable."}


created_at: 2024-03-15 18:52:31
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{"_node_content": "{\"id_\": \"5eb365ea-013f-477e-8ea3-408ecd380695\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"ce7eae62-2ed9-4e66-9442-6131b7628e9e\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"1de53a2db5293b4f337af9cd4b677d9bcd6d9e30285d2c118df774272ba0e71f\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"9c8c52b9-09f4-4058-8aea-0175c2e73716\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"3c27b6080c12b19c44533f84826ba965b78283dd0d4f9de72c92cb7203253232\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 916476, \"end_char_idx\": 921003, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "\u2022 For Disability Income Insurance , it refers to a specified period of time, \nbeginning with the onset of the disability, where benefits are not payable. The \nwaiting period in a Disability Income Insurance policy is sometimes called the \n\u201celimination period\u201d or the \u201cprobationary period\u201d.\n\u2022 For Long-Term Care (LTC) Insurance , it refers to a period of time beginning \nfrom the first day the insured person is unable to perform the specified \nActivities of Daily Living (ADLs), during which no LTC Insurance benefit will be \npayable. For LTC Insurance, this may also be known as the deferred period.\n\n38\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nIllness \u2022 Illness refers to a physical condition marked by a pathological deviation from \nthe normal healthy state.\nPre-hospitalisation \nbenefits\u2022 Refers to the diagnostic X-ray, laboratory tests and specialist consultation for \nan illness or injury which occurred within a specified number of days prior to \nhospitalisation. The insurer will pay only for such outpatient treatments if they \nlead to hospitalisation or surgical operation, within the time frame as specified \nin the policy.\nPer policy year limit \u2022 Maximum amount that a Medical Expense Insurance (MEI) policy will pay for all \nthe eligible medical expenses that an insured person incurs within each policy \nyear.\nLifetime limit \u2022 Maximum amount that a MEI policy will pay for all the eligible medical expenses \nthat an insured person incurs under the policy.\nDeductible and co-\ninsurance\u2022 Deductible is a flat amount of covered medical expenses that an insured person \nmust first incur, before the insurer will make any benefit payment under a MEI \npolicy. This amount will have to be borne by the insured person.\n\u2022 Co-insurance is a percentage of all eligible medical expenses, in excess of the \ndeductible, that the insured person must personally pay under a MEI policy.\nPro-ration factor \u2022 Percentage that the insurer will use to pro-rate the hospital bills before it \ncomputes the claim payout, if the insured person is admitted to a ward/hospital \nhigher than what he is entitled to under the policy.\nGeneral conditions sections that outline the \nrights of the policy owner and the insurer\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nEntire contract clause \u2022 This clause states that the present contract, together with any specified \nattachments/endorsements, make up the entire contract, and no other \ndocuments form another part of the contract.\nEffective date of cover \u2022 The effective date of cover is established in the policy by agreement between \nthe insurer and the policy owner. It is the date on which the insured person \nbegins to be covered under the Health Insurance policy.\nPremium clauses \u2022 Individual Health Insurance Policies Issued By Life Insurers - When the \npolicy is first incepted, the premiums must be paid before inception of cover. \nWhen the policy is renewed during the second year onwards, it is subject to a \nGrace Period whereby the premium must be paid within 30 days from inception \nof cover.\n\u2022 Group Health Insurance Policies Issued By Life Insurers \u2013 Grace Period \nprovision within such policies which states that the premium has to be paid \nwithin 30 days from the commencement date or renewal date (whichever is \napplicable); or the date of the insurer\u2019s premium tax invoice, whichever is later.\n\u2022 Health Insurance Policies Issued By General Insurers  \u2013 Subject to the \nPayment Before Cover Warranty  which states that the policy shall not be in \nforce, unless the premium is paid to the insurer or intermediary on or before \nthe date of inception of the policy.\n\u2022 Group Health Insurance Policies Issued By General Insurers  \u2013 Subject to the \nPremium Payment Warranty which states that if the period of insurance is \nmore than 60 days, the policyholder is required to pay the premium due under \nthe policy in full, within 60 days from the date of inception of the policy. \nFree-look period \u2022 Period of time after delivery of the policy document during which the policy \nowner may review the policy and return it for a refund of the premium paid to \nthe insurer (less any medical fees incurred)\nActively at work \u2022 Group Insurance  - It provides that an employee is not eligible for coverage, if \nhe is absent from work because of an illness, injury and other reasons on the \neffective date of his coverage.\n\u2022 Disability Income Insurance  - It provides that the cover will automatically \nterminate, when the person is not working owing to illness or termination of \nservice."}


created_at: 2024-03-15 18:52:31
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{"_node_content": "{\"id_\": \"9c8c52b9-09f4-4058-8aea-0175c2e73716\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"5eb365ea-013f-477e-8ea3-408ecd380695\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"3447635b436cf143ae400e9dfc40dc7292ce37e8633b661e8ab3c4c48d65d85c\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"d25eda95-b4db-438e-9b18-068ae1184aa2\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"af546a797d5dd7b2edd5c1767528048c21599dd70a4e4bf382bbda66aafbfa22\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 920837, \"end_char_idx\": 925668, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "\u2022 Disability Income Insurance  - It provides that the cover will automatically \nterminate, when the person is not working owing to illness or termination of \nservice.\n\n39\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nTermination of cover \u2022 When the insured person dies;\n\u2022 When the policy owner fails to pay the renewal premium at the end of the grace \nperiod;\n\u2022 When the total amount of claims paid by the insurer has reached the limit of \nindemnity; or\n\u2022 When the insured person reaches the specified maximum age during which the \ninsurer is not willing to offer cover.\nCover abroad Applicable only to the covered charges incurred in the \u201cCountry\u201d as specified in the \npolicy schedule. It is also applicable under the following circumstances:\n\u2022 The insured person, travelling abroad for a reason other than for medical \ntreatment, needs to be confined to a hospital outside the \u201cCountry\u201d as a \nconsequence of a medical emergency occurring within 90 days of leaving the \n\u201cCountry\u201d; or\n\u2022 The insured person, upon recommendation of a physician and with the prior \nwritten approval of the chief medical officer of the insurer, has to be transferred \nto a hospital outside the \u201cCountry\u201d because the specialised nature of the \ntreatment, aid, information or decision required can neither be rendered, nor \nfurnished, nor taken, in that \u201cCountry\u201d.\nRenewal The Renewal Provision describes:\n\u2022 Circumstances under which the insurer has the right to refuse to renew or the \nright to cancel the coverage; and\n\u2022 Insurer\u2019s right to increase the amount of premium payable on the policy\nMis-statement of age or \ngender\u2022 Provision specifies that, in the case of an insured person mis-stating his age \nor gender, the insurer will adjust the premium based on his correct age and \ngender. \n\u2022 Any excess premium paid will be refunded by the insurer, and any shortfall in \npremium will have to be made up by the policy owner.\nGrace period \u2022 Allows the policy owner to pay a renewal premium, within a stated grace period, \nfollowing the premium due date.\nReinstatement \u2022 If certain conditions are met, the insurer will reinstate a policy that has lapsed \nfor non-payment of premiums. The policy owner must pay any overdue \npremium (with or without interest as determined by the insurer) and the \ninsured person must complete a reinstatement application/health warranty.\nIncontestability \u2022 The Incontestability provision makes Life Insurance policies indisputable after \nthey have been in force for a certain minimum period (usually one year), with \nthe exception of fraud.\nChange of occupation \u2022 A Change Of Occupation provision that permits the insurer to adjust the \npremium rate or the amount of benefits payable under the policy if the insured \nperson changes occupation.\nCo-ordination of benefits \u2022 This provision states that the benefits payable under the policy will be reduced \nif the insured person is eligible for reimbursement from other sources.\nCancellation \u2022 A provision that allows the policy owner to cancel the policy by giving written \nnotice to the insurer within a certain period of time (e.g. seven days).\nChange of plan \u2022 A provision to allow the insured person to upgrade or downgrade the coverage \nplan. Any upgrading of plan is subject to satisfactory evidence of insurability at \nthe policy owner\u2019s expense.\nCurrency \u2022 Where payment of claims is on reimbursement basis, the policy will state the \ncurrency for the benefits payable.\n\u2022 Generally, payment of all claims and benefits will be made in Singapore \ncurrency.\nLast payer status \u2022 Appears in the MediShield Life and Private Integrated Shield Plans.\n\u2022 If the insured person has any other Medical Insurance, including medical \nbenefits (such as from Work Injury Compensation Insurance) under any \nemployment contract, which makes provision for reimbursement of medical \nexpenses, the insurer shall be the last payer reimbursing the claim.\n\n40\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nNomination of \nbeneficiariesThe insured who is the policyowner can make a nomination as long as he has \nattained the age of 18 years. Two options of nomination as briefly described below \nare available:\n\u2022 Trust or Irrevocable Nomination (Section 132 of the Act) \u2013 The insured loses \nall rights to the ownership of the policy. To revoke this trust nomination, the \ninsured needs the written consent of all the nominees.\n\u2022 Revocable Nomination (Section 133 of the Act) \u2013 The insured retains the \nownership of the policy and is free to change, add or remove nominees, without \ntheir consent.\nPolicy Owners\u2019 Protection \nScheme\u2022 Policy Owners\u2019 Protection Scheme (PPF Scheme) has been set up to protect the \npolicy owners in the event of failure of a life or general insurer which is a PPF \nScheme member.\n\u2022 The PPF Scheme is administered by the Singapore Deposit Insurance \nCorporation (SDIC)."}


created_at: 2024-03-15 18:52:31
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Coverage under the PPF Scheme is automatic, and no \nfurther action is required from the policy owners.\nVarious bases upon which Health Insurance policies can be issued\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nCancellable \u2022 The Renewal Provision included in a cancellable policy (e.g. some Medical \nExpense Insurance policies) grants the insurer the right to terminate the policy \nat any time, for any reason, simply by notifying the policy owner in writing that \nthe policy is cancelled, and by refunding any advance premium that has been \npaid for the policy.\nOptionally renewable \u2022 The insurer has the right to refuse to renew an optionally renewable policy on \ncertain dates as specified in the policy, usually either on the policy anniversary \ndate or on any premium due date.\n\u2022 The insurer is also allowed to increase its premium rate and to add coverage \nlimitations, such as eliminating coverage for injuries to certain parts of the body, \nor limiting the extent of coverage for certain occurrences.\nConditionally renewable \u2022 The insurer may elect not to renew only under conditions as specified in the \npolicy.\n\u2022 These conditions cannot be related to the insured person\u2019s health.\nGuaranteed renewable In some policies, the insurer relinquishes the rights to cancel the policy at any time, \nas well as to refuse renewal at a premium due date. This type of policy is said to be \nguaranteed renewable, and it includes several important features, such as:\n\u2022 Renewal is guaranteed, as long as the policy owner pays the premium;\n\u2022 The insurer may not cancel the policy, unless the policy owner fails to pay the \npremium;\n\u2022 Premiums may be increased on the basis of an entire classification, such as \noccupation or sub-plan; and\n\u2022 Guaranteed policy renewal until the specified age, such as 60, 65, 70 or 75 years, \ndepending on the insurer\u2019s policy.\nNon-renewable In some situations, an individual may need Health Insurance for a fixed, limited \nperiod of time. When it expires, the insured person must purchase another policy.\n\n41\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nCommon exclusions \nthat are found in Health \nInsurance policiesSurgical Procedures Or Examinations\n\u2022 Routine physical, pre-employment or premarital examination, immunisation or \ncircumcision;\n\u2022 Refraction, eye glasses or contact lenses, including fittings and examinations, \nor surgical correction of near-sightedness (such as, but not limited to, radial \nkeratotomy and keratectomy);\n\u2022 Examination, treatment or surgery of the teeth, gums or direct supporting \nstructure, except as necessitated by an injury to sound natural teeth occurring \nwhile the cover for the insured person under this contract is in force;\n\u2022 Aesthetic or cosmetic surgery, except for charges for treatment resulting \nfrom an injury which occurs while the cover for the insured person under the \ncontract is in force. Such treatment must take place within 12 months of the \ninjury, and while the cover for the insured person under this contract is in force;\n\u2022 Pregnancy, childbirth (including surgical delivery), abortion or miscarriage \n(except as a result of an injury) and pre-natal or post-natal care;\n\u2022 Prosthesis, corrective devices or medical appliances which are not medically \nnecessary;\n\u2022 Donation of any body organ by the insured person; and\n\u2022 Gender changes.\nCommon exclusions \nthat are found in Health \nInsurance policiesTreatments\n\u2022 Test or treatment related to impotence, infertility, contraception or sterilisation;\n\u2022 Treatment owing to birth defect, hereditary or congenital condition;\n\u2022 Treatment of any diagnosed emotional, mental or nervous disability, including \nany condition caused by or resulting from such disability;\n\u2022 Treatment which is in any way related to sexually transmitted disease, \nAcquired Immune Deficiency Syndrome (AIDS), or any infection from a human \nimmunodeficiency virus (HIV), as well as their related complications;\n\u2022 Treatment resulting from suicide, attempted suicide, self-inflicted injury, \nnarcotic or alcohol abuse, or participation in hazardous pursuit;\n\u2022 Treatment of a disability that results from participation in any assault, criminal \nor unlawful act, strike, civil disorder or riot;\n\u2022 Treatment directly or indirectly associated with invasion, act of foreign \nenemy, hostility or any act of war, whether or not declared, civil war, rebellion, \nrevolution, insurrection or military or usurped power, or full-time service in any \nof the armed forces, except for peacetime reservist training or mobilisation \nexercise in accordance with the Enlistment Act 1970;\n\u2022 Treatment of a disability resulting from the use of nuclear weapon or from \ncontact with nuclear material;\n\u2022 Treatment of morbid obesity or related conditions; and\n\u2022 Treatment arising from the insured person\u2019s failure to act on proper medical \nadvice."}


created_at: 2024-03-15 18:52:31
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{"_node_content": "{\"id_\": \"3ef2cab9-a62f-4ab1-af36-53ac27c1b8ff\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"d25eda95-b4db-438e-9b18-068ae1184aa2\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"af546a797d5dd7b2edd5c1767528048c21599dd70a4e4bf382bbda66aafbfa22\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"aa54f9cb-1bac-46b2-b9d7-cb7b457fb6f4\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"b968b3cf3aaf07415ce4f012960fae69d5f480fc5c6008445ee808385f6c10d8\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 930495, \"end_char_idx\": 936420, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Confinement\n\u2022 Services, supplies or confinement days, which are not medically necessary;\n\u2022 Period of confinement resulting from a disability not requiring surgery, unless \nthe period of confinement is more than a specified period of time (e.g.12 or 18 \nhours); and\n\u2022 Convalescent care, rest care, hospice care, rehabilitation or similar treatment.\nOther Services\n\u2022 Service performed by a person who ordinarily resides in the insured person\u2019s \nhome or is a close relative;\n\u2022 Transportation, other than ambulance transfer in the event of a medical \nemergency; and\n\u2022 Ancillary expenses, such as (but not limited to) television, telephone, video, \nnewspaper and family accommodation charges.\n\n42\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nNotification of claim \nconditionA typical Health Insurance policy includes provisions that define the insured\u2019s \nobligation to provide timely notification of loss to the insurer.\nPhysical examination \nprovisionAfter the policy owner submits a claim, the insurer has the right to have the insured \nperson examined by a doctor of the insurer\u2019s choice, at the insurer\u2019s expense.\nMediation/arbitration and \nlegal actions provisionAn individual Health Insurance policy will usually include a Dispute Resolution \nClause.\n\u2022 Referred to the Financial Industry Disputes Resolution Centre Ltd (FIDReC) to be \ndealt with accordingly. The policy owner should refer such dispute or matter to \nFIDReC within six months from the date of failure to reach an agreement with \nthe insurer.\n\u2022 If the dispute cannot be referred to or dealt with by FIDReC, the dispute will \nbe referred to and decided using arbitration. This will be according to the \nArbitration Rules of the Singapore International Arbitration Centre applicable at \nthat point of time.\n\u2022 Where both mediation and arbitration fail to settle the dispute, the policy owner \nmay seek legal action against the insurer.\nEndorsement A separate document that modifies the policy to which it is attached.\n\u2022 To amend or include additional terms to the policy\n\u2022 Serve as supplementary agreements that provide optional benefits not \npreviously contained in the basic policy.\n\u2022 Exclusions to restrict the scope of coverage.\n\n\nHealth Insurance  \n246 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4]  CHAPTER 1 1 \nHEALTH INSURANCE PRICING  \nCHAPTER OUTLINE  \n1. Introduction\n2. Key Factors Used In Premium Computation\n3. Parameters For Premium Rating\nLEARNING OUTCOMES  \nAfter studying this chapter, you should be able to:  \n\u25aaexplain the key factors used in the premium computation:\n-morbidity experience\n-investment income\n-operating expenses\n-medical inflation\n-scope of benefits covered\n-insurer\u2019s profit\n-modes of premium payment\n-extent of underwriting\n\u25aaknow the parameters for premium rating:\n-age\n-gender\n-physical condition\n-occupation\n-persistency\n-claims experience\n-group participation level\n\n11. Health Insurance Pricing  \n \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   247  \nContents  \nCHAPTER OUTLINE  ................................ ................................ ................................ .........  246 \nLEARNING OUTCOMES  ................................ ................................ ................................ .. 246 \n1. INTRODUCTIO N ................................ ................................ ................................ ..... 248 \n2. KEY FACTORS USED IN PREMIUM COMPUTATION  ................................ ...........  248 \nA. Morbidity Experience  ................................ ................................ ......................  248 \nB. Investment Income  ................................ ................................ ..........................  248 \nC. Operating  Expenses  ................................ ................................ ........................  249 \nD. Medical Inflation  ................................ ................................ ..............................  249 \nE. Scope Of Benefits Covered  ................................ ................................ .............  249 \nF. Insurer\u2019s Profit  ................................ ................................ ................................ . 250 \nG. Modes Of Premium Payment  ................................ ................................ .........  250 \nH. Extent Of Underwriting  ................................ ................................ ...................  251 \n3. PARAMETERS FOR PREMIUM RATING  ................................ ................................  251 \nA. Age ................................ ................................ ................................ ...................  251 \nB. Gender  ................................ ................................ ................................ .............  251 \nC. Health Status  ................................ ................................ ................................ ... 251 \nD. Lifestyle  ................................ ................................ ................................ ............  252 \nE. Occupation  ................................ ................................ ................................ ....... 252 \nF. Persistency  ................................ ................................ ................................ ....... 253 \nG. Claims Experien ce ................................ ................................ ...........................  253 \nH. Group Participation Level  ................................ ................................ ...............  253 \n \n \n\n\nHealth Insurance  \n248 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] 1. INTRODUCTION\n1.1 This chapter discusses the factors used in the premium computation for the\nHealth Insurance products, the premium system and the various forms of\npremium payment modes."}


created_at: 2024-03-15 18:52:31
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INTRODUCTION\n1.1 This chapter discusses the factors used in the premium computation for the\nHealth Insurance products, the premium system and the various forms of\npremium payment modes. It also summarises the parameters on which the\npremium rates for the Individual and Group Health Insurance policies are based.\n2. KEY FACTORS USED IN PREMIUM COMPUTATION\n2.1 It is important for you to get an idea of how insurers set prices for their\ninsurance products. If you understand the key factors used in the computing\npremiums, you will have a better understanding of the Health Insurance\nproducts themselves.\n2.2 The key fac tors used to calculate Health Insurance premiums are:\n\u25aamorbidity experience;\n\u25aainvestment income;\n\u25aaoperating expenses;\n\u25aamedical inflation;\n\u25aascope of benefits covered;\n\u25aainsurer\u2019s profit;\n\u25aamodes of premium payment; and\n\u25aaextent of underwriting.\nA. Morbidity Experience\n2.3 Morbidity experience or morbidity rate means the actual number of  illness ,\ninjury, or failure of health cases occurring in a given group of people. In Health\nInsurance, the primary consideration in pricing insurance coverage is the\nmorbidity e xperience (i.e. morbidity rate), although death experience is taken\ninto consideration , where death benefit is available. For the purpose of\ncomputing premiums easily, the insurers make use of morbidity tables. A\nmorbidity table is a table that shows the r ates of  illness , injury, or failure of\nhealth (i.e. morbidity rates) occurring among the given groups of people\ncategorised by age.  All things being equal, the morbidity rate of women is\nhigher than men. That is why women pay higher premium rates than men for\nmost Health Insurance policies.\nB. Investment Income\n2.4 The second key factor that affects pricing is investment income. Simply,\ninvestment income is the money that is earned , when an insurer invests the\npremiums which it receives from many insured s (po licyowners  or\npolicyholders ).\n\n11. Health Insurance Pricing  \n \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   249  \n2.5 As you know, premiums are the main source of money for paying out claims \non the different types of medical benefits (or even death benefits for those \npolicies that include both medical and death coverage).  However, not all of the \npremiums that an insurer receives each year are needed to pay benefits in that \nyear. Some insureds live for many years and pay premiums to keep their \npolicies in force throughout those years. These premiums are not left idle. \nInsure rs invest these premium dollars to earn more money. As such, \ninvestment income can be looked upon as an additional source of funds for the \ninsurer to meet its obligations.  \n \n2.6 Investment  income  also help s to reduce the amount of money that insurers \nhave to c harge for their insurance. Based on market conditions, if the insurer s \nexpect to earn greater investment income, the premiums that they charge will \nlikely be lower.  \n \nC. Operating Expenses  \n \n2.7 A third facto r, expenses, increases the price of insurance. It is not sufficient for \ninsurers  to collect enough premiums to just cover the cost s of insurance. They \nmust also collect enough money , to pay for the costs of operating the company, \nsuch as staff salaries, commissions  for sellers , taxes, office rent, advertising, \ncomputer systems, supplies, etc.  All of these expenses are necessary to run an \ninsurance company and must be added to the cost s of insurance. Otherwise, \nthe insurers  will not be able to operate.  \n \nD. Medical Inflation  \n \n2.8 Over the years, there has been a consistent upward trend in medical care claim \ncosts experienced by both individual and group plans. These rising costs of \nclaims are associated with increases in medical care charges and higher \nutilisation of services , especially when there is a growing ageing population  in \nSingapore .  \n \n2.9 To ensure that the  insurers  can meet their obligations, they also take into \naccount the medical inf lation factor . Otherwise, the premiums charged will not \nbe adequate to cover the rising medical costs.  \n \nE. Scope Of Benefits Covered  \n \n2.10 In a competitive insurance market, insurers  attempt to attract more insured  \nperson s and retain them for a long time through activities , such as  effective \ncustomer  promotion, innovative product design, efficient distribution channels, \ngood before -sales and after -sales service, etc."}


