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Do you think Moratoria Underwriting is a heavy load over claims management shoulders?

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Question added by Mohammad Qawasmi , Freelancer, Case Management , Freelancing
Date Posted: 2015/04/15
abdulrhman frikha
by abdulrhman frikha , MEDICAL CLAIMS SPECILAIST AND PROVIDER RELATIONSHIP , GLOBEMED SAUDI

1 As charged refers to the eligible expenses incurred by Life Assured which is subject to pro-ration, deductible, co-insurance, policy year limit, admission of ward class and other policy terms.2 Ward type benefits depend on the MyShield Plan type i.e. Plan 1, Plan 2 or Plan 3 to which Life Assured is entitled.3 Pre and Post hospital treatment refers to the eligible expenses incurred up to 90 days before admission (for pre-hospital) and 90 days after discharge (for post-hospital). Treatment received in the Accident and Emergency department in a hospital within 24 hours prior to the hospital admission is covered under pre-hospital treatment benefit. 4 Benefits depends on the MyShield Plan type under which Life Assured is covered. Pre-hospital treatment received before and post-hospital treatment received after emergency overseas treatments are not covered. Please refer to Product Summary and Policy contract for details. 5 Free coverage for children is provided based on Plan 2 of MyShield, subject to underwriting, up to 20 years of Age Next Birthday (ANB), provided you and your spouse are covered under Plan 1 or 2 of MyShield. 6 Only for applicant who has chosen Moratorium Underwriting and provided applicant has not been declined / deferred for the insurance applications and/or do not need to pay Additional Premiums for MediShield Life . Please refer to Product Summary and Policy contract for detailed terms and exclusion. 7 Letter of Guarantee (LOG) will be issued to Hospitals for Life Assured who is hospitalised as an inpatient at participating hospitals, provided that the estimated total bill amount exceeds the plan deductible amount (if applicable). Please refer to our website www.aviva.com.sg for the list of participating hospitals. 8 Upon referral from the attending doctor in a restructured hospital / private hospital for immediate admission to a community hospital for continuous stay. The treatment in the community hospital must arise from the same injury or illness that resulted in the life assured’s inpatient treatment in the restructured hospital or private hospital. 9 Please refer to the Benefits Schedule/ Product Summary for the list of complications covered under Inpatient pregnancy complications. Pre-hospital treatment received before and post-hospital treatment received after inpatient pregnancy complications treatments are not covered. 10 Please refer to Policy contract for details of major outpatient treatment. 11 Living donor organ transplant benefit covers charges for major organ transplants of the kidney or liver where the life assured is a living donor. Pre-hospital treatment received before and post-hospital treatment received after living donor organ transplant are not covered. - See more at: https://www.aviva.com.sg/life-and-health/for-individuals/health.html#sthash.3fCMP07w.dpuf

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