Tokio Marine Insurance Singapore Ltd.

TMCare is a comprehensive Health insurance package tailored to meet increasing healthcare costs by providing cover for hospitalization and surgery expenses as well as a host of ancillary benefits.

Corporate clients can also opt for our Mini Group package which caters for up to 50 employees, or custom group hospitalization programs.

TMCare's basic plan provides the following benefits subject to the limits of the plan you have selected (see Benefit Table):

• Hospital and Intensive care room and board

This pays for the normal ward room and board charges, intensive care ward charges incurred. There is no deductible and no limit on the number of days hospitalised.

• Hospital miscellaneous services

This pays for expenses in respect of in-hospital doctor's visit, drugs, medicine, laboratory tests, administration and the cost of blood or blood plasma, ambulance fees, etc.

• Surgery

This covers surgical procedures (including day surgery) without regard to a surgical schedule that is commonly imposed in other health and surgical insurance.

• Specialist consultation, examination and laboratory test.

This covers specialist fees in respect of consultation, pathology and radiography following referral from a general practitioner. However, this benefit will not apply if the insured person is not hospitalised or surgically treated subsequent to the diagnosis.

• Post-hospitalisation treatment

This pays for follow-up treatment by the same physician up to a period of 90 days immediately following the insured person's discharge from hospital.

• Emergency dental treatment

This pays for dental treatment expenses necessarily incurred to restore or replace sound natural teeth lost or damaged by an accident.

• Emergency accidental out-patient treatment

This covers expenses for emergency out-patient treatment of accidental bodily injuries received within 24 hours of the accident. It also pays for treatment of injuries (other than bone fractures) by Chinese physician subject to a limit of $200 per accident.

• Emergency illness out-patient treatment

This pays for expenses for emergency out-patient treatment between 12 midnight and 6 am of the same day at a hospital in connection with an illness.

• Special grant

This is payable if an insured person dies from an injury or illness during or after treatment at a hospital or in a day surgery.

• Medical report fee

This pays for costs of obtaining medical reports in respect of eligible medical claims under the policy.

• Daily hospital income

If an insured person is hospitalised in a government or government restructured hospital (excluding National University Hospital) due to a disability covered under this policy, an allowance will be paid for each 24-hour period of hospitalisation up to thirty (30) days. A time excess of forty-eight (48) hours is applicable to this benefit.

Major medical treatment

This optional cover supplements the basic medical plan and pays 80% of the medical expenses incurred after the limits under the basic plan have been exhausted.

Out-patient cancer treatment & out-patient kidney dialysis treatment

This optional cover will pay for the expenses incurred in respect of out-patient cancer treatment and/or out-patient kidney dialysis treatment. No deductible or co-insurance is imposed under this optional cover.

Notes to Benefits Table and Premiums of Basic Medical Plan and Optional Covers

• Premiums stated are for standard lives and non-manual occupations only. Premium may be loaded for more hazardous occupations
• Premium is based on non-contributory mode, i.e. employer pays the premium for all insuring members
• Premium is based on average age group of 40 years old and below
• We will advise premiums for dependants upon your providing the full information
• For "takeover" accounts, the application of the above rates may not apply and are subject to our confirmation
• For companies that have less than 20 employees, the insurance acceptance is subject to each employee completing a Health Declaration Form

TMCare is open to all companies having a minimum of 4 and a maximum of 50 full-time employees age (at next birthday) 65 years old and below. Subject to a yearly review, premium loading and approval the cover for the employees is renewable up to the age of 75 years old. For married employee, provided they are already insured under the policy, the policy can, subject to our approval, extend to cover the insured employees' families.

The following are some key provisions of TMCare:

• Policy cancellation

The policy may be cancelled by either us or you by giving the other party 30 days prior notice in writing. If the policy is cancelled by us, a pro-rata premium will be charged for the period cover has been provided. If you cancel the policy (provided there is no claim thereunder), the premium charged for the period covered will be based on our short-period rates.

• Terms of renewal

The insurance is renewable annually and renewal premium is payable on the policy anniversary date. At the time of the policy renewal, you must disclose to us, fully and faithfully all the facts you know or ought to know, otherwise you may not receive any benefit under the renewed policy.

• Non-guaranteed premium

Premiums payable for this insurance are not guaranteed (i.e. subject to change). Premiums may be increased at policy renewal at our full discretion.

• Waiting period

This policy shall not apply and no benefits will be payable if the insured person is hospitalised or has to undergo surgery due to an illness or a disorder diagnosed within 30 days from the first commencement date of this insurance. However, this condition does not apply to policy renewals.

• Reasonable & customary charges

This is defined as the general level of charges in Singapore for similar or comparable treatment, services or supplies rendered to individuals of the same sex and comparable age relating to similar disease or injury. The benefits payable under this insurance shall be the lower of the reasonable and customary charges as defined and the charges incurred in a foreign country in which actual treatment was administered.

• Exclusions

There are certain conditions/situations under which no benefits will be payable. These are stated as exclusions in the policy. The following are some of the exclusions. You are advised to refer to the policy for the full list of exclusions.

• Pre-existing condition

This is defined as any known medical condition from which the insured person is suffering on or before the issuance of the policy, including those for which treatment, medication or advice has been received before the issuance of the policy;

• Congenital anomalies or defects

This insurance does not cover any hospitalisation or surgical charges incurred directly or indirectly for the treatment of congenital abnormalities or physical defects that have been in existence since birth;

• Out-patient treatment that is not related to the in-patient treatment or day surgery except where it is resulting from an accident or unless cover is expressly given;
• Hospitalisation primarily for diagnosis, x-ray examinations, general physical or medical check-up;
• Treatment for obesity, weight reduction, weight improvement, refractive errors of the eyes, correction of vision, cosmetic or plastic surgery including the provision of implants, medical appliances, spectacles, lenses, hearing aids, wheel chairs and prostheses;
• Sexually transmitted diseases or communicable diseases requiring isolation or quarantine by Law
• Treatment arising from pregnancy which shall include childbirth, miscarriage (except as a result of an accident)
• War and terrorism

IMPORTANT
This brochure is for general information only and is not a contract of insurance. You should refer to the policy for the exact terms and conditions of this insurance.