created_at: 2024-03-15 18:52:31
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However, this strategy \ncomes with a price \u2013 additions of each benefit actually increase the final \npremium that the insurer charges.  \n \n \n \nIndivi\n\nHealth Insurance   \n \n250 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] 2.12 The effect of differences in benefit s can be explained using a Hospital & Surgical \n(H&S) Insurance policy.  Generally, some of the mo st common types of benefits \ncovered under a H&S Insurance policy are:  \n\u25aa Hospital Expense Benefits;  \n\u25aa Surgical Expense Benefits;  \n\u25aa Outpatient Medical Expense Benefits; and  \n\u25aa Other Medical Expense & Auxiliary Benefits.  \n \n2.13 H&S Insurance policies may provide very limit ed cover  and only one or two \ntypes of benefits , such as hospital or surgical expenses only. Other policies may \nbe more broadly written to cover virtually all medical expenses resulting from \naccident or  sickness , with only some specific exceptions.  Insurers often offer a \nfew types of plans under a H&S Insurance policy , and each type of plan has its \nown benefit limits, deductible and co -insurance features. Policies with higher \nbenefit limits, smaller deductible ; and smaller co -insurance will be more \nexpensive.   \n \n2.14 In Singapore, the most common type of H&S Insurance policies is the Integrated \nShield Plans that are paid using Medisave savings (as discussed in Chapter 8  of \nthis Study Guide ). The benefits that are offered by the insurers are very similar . \nAll of them offer an assortment of plans to cater for different needs , with a \nchoice of ward class  that the insured prefers. Naturally, those who prefer to stay \nin Private Hospitals w ill buy a plan that is more expensive than one that caters \nfor only Class A (Public Hospitals) and below.  \n \nF. Insurer\u2019s Profit  \n \n2.15 Insurers enter the market with the primary objective to profit from the business. \nWhen pricing a product,  insurers include a loading in the net premium to \nprovide a profit margin. This loading depends  on the insurer\u2019s  profit target and \nstrategy , as well as the nature of the business. For example, an insurer who is \ngoing for market share may settle for a thinn er profit margin. On the other hand, \na line of business that is volatile or requires more capital support will result in \nan increase in the amount of loading.  \n \nG. Modes Of Premium Payment  \n \n2.16 This means  the frequency with which the premiums are pa yable . Payments may \nbe made:  \n\u25aa annually \u2013 once a year;  \n\u25aa bi-annually \u2013 twice a year;  \n\u25aa quarterly \u2013 once every three months; or  \n\u25aa monthly \u2013 once a month.  \n \n2.17 Insurers generally calculate premiums on an annual basis.  If the insured wants \nto pay any of the other modes, the premium increases slightly as the frequency \nincreases.  The increases allow the insurer to recoup:  \nMode of Payment = \nFrequency of \nPremium Payment  \nAnnual, Bi-annual, \nQuarterly or \nMonthly  \n\n11.Health Insurance Pricing\nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]  251 \u25aathe additional billing and handling costs;  and\n\u25aathe lost interest that the insurer could have earned , by having the full annual\npremium to invest all at once.\n2.18 Thus, a monthly premium is slightly higher than a sixth of a semi -annual \npremium; and a semi -annual premium that is slightly higher than half of an \nannual premium.  \nH. Exten t Of Underwriting\n2.19 The time and effort required to gather medical declaration from the insured\nperson at the point of policy application can be lengthy. Some insurers choose\nto do minimal risk assessment , by reducing the  number of health declarations\non the proposal form. To do so, insurers will charge a higher premium.\n3. PARAMETERS FOR PREMIUM RATING\n3.1 After covering the seven key determinants that insurers use in computing\npremiums, let us now look at the parameters pertaining to a particular\nindividual or a group by age, gender, health status , lifestyle, occupation, claims\nexperience, moral hazard, etc., and see how each of them has an effect on the\nlevel of premiums to be charged.\nA. Age\n3.2 Age is a key parameter in arriving at the premium rates , regardless of whether\nit is an individual or group plan.  Among different age groups, there are\ndifferences in claim frequ ency and claim severity."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"e871b64a-9027-4f54-99b0-efd763aed2dc\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"ec94ffd5-40ad-42a7-9934-065259b44310\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"d46bdc96db07cda8fabe4ae55ece9ad0d23eab9c63607f0f933f83c41dce61c4\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"beb36d0f-8408-408f-a5f2-dfc6459266da\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"f07adfe3171e55c917c937276551c26da3b8bf6755518bf6f597e2df8cacf114\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 945056, \"end_char_idx\": 949516, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Among different age groups, there are\ndifferences in claim frequ ency and claim severity.  For example, a  50-year-old\nperson is more likely to experience a long illness  or need a longer recovery\nperiod  than a 30 -year-old person.\nB. Gender\n3.3 Gender is also an important factor in developing the premium rates for group\nand individual products.  Statistics shows that women  in general made more\nmedical claims  than men.  That is why a female pay s a higher premium for\nMedical Insurance  as compared to a male of the same age.\nC. Health Status\n3.4 The health status of the proposed insured  person  is a major consideration in\nthe policy pricing. An individual with a pre -existing medical condition can\nexpect his proposal to attract special underwriting terms a nd conditions , or\neven declined.\nME\nD\nI\nC\nA\nL \nC\nL\nA\nI\nM\n\nHealth Insurance   \n \n252 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] D. Lifestyle  \n \n3.5 The lifestyle of the proposed insured can also influence the premium charge. \nParticipation in a hazardous sport which exposes him to a hi gher risk of injuries  \n(e.g. recreational flying, mountaineering or scuba -diving) will require  extra \npremiums. The alternative by the insurer is to exclude injuries sustained in \nspecified activities from the insurance coverage.    \n \n3.6 The most important lifestyle factor for determi ning premium rate is smoking. \nFor example, a  proposed insured who is a non -smoker is usually at less risk, \nand can expect to pay a lower premium for insurance than a person who \nsmokes.  \n \nE. Occupation  \n \n3.7 A proposed insured\u2019s occupation can have a strong influence on the risk that he \npresents. Some occupation has o ccupational risk or hazard . This means that he \nhas a higher chance of an injury or illnes s by reason of the duties of a specific \noccupation.  \n \n3.8 Based on an analysis of information compiled over the years, insurers  have \ngrouped various occupations into classes with basically the same degree of \naccident or illness hazard.  This permits a fair means to establish premium rates \nbased upon occupational hazard. For example, a high -rise construction worker \ncould be more likely to suffer an injury by reason of occupation than would a n \noffice administrator .  \n \n \n \n \n \n \n \n \n3.9 Many insurers i ssue manuals to their insurance representatives  on which \noccupational classifications are listed. The insurer s cannot list every possible \noccupation, but most jobs have been broadly classified.   \n \n3.10 As you would expect, the higher the risk of injury or illness resulting from an \noccupation, the higher the insurance premium is likely to be.  \n \n  \n\n11.Health Insurance Pricing\nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]  253 F. Persistency\n3.11 Persistency, which refers to the percentage of policies renewed each year, is a\nparameter in pricing both Individual and Group  Health Insurance.  Persisten cy\nusually improves as the policies age.  For some types of coverage, the annual\npersistency rate may reach 95% or higher by the fifth policy year.\n3.12 Persistency also varies by age groups. A group of younger insureds (e.g. ages\nof 20 to 29  years ) may have poorer persistency than a group of older insureds\n(e.g. ages of 50 to 59  years ). The older insureds will tend to see the  policy as\nmore valuable , because they may have more difficulty satisfying the\nunderwriting  requirements  associated with buyi ng a new policy.\n3.13 If the persistency rate of a type of coverage is expected to be high, then the\ninsurer will reduce the amount of premium charged.\nG. Claims Experience\n3.14 Claims experience of the portfolio or population is important when pr icing\nHealth Insurance. An a ctuary has to ensure that, above all other expenses, the\npremium s must be sufficient to pay expected claims. For group plans, claims\nexperience of the group is a key factor affecting the premium rate charged. For\nexample, for gr oup outpatient plans, claims experience demonstrates the\ngeneral health condition of the group and the propensity of the group  members\nto file claims. The importance of the claims experience data in pricing increases\nas the group size gets bigger , and more years of data are\navailable.\nH. Group Participation Level  \n3.15 For voluntary group plans, the extent of participation by\nemployees in the plan is an important parameter in the\ndevelopment of premium rates."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"beb36d0f-8408-408f-a5f2-dfc6459266da\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"e871b64a-9027-4f54-99b0-efd763aed2dc\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"5b9e6f8df44dc147bf7424ebaccf0639b0bd433580efa2c3705691ab43a35ba5\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"eac6521c-0b39-4a82-a58d-8f4f6c97e53c\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"af015089c88048fa9f1a3ea76903b7cf11f79bd72f324e1f3ee514cee24ff8ca\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 949338, \"end_char_idx\": 954553, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "H. Group Participation Level  \n3.15 For voluntary group plans, the extent of participation by\nemployees in the plan is an important parameter in the\ndevelopment of premium rates.  If the participation is low, there will be a greater\nchance that a higher than normal proportion of unhealthy lives will seek\ncoverage. This is called adverse selection or anti -selection. If the participation\nlevel is high, there will likely be more healthy lives to compensate for anti -\nselection. T hus, many insurers vary premium rates based on the participation\nlevel.\nCLAIM  \nFORMS\n\n43\nHEALTH INSURANCE PRICING\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nMorbidity experience Morbidity experience or morbidity rate means the actual number of illness, injury, \nor failure of health cases occurring in a given group of people.\nInvestment income Investment income is the money that is earned, when an insurer invests the \npremiums which it receives from many insureds (policyowners or policyholders).\nOperating expenses Expenses increases the price of insurance. It is not sufficient for insurers to collect \nenough premiums to just cover the costs of insurance. They must also collect \nenough money, to pay for the costs of operating the company, such as staff salaries, \ncommissions for sellers, taxes, office rent, advertising, computer systems, supplies, \netc.\nMedical inflation \u2022 Consistent upward trend in medical care claim costs experienced by both \nindividual and group plans. \n\u2022 Rising costs of claims are associated with increases in medical care charges and \nhigher utilisation of services.\nScope of benefits covered Providing several types of benefits under one policy is another way of producing a \nproduct that is appealing to customers. However, this strategy comes with a price \n\u2013 additions of each benefit actually increase the final premium that the insurer \ncharges.\nInsurer\u2019s profit Insurers enter the market with the primary objective to profit from the business. \nWhen pricing a product, insurers include a loading in the net premium to provide a \nprofit margin.\nModes of premium \npaymentFrequency with which the premiums are payable.\n\u2022 Annually \u2013 once a year;\n\u2022 Bi-annually \u2013 twice a year;\n\u2022 Quarterly \u2013 once every three months; or\n\u2022 Monthly \u2013 once a month.\nExtent of underwriting Time and effort required to gather medical declaration from the insured person at \nthe point of policy application.\nParameters for premium \nrating\u2022 Age.\n\u2022 Gender.\n\u2022 Health status.\n\u2022 Lifestyle.\n\u2022 Occupation.\n\u2022 Persistency.\n\u2022 Claims experience.\n\u2022 Group participation level.CHAPTER\n11\n\nHealth Insurance   \n254 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4]  \n      CHAPTER 12  \nHEALTH INSURANCE UNDERWRITING  \n \n \n \nCHAPTER OUTLINE  \n \n1. Introduction  \n2. What Is Underwriting?  \n3. Underwriting Factors That Affect The Risk  \n4. Sources Of Underwriting Information  \n5. How An Insurance Representative Can Help In The Underwriting Process  \n6. Final Underwriting Decision  \n7. Commencement Of Risk  \n8. Conclusion  \nAppendix 12A \u2013 Sample Supplementary Lifestyle Questionnaire  \nAppendix 12B \u2013 Sample Individual Hospital & Surgical Insurance Proposal Form  \nAppendix 12C \u2013 Sample Group Hospital & Surgical Insurance Proposal And Health \nDeclaration Form  \n \n \nLEARNING OUTCOMES  \n \nAfter studying this chapter, you should be able to:  \n\u25aa explain what underwriting  is \n\u25aa explain the underwriting factors that affect a risk:  \n- medical factors  \n- non-medical factors  \n\u25aa know the underwriting factors that are specifically important for each type of Health \nInsurance  \n\u25aa know the types of underwriting methods for Medical Expense Insurance  \n\u25aa know the various underwriting factors for Group Insuran ce \n\u25aa identify the sources of underwriting information  \n\u25aa know how an insurance representative  can help in the underwriting process  \n\u25aa understand the various terms of acceptance for Health Insurance proposal s \n\u25aa know when the risk commences  \n \n \n \n \n \n\n12. Health Insurance Underwriting  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   255  \nContents  \nCHAPTER OUTLINE  ................................ ................................ ................................ .........  254 \nLEARNING OUTCOMES  ................................ ................................ ................................ .. 254 \n1. INTRODUCTION  ................................ ................................ ................................ ..... 257 \n2. WHAT IS UNDERWRITING?  ................................ ................................ ...................  257 \n3. UNDER WRITING FACTORS THAT AFFECT THE RISK  ................................ ..........  257 \nA. Medical Factors  ................................ ................................ ................................ . 257 \nA1. Medical History  ................................ ................................ ..........................  257 \nA2. Current Physical Conditions  ................................ ................................ ...... 258 \nB. Non-medical Aspects Of Underwriting  ................................ ............................  258 \nB1."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"eac6521c-0b39-4a82-a58d-8f4f6c97e53c\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"beb36d0f-8408-408f-a5f2-dfc6459266da\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"f07adfe3171e55c917c937276551c26da3b8bf6755518bf6f597e2df8cacf114\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"02181351-ac53-4358-90ec-3092990dd7a0\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"91f83e8b551d0761e186780be7ac94e9f5759de63365f96d44f80db6809260ac\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 954215, \"end_char_idx\": 960896, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Medical History  ................................ ................................ ..........................  257 \nA2. Current Physical Conditions  ................................ ................................ ...... 258 \nB. Non-medical Aspects Of Underwriting  ................................ ............................  258 \nB1. Financial Factor  ................................ ................................ ..........................  258 \nB2. Occupational Factor  ................................ ................................ ...................  259 \nB3. Age Factor  ................................ ................................ ................................ .. 259 \nB4. Residency Factor  ................................ ................................ ........................  259 \nB5. Additional Underwriting Considerations  ................................ ..................  259 \nC. Factors That Are Specifically Important For Each Type Of Health Insurance  260 \nC1. Medical Expense Insurance  ................................ ................................ ....... 260 \nC2. Disability Income Insurance  ................................ ................................ ...... 260 \nC3. Long -Term Care Insurance  ................................ ................................ ........  261 \nC4. Critical Illness Insurance  ................................ ................................ ............  261 \nC5. Managed Healthcare  ................................ ................................ ..................  261 \nD. Types Of Underwriting Methods For Health Insurance  ................................ .. 261 \nD1. Full Medical Underwriting  ................................ ................................ .........  262 \nD2. Moratorium Underwriting (Used for Medical Expense Insurance)  .........  262 \nD3. Simplified Issuance Offer (SIO)  ................................ ................................ . 263 \nD4. Guaranteed Issuance Offer (GIO)  ................................ ..............................  264 \nE. Group Underwriting  ................................ ................................ ..........................  264 \nE1. Reason For Existence  ................................ ................................ ................  264 \nE2. Group Stability  ................................ ................................ ...........................  264 \nE3. Group Size  ................................ ................................ ................................ .. 265 \nE4. Insured Company\u2018s Nature Of Business  ................................ ...................  265 \nE5. Employee Classes  ................................ ................................ ......................  265 \nE6. Level Of Participation  ................................ ................................ ................  265 \nE7. Age & Gender Within The Group  ................................ ..............................  265 \nE8. Expected Persistency  ................................ ................................ .................  266 \nE9. Past Claims Experience  ................................ ................................ .............  266 \nE10. Medical Inflation  ................................ ................................ .......................  267 \n\n\nHealth Insurance   \n256 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] E11. Medical Utilisation Rate & Trend  ................................ .............................  267 \n4. SOURCES OF UNDERWRITING INFORMATION  ................................ ..................  267 \nA. Proposal Form  ................................ ................................ ................................ ... 267 \nA1. Sections Of A Proposal Form  ................................ ................................ .... 268 \nB. The Agent\u2019s Statement  ................................ ................................ .....................  269 \nC. Medical Examinations/Tests  ................................ ................................ .............  269 \nD. Attending Physician\u2019s Statement (APS)  ................................ ...........................  270 \nE. Supplementary Questionnaires  ................................ ................................ ....... 270 \n5. HOW AN INSURANCE REPRESENTATIVE CAN HELP IN THE UNDERWRITING \nPROCESS  ................................ ................................ ................................ ................  270 \n6. FINAL UNDERWRITING DECISION  ................................ ................................ ....... 271 \nA. Standard Risks  ................................ ................................ ................................ .. 271 \nB. Sub-standard Risks  ................................ ................................ ...........................  271 \nB1. Modifications Of Cover  ................................ ................................ ..............  271 \nB2. Postponement  ................................ ................................ ............................  272 \nB3. Decline  ................................ ................................ ................................ ........  273 \n7. COMMENCEMENT OF RISK  ................................ ................................ ..................  273 \n8. CONCLUSION  ................................ ................................ ................................ .........  273 \nAPPENDIX 12A  ................................ ................................ ................................ ................  274 \nAPPENDIX 12B  ................................ ................................ ................................ ................  275 \nAPPENDIX 12C  ................................ ................................ ................................ ................  278 \n \n\n\n12. Health Insurance Underwriting  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   257  \n1. INTRODUCTION  \n \n1.1 In this chapter, we will discuss the factors that underwriters look at  when \nunderwriting Health Insurance proposal s on individual and group bas es. We \nwill also look at the various terms of acceptance that underwriters may impose \non Health Insurance proposal s. Let us begin by looking at what underwriting  is \nall about . \n \n \n2. WHAT IS UNDERWRITING?  \n \n2.1 Underwriting is the process , where by an insurer assesses the risk and \ndetermines whether or not to accept an application  and, if so, on what terms \nthat it will offer coverage to the applicant or proposer ."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"02181351-ac53-4358-90ec-3092990dd7a0\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"eac6521c-0b39-4a82-a58d-8f4f6c97e53c\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"af015089c88048fa9f1a3ea76903b7cf11f79bd72f324e1f3ee514cee24ff8ca\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"51b9c514-f416-429f-9ba8-46e1478b7caf\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"8ceb6138f9d6c18571fafcd6d918692873657e2642d09c79197350d4ac9afb43\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 960897, \"end_char_idx\": 965620, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "The main purpose of \nunderwriting is to ensure that the premiums charged correspond closely with \nthe risk that each proposer  represents. While Life Insurance underwriting is \nconcerned primarily with mortality (i.e. the incidence of death within a given \npopulation), Health Insurance underwriting is concerned primarily with \nmorbidity which is the incidence  of injury, illness or failure of health.   \n \n \n3. UNDERWRITING FACTORS THAT AFFECT THE RIS K \n \n3.1 The factors that affect a risk can be broadly classified as:  \n\u25aa medical; and   \n\u25aa non-medical  \n \n3.2 Let us begin by looking at the medical aspects of underwriting  of a Health \nInsurance proposal, assuming that the proposer and the person/life to be \ninsured (also known as the proposed insured in market practice) are the same \nperson  indicated in the proposal submission to the insurer . \n \nA. Medical Factors  \n \n3.3 This requires a review of both the medical history and current physical \ncondition s of the  proposer , to determine on what basis coverage can be offered. \nUnderwriters evaluate risk s by considering the probable influence of current \nimpairments and previous medical histories on future claims. For example, \nsigns of cognitive (psychological ) impairments indicate that the proposer  is a \npoor or uninsurable risk for Long -Term Care Insurance.  \n  \nA1. Medical History  \n \n3.4 The proposal  form asked questions on the medical history of the proposer . \nUnderwriter may require more information on the declared medical conditions.  \nFor example, if the proposer states that he is receiving treatment for high blood \npressure, an attending physician\u2019s statement will be required  for policies , such \nas Critical Illness  Insurance  and Disability Income  Insurance , etc. In addition to \nobtaining general medical information, the underwriter will ask the attending \nphysician about blood pressure readings, medication prescribed , and the \n  \n  \n\nHealth Insurance   \n258 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] degree of control achieved. If a physical examination was not required before, \nthe underwriter could now ask for one to get current blood pressure re adings.  \n \n3.5 Insurers review histories of previous conditions to determine \nthe: \n\u25aa possibility of recurrence;  \n\u25aa effect of a medical history on the proposer \u2019s general health;  \n\u25aa complications likely to develop at a later date;  and/or  \n\u25aa normal progression of any impairment.  \n \n3.6 Disabilities resulting from diseases of, say, the digestive system may also be \nmore frequent or prolonged than will be anticipated without such a history.  \n  \n3.7 Many  acute disorders can be disregarded if recovery has been prompt and \ncomplete , and without evidence of any residual impairment. Examples include \nsimple bone fractures or an appendectomy.  \n \n3.8 Latent complications, or the deterioration of an existing impairment are \npossible with many conditions. For example, overweight and elevated blood \npressure, while normally not disabling in themselves, are considered indicators \nof a higher future incidence of cardiovascular impairment.  \n \nA2. Current Physical Condit ions \n \n3.9 The proposer \u2019s statements on a proposal  form and medical examination results \nare the first indicators of present physical condition s. Additional tests and \nstudies, e.g.  urinalysis, blood studies, cognitive assessments and \nelectrocardiograms  (ECGs) , may be required, depending on the  age of the \nproposer and the amount of insurance coverage applied for.  \n \nB. Non-medical Aspects Of Underwriting  \n \n3.10 Non-medical factors can also have varying effects on the different classes of \nHealth Insurance , as can be seen in the sections  mentioned below :  \n \nB1. Financial Factor  \n \n3.11 The proposer \u2019s financial situation (i.e. income, assets and debts) is not a key \nconsideration in underwriting most types of Health Insurance policies. In \nconsidering an application, this information allows an underwriter to gauge if \nthe proposer has the ability to continue paying for the premium and keeping \nthe policy throughout the t erm.  \n \n3.12 Financial information is  important in underwriting individual Disability Income \nInsurance. This is because the underwriter must ensure that the  benefit amount  \napplied for is reasonable and not higher than 75% of his current income.   \n \n  \n \n \n\n12. Health Insurance Underwriting  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   259  \n3.13 To determine whether the benefit (for Disability Income Insurance) is justifiable, \nthe underwriter must consider the proposer \u2019s income, both earned and \nunearned ( e.g."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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He must also take into account the \nproposer \u2019s net worth. A high net wo rth is significant , even if the proposer \u2019s \nassets are not producing substantial investment income at the time of \nunderwriting. Assets can be shifted to income generating investments if the \ninsured becomes disabled , and the resulting income combined with disability \ninsurance benefits can lessen the insured\u2019s incentive to return to work.  \n \nB2. Occupational Factor  \n \n3.14 The proposer \u2019s occupation can have a strong influence on the risk that he \npresents. Occupational hazards fall into the following two main categories:  \n\u25aa accident hazards;  and \n\u25aa health hazards.  \n \n3.15 Some occupations, such as painter s engaged to paint the exterior of tall \nbuildings , have a higher risk of accidental injur ies, thereby  increasing the \nprobability of hospitalisation. Occupations involving the handling of asbestos \nproducts have a higher  risk of h ealth hazard over time , as it can lead to \nasbestosis1.  \n \nB3. Age Factor  \n \n3.16 Medical  problems tend to increase with age. Hence, the underwriting guidelines \ncall for more  requirement  on medical examinations /tests  and attending \nphysicians\u2019 statements for older proposer s. The underwriter  may also  be \ninvestigat ing on the  medical histories of older proposer s more thoroughly , \nbecause of the increased possibility of related problems that may not be \nreflected  in such  proposal forms submitted . \n \nB4. Residency Factor  \n \n3.17 Past, current  and future residency can be important risk factors. Underwriter \nlooks out for applicants who may travel to war zones, areas where there are \nhealth related risk or even politically unstable areas as part of the underwriting \nconsideration.  \n \nB5. Additional Underwriting Considerations   \n \n(a) Avocation  & Lifestyle Risks  \nAvocation  and lifestyle risks are those which are associated with higher \nprobabilities of contracting accident s or illnesses .  \n \n \n \n \n \n1  Asbestosis is a disease caused by the inhalation of asbestos fibres and dust which can lead to respiratory \nfailure and other complications. The incidence of carcinoma (cancer) of the lung is also higher for people \nexposed to asbestos dust.  \n \n\nHealth Insurance   \n260 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] Engagements in the following activities are considered to be lifestyle risks:  \n\u25aa drug abuse;  \n\u25aa multiple sexual partners;  \n\u25aa navigational recreational activity;  \n\u25aa hazardous occupations;  and \n\u25aa hazardous sports, such as motor racing , mountaineering , parachuting  \nand scuba  diving.  \n  \nInsurers may require the completion of specially designed questionnaires, \nsuch as a supplementary lifestyle questionnaire for underwriting (see \nAppendix 1 2A). \n \n(b) Habits  \nBoth alcohol and drug use s by the proposer represent serious risks. Either \nactivity can result in significant health problems  or cause serious accidents \nwhile driving or during leisure activities. This is also known as the \nProximate Cause.  \n \nC. Factors That Are Specifically Important For Each Type Of Health Insurance  \n \n3.18 Certain factors tend to be more important than others in the underwriting of \neach type of Health Insurance.  \n \nC1. Medical Expense Insurance  \n  \n3.19 When  assessing Medical Expense Insurance, the medical background or history \nand current physical condition of the proposer  are the basic indicators of the \nprobability of future problems that may result in medical expenses for \nhospitalisation and treatment. A proposer with a pre -existing condition  when \nbuying Medical Expense Insurance will usually have the condition excluded \nfrom coverage by the insurer. For example, the  insurer  will exclude all \nconditions relat ing to the heart for any proposer  with hypertension (or high \nblood pressure ). \n \nC2. Disability  Income I nsurance   \n \n3.20 The size and stability of the proposer \u2019s earnings and his overall financial \nsituation are important factors for the underwriting of Disability Income \nInsurance . Minor accident or illness may result in a disability for some people \nbecause of his nature of work, e.g. a throat infection may resul t in a singer \nhaving to cancel his show , and thus, disrupting his flow of earnings."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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To evaluate \nthe occupational risks more accurately, underwriters have developed \noccupational risk classifications , as statistics show that persons in professional \noccupatio ns (such as accountants) and those with relatively high incomes have \nfewer periods of disabilities , as well as  disabilities of shorter duration than \npersons in other occupations. Details of the various types of occupational risk s \nclassifications used by un derwriters are given in Chapter 4  of this Study Guide . \nThe chapter also discusses in detail the other underwriting factors for this class \nof insurance.  \n \n  \n\n\n12. Health Insurance Underwriting  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   261  \nC3. Long -Term Care Insurance  \n \n3.21 The two key factors for the underwriting of Long -Term Care Insurance (LTC) \ncover is the detection of any early cognitive impairment and morbidity risk. \nStatistics show that cognitive impairment is the major source of LTC claims that \ncan last a long time. This is why some insurers require the proposer  to undergo \nsome form of cognitive assessment during the underwriting stage. The second \nfactor is assessing the morbidity risk of an individual. This means the chance of \na person suffering any physical disability w hich will affect the individual\u2019s \nability to perform his activities of daily living. Many conditions which may not \nbe significant in the assessment of a mortality risk will be critical for a LTC risk. \nFor example, any musculoskeletal condition will be a potential risk for LTC \ncoverage.   \n \nC4. Critical Illness Insurance  \n \n3.22 For Critical Illness Insurance underwriting, besides the proposer \u2019s medical \nhistory and current physical condition s, the following two other factors are also \nimportant:  \n\u25aa smoking habit ; and \n\u25aa family history . \n \n3.23 Smoking can increase the incidence of a person suffering from cardiovascular \nand cerebrovascular diseases , and cancer. Some diseases like diabetes \nmellitus , and breast and colon cancer s have high prevalence among family \nmembers.   \n \nC5. Managed Healthcare  \n \n3.24 The key considerations for the underwriting of Managed Healthcare (MHC) are \nsimilar to  those for Medical Expense Insurance cover.  \n \n3.25 However, when MHC covers are issued to groups, the age and gender of the \ngroup are strong factors in assessing the risk in the group. Older groups are \nassociated with higher morbidity , while groups with a large proportion of \nfemales of child -bearing age tend to have higher costs , in view of healthcare \nand hospitalisation associated with pregnancies and deliveries.  \n \nD. Types Of Underwriting Methods For Health Insurance  \n \n3.26 There are  four underwriting methods for Health Insurance cover : \n\u25aa Full Medical Underwriting ;  \n\u25aa Moratorium Underwriting  also known as Point -of-Claim Underwriting . \n\u25aa Simplified Issuance Offer  (SIO)  \n\u25aa Guaranteed Issuance Offer  (GIO)  \n \n \n \n\n\nHealth Insurance   \n262 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] D1. Full Medical Underwriting   \n \n3.27 Full medical underwriting is where the proposer complete s a health declaration  \nwhen he first appl ies for cover,  in order to let the insurer know about his health \nand medical background or history. The insurer will review the health \ndeclaration details and decide the basis on which the  insurer  can accept him for \ncover. If necessary, the insurer may need to ask him or his attending physician \nfor further information.  The insurer may also ask him to undergo a medical \nexamination.  \n \n3.28 If the proposer has a pre -existing condition that may need treatment in the \nfuture, it will usually be excluded from cover, along with any conditions related \nto it.  \n \n3.29 The insurer will provide written confirmation of any specific medical conditions \nthat are excluded because of the proposer\u2019s personal medical history, as well \nas the terms of the policy. The proposer could request the insurer to review the \nexclusions in the future should he wish to do so.  \n \n3.30 Advantage Of Full Medical Underwriting  - Although this method involves  the \nproposer  more time to complete his proposal form , when he (the insured) \nreceive s his policy document, he will have the certainty as to what is covered at \nthe point of commencing the insurance cover , rather than at the time of making \na claim.  \n \nD2."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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Moratorium Underwriting  (Used for Medical Expense Insurance)  \n \n3.31 The proposer does not need to fill in a health declaration in his application , nor \nneed to undergo a medical examination  for this method . Instead, the insurer \nwill declare a waiting period (usually two to five years) that will automatically \nexclude any pre -existing conditions for which he has received treatment and/or \nmedication, or has been asked advice on, or has symptoms of (whether or not \ndiagnosed) during the declared waiting period immediately before the \ncommencement date of the M edical Expense Insurance cover.  \n \n3.32 However, if the proposer does not have any symptom, treatment, medication, \nor advice for those pre -existing conditions, and any directly related conditions  \nduring the waiting period , he will be cov ered when those conditions recur , \nsubject to the terms and conditions of the policy , once the declared waiting \nperiod ends .  \n \n3.33 It is important to understand that long -term medical conditions  (such as stroke, \nkidney failure, heart bypass and dementia ), which are likely to continue to need \nregular or periodic treatment, medication or medical advice, will never be \ncovered by the policy , even after a moratorium , or waiting period , has elapsed \nor passed , as it is unlikely they  will meet the moratorium condit ions. However, \neven if the proposer declares these conditions under a full medical underwriting \nmethod, these declared conditions will also be permanently excluded by the \ninsurer.  \n \n  \n\n12. Health Insurance Underwriting  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   263  \n3.34 The proposer should not delay in seeking medical advice or treatment for a pre -\nexisting condition simply to obtain cover under the policy.  \n \n3.35 Advantage Of Moratorium Underwriting  - The method allows policy to be \nissued quickly. T he proposed insured will be asked to provide only basic \ninformation about himself. He will not be asked to disclose details of his medical \nhistory . However, he has to understand that , if he has any pre-existing medical \ncondition , it will be excluded from cover. Also, if he can satisfy the moratorium \ncriter ia (two to five years as outlined in the above section ) for a pre -existing \ncondition, then treatment for that condition will automatically be covered if it \nlater recur s, subject to the policy terms and conditions.  \n \n3.36 Full medical  underwriting should always be the starting point, and  insurance \nadvisers should never use the moratorium underwriting for their own \nconvenience.  Moratorium underwriting should only be used where it affords a \ngenuine advantage for the clients.  \n \nExample 1 2.1 \n \nThe proposer has suffered from kidney stones recently. Will he be covered \nfor any further treatment after the commencement date of his policy?  \n \nUnder Full Medical Underwriting : No , he has to declare this information \nunder his full medical declaration, and a personal medical exclusion will be \napplied to his policy . This means that he will not be covered for future \nproblems associated with his kidney stones and any related conditions.  \n \nUnder Moratorium Underwriting : No, as he has suffered from this condition \nbefore the commencement date of his policy, t his condition will not be \ncovered. He will be eligible for cover only if he does not have any symptom, \ntreatment, medication or advice over a continuous period of time (two to five \nyears , depending on the policy conditions) after the commencement date of \nhis policy.  \n \nD3.       Simplified Issuance Offer  (SIO)  \n \n3.37 In Simplified Issuance Offer, the proposer is typically asked only a few questions \nand depending on the underwriting guidelines of the insurance company you \nare applying for coverage, the answers to those questions will determine \nwhether the application is approved or not, as well as the cost of the policy. The \nproposer will not be sent for medical examination.  \n \n3.38 SIO are typically used in Critical Illness Plans where insurers market it via d irect \nor online channel.  \n \n3.39 Pros and Cons  of SIO \u2013 This method allows applicants to get coverage quickly \nas compared to days or weeks with Full Medical Underwriting method. \nHowever, premium is higher due to greater risk the insurer will assume . \n \n\nHealth Insurance   \n264 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] D4.       Guaranteed Issuance Offer  (GIO)  \n \n3.40 Guaranteed  Issuance Offer required no medical questions nor medical \nexamination."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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created_at: 2024-03-15 18:52:31
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The members in the group become older , without any new \n\n\n12. Health Insurance Underwriting  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   265  \nand presumably younger members being added to the group , and henc e, the  \ngroup  becomes a greater underwriting risk at each renewal  because of  higher \naverage age.  \n \n3.48 An ideal  group for insurers is one in which there is a steady flow of new \nmembers to replace those who leave the group , but not a massive influx or \noutflow of members.  \n \nE3. Group Size  \n \n3.49 Group size is important  as it provides a better spread and diversification of the \nrisk. It allows for more efficient administration and lower costs. However, the \ngender distribution, age profile and the sum assured  of each insured member \nare also factors directly affecting the pr emium s. \n \nE4. Insured Company\u2018s Nature Of Business  \n \n3.50 Certain lines of business tend to be more risky than others. A group from the \noil rigging or timber logging industry is an example of a high -risk group.  The \neconomic prospects of the industry in which the business operates and the \nstrength and financial condition of the business itself are also important factors , \nas they will affect the sustainability and growth potential of the group.  \n \nE5. Employee Classes  \n \n3.51 Employee classes are often based on conditions of employment, such as job \ntitle, salary amount or length of service.  It has effects of over -representation. \nFor example, over -representation by a highly paid class can result in higher -\nthan -average medical c laims , since people with higher incomes tend to use  \nmore expensive  medical services  (e.g. private clinics and private hospitals)  than \ndo people with lower incomes. Over -representation by a class in which the \nemployees earn low incomes can result in a highe r-than -desired rate of \nturnover.  \n \nE6. Level Of Participation   \n \n3.52 Underwriters are particularly concerned about the level of participation in a \ncontributory plan as members\u2019 participation in such a plan is on a voluntary \nbasis. Insurers normally specify a minimum participation level requirement  \n(e.g. between 70% and 90%) of eligible group members. This is  to guard against \nanti-selection  by spread ing of  risk, as well as to reduce administrative  costs , \nacross a wide range of expected mortality within such a group .  \n \nE7. Age & Gender Within The Group  \n \n3.53 Age is an important factor in underwriting , as it increases the mortality of the \ngroup to be insured. Gender in the form of the ratio of males to females is also \nan important consideration , as females have lower mortality rate s (but higher \nmorbidity rate s) than male s. \n \n  \n\n\nHealth Insurance   \n266 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] 3.54 The underwriting requirements are very much dependent on the size of the \ngroup and the type of insurance applied for. For example, a group  size of  20 \nmembers applying for a Group Medical Expense  Insurance policy may not be \nrequire d to complete individual Health Declaration form s. However , if this \ngroup appl ies for a Critical Illness Insurance policy, the underwriter w ill require \nevery member to complete a Health Declaration form . For those whose sum \nassured s exceed the free cover limit2, the underwriter w ill requir e them to go \nfor medical examinations and/or other tests in accordance with the \nunderwriting guidelines.  \n \n \n \n \n \n \n  \n \n \n \n \n \n \n \nE8. Expected Persistency  \n \n3.55 New business cost (acquisition expenses) can be substantial (e.g. underwriting  \nthe proposal ) to the insurer when acquiring a new group. The insurer will \nspread the acquisition expenses over an extended period, typically three to five \nyears , so that the fir st year will be more competitive. For this reason, the insurer \nwants some assurance that the new business will remain in the books until \nthese expenses are recovered. As such, the  insurer will want to avoid any \nbusiness that may be short -lived (e.g. specia l project group) or an employer that \nhas a history of frequently switching insurers.  \n \nE9. Past Claims Experience  \n \n3.56 A group\u2019s claims history can be a good indicator of the likely future claims \nexperience  of this portfolio ."}


created_at: 2024-03-15 18:52:31
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Past Claims Experience  \n \n3.56 A group\u2019s claims history can be a good indicator of the likely future claims \nexperience  of this portfolio . For example, for a large group with an average  \nS$100,000 past claims per year , an insurer can reasonably expect similar claim s \nutilisation (assuming no change in the composition and profile of the group) \nand can charge premiums accordingly. This is why past claims experience is an \nimportant  factor in group underwriting  consideration . \n \n  \n \n2  Free cover limit is the maximum coverage that an insurer is willing to provide to each member of a \ngroup without asking for declaration of health. Excess sum assured above the free cover limit will be \nunderwritten before such coverage is granted.  \n GROU P COVERAGE  \n \n \n \n      All Employees  Some Employees  Vs\n. \n\n12. Health Insurance Underwriting  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   267  \nE10. Medical Inflation  \n \n3.57 Medical inflation is the increase in the costs for medical services  over a period \nof time . It may vary based on the types of service s. For example, hospital costs \nmay increase faster than physician charges.  \n \n3.58 Medical inflation will affect the claims experience of a group  and is an important \nfactor in  group  underwriting. It is measured by comparing historical data to \nmore current cost data , over a period of time (e.g . 12 months) .  \n \nE11. Medical Utilisation Rate & Trend  \n \n3.59 Changes in utilisation can affect the trend. For example, when a group policy \nhas been in  force for some time, the average age may rise, thus increasing the \nfrequency of claims in the group. Changes in medical practice, such as the use \nof new drugs , will also affect the cost of a plan. Hence, the medical utilisation \nrate and trend are importan t factors that underwriters will take into \nconsideration , when assessing the risks posed by the group.  \n \n \n4. SOURCES  OF UNDERWRITING INFORMATION  \n \n4.1 The underwriter relies on information obtained from various sources to make \nhis decision. The primary source is the proposal form. Others include:  \n\u25aa Agent\u2019s Statement;  \n\u25aa Medical Examinations/Tests;  \n\u25aa Attending Physician \u2019s Statement (APS);  and \n\u25aa Supplementa ry Questionnaires.  \n \n4.2 The extent to which the und erwriter uses these sources of information depends \non the type and size of  the policy applied for. A proposal  for a S$500 (per month ) \nDisability Income Insurance policy with benefits for two years on a person under  \nthe age of 30 years may require a review of only the most significant health \nhistory , as well as a confirmation of the person\u2019s salary that he is earning at the \nmoment. On the other hand, a proposal  from a 50 -year-old person for a \nDisability Income Insurance policy for S$10,000 a month , with benefits to the \nage of 65 years , will require more careful scrutiny. More information, such as \nadditional medical tests and a large  sum assured  financial  questionnaire , will \nbe required for underwriting.  \n \nA. Proposal Form  \n \n4.3 The proposal  (application)  form is the primary source of underwriting \ninformation for the insurer. It provides the basic information for the underwriter \nto make a decision , to provide the requisite coverage , or to modify it, to try to \nobtain more information , or to re ject the proposal entirely.  \n \n4.4 After the policy is issued, the proposal  will form a part of the insurance contract \nand is used as the basis when a claim is filed.  If an insurer determines before \nthe end of the contestable period that there has been a false s tatement or \n \n\nHealth Insurance   \n268 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] incomplete dis closure of material information on the proposal , the insurer may \nreject the claim and rescind the contract. As such, every proposal form is \nrequired by the Insurance Act 1966 , to include a  warning statement , such as the \nfollowing, to ensure  that the duty of good faith  is kept by the insured : \n \n\u201cPursuant to Section 23(5) of the Insurance Act 1966 , you are to disclose \nin this proposal form fully and faithfully, all the facts which you know or \nought to know, otherwise, you may receive nothing from the policy.\u201d  \n \nA1."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 87853d52-2684-4c68-bf93-91242c335677
encoding: FLOAT32
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{"_node_content": "{\"id_\": \"87853d52-2684-4c68-bf93-91242c335677\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"7b447792-3b32-4501-b85e-936fb85b0b1f\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"03c31504c531349a86c1f509c02e3e7b06340438588fbbbcea29a95069651bd9\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"4c3962fb-aa21-4a6a-a08d-8aed3ac1460a\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"350a659224e70b59d2facf0fc119ed81972c6b28f458f7e207bc1bc7f8485280\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 989721, \"end_char_idx\": 994351, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Sections Of A Proposal Form  \n \n4.5 Although the proposal form can vary for each of the Health \nInsurance products, it generally contain s the information  as \ndescribed below : \n \n(i) Identities Of The Contract Parties  \nThe insurance contract is between the insurer and the proposer.  \n \nThe header of the proposal  form  has the name of the insurer , its principal \nplace of business  and contact details , so the proposer  knows to which \ninsur er he is applying for an insurance policy. The questions contained in \nthe \u201cParticulars of Life To Be Insured (the proposed insured ) and \nParticulars of Proposer\u201d secti ons serve two pur poses : \n\u25aa They distinguish the proposer from the proposed insured . Although t he \nproposed insured and the proposer are normally the same person , in a \nthird -party insurance (for example , a mother applying for insurance for \na child), they are d ifferent persons.  \n \n\u25aa They provide relevant information to the underwriting department to \nassess the risk  factors , such as occupation, age and gender . The \ninformation determines the eligibility of the person applying for \ncoverage , as well as the correct  premium to be charged.  \n \n(ii) Particulars Of Policy Applied For  \nThis section indicate s the details of the policy that the proposer is applying  \nfor, such as the type of plan and sum insured . \n \n(iii) Information On Past Applications & Existing Policies  \nThis sect ion is meant for the proposer  to state the types of policies that he \nalready has or has applied for , but was postponed or rejected.  The \nproposer  also needs to indicate whether he is purchasing this policy to \nreplace an existing policy.   \n \n(iv) Personal Health Details & Habits Of The Proposed Insured  \nThis section provides a detailed description of the proposed insured\u2019s \nmedical history, current physic al condition, habits in terms of drug taking, \nalcohol drinking, as well as family history.  \n \n  \n \n\n12. Health Insurance Underwriting  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   269  \n(v) Declaration  \nThe signatures of the proposer and proposed insured  are very important , \nas they serve  a number of purposes as follows:  \n\u25aa that the proposer /proposed insured  has disclosed all material facts \ntruthfully and faithfully in the proposal form;  \n\u25aa that the proposer /proposed insured  has not withheld any material facts;  \n\u25aa that the proposer /proposed insured  is aware that the benefits may be \nlost if material facts are not disclosed;  and \n\u25aa that the proposer /proposed insured  agrees and authorises the insurer \nto release to any medical source  or insurance office and vice versa, any \ninformation concerning  him at any time , regardless of whether the \nproposal is eventua lly taken up.  \n \n4.6 The format of the proposal  form  and the depth of its questions vary among the  \ninsurer s, depend ing on the types of products . Sample copies of the Individual \nInsurance proposal form and Group Insurance proposal  form are in Appendices \n12B and 12C respectively.  \n \n4.7 The proposer  and proposed insured  must personally sign the proposal form  \nand counter -sign on any changes made to the proposal form , as the \nresponsibility of proper disclosure of material facts in the proposal  form lies \nwith the proposer  and proposed insured . \n \nB. The Agent\u2019s Statement  \n \n4.8 Most insurers provide separate form s for confidential remarks by agents, such \nas how long and how well they know the ir proposer s.  \n \n4.9 An agent may also be asked to indicate:  \n\u25aa knowledge of any information on the proposer  that is not included in the \nproposal  form , but which may have a bearing on risk selection; and  \n\u25aa the proposer \u2019s approximate net worth, annu al earned income, and income \nfrom sources other than employment.  \n \n4.10 An insurance representative  who lets the under writer know of special \ncircumstances of the sale , or a special problem not otherwise identified  will gain \nthe underwriter\u2019s confidence. Often the insurance representative \u2019s remarks may \nclarify a situation that is questionable or unclear , based on information from \nother sources.  \n \nC. Medical Examinations/Tests  \n \n4.11 Insurers re quire medical examinations/te sts for  certain types of Health \nInsurance , namely  Disability Income Insurance, Critical Illness Insurance and \nLong -Term Care Insurance. A physician appointed by the medical director of \nthe insurer usually completes these examinations and records the an swers to \nthe medical questions. The proposer  needs to sign the medical examination \nform."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 4c3962fb-aa21-4a6a-a08d-8aed3ac1460a
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{"_node_content": "{\"id_\": \"4c3962fb-aa21-4a6a-a08d-8aed3ac1460a\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"87853d52-2684-4c68-bf93-91242c335677\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"c28a48738c445775233b2b12eec09933640d2d9bd221cc626db7c7c84419e007\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"2d14e97d-1c47-4093-b864-e44f07bf4d34\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"a04c0cd908eddd09cc4d613b4398b955b094588bc36fe77c588e933219e33561\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 994142, \"end_char_idx\": 998314, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "A physician appointed by the medical director of \nthe insurer usually completes these examinations and records the an swers to \nthe medical questions. The proposer  needs to sign the medical examination \nform.  \n \n\nHealth Insurance   \n270 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] 4.12 The examination provides information on the height and weight, pulse, blood \npressure, and other important clinical/medical findings.  \n \n4.13 Other common tests that an insurer may request include:  \n\u25aa Electrocardiogram (ECG) test; \n\u25aa Chest X -ray; \n\u25aa Micro -urinalysis;  \n\u25aa Blood profile analysis;  \n\u25aa Human immunod eficiency virus ( HIV) Antibody test;  and \n\u25aa Cognitive assessment for Long -Term Care Insurance.  \n \n4.14 Cost of the medical examination is borne by the insurer , unless the policy is \nsubsequently not taken up.  \n \nD. Attending Physician \u2019s Statement (APS)  \n \n4.15 An APS is a standard pre -printed form for the attending physician to complete \non his personal knowledge of the proposer , based on the proposer \u2019s medical \nrecords. This report is usually required , when the underwriter needs to have a \nbetter insight into the proposer \u2019s medical history , that is not available from the \nmedical examination.   \n \nE. Supplementary Questionnaires  \n \n4.16 The p roposed insured may have to complete s pecial questionnaires  for the \ninsurer to gather additional information to classify a risk. The forms usually deal \nwith medical histories, financial information and special hazards.  \n \n4.17 The typical medical question naires are for such specific health his tories  like \nblood pressure conditions, asthma, ulcers  or diabetes. The financial \nquestionnaires attempt to elicit information about net worth and unearned \n(passive) income , or de velop information on an in surable interest in a special \ntype of business insurance situation. Some insurers use the supplementa ry \nquestionnaire s designed to obtain and de velop information on certain activi ties, \nsuch as aviation, scuba diving, and various forms of racing.  \n \n \n5. HOW AN INSURANCE REPRESENTATIVE  CAN HELP IN THE UNDERWRITING \nPROCESS  \n \n5.1 Since  the insurance representative  has personal contact with the client, he  is in \nthe best position to select the client. In fact, he is considered to be the field \nunderwriter.  \n \n5.2 He can help by firstly, establishing his client\u2019s motivation and needs to  purchase \nthe policy. Sec ondly, he should go through the questions in the proposal form, \ninforming his client to declare all the information truthfully and faithfully, and \nto the best of his knowledge  and belief .   \n \n \n \n\n12. Health Insurance Underwriting  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   271  \n5.3 If any of the answers in the proposal  form is \u201cYes\u201d, he should ex tract as much \ndetail s as possible  from his client. For example, if his client has told him of \nseeing a doctor for diabetes, the insurance representative should find out from \nhis client as much information as possible, such as  the following : \n\u25aa Name and addres s of the attending doctor . \n\u25aa When was the onset of the diabetes ? \n\u25aa Is he on insulin treatment or oral medication ? \n\u25aa Frequency that he needs to go for his follow -up treatment . \n\u25aa Is he careful with his diet, etc.?  \n \n5.4 By obtaining all such information, the insurance representative can help the \nunderwriter to decide whether there is a need to call for an  APS, or a completion \nof a questionnaire on diabetes. If, on the other hand, his client says that he has \ndiabetes without detailed information being provi ded, the underwriter is likely \nto request for further  underwritin g information . \n \n5.5 By ensuring that all questions in the proposal form are duly completed and \nsigned by the propose r in the presence  of the insurance representative , it \nenables the proposal  form  to be processed expeditiously . Knowing the \nunderwriting guidelines, such as when medical examinations/tests and \nsupplementary  questionnaires are required , will also help to expedite the \nunderwr iting process.  \n \n \n6."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 2d14e97d-1c47-4093-b864-e44f07bf4d34
encoding: FLOAT32
metadata:
{"_node_content": "{\"id_\": \"2d14e97d-1c47-4093-b864-e44f07bf4d34\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"4c3962fb-aa21-4a6a-a08d-8aed3ac1460a\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"350a659224e70b59d2facf0fc119ed81972c6b28f458f7e207bc1bc7f8485280\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"97b64c71-a23a-4aa6-9028-99115c4d9d45\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"3c233dad2784c584292838dfed51c63cd95b68fd515d521518d9e0a9c52273b2\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 998123, \"end_char_idx\": 1002468, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Knowing the \nunderwriting guidelines, such as when medical examinations/tests and \nsupplementary  questionnaires are required , will also help to expedite the \nunderwr iting process.  \n \n \n6. FINAL UNDERWRITING DECISION  \n \n6.1 The underwriter may accept a Health Insurance proposal  on any one of the \nterms of acceptance  as described below : \n \nA. Standard Risks  \n \n6.2 When  a proposal is accepted as a standard risk, the policy is issued , based on \nthe premium rate stated in the rate book or brochure . The policy will then be \nissued if the premium has been fully paid. 80% to 90% of all proposal s received \nby the insurer are accepted at standard rates.  \n \nB. Sub-standard Risks  \n \n6.3 Sub-standard risk s are people with medical or non -medical impairments which \nmake them higher risk s to the insurer . The i nsurer deal s with a sub-standard \nrisk, by modifying the cover that the proposer has applied for. The insurer c an \nmodify the cover  as describe d overleaf.  \n \nB1. Modifications Of Cover  \n \n6.4 Coverage  modification may be an  exclusion, an extra premium  charge , a \nchange in benefits, reducing the benefit -paying period, increasing the deferred \nperiod , or a combination of some of these approaches.  \n \n\n\nHealth Insurance   \n272 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] (i) Specific Exclusions  \nExclusions is used as a means of issuing coverage to persons who would \notherwise have to be declined. When an exclusion is imposed, an \nendorsement is issued to state that the in surer will not pay for any claim \narising out of the particular excluded risk, such as from a particular \nmedical problem, e.g. back disorder or an unusually hazardous activity \n(e.g. motor car racing). The endorsement may be worded to exclude \ncoverage for on ly a specific disorder, such as \u201chernia\u201d , or it may exclude \nan entire system or bodily area, such as \u201cdisease or disorder of the \nstomach or intes tines.\u201d The actual wording is deter mined by the nature \nand severity of the person\u2019s medical history or impair ment , as well as by \nthe insurer\u2019s underwriting philosophy.  Specific e xclusions are commonly \nused in Medical Expense Insurance.  \n \n(ii) Extra Premiums  \nDepending on the types of Health Insurance products that are \nunderwritten, the insurer may charge extra premiums.  This is commonly \nused in the underwriting of Disability Income Insurance and Critical Illness \nInsurance. However, it is rarely  used in Medical Expense Insurance.  \n \n(iii) Modification Of Benefits Offered  \nAnother method of modification is to change the benefits t o something \nother than what the propose r has requested. Examples of such \nmodifications include a reduction in the amount of monthly benefit, a \nlonger deferred period , or shorter benefit period on a Disability Income \nInsurance policy . Some times, modificat ions are used in conjunction with \nimposition of extra premiums or exclusions.  \n \nIn fact, some insur ers will automatically limit the benefit period on a \nDisability Income proposer  who requires a large extra premium. For \ninstance, an insurer may not issue a  benefit period of more than five years \nto any risk requiring an extra pre mium of over 50%.  \n \nBenefits may also be reduced , or expens e participation (deductible and \nco-insurance) increased, to counteract the possible over -utilisation of \nMedi cal Expense Insurance policies.  \n \nB2. Postponement  \n \n6.5 At times, a proposed insured may have just undergone a surgical operation or \nis going for a  surgery . For such a case, the underwriter will normally postpone \nthe proposal  for a specified period of time (e.g. six months after the surgical \noperation). That is, the underwriter is not able to offer any terms at that point \nof time , but is prepared to reconsider the case at a later date.  \n \n  \n\n12. Health Insurance Underwriting  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   273  \nB3. Decline  \n \n6.6 The most drastic underwriting action is to decline a proposal . This choice is \nused only for serious medical reasons , or because the proposed insured is \nclearly outside a particular insurer\u2019s parameters of acceptable risks for \noccupational or financial reasons.  Most insurers have declination rates below \n10%."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 97b64c71-a23a-4aa6-9028-99115c4d9d45
encoding: FLOAT32
metadata:
{"_node_content": "{\"id_\": \"97b64c71-a23a-4aa6-9028-99115c4d9d45\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"2d14e97d-1c47-4093-b864-e44f07bf4d34\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"a04c0cd908eddd09cc4d613b4398b955b094588bc36fe77c588e933219e33561\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"7d367317-e6cb-4658-90d8-41ce7a58ec07\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"6f05ed1601102cfa8e3bd8a33387c736af9483bdad48bf11cdb43aba0c916e74\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1002217, \"end_char_idx\": 1006807, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "This choice is \nused only for serious medical reasons , or because the proposed insured is \nclearly outside a particular insurer\u2019s parameters of acceptable risks for \noccupational or financial reasons.  Most insurers have declination rates below \n10%.  \n \n6.7 Hence, it is important for the insurance representative to inform his prospective \nclient that he should apply for Health Insurance when he is healthy , to avoid the \nrisk of being declined later when his health deteriorates or fails. Furthermore, \nHealth Insurance premiums typically increase with age as one gets older.  \n \n \n7. COMMENCEMENT OF RISK  \n \n7.1 Whatever the terms of acceptance, the insurer will communicate the \nunderwriting decision to the proposer  in the form of a letter of acceptance. If \nthe proposer  agrees to the terms as stated in the letter of acceptance and pays \nthe premium, the cover will be effected , and a policy will be issued to him.  \n \n \n8. CONCLUSION  \n \n8.1 As can be seen, underwriting is an important process , because it helps to sieve \nout undesirable risks , and ensures that t he premium charged corresponds with \nthe risks involved. In fact, underwriters are considered as gatekeepers . They \nhelp to protect the insurer against anti -selection  risk. It is important that the \ninsurance representative  cum field underwriter  clearly under stand s the \nunderwriting process and the factors involved in underwriting , as this will be of \ngood help to both the insurer  and the client.     \n \n  \n \n\nHealth Insurance   \n274 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] APPENDIX  12A \n \nSUPPLE MENTARY LIFESTYLE QUESTIONNAIRE  \n \n \nName of Life to be In sured   Proposal  for Life Insurance Number  \nName of Propo ser (if other than Life to be In sured)  \nPURSUANT TO SECTION 2 3(5) OF THE INSURANCE ACT  1966  AND ANY REPLACEMENT THEREOF, YOU ARE TO DISCLOSE IN THIS \nSUPPLEMENTARY QUESTIONNAIRE, FULLY AND FAITHFULLY, ALL FACTS WHICH  YOU KNOW OR OUGHT TO KNOW, OTHERWISE THE \nPOLICY ISSUED HEREUNDER MAY BE VOID.  \nAcquired Immune Deficiency Syndrome ( AIDS ) is a new but significant risk for life in surance, particularly as there is now no known cure. As \nwith dangerous sports, occupations a nd fatal diseases, life insurers are concerned to identify those individuals who are at risk of contracting \nAIDS. This is to ensure equity for all new proposer s and to protect the funds and  bonuses of all existing policy owners. To date, AIDS has \nmainly affected certain groups of people, although not exclusively. The life insurance industry, therefore, needs to identify  members of \nthese risk groups to ensure that established life selection principles are maintained. ( This does not mean that all mem bers of such high risk \ngroups will be refused cover).  \nThis questionnaire will also be given to those who purchase large sum assured.  \nIn order to fulfil this aim, we must, therefore ask you to complete this form and return it to us in the envelope provided.  Your answers will \nbe treated confidentially. When completing this form, please ensure that you answer each question fully and to the best of yo ur knowledge.  \nWe would ask you to read carefully  the declaration at the bottom of this form. Failure to disclose facts pertinent to these questions could \naffect payment of benefits. If you have any doubts whether to disclose any information, you are strongly advised  to do so.  \n1. Do you belong to, or have y ou ever belonged to, any of the following AIDS high -risk groups? \nIf yes, please indicate accordingly.  \na. homosexuals  \nb. bisexuals  \nc. intravenous drug users  \nd. haemophiliacs  \ne. prostitutes   \n2. Have you ever had sexual relationships with any of the AIDS high risk groups indicated in \nQuestion (1)? If so, indicate which and when was the most recent encounter.   \n3. Have you ever been tested, received medical advice, counselling  or treatment in connection \nwith AIDS or an AIDS -related condition or on suspicion that you may have AIDS, or an AIDS -\nrelated condition or are carrying the Human immunodeficiency virus (HIV)? Please give details \nof the circumstances in which the test or ad vice was sought.  \n(Routine testing for blood donation purposes may be ignored).   \n4. Have you ever been tested, received medical advice or treatment in connection with any \nsexually transmitted disease including hepatitis? If yes:  \na. indicate the type of sexually transmitted disease which you have contracted in the past.  \nb. state the number of occasions and dates exposed to sexually transmitted diseases."}


created_at: 2024-03-15 18:52:31
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Have you ever been rejected as a blood or organ donor? If yes, when, by whom and for what \nreasons?   \nI/We declare that the answers I/we have given are, to the best of my knowledge, true and complete and that I have not withhel d any material \ninformation that may influence the assessment or acceptance of this proposal.  \nI/We consent to the Company seeking information from any doctor who has attended to me, including any named in my answers to the \nquestions above.  \nI/We agree that this form will constitute part of my/our Proposal  for Life In surance and that failure to disclose any material fact known to \nme/us may invalidate the contract.  \n \n \nSignature of Life to be In sured                                               Signature of Propo ser (if other than Life to be In sured)  \nDate:                                                                   Date:  \nABC Insurance Company (Singapore) Limited  \n21 Any Street, ABC Centre, Singapore 654321  Tel : (65) 6789 8181  Fax : (65) 6789 8282  \n\n\n12. Health Insurance Underwriting  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   275  \n \n                                                                                                                      \n                                                                                \n \n \n  APPENDIX  12B \n \nABC Insurance Company (Singapore) Limited  \n21 Any Street, ABC Centre, Singapore 654321  \nTel: (65) 6789 8181   Fax: (65) 6789 8282  \n \nINDIVIDUAL HOSPITAL & SURGICAL INSURANCE PROPOSAL FORM  \n \n \nAgent\u2019s Code:    Policy No:  \n  \nAgent\u2019s Name:   ____________________________________________________  \n \nWARNING:  \nPURSUANT TO SECTION 23(5) OF THE INSURANCE ACT 1966 , YOU ARE TO DISCLOSE IN THIS PROPOSAL FORM, FULLY AND FAITHFULLY, \nALL THE FACTS WHICH YOU KNOW OR OUGHT TO KNOW, OTHERWISE NOTHING MAY BE PA YABLE UNDER THE POLICY. IF YOU ARE NOT \nABLE TO ANSWER ANY OF THE QUESTIONS IN THIS PROPOSAL BECAUSE YOU DO NOT HAVE THE ANSWERS AND ARE ALSO NOT ABLE \nTO OBTAIN THE INFORMATION TO ANSWER THE QUESTION(S), PLEASE INDICATE ACCORDINGLY.  \n \nA. PARTICULARS OF PROPOS ER (Proposer  can be a company / firm / individual)  \nFull Name as shown on NRIC/Passport/BC*    \nMr/Mrs/Mdm/Miss/Dr*  \n \n          Sex: M  F \nAddress:  \n \nTel. No. Home:   Office:                  Ext: \nRace:                            Chinese                    Malay                  Indian                   Caucasian                 Others :  \nNationality:                                                                                                                    Place of Birth:  \n*NRIC/Passport No.                                                                                                        Date of Birth:                  /                /  \n \nAge Next Birthday:                        Marital Status    :        Single         Married           Widowed        Divorced        \n \nPresent Employment Status:              Employed                Unemployed                   Self -employed  \n \nName and Address of Company: __________________________________________ __________________________________________ ______________ ________  \n \nPosition Held: _______________________________ ______________     Exact Nature of Duties involved:  ________________ ____________________________  \n \nB. PLAN PROPOSED  \n \n PLAN:                      A           B             C            D            E  \n \nPeriod of Insurance:  from                      to        Total Premium:         PP:                  GST:  \n              (dd/mm/yyyy)                      (dd/mm/yyyy)  \n                \nC. PARTICULARS  OF PERSONS TO BE INSURED  \n \nFull Name as in *NRIC/Passport/B .C. *NRIC/B.C./Passport \nNo. Sex Date of Birth  ANB  Height (m)  Weight \n(Kg) Occupation  Relationship to Proposer  \n1.         \n2.         \n3.         \n4.         \n \nD. ADDRESS  OF PERSON(S) TO BE INSURED (To be completed if it differs from above)  \n \n \n*Please delete accordingly.  \n  Month                 Day                         Year  Postal Code : \n::"}


created_at: 2024-03-15 18:52:31
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created_at: 2024-03-15 18:52:31
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created_at: 2024-03-15 18:52:31
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Health Insurance Underwriting  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   279  \nG. HEALTH STATEMENT \u2013 To be completed by each insured employee  \n1. Have you or any of the family members to be insured ever had any life, \naccident, hospitalisation or sickness insurance rejected or cancelled or issued \non special terms or declined on renewal?  \n2. Do you or any of the family members to be insured have life, ac cident \nhospitalisation or sickness insurance with this or any other company?  \n3. Do you or any of the family members to be insured have any physical defect, \ndeformity, impairment of hearing or vision, or loss of hand, foot or vision?  \n4. Have you or any of the fa mily members to be insured:  \n(a) ever had a surgical operation?  \n(b) ever been advised to have a surgical operation which has not yet been \nperformed?    \n5. Are you or any of your family members to be insured currently under any \nobservation or receiving any treatment or medicine?  \n6. Have you or any of the family members to be insured ever had or been told \nyou had or been treated for the following disorder or disease:  \n(a) Chronic cough, spitting of blood, asthma, hay fever, pleurisy, \ntuberculosis or an y other disease of the respiratory system?  \n(b) High or low blood pressure, heart disease, chest pain, heart attack, \nshortness of breath, palpitations or any heart disorder?  \n(c) Apoplexy, paralysis, epilepsy, fits, dizziness, mental or nervous \ndisorder?  \n(d) Diabetes, sugar or blood in urine, kidney disorder, kidney colic or stone \nor hernia?  \n(e) Arthritis, sciatica, rheumatism, back, spine, bone, joint, muscle or skin \ndisorder?  \n(f) Ulcer or disorder of the stomach, intestines, haemorrhoids or rectal \ndisorder?  \n(g) Gall bladder stone or liver disease or any type of hepatitis?  \n(h) Cancer, tumour or growth of any organ system, thyroid disorder (such \nas Goitre) or anaemia?  \n(i) Female reproductive system including lumps, but not limited to fibroids \nor cysts.  \n(j) Sexually transmitted disease such as syphilis, gonorrhoea  or herpes or \nnon-specific urethritis?  \n(k) Any illness or disease or injury not mentioned above?  \n \n7. What are the complete details of any questions under 1 to 6 above  \nanswered \u201cYES\u201d?  \n \n \n \n \nQuestion \nNo. Name of Person  Details of Medical \nCondition  Date of First \nConsultation  Duration \nof Illness  Name & Address \nof Dr/Hospital  \n \n \n8. Name and address of your regular doctor (if any)?  \n \n \n9. Please state the type of policy and policy number to Question 2 (above) if your answer is \u201cYes\u201d.  \n \n \nI hereby declare that the foregoing statement and particulars are true and complete and I have not withheld any information t hat \nmay influence the acceptance of this proposal, and I agree that this proposal and declaration shall be the basis of the contr act \nbetween me and the insurer . \nI declare that I and all the named family members to be insured are Singapore citizens or permanen t residents or work permit \nholders or employment pass holders working in Singapore.  \nIt is further understood and agreed that the proposal will be effective only if it has been accepted by the company and the \napplicable premium has been paid.  \nI hereby authorise any hospital, surgeon, medical practitioner, clinic or other medical or medically related facilities, insurer  or \nother organisation or person to release to ABC Insurance Company  (Singapore) Limited any such information with respect to any \nillness and to provide earlier medical history concerning me/us.    \n \n \n \n \n                  Date                             Signature of Prop oser  \nEmployee  \nYes/No  Spouse  \nYes/No  1st Child  \nYes/No  2nd Child  \nYes/No  3rd Child  \nYes/No"}


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{"_node_content": "{\"id_\": \"0986106f-c6f7-4093-b5fd-20d17e3f8cab\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"dedc182e-21d6-4bbf-bfae-ba8c0047fe51\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"7a4a5ee7470eca893313d5ce1e6af5312fd4de1811dab2504c759a43196c6e45\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"69e7c6ef-5f73-4cc7-8154-2bb3ae3c06ef\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"1080445e2a1b6528221cc9dcc8b9396ed8ec0d35fae36203f4ab573cf3e95770\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1021971, \"end_char_idx\": 1025055, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "44\nHEALTH INSURANCE UNDERWRITINGCHAPTER\n12\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nWhat is underwriting? \u2022Underwriting is the process, whereby an insurer assesses the risk and\ndetermines whether or not to accept an application and, if so, on what termsthat it will offer coverage to the applicant or proposer.\nMedical factors \u2022\nMedical history.\n\u2022Current physical condition.\nNon-medical factors \u2022Financial factor.\n\u2022Occupational factor.\n\u2022Age factor.\n\u2022Residency factor.\n\u2022Additional underwriting considerations.\nUnderwriting factors that are specifically important for Medical Expense Insurance\u2022\nMedical background or history.\n\u2022Current physical condition.\nUnderwriting factors that are specifically important for Disability Income Insurance\u2022\nSize and stability of the proposer\u2019s earnings.\n\u2022Overall financial situation.\nUnderwriting factors that are specifically important for Long-Term Care Insurance\u2022\nDetection of any early cognitive impairment.\n\u2022Morbidity risk.\nUnderwriting factors that are specifically important for Critical Illness Insurance\u2022\nSmoking habit.\n\u2022Family history.\nUnderwriting factors that are specifically important for Managed Healthcare\u2022\nSimilar to those for Medical Expense Insurance cover.\n\u2022Age and gender of the group are strong factors in assessing the risk in thegroup.\nTypes of underwriting methods for Health Insurance\u2022\nFull Medical Underwriting.\n\u2022Moratorium Underwriting also known as Point-of-Claim Underwriting.\n\u2022Simplified Issuance Offer (SIO).\n\u2022Guaranteed Issuance Offer (GIO).\nVarious underwriting factors for Group Insurance\u2022\nReasons for existence.\n\u2022Group stability.\n\u2022Group size.\n\u2022Insured company\u2019s nature of business.\n\u2022Employee classes.\n\u2022Level of participation.\n\u2022Age & gender within the group.\n\u2022Expected persistency.\n\u2022Past claims experience.\n\u2022Medical inflation.\n\u2022Medical utilisation rate and trend.\nSources of underwriting information\u2022\nProposal form.\n\u2022Agent\u2019s Statement.\n\u2022Medical Examinations/Tests.\n\u2022Attending Physician\u2019s Statement (APS).\n\u2022Supplementary Questionnaires.\n\n45\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nHow an insurance \nrepresentative can help in \nthe underwriting process?\u2022 \u201cField underwriter\u201d.\n\u2022 By obtaining all required information, the insurance representative can help \nthe underwriter to decide whether there is a need to call for an APS, or a \ncompletion of a questionnaire on diabetes.\n\u2022 By ensuring that all questions in the proposal form are duly completed and \nsigned by the proposer in the presence of the insurance representative, it \nenables the proposal form to be processed expeditiously.\n\u2022 Knowing the underwriting guidelines, such as when medical examinations/tests \nand supplementary questionnaires are required, will also help to expedite the \nunderwriting process.\nVarious terms of \nacceptance for Health \nInsurance proposals\u2022 Standard risks.\n\u2022 Sub-standard risks.\n \u00bbModifications of cover.\n \u00bbPostponement.\n \u00bbDecline.\nWhen does the risk \ncommences?When the proposer agrees to the terms as stated in the letter of acceptance and \npays the premium, the cover will be effected, and a policy will be issued to him."}


created_at: 2024-03-15 18:52:31
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{"_node_content": "{\"id_\": \"69e7c6ef-5f73-4cc7-8154-2bb3ae3c06ef\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"0986106f-c6f7-4093-b5fd-20d17e3f8cab\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"35f44db2446f09af306617c04c9bcea308babe8824f5c6bd50e7623bee775855\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"4ebca2ef-e46b-475b-be5b-34983e34f1ff\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"c9ae5b6c01506e08c8b15d01cdab4411c6854156224fd9165203bbff0bd924ff\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1025060, \"end_char_idx\": 1029636, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Health Insurance   \n280 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4]  \n      CHAPTER 13  \nNOTICE NO: MAS 120 \u2013 DISCLOSURE AND \nADVISORY PROCESS REQUIREMENTS FOR \nACCIDENT AND HEALTH INSURANCE \nPRODUCTS  \n \n \n \nCHAPTER OUTLINE  \n \n1. Introduction  \n2. Scope Of Notice No: MAS 120  \n3. Structure Of Notice No: MAS 120  \nAppendix 13A \u2013 Notice No: MAS 120  \n \n \nLEARNING OUTCOMES  \n  \nAfter studying  this chapter, you should be able to:  \n\u25aa understand the objective of Notice No: MAS 120  \n\u25aa know the types of products covered by this Notice and their definitions  \n\u25aa understand and explain the mandatory requirements  for: \n- the disclosure requirements  for sales of : \no A&H policies  \no life policies that contain A&H benefits  \n- the advisory process requirements in respect of:  \no know -your -client  \no needs analysis  \no documentation and record keeping  \no switching  \n- the additional disclosure requirements being adhered to by direct insurers  \n\u25aa know about the non -mandatory best practice standards on information disclosure, \nprovision of advice, and monitoring of switching for long -term A&H policies under this \nNotice  \n \n \n \n \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   281  \nConten ts \nCHAPTER OUTLINE  ................................ ................................ ................................ . 280 \nLEARNING OUTCOMES  ................................ ................................ ..........................  280 \n1. INTRODUCTION  ................................ ................................ ...............................  282 \n2. SCOPE OF NOTICE NO: MAS 120  ................................ ................................ ..... 282 \n3. STRUCTURE OF NOTICE NO: MAS 120 ................................ .............................  282 \nAPPENDIX 13A  ................................ ................................ ................................ ........  285 \n \n \n\n\n \nHealth Insurance   \n282 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] 1. INTRODUCTION  \n \n1.1 The Monetary Authority of Singapore (MAS) first issued  Notice No: MAS 120 \u2013 \nDisclosure And Advisory Process Requirements For Accident And Health (A&H) \nInsurance Products on 30 January 2004. The last amendment to MAS 120 was \nmade on  1 June 20 22. \n \n \n2. SCOPE OF NOTICE NO: MAS 120  \n  \n2.1 This Notice comprises both mandatory requirements and best practice \nstandards on the disclosure of information and provision of advice to policy \nowners for A&H policies and life policies that provide A&H benefits. This Notice \nis issued in accordance with S ections 67, 72 and 154(4) of the Insurance Act \n1966 . \n \n2.2 Generally, this Notice applies to all direct insurers, licensed or exempt financial \nadvisers who provide advice and/or arranges A&H policies and life policies that \nprovide A&H benefits. This Notice does  not apply where:  \n(a) such policies are in respect of reinsurance of liabilities under insurance \npolicies;  and  \n(b) such policies provide that the A&H benefits are paid out only if the insured \nbecomes totally and permanently disabled, as defined under that policy.  \n \n \n3. STRUCTURE  OF NOTICE NO: MAS 120  \n \n3.1 This Notice comprises the following:  \n \nPart I \u2013 Mandatory Requirements  made up of:  \n \nDivision 1 : General Requirements For A&H Policies \u2013 No direct insurer should  \nuse the word \u201cShield\u201d when naming A&H policy, unless that policy is a \nMedisave -approved policy.  \n \nDivision 1A : Disclosure Requirements For  A&H Policies \u2013 This covers the \nfollowing:  \n(a) General information about the A&H insurance intermediary (including its \nbusiness name under which it conducts its insuranc e business, its \nbusiness address and its telephone number) and status of an A&H \ninsurance representative (including his name, the A&H insurance \nintermediary or intermediaries for which he acts);  \n(b) Remuneration of the A&H insurance intermediary;  \n(c) Conflict of interest;  \n(d) Disclosure when providing advice, including :  \n(i) nature and objective of the policy;  \n(ii) details of the insurer;  \n(iii) contractual rights and obligations;  \n(iv) benefits of the policy;  \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1."}


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{"_node_content": "{\"id_\": \"4ebca2ef-e46b-475b-be5b-34983e34f1ff\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"69e7c6ef-5f73-4cc7-8154-2bb3ae3c06ef\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"1080445e2a1b6528221cc9dcc8b9396ed8ec0d35fae36203f4ab573cf3e95770\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"73afb963-6311-45d0-9579-579e44ec3d4e\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"bc4a8a7f089ade5e6b001b188dc3445daa6e3d506745fcdebb08b91dec75733e\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1029447, \"end_char_idx\": 1033857, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   283  \n(v) risks of the policy;  \n(vi) provision on free -look period of the policy;  \n(vii) claim on termination;  \n(viii) warnings, exclusions and disclaimers;  \n(e) Provisions and explanations of any benefit illustration, product summary, and \ngroup policy under A&H policies;  \n(f) Marketing material; and  \n(g) Telemarking and  direct marketing.  \n \nDivision 2 : Disclosure Requirements For Life Policies That Contain A&H Benefits \u2013 \nThis specifies the regulatory  requirements by an A&H insurance intermediary and an \nA&H insurance representative of a licensed or exempt financial adviser, when \nproviding advice and/or arrange life policies containing A&H benefits.  \n \nDivision 3 : Additional Disclosure Requirements For Direct Insurers \u2013 This covers:  \n(a) meeting the industry standards on the preparation of a benefit illustration or a \nproduct  summary in respect of a policy that the direct insurer underwrites;  \n(b) disclosure of relevant information in the respective documents for every \nIntegrated Shield Plan ( IP) or non -IP;  \n(c) required font size (Times New Roman 10 -point or larger) for product summa ry, \nstatement, conditional offer letter or termination letter with standardised \nrelevant statement of disclosures for any individual Medical Expense Insurance \npolicy, as well as any A&H policy not being Medisave -approved policy; and  \n(d) disclosing and explain ing the policy terms, including any addition, amendment \nor variation to be made in writing to the policy owner, at least 30 days before \ntaking effect.  \n \nDivision 4 : Requirements On Provision Of Advice Relating To A&H Policies \u2013 This \nspecifies that an A&H in surance intermediary who provides health policies to policy \nowners must comply with the requirements relating to the following aspects:  \n(a) Reasonable basis for providing advice;  \n(b) \u201cKnow -Your -Client\u201d;  \n(c) Needs analysis;  \n(d) Documentation and record keeping; and  \n(e) Switching of A&H Insurance policies.  \n \nThis Division shall not apply:  \n(i) in circumstances where no recommendation is made, or where only factual \ninformation is provided with respect to any health policy; or  \n(ii)   to any advice provided in respect of any ElderShield policy.  \n \nDivision 5 : Requirements On Provision Of Advice Rela ting To Life Policies That Contain \nA&H Benefits \u2013 This requires any A&H insurance intermediary or A&H insurance \nrepresentative who is licensed or exempt financial adviser to comply with \nrequirements relating to recommendations and provisions of advice as s et out in the \nFinancial Advisers Act 2001  and its notices issued, including Notice No: MAS 120.  \n \n\n \nHealth Insurance   \n284 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] Division 6 : Offences Relating To This Part \u2013 This specifies that any person who fails to \ncomply with any requirement under any relevant paragraph of Notice No:  MAS 120 \nshall be guilty of an offence punishable under Section 142(3) of the Insurance Act 1966 . \n \nPart II \u2013 Non-mandatory Best Practice Standards  \n \n(1) Information Disclosure & Provision Of Advice \u2013 This specifies that an A&H \ninsurance intermediary is expected  to meet disclosures of all product and \nmarketing information given to policy owners.  \n \n(2) Monitoring Of Switching For Long -Term A&H Policies \u2013 This requires the A&H \ninsurance intermediary should ensure that the policy owner declares in writing \nwhether he had been advised by the A&H insurance representative to switch \npolicy.  \n \n3.2 For details of this Notice and its compliance requirements, refer to Appendix  \n13A which has been adapted in full  from the MAS Website.  \n \n    \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   285  \nAPPENDIX  13A \nNotice No     :        MAS 120  \nIssue Date    :        30 January 2004  \n \nLast revised on 1 June 2022 *   \n \nDISCLOSURE AND ADVISORY PROCESS REQUIREMENTS FOR ACCIDENT AND \nHEALTH INSURANCE PRODUCTS  \n \nIntroduction  \n \n1."}


created_at: 2024-03-15 18:52:31
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{"_node_content": "{\"id_\": \"73afb963-6311-45d0-9579-579e44ec3d4e\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"4ebca2ef-e46b-475b-be5b-34983e34f1ff\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"c9ae5b6c01506e08c8b15d01cdab4411c6854156224fd9165203bbff0bd924ff\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"6e3bcc8a-2301-4589-819b-3174d8752bcf\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"7b855e96476f01f9f2c1fe50982b97c8c6416363bc42f37cd19cddf6e2727f00\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1033858, \"end_char_idx\": 1038037, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "This Notice is issued pursuant to sections 67, 72 and 154(4) of the Insurance Act \n1966 [\u201cthe Act\u201d] and comprises both mandatory requirements and best p ractice \nstandards on the disclosure of information and provision of advice to policy owners for \naccident and health policies and life policies that provide accident and health benefits.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n2. This Notice applies to \u2014 \n \n(a) any direct insurer licensed under the Act;  \n \n(b) any licensed financial adviser or exempt financial adviser which provides \nany financial advisory service in respect of life policies;  \n \n(c) any representative of a licensed financial adviser or an exempt financial \nadviser who provides any financial advisory service in respect of life \npolicies;  \n \n(d) any direct insurance broker or exempt direct insurance broker;  \n \n(e) any perso n acting for a direct insurance broker or an exempt direct \ninsurance broker;  \n \n(f) any insurance agent operating under written agreement pursuant to \nsection 64; or \n \n(g) any insurance agent who is not required to comply with section 64 \n \nwhen he or she or it provides advice or arranges contracts of insurance or both, in \nrespect of accident and health policies and life policies that provides accident and health \nbenefits but does not apply where \u2013  \n \n(i) such policies are in respect of reinsurance of liabilities under \ninsurance policies; and  \n \n(ii) such policies provide that the accident and health benefits are paid \nout only if the insured becomes totally and permanently disabled, as \ndefined under that policy.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n3. This Notice sets out the following in two parts:  \n \n(a) Part I \u2014 Mandatory Requirements  \n\n \nHealth Insurance   \n286 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] (i) Division 1: General requirements for accident and health policies  \n \n(ii) Division 1A: Disclosure requirements for accident and health policies;  \n \n(iii) Division 2: Disclosure requirements for life policies that contain \naccident and health benefits;  \n \n(iv) Division 3: Additional disclosure requirements for direct  insurers;  \n \n(v) Division 4: Requirements on provision of advice relating to accident \nand health policies;  \n \n(vi) Division 5: Requireme nts on provision of advice relating to life \npolicies that contain accident and health benefits;  \n \n(vii) Division 6: Offences relating to this Part;  \n \n(b) Part II \u2014 Non-mandatory Best Practice Standards.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2 015] \n \n4. This Notice shall come into effect on 1 April 2004.  \n \nDefinition  \n \n5. For the purpose of this Notice:  \n \n\u201caccident and health insurance intermediary (hereinafter referred to as A&H \ninsurance intermediary)\u201d means \u2014  \n \n(a) a direct insurer;  \n \n(b) a licensed financial adviser;  \n \n(c) an exempt financial adviser;  \n \n(d) a direct insurance broker; or  \n \n(e) an exempt direct insurance broker,  \n \nwho provides advice on or arranges contracts of insurance or both, in respect of \naccident and health policies and life policies that provides accident and health benefits \nas an insurance intermediary;  \n \n\u201caccident and health insurance repr esentative (hereinafter referred to as A&H \ninsurance representative) \u201d means a person who is \u2014  \n \n(a) employed by or who acts as an insurance agent for, a direct insurer;  \n(b) employed by or who acts for, a direct insurance broker or an exempt direct \ninsurance broke r; or \n(c) employed by or who acts as a representative of, a licensed financial adviser \nor exempt financial adviser,  \n \nand provides advice on or arranges contracts of insurance or both, in respect \nof accident and health policies and life policies that provides accident and \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1."}


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{"_node_content": "{\"id_\": \"6e3bcc8a-2301-4589-819b-3174d8752bcf\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"73afb963-6311-45d0-9579-579e44ec3d4e\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"bc4a8a7f089ade5e6b001b188dc3445daa6e3d506745fcdebb08b91dec75733e\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"574cfee7-75d5-48e1-ab5a-1771bcd61d8f\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"9ff9fbf750fddcc503ba03d5715b2ac8b47adede7bb6a1ff4182415a9b04e0ef\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1037848, \"end_char_idx\": 1040776, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   287  \nhealth benefits as an insurance intermediary, but does not include a person \nwho is an A&H insurance i ntermediary;  \n \n\u201cadditional private insurance coverage\u201d has the same meaning as in regulation \n2 of the MediShield Life Scheme (Private Medical Insurance Scheme) \nRegulations  2015 ; \n  \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n[MAS Not ice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n[Deleted by MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n\u201cCentral Provident Fund Board\u201d means the Central Provident Fund Board \nconstituted under section 3 of the Central Provident Fund Act  1953 ;  \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n[Deleted by MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n[Deleted by MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n\u201cexempt direc t insurance broker\u201d means a person exempt from  registering as a \ndirect insurance broker under section 92(1)(a) to ( f) of the  Act who has notified \nthe Authority, in such manner as may be prescribed under  section 154(1), of his \nor her commencement of insuran ce broking business;  \n \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n\u201chealth policy\u201d means an accident and health policy that is not a personal \naccident policy;  \n \n\u201cindividual medical expense policy\u201d means an accident and health policy, other \nthan an integrated shield plan and a non -integrated shield plan \u2014  \n \n(a) where the policy  owner is an individual; and  \n \n(b) the main purpose of the policy is to reimburse an insured for the medical \ncosts incurred by him in seeking inpatient medical treatment;  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n\u201cintegrated shield plan\u201d has the same meaning as in regulation 2 of the \nMediShield Life Scheme (Private Medical Insurance Scheme) Regulations  2015 ; \n  \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n\u201cinsured\u201d i ncludes an intending insured;  \n \n\u201cmedisave account\u201d has the same meaning as section 2 of the MediShield Life \nScheme Act 2015;  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 202 2] \n \n\u201cMedisave -approved policy\u201d means any,  integrated shield plan , non-integrated \nshield plan  or supplementary disability insurance policy ;  \n \n\n \nHealth Insurance   \n288 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] [MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n[MAS Notice 120 (Amendment No."}


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{"_node_content": "{\"id_\": \"574cfee7-75d5-48e1-ab5a-1771bcd61d8f\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"6e3bcc8a-2301-4589-819b-3174d8752bcf\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"7b855e96476f01f9f2c1fe50982b97c8c6416363bc42f37cd19cddf6e2727f00\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"e6915c5c-423d-4162-b09c-22beb7d45dba\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"83509c8c3fe8f4677bafde215e7fb12e1b4d9b22a5f5fbb4426d6f9600457945\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1040673, \"end_char_idx\": 1043624, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "4] [MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n[MAS Notice 120 (Amendment No. 2) 2020, with effect from 1 October 2020]  \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n\u201cMediShield Life Component\u201d has the same meaning as regulation 2 of the \nMediShield Life Scheme (Private Medical Insurance Scheme) Regulations  2015 ;  \n \n[MAS Not ice 120 (Amendment) 2015, with effect from 1 November 2015]  \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n\u201cMediShield Life Scheme\u201d means the Scheme established under section 3 of the \nMediShield Life Scheme Act 2015;  \n \n[MAS Notice 120 (Am endment) 2015, with effect from 1 November 2015]  \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n\u201cMedisave Withdrawal Limits\u201d means the respective withdrawal limits specified \nin regulation 5(1) of the MediShield Life Scheme (Private Medical Insurance \nScheme) Regulations  2015 ;  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n\u201cnon -integrated shield plan\u201d has the same meaning as in regulation 2 of the \nMediShield Life Scheme (Private Medical Insurance Scheme) Regulations  2015 ;  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n\u201cpersonal accident policy \u201d means an accident and health policy where accident \nand health benefits are paid out only \u2014  \n \n(a) in the event of an injury to, or disability of, the insured as a result of \naccident;  \n(b) on the death by accident of the insured; or  \n(c) on the occurrence of a combinat ion of (a) and (b);  \n \n\u201cpolicy owner\u201d includes an intending policy owner;  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n\u201crepresentative\u201d has the same meaning as in section 2 of the Financial Advisers \nAct 2001 [\u201cthe FA Act\u201d];  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n\u201cselected A&H insurance representative client\u201d means a client of the A&H \ninsurance intermediary who has p urchased a Medisave -approved policy through \nan A&H insurance representative who has been assigned a balanced scorecard \ngrade B or worse under the remuneration framework set out under section 47 of \nthe FA Act consecutively for two calendar quarters immediat ely preceding the \nquarter in which the representative closed the sale of the relevant Medisave -\napproved policy on behalf of the A&H insurance intermediary;  \n \n[MAS Notice 120 (Amendment) 2020, with effect from 13 April 2020]  \n[MAS Notice 120 (Amendment) 2022 , with effect from 1 June 2022]  \n \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1."}


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{"_node_content": "{\"id_\": \"e6915c5c-423d-4162-b09c-22beb7d45dba\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"574cfee7-75d5-48e1-ab5a-1771bcd61d8f\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"9ff9fbf750fddcc503ba03d5715b2ac8b47adede7bb6a1ff4182415a9b04e0ef\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"42afc704-0875-4a8d-b287-5a58e499f080\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"938a0f27a5d081799992b3b759a7801f83759ee59b0be7b2b37fe6dcd5781bcc\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1043435, \"end_char_idx\": 1047464, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   289  \n\u201cselected client\u201d means any client who meets any two of the following criteria \u2013  \n(a) is 62 years of age or older;  \n(b) is not proficient in spoken or written English;  \n(c) has below GCE \u2018O\u2019 level or \u2018N\u2019 level certifications, or equivalent academic  \nqualifications;  \n \n[MAS Notice 120 (Amendment) 2020, with effect from 13 April 2020]  \n \n\u201csupplementary disability insurance policy\u201d has the meaning given by regulation 2 \nof the CareShield Life and Long -Term Care (Supplem ent Scheme) Regulations 2020  \n \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n\u201cswitching\u201d includes terminating a policy and replacing it with another policy, and \n\u201cswitch\u201d shall be construed accordingly;  \n \n\u201cupgrading\u201d means varying the ter ms of an existing policy or terminating an \nexisting policy to purchase a new policy with the same insurer for the purpose of \nhaving better benefits than that under the existing policy, and \u201cupgrade\u201d shall be \nconstrued accordingly.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n6. The expressions used in this Notice shall, except where expressly defined in this \nNotice or where the context otherwise requires, have the same respective meanings as \nin the Act.  \n \nSections 67 and 72 \n \n7. For the purposes of section 67(1)(d) and (2)(e) of the Act, an A&H intermediary \nmust  also disclose the material information set out in paragraphs 12 to 18, 20 to 22, and \n27(a) to (d).  \n \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n8. For the purposes of section 72 of the Act, the standards to be maintained by an \ninsurance intermediary in the conduct of business relating to disclosure and advisory \nprocess include those set out in paragraphs 19, 23 to 25, 27(e), 30, 34 to 46, and 48.  \n \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \nRepresentative of A&H Insurance Intermediary  \n \n9. Unless otherwise specified, an A&H insurance intermediary shall ensure that all \nits A&H insurance representatives comply with any mandatory requi rement imposed \non an A&H insurance intermediary in this Notice when the A&H insurance \nrepresentatives are acting on behalf of the A&H insurance intermediary.  \n \nApplication to Direct Insurers  \n \n10. Unless otherwise specified, this Notice applies to a direct insurer, when it \nprovides advice or arranges contracts of insurance in respect of accident and health \npolicies underwritten by it, as if it were an A&H insurance intermediary.  \n \n[MAS Notice 120 (A mendment) 2015, with effect from 1 November 2015]  \n \n \n \n\n \nHealth Insurance   \n290 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] Part I \u2013 Mandatory Requirements  \n \nDivision 1: General Requirements for Accident and Health Policies  \n \n10A.  No direct insurer shall use the word \u201cShield\u201d in the name, description or title of \nany accident and health policy issued by it unless that policy is a Medisave -approved \npolicy.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n10B. Notwiths tanding paragraph 10A, a direct insurer may, prior to 1 November 2017, \ncontinue to use the word \u201cShield\u201d in the name, description or title of any accident and \nhealth policy issued by it prior to 1 November 2015.  \n \n[MAS Notice 120 (Amendment) 2015, with eff ect from 1 November 2015]  \n \nDivision 1A: Disclosure Requirements for Accident and Health Policies  \n \n11. This Division sets out the minimum standard on disclosure to policy owners by \nA&H insurance intermediaries in relation to accident and health policies that a re \nmandatory.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \nGeneral information about the A&H insurance intermediary and status of an A&H \ninsurance representative  \n \n12."}


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An A&H insurance intermediary shall disclose to the policy owner in writing its \nbusiness name under which it conducts its insurance business, its busin ess address \nand its telephone number.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n13. An A&H insurance representative shall disclose the following to the policy owner \nin writing:  \n(a) his name;  \n(b) the A&H insurance intermediary (or intermed iaries) for which he acts.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n14. Where there is a change to such information referred to in paragraphs 12 and \n13, an A&H insurance intermediary or an A&H insurance representative, as the case  \nmay be, shall inform a policy owner, in writing, of any change to such information in \nthe next dealing right after the change, with the policy owner.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n15. An A&H insurance intermediary shall disclose in writing to a policy owner all \nremuneration, including any commission, fee and other benefit, that it has received or \nwill be receiving for providing advice on, or arranging insurance contracts or both, in \nrespect of any accident and health policy.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \nConflict of Interest  \n \n16. An A&H insurance intermediary shall disclose, in writing, to its policy owners \nany actual or potential conflict of interest arising from any connection to or association \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   291  \nwith any insurer, including any material information or facts that may compromise its \nobjectivity in advice provided by the A&H insurance intermediary.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \nDisclosure when Providing Advice  \n \n17. When dealing with a policy owner who is an individual in respect of any accident \nand health insurance policy, an A&H insurance intermediary shall disclose the following \ninformation to the policy owner:  \n \n(a) Nature and objective of the policy  \n \nThe A&H insurance intermediary shall disclose and explain to the policy \nowner the nature and objective of the policy, including:  \n \n(i) whether the policy is a health policy or a personal accident policy; and  \n \n(ii) whether the policy seeks to reimburse health servi ces costs incurred \nby the insured, provide continuous income during disability or \nsickness, provide lump sum benefits on the occurrence of specified \nevents, or a combination of these.  \n \n(b) Details of the insurer  \n \nIn addition to disclosing to the policy owner the insurer underwriting the \npolicy and its relationship with that insurer required under section 67(1)(a) \nand (b) of the Act, an A&H insurance intermediary must disclose to the \npolicy owner the business addres s of the insurer.  \n \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n(c) Contractual rights and obligations  \n \nThe A&H insurance intermediary shall disclose and explain to the policy \nowner \u2014  \n \n(i) the party against which the policy owner may take action to enforce \nhis rights with respect to the policy he has purchased;  \n \n(ii) that he is responsible for the accuracy and completeness of the \ninformation given to the insurer when applying for the policy and \nwhen making a claim under the policy;  \n \n(iii) that any mis -statement or non -disclosure of material facts may affect \nthe validity of the policy; and  \n \n(iv) the amount of, frequency with which, and period over which,  \npayment is to be made in respect of the policy, incl uding whether the \npremium rate is guaranteed or non -guaranteed.  \n \n(d) Benefits of the policy  \nThe A&H insurance intermediary shall disclose and explain to the policy \nowner the benefits of the policy, including \u2014  \n \n(i) the conditions under which payment of policy moneys are made;  \n \n\n \nHealth Insurance   \n292 Copyright reserved by the Singapore College of Insurance Limited [Version 1."}


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{"_node_content": "{\"id_\": \"e41918ca-3961-4dc8-9599-3c8692d7f32c\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"42afc704-0875-4a8d-b287-5a58e499f080\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"938a0f27a5d081799992b3b759a7801f83759ee59b0be7b2b37fe6dcd5781bcc\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"858c6df4-43e6-4372-aaf4-4cdbdecc2c4b\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"5057977f5166c6d51c51bbfbbccf71fcb52581dffaf99bc84449776677f8575e\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1051646, \"end_char_idx\": 1055790, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "4] (ii) the conditions under which payment of policy moneys will not be \nmade;  \n \n(iii) the amount and timing of the payment of policy moneys;  \n \n(iv) whether the payment of policy moneys are guaranteed or non -\nguar anteed; and  \n \n(v) any lien on the policy.  \n \n(e) Risks of the policy  \n \nThe A&H insurance intermediary shall disclose and explain to the policy \nowner the risks to be borne by the insured or policy owner in the purchase \nof the policy, including:  \n \n(i) whether the insurer may alter the terms of contract, and if so, what are the \nterm s that may be altered and under what conditions would alterations be \nallowed; and  \n(ii) whether the insurer may decline to renew the policy or unilaterally \nterminate the policy.  \n \n(f) Provision on free -look period of the policy  \n \nThe A&H insurance intermediary shal l disclose and explain to the policy \nowner, where applicable \u2014  \n \n(i) the time frame for the policy owner to reconsider his purchase of an \naccident and health policy (\u201cfree -look provision\u201d); and  \n \n(ii) the terms and procedures for exercising the policy owner\u2019s rights \nunder the free -look provision.  \n \n(g) Claim or termination  \n \nThe A&H insurance intermediary shall disclose and explain to the policy \nowner the procedures for, and restrictions on, a claim under his accident \nand health policy and the procedures and  charges for, and restrictions on, \nthe termination of the policy.  \n \n \n(h) Warnings, exclusions and disclaimers  \n \nThe A&H insurance intermediary shall disclose and explain to the policy \nowner all warnings, exclusions and disclaimers in relation to the product it  \nhas recommended to the policy owner.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n18. Where a benefit illustration or a product summary in respect of the accident and \nhealth policy prepared by the insurer or the A&H insurance intermediary is given to the \npolicy owner, the A&H insurance intermediary shall furnish the policy owner with, and \nexplain to the policy owner the content of any such benefit illustration or product \nsummary.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   293  \n19. Where the A&H insurance intermediary prepares a benefit illustration or a \nproduct summary for  a policy owner, it shall be prepared according to industry \nstandards, if any, set for insurers.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n20. In the case of a personal accident policy, the A&H insurance intermediary shall \nensure t hat the policy owner is aware that policy moneys shall be paid as a result of \naccident only.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n21. When dealing with a person who is, or would be the policy owner of a group \npolicy, in respec t of any accident and health policy, an A&H insurance intermediary \nshall disclose the following information to the insured:  \n \n(a) information described in paragraph 17;  \n \n(b) duration of coverage; and  \n \n(c) whether premium paid under the policy qualifies for any special tax \ntreatment, and if so, the nature of such incentive.  \n \n22. For a group policy, where any person insured under the policy is liable to pay \nany premium (whether in monetary form or otherwise), th e A&H insurance \nintermediary shall disclose to every person in the group information as if it is dealing \nwith them individually.  \n \nMarketing Material  \n \n23. An A&H insurance representative shall only use marketing materials which \u2014  \n \n(a) with respect to an integrated shield plan, is approved by the insurer issuing \nthe policy; and  \n \n(b) with respect to an accident and health policy, is approved by the A&H \ninsurance intermediary for which an A&H insurance representative acts for.  \n \n[MAS Notice 1 20 (Amendment) 2015, with effect from 1 November 2015]  \n \nTelemarketing and Direct Marketing  \n \n24."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"858c6df4-43e6-4372-aaf4-4cdbdecc2c4b\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"e41918ca-3961-4dc8-9599-3c8692d7f32c\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"ab63f0981f603e60ac83a5facfdbb4ba24df5a619b8162cbe0fde1a6f5823280\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"35da00b5-9499-45db-ac67-119eccd093bb\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"cbce1eec1bdcd698d463d0722eb9a3dd8d11c1e0245f3aeda802ad71ca094f3c\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1055675, \"end_char_idx\": 1059610, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "[MAS Notice 1 20 (Amendment) 2015, with effect from 1 November 2015]  \n \nTelemarketing and Direct Marketing  \n \n24. Where an A&H insurance intermediary engages in any marketing of accident and \nhealth policies which are not Medisave -approved policies over the telephone in a \nmanne r that is designed to solicit and close a sale, it shall \u2014  \n \n(a) where no advice is provided, communicate to the call recipient a warning \nthat\u2014  \n \n(i) the call recipient may wish to seek advice from an A&H insurance \nintermediary before making a commitment to purchase the policy; \nand  \n(ii) in the event that the call recipient chooses not to seek advice from an \nA&H insurance intermediary, he should consider whe ther the policy \nin question is suitable for him; and  \n \n \n\n \nHealth Insurance   \n294 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] (b) maintain a record of all conversations made over the phone sufficient for \nthe purpose of conducting audit checks where necessary.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n24A.  An A&H insurance intermediary shall not close a sale of any Medisave -approved \npolicy over the telephone where it has engaged in the marketing of the Medisave -\napproved policy over the telephone. Where an A&H insurance intermediary engages in \nthe marketing of any Medisave -approved policy over the telephone in a manner that is \ndesigned to solicit a sale, it shall \u2014  \n \n(a) communicate clearly to the call recipient that it is calling only to provide \ninformation and not to advise the call recipient on the Medisave -approved \npolicy or sell that policy over the telephone;  \n \n(b) follow the script approved by the insurer issuing the po licy, in providing \nany information relating to the policy; and  \n \n(c) maintain a record of all conversations made over the phone sufficient for \nthe purpose of conducting audit checks where necessary.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 Novemb er 2015]  \n \nTemporary Exemption  \n  \n24B. Paragraph 24A of this Notice does not apply for the period from 13 April 2020 to \n30 September 2022  (both dates inclusive).  \n \n[MAS Notice 120 (Amendment) 2020, with effect from 13 April 2020]  \n[MAS Notice 120 (Amendment No. 2) 2020, with effect from 1 October 2020]  \n[MAS Notice 120 (Amendment) 2021, with effect from 1 October 2021]   \n \n24BA. Where an A&H insurance intermediary enga ges in any marketing of any \nMedisave -approved policy over the telephone in a manner that is designed to solicit, \nbut not close a sale of the Medisave -approved policy over the telephone, whether \nadvice is provided on the Medisave -approved policy or not, dur ing the period \nmentioned in paragraph 24B, it shall \u2013 \n \n(a) follow the script approved by the insurer issuing the policy, in providing any \ninformation relating to the policy; and \n \n(b) maintain a record of all conversations made over the phone sufficient for the \npurpose of conducting audit checks where necessary.  \n \n[MAS Notice 120 (Amendment) 2020, with effect from 13 April 2020]  \n \n24BB. Where an A&H insurance intermediary engages in any marketing of any \nMedisave -approved policy over the telephone in a manner that is designed to solicit \nand close a sale of the Medisave -approved policy over the telephone, whether advice \nis provided on  the Medisave -approved policy or not, during the period mentioned in \nparagraph 24B, it shall \u2014  \n \n(a) where no advice is provided by the A&H insurance intermediary on the \npolicy, communicate clearly to the call recipient a warning that \u2013  \n \n(i) the call recipient may  wish to seek advice from an A&H insurance \nintermediary before making a commitment to purchase the policy; and  \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"35da00b5-9499-45db-ac67-119eccd093bb\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"858c6df4-43e6-4372-aaf4-4cdbdecc2c4b\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"5057977f5166c6d51c51bbfbbccf71fcb52581dffaf99bc84449776677f8575e\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"66be8d96-d9af-416c-bb24-c9c48291389c\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"730ef399243b0501dfdd283efe71dbd7c8e6505028075682bd49c99fb1edbadb\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1059421, \"end_char_idx\": 1063291, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   295  \n(ii) in the event that the call recipient chooses not to seek advice from an \nA&H insurance intermediary, the call recipient should consider \nwhether t he policy in question is suitable for him;  \n \n(b) follow the script approved by the insurer issuing the policy, in providing \nany information relating to the policy;  \n \n(c) conduct client call -back with every selected client or selected A&H \ninsurance representative client whom the A&H insurance intermediary had \nclosed the sale of any Medisave -approved policy with, within the time \nframe for the client to reconsider his purchas e of that policy as set out in \nthe terms of the policy in accordance with regulation 8 of the Insurance \n(General Provisions) Regulations; and  \n \n(d) maintain a record of all conversations made over the phone sufficient for \nthe purpose of conducting audit checks  where necessary.  \n[MAS Notice 120 (Amendment) 2020, with effect from 13 April 2020]  \n \n25. Where an A&H insurance intermediary engages in the marketing of accident and \nhealth policies using direct response advertising communications through any \nmedium, includin g mail, print, TV, radio and electronic media, that is designed to solicit \nand close a sale, it shall include, in all its marketing materials, a prominent warning \nthat\u2014  \n \n(a) the policy owner may wish to seek advice from an A&H insurance \nintermediary before pu rchasing the policy;  \n \n(b) in the event that the policy owner chooses not to seek advice from an A&H \ninsurance intermediary, he should consider whether the type of policy in \nquestion is suitable for him; and  \n \n(c) in the event that the policy owner decides that the policy is not suitabl e \nafter purchasing the policy, he may terminate the policy in accordance with \nthe free -look provision, if any, and the insurer may recover from the policy \nowner any expense incurred by the insurer in underwriting the policy.  \n \n[MAS Notice 120 (Amendment) 2 015, with effect from 1 November 2015]  \n \nDivision 2: Disclosure Requirements for Life Policies that Contain Accident and Health \nBenefits  \n \n26. Any A&H insurance intermediary who is a licensed financial adviser or an \nexempt financial adviser and any A&H insurance representative who is a representative \nof such a licensed financial adviser or an exempt financial adviser, providing any \nfinancial advi sory service in respect of life policies is to comply with the disclosure \nrequirements set out in the FA Act.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n27. In addition to those requirements, an A&H insurance intermediary or an A&H \ninsurance representative must  comply with the following paragraphs of this Notice \n(with the necessary modifications) when it provides advice to or arranges  contracts of \ninsurance or both, in respect of life policies that contain accident and health benefi ts:  \n \n(a) paragraph 17(a), (c)(iv), (d)(i), (d)(ii), (e), (f), (g) and (h);  \n \n(b) paragraph 20;  \n \n\n \nHealth Insurance   \n296 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] (c) paragraph 21(b) and (c);  \n \n(d) paragraph 22; and  \n \n(e) paragraph 24.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \nDivision 3: Additional Disclosure Requirements for Direct Insurers  \n \n28. When a direct insurer prepares a benefit illustration or a product summary for \npolicies that it underwrites, it shall be prepared according to industry standards, if any.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n28A."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 66be8d96-d9af-416c-bb24-c9c48291389c
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{"_node_content": "{\"id_\": \"66be8d96-d9af-416c-bb24-c9c48291389c\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"35da00b5-9499-45db-ac67-119eccd093bb\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"cbce1eec1bdcd698d463d0722eb9a3dd8d11c1e0245f3aeda802ad71ca094f3c\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"7ee4505a-955f-42d1-b471-04e7e0086ce9\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"1d52082310a7c0538701923a3a09860d4e6e6ee00152d88c78b6115ac2ea3731\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1063215, \"end_char_idx\": 1067169, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n28A.  For every integrated shield plan or non -integrated shield plan which a direct \ninsurer issues, where the direct insurer provides the policy owner with any of the \nfollowing documents, it shall disclose the following information in the respective \ndocuments:  \n \n(a) the inform ation specified in Part A -1 of Appendix A in any product \nsummary that the insurer issues for the policy;  \n(b) the information specified in Part A -2 of Appendix A in any proposal form \nthat the insurer issues for the policy;  \n(c) the information specified in PartA -3 of Appendix A, in any acceptance letter \nthat the insurer issues for the policy;  \n(d) the information specified in Part A -4 of Appendix A, in any conditional letter \nof offer that the insurer issues for the policy;  \n(e) the information specified in Part A -5 of Appendix A, in any premium \nnotification letter that the insurer issues for the policy;  \n(f) the information specified in Part A -6 of Appendix A, in any termination \nletter that the insurer issues for the policy; and  \n(g) the information specified in Part A -7 of Appendix A, in any claims \nsettlement letter that the insurer issues for the policy.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n28B. Where a direct insurer provides the policy owner who is an indiv idual who is a \ncitizen or permanent resident of Singapore with a conditional letter of offer or \ntermination letter for any individual medical expense policy it issues, it shall include, in \na font size Times New Roman 10 -point or larger, in the conditional letter of offer or the \ntermination letter, as the case may be, the statements as set out in Appendix B.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 30 June 2016]  \n \n28C. Where a direct insurer provides the policy owner with a product summary of any \naccid ent and health policy it issues which is not a Medisave -approved policy, it shall \ninclude, in a font size Times New Roman 10 -point or larger, in the product summary, \nthe statement as set out in Appendix C.  \n \n[MAS Notice 120 (Amendment) 2015, with effect fr om 30 June 2016]  \n \n28D.  Where a direct insurer provides the policy owner with a product summary of any \nrenewable short term accident and health policy it issues, it shall include, in a font size \nTimes New Roman 10 -point or larger, in the product summary, the statement as set out \nin Appendix D.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 30 June 2016]  \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   297  \n29. Where the accident and health policy for a policy owner who is an individual \nprovides that the insurer may vary, amend, or add to the terms of the contract of \ninsurance in th e duration of the contract, the direct insurer shall:  \n \n(a) disclose the existing terms of the contract;  \n \n(b) disclose and explain the new terms of the contract;  \n \n(c) disclose and explain the manner in which the policy owner may accept the \nnew terms or the circumstances under which the policy owner will be \ndeemed to have accepted the new terms; and  \n \n(d) furnish the information under (a), (b), and (c) to the policy owner in  writing \nat least 30 days before the variation, amendment or addition takes effect.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \nDivision 4: Requirements on Provision of Advice Relating to Accident and Health \nPolicies  \n \n30. No A&H insu rance intermediary shall provide any advice with respect to any \nhealth insurance policy to a person who may reasonably be expected to rely on the \nadvice if the A&H insurance intermediary does not have a reasonable basis for \nproviding the advice to the pers on. \n \n31."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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For the purposes of paragraph 30, an A&H insurance intermediary does not have \na reasonable basis for providing an advice to a person unless \u2014  \n \n(a) he has, for the purposes of ascertaining that the advice is appropriate, \nhaving regard to the information posses sed by him concerning the \nobjectives, financial situation and particular needs of the person, given \nsuch consideration to, and conducted such investigation of, the subject -\nmatter of the advice as is reasonable in all the circumstances; and  \n \n(b) the advice is based on the consideration and investigation referred to in \nsub-paragraph (a).  \n32. In this Division, a reference to the provision of advice is a reference to the \nprovision of advice either expressly or by implication and the expression \u201cproviding \nadvice\u201d shall  be construed accordingly.  \n \nThis Division does  not apply \u2013  \n \n33. in circumstances where no recommendation is made or where only factual \ninformation is provided with respect to any health policy . \n \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \n34. An A&H insurance intermediary that is involved in providing advice on health \npolicies to policy owners shall comply with the requirements set out in this Division in \nrelation to the following aspects:  \n \n(a) \u201cKnow -Your -Client\u201d;  \n \n(b) needs analysis; and  \n \n(c) documentation and record keeping.  \n \n\n \nHealth Insurance   \n298 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] [MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n\u201cKnow -Your -Client\u201d  \n \n35. In order for an A&H insurance intermediary to provide an advice to an individual \nthat takes into account a policy owner\u2019s investme nt objectives, financial situation and \nparticular needs, the A&H insurance intermediary shall collect and document the \nfollowing information from the policy owner:  \n \n(a) the objectives of the policy owner, including \u2014  \n \n(i) the event, or events, which financial impact the insured is seeking \nprotection from; and  \n(ii) the nature of benefits payment that the policy owner is seeking, \nwhether it is a lump sum payment or in periodical payments, and \nwhether it relates to cost actually i ncurred by the policy owner or \ninsured; and  \n(iii) the class of hospital ward that the insured is seeking to stay in;  \n \n(b) the employment status of the policy owner;  \n \n(c) the financial situation of the policy owner, including assets, liabilities, cash \nflow and income;   \n \n(d) the source and amount of the policy owner\u2019s regular income;  \n \n(e) the financial commitments of the policy owner;  \n \n(f) any existing health policy of the insured, including any policy moneys \narising from any insurance scheme established and maintained by the \nCentral Provident Fund Board;  \n \n(g) any medical conditions that the insured may have; and  \n \n(h) for any recommendation made in respect of a health policy that intends to \ninclude the policy owner\u2019s dependants as the insureds, the information \nlisted in (a) to (e) for such dependants.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n36. In order for an A&H insurance intermediary to provide advice in relation to a \ngroup insurance policy that takes into account a policy owner\u2019s investment objectives, \nfinancial situation and particular needs, the A&H insurance intermediary shall collect \nand document the following information from the policy owner:  \n \n(a) the objectives of the policy owner, including  \n \n(i) the financial impact of any event for which the policy owner is seeking \nprotection for members of the group;  \n \n(ii) the mode of policy moneys payment that the insured is seeking, \nwhether it is a lump sum payment or in periodical payments, and \nwhether it relates to cost actually incurred by the policy owner or \ninsured; and  \n \n(iii) the class of hospital ward that the insured is  seeking to stay in.  \n \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   299  \n(b) the size and composition of the group, including a breakdown by gender, \nage, income, occupation;  \n \n(c) the claims history of the group; and  \n \n(d) any medical conditions that members of the group may have.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n37."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: cb744d80-1729-4ae4-8daa-6ece4e3439ff
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{"_node_content": "{\"id_\": \"cb744d80-1729-4ae4-8daa-6ece4e3439ff\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"7ee4505a-955f-42d1-b471-04e7e0086ce9\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"1d52082310a7c0538701923a3a09860d4e6e6ee00152d88c78b6115ac2ea3731\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"065bd36e-2f78-476c-bcbc-5055b8bc778a\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"d7c9c81b7d23b188bc56d0cb63f4082437a37215fc20cf3c1191bb1a216cc31e\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1071555, \"end_char_idx\": 1075372, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n37. An A&H insurance intermediary shall highlight the following in writing to its \npolicy owner:  \n \n(a) the information provided by the policy owner will be the basis on which \nthe advice will be made; and  \n(b) any inaccurate or incomplete information provided by the policy owner \nmay affect the suitability of the advice.  \n \n[MAS Notice 120 (Amendment) 2015, with e ffect from 1 November 2015]  \n \nNeeds Analysis  \n \n38. An A&H insurance intermediary shall analyse the information provided by the \npolicy owner and identify the type of policy that is suitable for the insured based on the \ninformation obtained from the policy owner.   \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n39. Where the A&H insurance intermediary is unable to identify a suitable policy, it \nshall inform the policy owner accordingly.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n40. An A&H insurance intermediary shall explain to its policy own er the basis for its \nadvice. The basis on which the A&H insurance intermediary is providing the advice to \nthe policy owner shall be documented.  \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n41. Where a policy owner does not want to:  \n \n(a) provide any information requested by the A&H insurance intermediary in \naccordance with paragraph 35 or 36; or  \n \n(b) accept the advice of the A&H insurance intermediary and chooses to \npurchase another health policy which is not advised by the A&H insurance \ninter mediary,  \n \nthe A&H insurance intermediary may proceed with the policy owner's request, but it \nshall document the decision of the policy owner and inform the policy owner that it is \nthe policy owner\u2019s responsibility to ensure the suitability of the type of policy selected.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n42. Where a policy owner chooses not to receive any advice from an A&H insurance \nintermediary, the A&H insurance intermediary shall properly document the policy \nowner\u2019s decision.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n\n \nHealth Insurance   \n300 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] Documentat ion and Record Keeping  \n \n43. An A&H insurance intermediary shall furnish to its policy owner a document \ncontaining the following when providing an advice in respect of a health policy to the \npolicy owner \u2014  \n \n(a) a summary of the information gathered by the A&H insu rance intermediary \npursuant to paragraph 35 or 36; and  \n \n(b) any advice provided to the policy owner by the A&H insurance \nintermediary and the basis for the advice,  \n \nand, where applicable, a statement that the policy owner does not want to \u2014  \n \n(i) provide any information requested by the A&H insurance \nintermediary in accordance with paragraph 35 or 36;  \n \n(ii) accept the advice of the A&H insurance intermediary and has chosen \nto purchase another health policy which is not that advised by the \nA&H insurance intermediary ; or  \n \n(iii) receive any advice from the A&H insurance intermediary,  \n \nbefore the policy owner signs on the application form for the purchase of a health policy \nor gives h is consent for the withdrawal or surrender of a health policy.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \nSwitching of Accident and Health Insurance Policies  \n \n44. An A&H insurance intermediary shall not provide advice to a policy owner who \nis an individual to switch from one accident and health policy (referred to as \u201coriginal \npolicy\u201d) to another accident and health policy (referred to as \u201creplacement policy\u201d) in \na manner that would be detrimental to the insured."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 065bd36e-2f78-476c-bcbc-5055b8bc778a
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metadata:
{"_node_content": "{\"id_\": \"065bd36e-2f78-476c-bcbc-5055b8bc778a\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"cb744d80-1729-4ae4-8daa-6ece4e3439ff\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"a66303d5cbc73d84ae35c272aebf70b1dafee6156e2702846639bf950fb7db2c\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"1da2d46d-53be-4e2d-8ba3-f00fd16f978d\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"a3879b4cf19ad741057d7e633f9b559f67726c2528f1f026415e6d7bde015267\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1075373, \"end_char_idx\": 1079807, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "In considering whether a switch is \ndetrimental, the Authority shall have regard to a number of factors, including \u2014  \n(a) whether the policy owner suffers any penalty for terminating the original \npolicy;  \n \n(b) whether  the policy owner will incur any transaction cost without gaining \nany real benefit from such a switch;  \n \n(c) whether the replacement policy confers a lower level of benefit at a higher \ncost or same cost to the insured, or the same level of benefit at a higher \ncost; and  \n \n(d) whether the replacement policy is less suitable for the insured.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n45. An A&H insurance intermediary that provides an advice to a policy owner to \nswitch from one accident and heal th policy to another shall comply with the \nrequirements in relation to provision of advice set out in this Division.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n46. An A&H insurance intermediary shall disclose, in writing, to a policy owner \u2014  \n \n(a) any fee or charge the policy owner would have to bear; and  \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   301  \n(b) the changes in level of benefits,  \n \nif he were to switch from one accident and health policy to another, in order to  ensure \nthat the policy owner is able to make an informed decision on whether to switch.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \nDivision 5: Requirements on Provision of Advice Relating to Life Policies that Contain \nAccident and Health Benefits  \n \n47. Any A&H insurance intermediary who is a licensed financial adviser or an \nexempt financial adviser and any A&H insurance representative who is a representative \nof such a licensed financial adviser or an exempt financial adviser, provid ing any \nfinancial advisory service in respect of life policies is to comply with requirements \nrelating to recommendations and provision of advice set out in the FA Act and Notices \nissued thereunder.  \n \n48. In addition to these requirements, an A&H insurance intermediary or A&H \ninsurance representative shall comply (with necessary modifications) with paragraphs \n35(a), (f), (g), (h), 36 and 43 of this Notice when it provides advice in respect of life \npolicies that contain accident and health benefits.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \nDivision 6: Offences relating to this Part  \n \n49. [Deleted by MAS Notice 120 (Amendment) 2015, with effect from 1 November \n2015]  \n \n50. [Deleted by MAS Notice 120 (Amendment) 2015, with effect from 1 November \n2015]  \n \n51. Any person who fails to comply with any requirement under any paragraph in \nPart I of this Notice shall be guilty of an offence punishable under section 142(3)  of the \nAct.  \n \n[MAS Notice 120 (Amendment) 2022, with effect from 1 June 2022]  \n \nPart II \u2013 Non-mandatory Best Practice Standards  \n \nInformation Disclosure and Provision of Advice  \n \n52. The best practice standards which an A&H insurance intermediary is expected \nto meet in all product informati on disclosures and information (including marketing \nmaterials) given to policy owners are as follows.  \n(a) Information disclosed to policy owners in any advertisement or publicity \nmaterial in any media should be presented in plain language, and in a \nmanner tha t is easy for the policy owner to understand.  \n \n(b) Jargon or technical terms used should be clearly explained to policy \nowners.  \n \n(c) Information disclosed to policy owners should not be limited to seeking \ncompliance with requirements the Act and this Notice, but should accord \nwith industry best practices. In addition, the information provided should \nbe sufficient to help policy owners m ake an informed decision.  \n \n\n \nHealth Insurance   \n302 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] (d) Warning and important information such as the nature and objective of the \nproduct, risks of the product, fees and charges, and contractual  \nrights and obligations of policy owners and the insurer, should be \nprominently presented  and clearly explained.  \n \n(e) Information disclosed to policy owners should not be ambiguous in \nlanguage or presentation."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 1da2d46d-53be-4e2d-8ba3-f00fd16f978d
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{"_node_content": "{\"id_\": \"1da2d46d-53be-4e2d-8ba3-f00fd16f978d\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"065bd36e-2f78-476c-bcbc-5055b8bc778a\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"d7c9c81b7d23b188bc56d0cb63f4082437a37215fc20cf3c1191bb1a216cc31e\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"ddf3c16b-0249-4111-85a5-83f7acf0f61d\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"d7f6fcdbecbcf5d1142a0ad13da69fa7ac5cf195eb9becdf52c8cd144b0c8b33\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1079711, \"end_char_idx\": 1084303, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "(e) Information disclosed to policy owners should not be ambiguous in \nlanguage or presentation.  \n \n(f) Information relating to accident and health insurance products should be \ndisclosed in an objective and unbiased manner.  \n \n(g) Where an opini on is expressed, there should be a reasonable basis for \nexpressing the opinion and it should be unambiguously stated that it is a \nstatement of opinion.  \n \n(h) Documents to be given to policy owners should be kept up -to-date.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n53. Where an A&H insurance intermediary provides an advice on or arranges \ncontracts of insurance in respect of accident and health policy, it is expected to comply \nwith any industry standard and/or guideline  on needs -based sales process.  \n \nMonitoring of switching for long -term accident and health policies  \n \n54. To facilitate the monitoring of switching for long -term accident and health \npolicies that may be detrimental to an insured\u2019s interests by an A&H insurance  \nrepresentative, the A&H insurance intermediary should ensure that the policy owner \ndeclares in writing whether he had been advised by the A&H insurance representative \nto switch policy. For the avoidance of doubt, such a declaration should also be made in \nthe following situations:  \n \n(a) the switch is to another accident and health policy with different accident \nand health benefits as the policy that was terminated; and  \n(b) the policy that was terminated was purchased from another A&H insurance \nintermediary.  \n \n[MAS  Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n55. If the policy owner declares that he had been advised by an A&H insurance \nrepresentative to switch, the A&H insurance intermediary should ensure that the policy \nowner makes a declaration on \u2013  \n \n(a) whether the representative has drawn his attention to the costs and \npossible disadvantages associated with the switch; and  \n \n(b) whether he wishes to proceed with the switch notwithstanding that the \nfees, charges or disadvantages that may arise from the switch could \noutweigh any potential benefits.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n56. Where the poli cy owner declares that the A&H insurance representative has \nrecommended a switch, the A&H insurance intermediary should ensure that the \nsupervisor of the A&H insurance representative reviews the switching \nrecommendation, and indicates in writing, whether h e agrees with the recommendation \nmade and if not, the actions that have been taken to rectify the situation. In considering \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   303  \nwhether a switch is appropriate, the supervisor should take into account the factors \nstated in paragraph 44.  \n \n[MAS Notice 120 (Amen dment) 2015, with effect from 1 November 2015]  \n \n57. An A&H insurance intermediary should institute controls, processes and \nprocedures to effectively monitor and track the switching of long -term accident and \nhealth plans, including but not limited to the follow ing \u2013  \n \n(a) tracking the volume of switches so as to identify any A&H insurance \nrepresentatives with an unusually high volume of switching transactions;  \n \n(b) putting in place procedures to ensure that each switch recommended by \nan A&H insurance representative is reviewed  by a supervisor from the A&H \ninsurance intermediary for appropriateness; and  \n \n(c) implementing procedures and controls to identify any unusual trends in \nswitching transactions.  \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n58. Where an A&H insurance intermediary detects a switch that is not declared by \nthe policy owner, the A&H insurance intermediary should ensure that the supervisor of \nthe A&H insurance representative reviews the switch and indicates in writing whether \nhe agree s with the recommendation made, if any, and if not, the actions that have been \ntaken to rectify the situation. In considering whether a recommended switch is \nappropriate, the supervisor should take into account the factors stated in paragraph 44.  \n \n[MAS No tice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n59. An A&H insurance intermediary should ensure that the back -end controls, \nprocesses and procedures implemented are commensurate with the A&H insurance \nintermediary\u2019s nature of business and risks."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"ddf3c16b-0249-4111-85a5-83f7acf0f61d\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"1da2d46d-53be-4e2d-8ba3-f00fd16f978d\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"a3879b4cf19ad741057d7e633f9b559f67726c2528f1f026415e6d7bde015267\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"721885cb-3ebc-46fa-8eef-b7512ddd8a5c\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"a47e7f0a3c38da7452f6b3d7606b213cb33060971610fc8165a10df1b1c1c018\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1084107, \"end_char_idx\": 1088694, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "An A&H insurance intermediary should ensure that the back -end controls, \nprocesses and procedures implemented are commensurate with the A&H insurance \nintermediary\u2019s nature of business and risks.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n\n \nHealth Insurance   \n304 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] APPENDIX A: Information to be included in the respective documents for integrated \nshield plans and non -integrated shield plans  \n \nA-1: Information to be disclosed in the product summary  \n \nComparison of Benefits  \n1. The insurer shall \u2013  \n \n(a) disclose that an integr ated shield plan comprises a MediShield Life \nComponent and the additional private insurance coverage;  \n \n(b) disclose that the final payout, in the event of hospitalisation or medical \ntreatment, will comprise both the MediShield Life Component payout and \nthe integrated shield plan payout, where applicable; and  \n \n(c) provide a comparison of the benefits provided by th e MediShield Life \nScheme and the integrated shield plan.  \n \nBreakdown of standard premium rates  \n2. The insurer shall provide a breakdown of the premiums payable for all age bands \non the basis that the insured does not have any pre -existing condition at the ti me that \nthe product summary is prepared in respect of --  \n \n(a) a citizen or permanent resident of Singapore insured under an integrated \nshield plan; and  \n \n(b) a foreigner insured under a non -integrated shield plan.  \n \nThe insurer shall also include information on the applicable Medisave Withdrawal Limits \nand cash outlay. Where the plan is an integrated shield plan, the insurer shall ensure that \nthe breakdown of premiums payable shows separately the premiums payable for the \nMediShield Life Component and the additional private insurance coverage.  \n \nRisks and limitations of switching or upgrading  \n3. The insurer shall highlight the risks and limitations of \u2014  \n \n(a) switching the integrated shield plan issued by the insurer to that i ssued by \nanother insurer; and  \n \n(b) upgrading the integrated shield plan.  \n \nOption to downgrade an existing integrated shield plan  \n4. The insurer shall highlight that, where the policy owner has concerns on \naffordability, the policy owner has the option to switch to another integrated shield plan \nwith a lower coverage but more affordable plan or, terminate his integrated shield plan. \nWhe re the insured is a citizen or permanent resident of Singapore, the insurer shall \ninform the policy owner that the insured will continue to be covered by the MediShield \nLife Scheme, even if the policy owner terminates the insured\u2019s existing integrated shie ld \nplan.  \n \n \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   305  \nA-2: Information to be disclosed in the proposal form  \nMonies in Medisave account  \n5. The insurer shall ensure that the policy owner declares, before he purchases any \nintegrated shield plan issued by the insurer, that he has received advice from his A&H \ninsurance representative to consider the policy owner\u2019s long -term financial commitment \nto pay the premiums for an integrated shield plan and, that the policy owner should have \nsufficient monies in his Medisave account or sufficient means to pay the MediShield Life \nScheme premiums on an ongoing basis.  \n \nRisks and limitations of switching or up grading  \n6. Where the policy owner has indicated to the insurer that he intends to switch or \nupgrade the policy owner\u2019s existing integrated shield plan, the insurer shall ensure that \nthe policy owner declares that the policy owner\u2019s A&H insurance representati ve has \nhighlighted to the policy owner the risks and limitations of \u2014  \n \n(a) switching the integrated shield plan issued by the insurer to that issued by \nanother insurer; or  \n \n(b) upgrading the integrated shield plan.  \n \nA-3: Information to be disclosed in the accep tance letter  \n \nRisks and limitations of switching or upgrading  \n7. Where the policy owner has indicated to the insurer that he intends to switch or \nupgrade the policy owner\u2019s existing integrated shield plan, the insurer shall highlight to \nthe policy owner the risks and limitations of \u2014  \n \n(a) switching the integrated shield pla n issued by the insurer to that issued by \nanother insurer; or  \n \n(b) upgrading the integrated shield plan.  \n \nStart of policy coverage  \n8."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 721885cb-3ebc-46fa-8eef-b7512ddd8a5c
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Where the inception date of the policy is after the issuance of the acceptance letter, \nthe insurer shall state that \u2013  \n \n(a) the policy commences on the inception date of the policy and not on the date \nof the acceptance letter;  \n \n(b) the policy inception date will be reflected in the policy schedule, which will \nbe sent to the policy owner after the issuance of the policy; and  \n \n(c) where the inception date of the policy is dependent on the successful \ndeduction of monies from the policy own er\u2019s medisave account, the insurer \nshall also state that the policy schedule will be sent to the policy owner upon \nthe successful deduction of monies from the policy owner\u2019s medisave \naccount.  \n \n \n \n \n\n \nHealth Insurance   \n306 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] A-4: Information to be disclosed in the conditional letter of offer  \nBreakdown of premiums payable for insured  \n \n9. The insurer shall, in respect of any integrated shield plan --  \n \n(a) provide a breakdown of the premiums payable for the MediShield Life \nComponent and the additional private insurance coverage;  \n \n(b) a further breakdown of the premiums payable for the MediShield Life \nComponent to reflect any applicable government subsidy, any p remium \nrebate and any additional premiums for serious pre -existing conditions;  \n \n(c) provide a further breakdown of the premiums for additional private \ninsurance coverage to reflect any rebates or any loading imposed by the \ninsurer; and  \n \n(d) indicate the respecti ve amounts payable from the policy owner\u2019s medisave \naccount and cash outlay, where applicable.  \n \n10. The insurer shall, in respect of any non -integrated shield plan, provide a \nbreakdown of the premiums payable to reflect any rebates or any loading imposed by \nthe insurer. The insurer shall indicate the respective amounts payable from the policy \nowner\u2019s medisave account and cash outlay, where applicable.  \n \nMedisave Withdrawal Limits  \n11. The insurer shall provide information on the Medisave Withdrawal Limits \napplicab le for \u2013  \n \n(a) the MediShield Life Component of an integrated shield plan;  \n \n(b) the additional private insurance coverage of an integrated shield plan, in the \ncase where the insured is a citizen or permanent resident of Singapore; or  \n \n(c) the non -integrated shield plan, in the case where the insured is a foreigner.  \n \nRisk-loading factor and standard premium rates  \n12. Where an insurer offers a policy which provides benefits for any medical \nconditions that would otherwise be excluded, for additional premiums, the insurer shall \nindicate the risk -loading factor to be applied to the premiums on t he basis that the policy \nowner does not have any pre -existing condition.  \n \n13. The insurer shall provide a breakdown of the premiums payable for all age bands \non the basis that the policy owner does not have any pre -existing condition at the time \nthat the prod uct summary is prepared in respect of \u2013  \n \n(a) a citizen or permanent resident of Singapore insured under an integrated \nshield plan; and  \n \n(b) a foreigner insured under a non -integrated shield plan.  \n \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   307  \nThe insurer shall also include information on the applicable Medisave Withdrawal Limits \nand cash outlay. Where the plan is an integrated shield plan, the insurer shall ensure that \nthe breakdown of premiums payable shows separately the premiums payable for the \nMediShield Life Component and the additional p rivate insurance coverage.  \n \nRisks and limitations of switching or upgrading  \n14. Where the policy owner has indicated to the insurer that he intends to switch or \nupgrade the policy owner\u2019s existing integrated shield plan, the insurer shall highlight to \nthe policy owner the risks and limitations of \u2014  \n \n(a) switching the integrated shield pla n issued by the insurer to that issued by \nanother insurer; or  \n \n(b) upgrading the integrated shield plan.  \n \nMediShield Life coverage  \n15. Where the insured is a citizen or permanent resident of Singapore, the insurer \nshall disclose that \u2013  \n \n(a) the integrated shield plan comprises a MediShield Life Component; and  \n \n(b) if the policy owner does not purchase the integrated shield plan, the \nMediShield Life Scheme will continue to provide lifetime cover to the \ninsured, without excluding any existing medi cal condition.  \n \nStart of policy coverage  \n16."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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Where the inception date of the policy is after the issuance of the acceptance letter, \nthe insurer shall state that \u2013  \n \n(a) the policy commences on the inception date of the policy and not on the date \nof the acceptanc e letter;  \n \n(b) the policy inception date will be reflected in the policy schedule, which will \nbe sent to the policy owner after the issuance of the policy; and  \n \n(c) where the inception date of the policy is dependent on the successful \ndeduction of monies from th e policy owner\u2019s medisave account, the insurer \nshall also state that the policy schedule will be sent to the policy owner upon \nthe successful deduction of monies from the policy owner\u2019s medisave \naccount.  \n \nA-5: Information to be disclosed in the premium no tification letter  \nMediShield Life coverage  \n17. Where the insured is a citizen or permanent resident of Singapore, the insurer \nshall disclose that \u2013  \n \n(a) the integrated shield plan comprises a MediShield Life Component; and  \n(b) if the policy owner does not purchase the integrated shield plan, the \nMediShield Life Scheme will continue to provide lifetime cover to the \ninsured, without excluding any existing medic al conditions.  \n \n\n \nHealth Insurance   \n308 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] Option to downgrade an existing integrated shield plan  \n18. The insurer shall highlight that, where the policy owner has concerns on \naffordability, the policy owner has the option to switch to another integrated shield plan \nwith a lower covera ge but more affordable plan or, terminate his integrated shield plan. \nWhere the insured is a citizen or permanent resident of Singapore, the insurer shall \ninform the policy owner that the insured will continue to be covered by the MediShield \nLife Scheme, e ven if the policy owner terminates the insured\u2019s existing integrated shield \nplan.  \n \nList of policies due for renewal  \n19. The premium notification letter shall include a list of the policies issued by the \ninsurer that are purchased by the policy owner, at leas t one month before the date of \nrenewal of each policy. The insurer shall, in respect of any integrated shield plan \u2013  \n \n(a) provide a breakdown of the premiums payable for the MediShield Life \nComponent and the additional private insurance coverage;  \n \n(b) provide a further breakdown of the premiums payable for the MediShield \nLife Component to reflect any applicable government subsidy;  \n \n(c) indicate where there are exclusions imposed on the insured in the policy; \nand  \n \n(d) indicate the respective amounts payable fr om the policy owner\u2019s medisave \naccount and cash outlay, where applicable.  \n \nThe insurer shall, in respect of any non -integrated shield plan \u2013  \n \n(a) indicate where there are exclusions imposed on the insured in the policy; \nand  \n \n(b) indicate the respective amounts payable from the policy owner\u2019s medisave \naccount and cash outlay, where applicable.  \n \nBreakdown of premiums payable for insured  \n20. The insurer shall, in respect of any integrated shield plan \u2014 \n \n(a) provide a breakdown of the premiums payable for the MediShield Life \nComponent and the additional private insurance coverage;  \n \n(b) a further breakdown of the premiums payable for the MediShield Life \nComponent to reflect any applicable government subsidy, any p remium \nrebate and any additional premiums for serious pre -existing conditions;  \n \n(c) provide a further breakdown of the premiums for additional private \ninsurance coverage to reflect any rebates or any loading imposed by the \ninsurer; and  \n \n(d) indicate the respecti ve amounts payable from the policy owner\u2019s medisave \naccount and cash outlay, where applicable.  \n \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   309  \n21. The insurer shall, in respect of any non -integrated shield plan, provide a \nbreakdown of the premiums payable to reflect any rebates or any loading imposed by \nthe insurer. The insurer shall indicate the respective amounts payable from the policy \nowner\u2019s medisave account and cash outlay, where applicable.  \n \nMedisave Withdrawal Limits  \n22. The insurer shall provide information on the Medisave Withdrawal Limits \napplicab le for -  \n \n(a) the MediShield Life Component of an integrated shield plan;  \n \n(b) the additional private insurance coverage of an integrated shield plan, in the \ncase where the insured is a citizen or permanent resident of Singapore; or  \n \n(c) the non -integrated shield plan, in the case where the insured is a foreigner.  \n \nBreakdown of standar d premium rates  \n23."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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The insurer shall provide a breakdown of the premiums payable for all age bands \non the basis that the policy owner does not have any pre -existing condition at the time \nthat the product summary is prepared in respect of \u2013  \n \n(a) a citizen or per manent resident of Singapore insured under an integrated \nshield plan; and  \n \n(b) a foreigner insured under a non -integrated shield plan.  \n \nThe insurer shall also include information on the applicable Medisave Withdrawal Limits \nand cash outlay. Where the plan is an integrated shield plan, the insurer shall ensure that \nthe breakdown of premiums payable shows separately the premiums payable for the \nMediShield Life Component and the additional private insurance coverage.  \n \nA-6: Information to be disclosed in the termination letter  \n \nRisks and limitations of switching or upgrading  \n24. The insurer shall highlight the risks and limitations of \u2014  \n \n(a) switchi ng the integrated shield plan issued by the insurer to that issued by \nanother insurer; or  \n \n(b) upgrading the integrated shield plan.  \n \nMediShield Life coverage  \n25. Where the insured is a citizen or permanent resident of Singapore and is not \nterminating this policy in order to switch to another integrated shield plan, the \ninsurer shall inform the policy owner that the insured will continue to be covered \nby the MediShi eld Life Scheme, without excluding any existing medical condition, \neven if the policy owner terminates the insured\u2019s existing integrated shield plan.  \n \n \n \n \n\n \nHealth Insurance   \n310 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] Reinstatement period  \n26. For cases where a policy owner terminates a policy with the intention to switch , \nthe insurer shall highlight to the policy owner that the policy owner may reinstate the \npolicy within 30 days of the date of notice of termination without the need for the insured \nto provide a health declaration.  \n \nA-7: Information to be disclosed in the  claims settlement letter  \n \nBreakdown of claims paid out  \n27. In the event of a claims payment, the insurer shall provide the policy owner with \na breakdown of the claims to be paid out under each of the following, where applicable \n\u2013  \n \n(a) the MediShield Life Component;  \n \n(b) the additional private insurance coverage; and  \n \n(c) integrated shield plan rider, if any.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 1 November 2015]  \n \n\n13. Notice No: MAS 120 \u2013 Disclosure and Advisory Process Requirements  \nfor Accident and Health Insurance Products  \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   311  \nAPPENDIX B: Standardised Disclosures for all Individual Medical Expense Policies  \n \nStatement to be included in the Conditional Letter of Offer for the policy  \n \nStatement to be included in the Termination Letter for the p olicy  \n \nIf you are a citizen or permanent resident of Singapore, you are covered by \nMediShield Life for life, for treatments in Singapore even though you have \nterminated the policy. The cover is provided regardless of pre -existing medical \nconditions or oth er circumstances that you face. For more details on your \ncoverage, please visit www.medishieldlife.sg.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 30 June 2016]  If you are a citizen or permanent resident of Singapore, you are covered by \nMediShield Life for life, for treatments in Singapore, regardless of pre -existing \nmedical conditions or other circumstances that you face. For more details on your \ncoverage, please visit www.medishieldlife.sg.  \n  \nAPPENDIX C: Standardised Disclosures for all accident and health policies which \nare not Medisave -approved policies  \n \nStatement to be included in the product summary of the policy  \n \n \nThis policy is not a Medisave -approved policy and you may not use Medisave to \npay the premium for this policy.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 30 June 2016]  \n \n\n \nHealth Insurance   \n312 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] APPENDIX D: Standardised Disclosures for renewable Short -term Accident and \nHealth Policies  \n \nStatement to be included in the product summary of the policy  \n \nThis is a short -term accident and health policy1 and the insurer is not required to \nrenew this policy. The insurer may terminate this policy by giving you ____2 notice \nin writing.  \n*If you have any existing medical condition at the policy renewal d ate, you may \nnot be covered under the renewed policy for such a medical condition."}


created_at: 2024-03-15 18:52:31
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If such a \nmedical condition is covered under the renewed policy, you may need to pay \nadditional premiums.  \n \n1The insurer shall use in the above statement the same term that is used in the \nproduct summary to refer to the short -term accident and health policy.  \n2The insurer shall set out the relevant notice period, whether in days, weeks or \nmonths.  \n* The insurer shall include this statement only if it imposes exclusions or req uire \nadditional premiums to cover existing medical conditions under the short -term \naccident and health policy at renewal.  \n \n[MAS Notice 120 (Amendment) 2015, with effect from 30 June 2016]  \n \n \n*Endnotes of History of Amendments   \n \n1. MAS Notice 120 (Amendment) 2015, dated 30 October 2015 with effect from 1 \nNovember 2015, except paragraphs 2(z) and 4 which are effective from 30 June \n2016.  \n2. MAS Notice 120 (Amendment) 2020 with effect from 13 April 2020.  \n3. MAS Notice 120 (Amendmen t No. 2) 2020 with effect from 1 October 2020.  \n4. MAS Notice 120 (Amendment) 2021  with effect from 1 October 2021.  \n5. MAS Notice 120 (Amendment) 2022 with effect from 1 June 2022.  \n \nSource: MAS Website   \n \n\n46\nNOTICE NO: MAS 120 \u2013 DISCLOSURE AND \nADVISORY PROCESS REQUIREMENTS FOR \nACCIDENT AND HEALTH INSURANCE PRODUCTSCHAPTER\n13\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nObjective of Notice No: \nMAS 120\u2022 Comprises both mandatory requirements and best practice standards on the \ndisclosure of information and provision of advice to policy owners for A&H \npolicies and life policies that provide A&H benefits.\nGeneral Requirements For \nA&H Policies\u2022 No direct insurer should use the word \u201cShield\u201d when naming A&H policy, unless \nthat policy is a Medisave-approved policy.\nTypes of products covered \nby this Notice and their \ndefinitions\u2022 \u201cElderShield policy\u201d means a policy purchased under the ElderShield Scheme \nas defined in regulation 2 of the Central Provident Fund (Withdrawals for \nElderShield Scheme) Regulations.\n\u2022 \u201cElderShield Supplement policy\u201d means a policy purchased under the \nElderShield Supplement Scheme as defined under regulation 2 of the Central \nProvident Fund (Withdrawals for ElderShield Scheme) Regulations.\n\u2022 \u201cHealth policy\u201d means an accident and health policy that is not a personal \naccident policy.\n\u2022 \u201cIndividual medical expense policy\u201d means an accident and health policy, other \nthan an integrated shield plan and a non-integrated shield plan.\n\u2022 \u201cMedisave-approved policy\u201d means any CareShield Life Supplement policy, \nElderShield policy, ElderShield Supplement policy, integrated shield plan or non-\nintegrated shield plan.\n\u2022 \u201cMediShield Life Component\u201d has the same meaning as regulation 2 of the \nMediShield Life Scheme (Private Medical Insurance Scheme) Regulations.\n\u2022 \u201cMediShield Life Scheme\u201d means the Scheme established under section 3 of the \nMediShield Life Scheme Act 2015 (No. 4 of 2015).\n\u2022 \u201cNon-integrated shield plan\u201d has the same meaning as in regulation 2 of the \nMediShield Life Scheme (Private Medical Insurance Scheme) Regulations.\n\u2022 \u201cPersonal accident policy\u201d means an accident and health policy where accident \nand health benefits are paid out only\u2014 \na. in the event of an injury to, or disability of, the insured as a result of \naccident; \nb. on the death by accident of the insured; or \nc. on the occurrence of a combination of (a) and (b).Please refer to the full notice for more details as not all information is detailed here.\n\u2022 Except for the Notices which were extracted in full from the MAS website, amendments were only made to the title of the \nActs in the relevant paragraphs of the study text. \n\u2022 As the respective notices are still pending release from MAS, they will be updated once MAS has published them."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"ec05fa1d-8aaa-41c5-8fde-ddb7e4eee537\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"7a358754-5768-4853-812f-909ae2dde459\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"8a37339dd78a43c379edb2347c322f5c27141400b1a49421ec310878926decfd\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"5ab0e5b8-9626-44af-98ed-59e8e7ea9eb2\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"e28a37e99eb7d37b12119c7c523c9253e28400ebd4814affa96c1d3311ab857e\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1106336, \"end_char_idx\": 1110741, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "\u2022 As the respective notices are still pending release from MAS, they will be updated once MAS has published them.\n\n47\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nDisclosure requirements \nfor sales of:\u2022\n A&H policies\u2022\n General information about the A&H insurance intermediary (including its business name under which it conducts its insurance business, its business address and its telephone number) and status of an A&H insurance representative (including his name, the A&H insurance intermediary or intermediaries for which he acts).\n\u2022\n Remuneration of the A&H insurance intermediary.\n\u2022\n Conflict of interest.\n\u2022\n Disclosure when providing advice, including: \n \u00bbNature and objective of the policy; \n \u00bbDetails of the insurer; \n \u00bbContractual rights and obligations.\n \u00bbBenefits of the policy.\n \u00bbRisks of the policy. \n \u00bbProvision on free-look period of the policy. \n \u00bbClaim on termination.\n \u00bbWarnings, exclusions and disclaimers.\n \u00bbProvisions and explanations of any benefit illustration, product summary, and group policy under A&H policies.\n\u2022\n Marketing material.\n\u2022\n Telemarking and direct marketing.\nDisclosure requirements for sales of:\u2022\n Life policies that contain A&H benefits\u2022\n Regulatory requirements by an A&H insurance intermediary and an A&H insurance representative of a licensed or exempt financial adviser, when providing advice and/or arrange life policies containing A&H benefits.\n\u2022\n Please refer to the respective paragraphs of the Notice:\n \u00bbParagraph 17(a), (c)(iv), (d)(i), (d)(ii), (e), (f), (g) and (h); \n \u00bbParagraph 20; \n \u00bbParagraph 21(b) and (c); \n \u00bbParagraph 22; and \n \u00bbParagraph 24.\nAdvisory process requirements in respect of:\u2022\n Know-your-client (Individual)\u2022\n Objectives of the policy owner, including\u2014 \n \u00bbthe event, or events, which financial impact the insured is seeking protection from; and \n \u00bbthe nature of benefits payment that the policy owner is seeking, whether it is a lump sum payment or in periodical payments, and whether it relates to cost actually incurred by the policy owner or insured; and \n \u00bbthe class of hospital ward that the insured is seeking to stay in; \n\u2022\n Employment status of the policy owner; \n\u2022\n Financial situation of the policy owner, including assets, liabilities, cash flow and income; \n\u2022\n Source and amount of the policy owner\u2019s regular income; \n\u2022\n Financial commitments of the policy owner; \n\u2022\n Any existing health policy of the insured, including any policy moneys arising from any insurance scheme established and maintained by the Central Provident Fund Board; \n\u2022\n Any medical conditions that the insured may have; and \n\u2022\n For any recommendation made in respect of a health policy that intends to include the policy owner\u2019s dependants as the insureds and the required information for such dependants. \nAdvisory process requirements in respect of:\u2022\n Know-your-client (Group)\u2022\n Objectives of the policy owner, including \n \u00bbthe financial impact of any event for which the policy owner is seeking protection for members of the group; \n \u00bbthe mode of policy moneys payment that the insured is seeking, whether it is a lump sum payment or in periodical payments, and whether it relates to cost actually incurred by the policy owner or insured; and \n \u00bbthe class of hospital ward that the insured is seeking to stay in. \n\u2022\n Size and composition of the group, including a breakdown by gender, age, income, occupation; \n\u2022\n Claims history of the group; and \n\u2022\n Any medical conditions that members of the group may have. \n\n48\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nAdvisory process \nrequirements in respect of:\u2022\nNeeds analysis\u2022Analyse the information provided by the policy owner and identify the type ofpolicy that is suitable for the insured based on the information obtained fromthe policy owner.\n\u2022\nIf unable to identify a suitable policy, it shall inform the policy owneraccordingly.\n\u2022\nExplain to its policy owner the basis for its advice and the basis shall bedocumented.\n\u2022\nWhere a policy owner does not want to provide any information or  accept theadvice of the A&H insurance intermediary and chooses to purchase anotherhealth policy which is not advised by the A&H insurance intermediary,\n\u00bbA&H insurance intermediary may proceed with the policy owner's request,but it shall document the decision of the policy owner and inform the policyowner that it is the policy owner\u2019s responsibility to ensure the suitability ofthe type of policy selected."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"5ab0e5b8-9626-44af-98ed-59e8e7ea9eb2\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"ec05fa1d-8aaa-41c5-8fde-ddb7e4eee537\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"c56e322f09e2ec7a19986d67d0d4dc4065776b804e9f9e730e6bf707de7e466e\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"5ac6195e-e386-400d-98b9-f4b39e772fd8\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"23f40aa36f62402b0c7e81a5e1435c3a88bf114e6c061393e4f1a55fa1c3a60a\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1110742, \"end_char_idx\": 1115819, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Advisory process requirements in respect of:\u2022\nDocumentation andrecord keeping\u2022\nFurnish the policy owner a document containing the following when providingan advice in respect of a health policy to the policy owner\n\u00bbKnow-your-client (Individual); or\n\u00bbKnow-your-client (Group).\n\u2022Any advice provided to the policy owner by the A&H insurance intermediary andthe basis for the advice.\n\u2022\nWhere applicable, a statement that the policy owner does not want to:\n\u00bbProvide any information requested by the A&H insurance intermediaryunder Know-your-client;\n\u00bbAccept the advice of the A&H insurance intermediary and has chosento purchase another health policy which is not that advised by the A&Hinsurance intermediary; or\n\u00bbReceive any advice from the A&H insurance intermediary\nAdvisory process requirements in respect of:\u2022\nSwitching\u2022An A&H insurance intermediary shall not provide advice to a policy ownerwho is an individual to switch from one accident and health policy (referredto as \u201coriginal policy\u201d) to another accident and health policy (referred to as\u201creplacement policy\u201d) in a manner that would be detrimental to the insured. Inconsidering whether a switch is detrimental, the Authority shall have regard to anumber of factors, including\u2014\n\u00bbWhether the policy owner suffers any penalty for terminating the originalpolicy;\n\u00bbWhether the policy owner will incur any transaction cost without gainingany real benefit from such a switch;\n\u00bbWhether the replacement policy confers a lower level of benefit at a highercost or same cost to the insured, or the same level of benefit at a highercost; and\n\u00bbWhether the replacement policy is less suitable for the insured.\n\u2022An A&H insurance intermediary shall disclose, in writing, to a policy owner:\n\u00bbAny fee or charge the policy owner would have to bear; and\n\u00bbThe changes in level of benefits.\nAdditional disclosure requirements being adhered to by direct insurers\u2022\nMeeting the industry standards on the preparation of a benefit illustration or aproduct summary in respect of a policy that the direct insurer underwrites.\n\u2022\nDisclosure of relevant information in the respective documents for everyIntegrated Shield Plan (IP) or non-IP.\n\u2022\nRequired font size (Times New Roman 10-point or larger) for product summary,statement, conditional offer letter or termination letter with standardisedrelevant statement of disclosures for any individual Medical Expense Insurancepolicy, as well as any A&H policy not being Medisave-approved policy.\n\u2022\nDisclosing and explaining the policy terms, including any addition, amendmentor variation to be made in writing to the policy owner, at least 30 days beforetaking effect.\n\n49\nIMPORTANT CONCEPTS DEFINITIONS/EXPLANATIONS\nNon-mandatory best \npractice standards on information disclosure, provision of advice\u2022\nInformation disclosed to policy owners in any advertisement or publicitymaterial in any media should be presented in plain language, and in a mannerthat is easy for the policy owner to understand.\n\u2022\nJargon or technical terms used should be clearly explained to policy owners.\n\u2022Information disclosed to policy owners should not be limited to seekingcompliance with requirements the Act and this Notice, but should accordwith industry best practices. In addition, the information provided should besufficient to help policy owners make an informed decision.\n\u2022\nWarning and important information such as the nature and objective of theproduct, risks of the product, fees and charges, and contractual rights andobligations of policy owners and the insurer, should be prominently presentedand clearly explained.\n\u2022\nInformation disclosed to policy owners should not be ambiguous in language orpresentation.\n\u2022\nInformation relating to accident and health insurance products should bedisclosed in an objective and unbiased manner.\n\u2022\nWhere an opinion is expressed, there should be a reasonable basis forexpressing the opinion and it should be unambiguously stated that it is astatement of opinion.\n\u2022\nDocuments to be given to policy owners should be kept up-to-date.\nNon-mandatory best practice standards on monitoring of switching for long-term A&H policies\u2022\nAn A&H insurance intermediary should institute controls, processes andprocedures to effectively monitor and track the switching of long-term accidentand health plans, including but not limited to the following \u2013\n\u00bbTracking the volume of switches so as to identify any A&H insurancerepresentatives with an unusually high volume of switching transactions;\n\u00bbPutting in place procedures to ensure that each switch recommended byan A&H insurance representative is reviewed by a supervisor from the A&Hinsurance intermediary for appropriateness; and\n\u00bbImplementing procedures and controls to identify any unusual trends inswitching transactions.\n\n14. Financial Needs Analysis  \n \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   313  \n      CHAPTER 14  \nFINANCIAL NEEDS ANALYSIS  \n \n \n \nCHAPTER OUTLINE  \n \n1. Introduction  \n2. Needs Selling Versus Product Selling  \n3. What Is Fact -Finding?  \n4."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
id: 5ac6195e-e386-400d-98b9-f4b39e772fd8
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{"_node_content": "{\"id_\": \"5ac6195e-e386-400d-98b9-f4b39e772fd8\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"5ab0e5b8-9626-44af-98ed-59e8e7ea9eb2\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"e28a37e99eb7d37b12119c7c523c9253e28400ebd4814affa96c1d3311ab857e\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"3f964ace-cdc7-4982-b3ad-8cd03789bdd0\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"3de7e5cb881036fdeb8b464655999abe0468cfae90b8dfe5462f9f153f0bd742\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1115732, \"end_char_idx\": 1121546, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Introduction  \n2. Needs Selling Versus Product Selling  \n3. What Is Fact -Finding?  \n4. Identifying & Quantifying Needs   \n5. Product Recommendations  \n6. Presenting Your Recommendations  \n7. Periodic  Client Review  \nAppendix 1 4A \u2013 Top 10 Conditions Of Hospitalisation  \nAppendix 1 4B \u2013 Hospital Bill Size By Conditions/Procedures  \n \n \nLEARNING OUTCOMES  \n \nAfter studying this chapter, you should be able to:  \n\u25aa know how needs selling differs from product selling  \n\u25aa explain what fact -finding  is \n\u25aa understand the purposes served by the various sections of the Fact-Find Document  \n\u25aa know the answers to the quantification of needs  questions which must be taken into \nconsideration , when going through the prospective client\u2019s Fact-Find Document to \nidentify his needs  \n\u25aa understand the importance of an emergency fund  \n\u25aa know at which stage of the prospective client\u2019s life cycle , where  the need to protect \none\u2019s earnings against disability and  ill health , is critical  \n\u25aa know what to do if the prospective client has the following existing policies:  \n- Disability Income Insurance  \n- Life Insurance with Total & Permanent Disability Benefit  \n- Medical Expense Insurance  \n- Critical Illness Insurance  \n- Personal Accident Insurance  \n- Long -Term Care Insurance  \n- Managed Healthcare Insurance  \n- Hospital Cash Insurance  \n- Life Insurance Polic y & Work Injury Compensation  Insurance    \n\u25aa know how to quantify the following:  \n- disability income protection need s \n\nHealth Insurance   \n314 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] - medical and ancill ary costs  \n- hospital cash income needs  \n- Critical Illness Insurance  \n\u25aa list the two basic principles that you should be aware of , before making any product \nrecommendation  \n\u25aa know the types of product knowledge that you must possess  \n\u25aa understand why is affordability a n important factor when you are selecting a suitable \nproduct to recommend to the prospective client  \n\u25aa know the important points that you must note on policy selection  \n\u25aa know the systematic process of explaining your recommendations to the prospective \nclient  \n\u25aa know when  the reviews for prospective  client are necessary  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n14. Financial Needs Analysis  \n \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   315  \nContents  \nCHAPTER OUTLINE  ................................ ................................ ................................ .........  313 \nLEARNING OUTCOMES  ................................ ................................ ................................ .. 313 \n1. INTRODUCTION  ................................ ................................ ................................ ..... 316 \n2. NEEDS SELLING VERSUS PRODUCT SELLING  ................................ ...................  316 \n3. WHAT IS FACT -FINDING?  ................................ ................................ ......................  317 \nA. Common Sections Of The Fact -Find Document  ................................ ............  317 \n4. IDENTIFYING & QUANTIFYING NEEDS  ................................ ................................  322 \nA. Identifying Needs  ................................ ................................ ............................  322 \nA1. Emergency Fund  ................................ ................................ .......................  322 \nA2. Employment Status & Occupation  ................................ ..........................  323 \nA3. Life Stages  ................................ ................................ ................................  323 \nA4. Dependants  ................................ ................................ ...............................  323 \nA5. Existing Insurance Policies  ................................ ................................ ...... 323 \nA6. Need For Health Insurance  ................................ ................................ ...... 326 \nB. Quantifying Needs  ................................ ................................ ..........................  326 \nB1. Disability Income Protection Needs  ................................ ........................  326 \nB2. Medical Costs  ................................ ................................ ...........................  328 \nB3. Hospital Cash Insurance  ................................ ................................ ...........  329 \nB4. Critical Illness Insurance  ................................ ................................ ..........  330 \n5. PRODUCT RECOMMENDATIONS  ................................ ................................ .........  331 \nA. Product Suitability  ................................ ................................ ...........................  331 \nA1. Good Product Knowledge  ................................ ................................ ........  331 \nB. Affordability  ................................ ................................ ................................ ..... 332 \nC. Important Points To Note On Policy Selection  ................................ ..............  332 \n6. PRESENTING YOUR RECOMMENDATIONS  ................................ ........................  333 \n7. PERIODIC CLIENT REVIEW  ................................ ................................ ....................  334 \nAPPENDIX 14A  ................................ ................................ ................................ ................  335 \nAPPENDIX 1 4B ................................ ................................ ................................ ................  336 \n \n\n\nHealth Insurance   \n316 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] 1."}


created_at: 2024-03-15 18:52:31
topic: persistent://default/default/71e17ef0-3bc9-4074-a848-f5d2cfa67ab5
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{"_node_content": "{\"id_\": \"3f964ace-cdc7-4982-b3ad-8cd03789bdd0\", \"embedding\": null, \"metadata\": {}, \"excluded_embed_metadata_keys\": [], \"excluded_llm_metadata_keys\": [], \"relationships\": {\"1\": {\"node_id\": \"fa2d9045-7b86-42b8-be24-f1750f5bd4a1\", \"node_type\": \"4\", \"metadata\": {}, \"hash\": \"59c4fda642f7a90fe0cffa1f7ef298e0f041e802b8044620af0ef6b6309b0c9d\", \"class_name\": \"RelatedNodeInfo\"}, \"2\": {\"node_id\": \"5ac6195e-e386-400d-98b9-f4b39e772fd8\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"23f40aa36f62402b0c7e81a5e1435c3a88bf114e6c061393e4f1a55fa1c3a60a\", \"class_name\": \"RelatedNodeInfo\"}, \"3\": {\"node_id\": \"d8507d12-e7ef-44e5-9aa1-a610a5a29465\", \"node_type\": \"1\", \"metadata\": {}, \"hash\": \"676e55a422beb3f8bcd7fd83f092d6ddd3487f9f8b094c03912023a782e07321\", \"class_name\": \"RelatedNodeInfo\"}}, \"text\": \"\", \"start_char_idx\": 1121440, \"end_char_idx\": 1125502, \"text_template\": \"{metadata_str}\\n\\n{content}\", \"metadata_template\": \"{key}: {value}\", \"metadata_seperator\": \"\\n\", \"class_name\": \"TextNode\"}", "_node_type": "TextNode", "document_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "ref_doc_id": "fa2d9045-7b86-42b8-be24-f1750f5bd4a1", "chroma:document": "Health Insurance   \n316 Copyright reserved by the Singapore College of Insurance Limited [Version 1. 4] 1. INTRODUCTION  \n \n1.1 In this chapter, we will bring you through the needs analysis process, namely \nfact-finding, identifying  and quantifying needs, product recommendations, \npresenting the recommendations and review.  You are reminded to keep \nyourself abreast of the LIA and GIA Guidelines On Disclosure Requirements and \nNeeds -Based Sales Process for A&H Insurance Products.  Let us begin by \nlooking at the differences between needs selling and product selling.  \n \n \n2. NEEDS SELLING VERSUS PRODUCT SELLING  \n \n2.1 Needs selling  differs from product selling in the following ways:  \n \nTYPES  NEEDS SELLING  PRODUCT SELLING  \n(a) Service  \nOrientation  You help to discover the \nprospect ive client\u2019s  needs \nand advise on the most \nsuitable product , and how \nmuch to buy. You spend \nmore time on the \nprospect ive client\u2019s  \nsituation than you do on \nyour product. You are not \npushing a product, you are \nproviding a serv ice through \na proper needs -based \nadvisory process . \n You assume that the \nprospect ive client  needs \nyour product  and that \nyou go straight into it . \nHowever,  making such \nassumptions can give  the \nprospect ive client  the \nimpression  that your \nmain concern is just to \nsell your product and \nclose a sale.  \n \n \n(b) Pressure To \nBuy You help the prospect ive \nclient  to uncover  his needs \nand recommend suitable \nsolutions  for him. His \nconcerns are already  there \nbefore you r arrival,  and will \nremain after you go , unless \nthe prospect ive client  takes \naction. You are not there to \npressure him to buy your \nproducts , but to offer \nsolutions to his needs.   \n You create pressure to \nbuy and the prospective \nclient may not know why \nhe needs the product . \nPeople will resist \npressure , even if they like \nyour product.  \n \n(c) Long -Term \nRelationships  The focus is on the \nprospect ive client\u2019s  \nsituation , rather than the \nproduct. You show that : \n\u25aa you care his particular \nsituation , rather than \nabout selling your \nproducts ; Your relationship with  the \nprospect ive client  \ndepend s on how well he \nlikes your product. Just \nas you would like to shop \naround before deciding \non a purchase, so would \nthe prospect ive client .  \n\n14. Financial Needs Analysis  \n \nCopyright reserved by the Singapore College of Insurance Limited [Version 1. 4]                                   317  \nTYPES  NEEDS SELLING  PRODUCT SELLING  \n\u25aa you have the knowledge \nto help him to identify his \nneeds and can be trusted \nto help him to find \nrelevant solutions.  \n \nBased on your \nunderstanding of the \nprospective client , you \npropose solutions that meet \nhis budget  and needs.  \n \nYou return to review his \nneeds periodically , hence, \nestablishing an ongoing \nrelationship with him.  The prospective client \nmay become product \nconscious , and expect \nyou to always provide the \nbest-priced solution. Even \nif you make the sale,  the \nnext sale to your new \nclient is not necessarily \ngoing to be easier than \nthe first one.  \n \n \n2.2 In short, needs selling is more desirable than product selling because it is:  \n\u25aa service -oriented;  \n\u25aa not pressure selling; and  \n\u25aa relationship based.  \n \n2.3 In order to  carry out needs selling, you need to know the prospective  client (a \nrequirement under the Notice No: MAS 120 ). This can be achieved by way of  \ncompleting  a fact -find using a Fact-Find Document . There is also Group Fact \nFind, but we will not be touching on the details in this chapter.  \n \n \n3. WHAT IS FACT -FINDING?  \n \n3.1 Fact-finding is the process of obtaining answers to a series of questions about \na prospective client\u2019s personal circumstances, finance and ambitions, etc. for \nthe future. This information will enable y ou to have a better understanding of \nthe prospective client\u2019s objectives, needs and personal profile which will enable \nyou to have a proper basis to recommend suitable Accident and Health ( A&H ) \nInsurance  products to the prospective client."}


