PRODUCT SUMMARY

FOR
ENHANCED HOSPITAL & SURGICAL INSURANCE
______________
Policyholder : SAP Asia Pte Ltd
Policy No. : 2020761
Period of Insurance : 1 Jan 2020 to 31 Dec 2020

PRODUCT INFORMATION

Group Hospital & Surgical Plan is a medical expense insurance plan that seeks to reimburse the
expenses incurred by an employee and his specified dependents as a result of hospitalization. Through
this insurance scheme, the employee would be able to protect himself against exorbitant and escalating
hospital bills.

Expenses incurred for outpatient kidney dialysis and/or radiotherapy treatment for cancer shall be
payable up to the maximum limit specified in the Benefit Schedule subject to Co-Insurance.

This cover is extended 24 hours a day on worldwide basis and you will begin to receive benefit when
you are :-

(i) hospitalized for at least 6 consecutive hours and room and board charges made or
(ii) undergoing a surgical intervention

paver.1
Aviva: Public 1
SCHEDULE OF BENEFITS

GROUP HOSPITAL & SURGICAL

PLAN D
ELIGIBLE EXPENSES
(Optional)
S$

S$300,000
Annual Limit per Insured Person

Core Benefits
1. Hospital & Related Services
a. In-hospital accommodation up to standard private single In Full
bed, surgery, treatment, facilities and services In Full
b. Cancer Treatment (Inpatient and Outpatient) In Full
c. Kidney Dialysis (Inpatient and Outpatient) In Full
d. Physiotherapy Treatment In Full
e. Day Surgery In Full
f. Casualty ward Accident & Emergency Services In Full
g. Pre-Hospital Specialist & Diagnostic Services In Full
(Within 60 days of hospital admission)
h. Post-Hospital Follow-up Treatment In Full
(Up to 90 days after discharge)
i. Hospital accommodation for accompanying parent In Full
(For Insured Child below 18 years old)
j. Accidental Dental Treatment 2,000
k. Daily Hospital cash for non-paying patient 250
(Max 30 days per disability)

Organ Transplantation
a. Operation costs for Kidney, Heart, Liver & Bone-Marrow In Full
Transplants
(Excluding costs of obtaining donor organs)

Emergency Medical Evacuation & Repatriation

a. Emergency Medical Evacuation & Assistance In Full
b. Repatriation In Full
c. Emergency Medical Advice & Assistance Provided
d. Int’l Travel Assistance Services Provided

Special Benefits
a. Accidental Miscarriage 1,000
b. Death Benefit 5,000

paver.1
Aviva: Public 2
DESCRIPTION OF BENEFITS

Group Hospital & Surgical

Core Benefits

a. In-Hospital accommodation

All Medically Necessary treatment and services shall be payable up to the maximum amount
as specified in the Benefit Schedule. Covers include Hospital accommodation up to the cost
of a standard private class single-bed air conditioned room categorized as a standard
private in that Hospital, meal charges, general nursing services, diagnostic, laboratory or
other Medically necessary facilities and services, physician’s/surgeon’s/anesthetist’s or
physiotherapist’s fee, operating theater charges, intensive care unit charges, specialist
consultations or visits and all drugs, dressings or medications prescribed by the treating
Physician for in-hospital use.

b. Cancer Treatment

Charges for treatment of an insured Person for Cancer irrespective of whether such
treatment is received as a registered in-patient or as an outpatient at a registered Cancer
Treatment Centre

C. Kidney Dialysis Treatment

Charges for treatment of an insured Person for Kidney Dialysis irrespective of whether such
treatment is received as a registered in-patient or as an outpatient at a legally registered
dialysis centre.

D. Physiotherapy Treatment

Charges for physiotherapy treatment of an Insured Person which is received a registered

in-patient at a Hospital.

E. Day Surgery

The cover provided by the Hospital Treatment & Services benefit extends to include Day
Surgery. Day Surgery means all Medically Necessary surgical procedures and related
treatments provided by or order of a Physician to the Insured Person at a hospital.

F. Casualty Ward Accident & Emergency Services

Service provided to the Insured Person as an outpatient in a Hospital Casualty Ward

immediately following an Emergency Medical Complain or Accident.

G. Pre-Hospital Specialist and Diagnostic Services

Charges by Specialist and Laboratory, X-Ray or other Medically Necessary diagnostic

procedures ordered by a Physician and which within 60 days of being carried out, result in
the Insured Person being admitted as a registered in-patient to a Hospital for the treatment
of the specific medical condition diagnosed, provided that such medical condition is covered
by the Policy.

paver.1
Aviva: Public 3
 H. Post-Hospital Follow-Up Treatment

The Medically Necessary follow-up treatment ordered by a Physician to be rendered for up to

90 days from the Insured Person’s discharge from Hospital and in total for any one claim or
disability. Cover is restricted to follow-up treatment on the specific medical condition for which
the Insured Person received in-hospital treatment covered by the Policy.

I. Hospital Accommodation for accompanying parent of Insured child

Accommodation charges incurred by 1 parent sharing the Hospital room of an Insured child
under 18 years old, where the latter us treated for Illness or Injury at a Hospital as an in-patient
for a period.

J. Accident Dental Treatment

Dental treatment required to restore or replace sound natural teeth lost or damaged in the
Accident and for which treatment was received within 14 days following the Accident

K. Daily Hospital Cash

If an Insured Person is admitted to Hospital as a non-paying in patient, where the treatment

is received is free of charged and covered within the terms under this Policy, we will pay the
Insured Person a daily hospital cash benefits up to the sub limits stated in the Benefit
Schedule for a max of 30 days.

Organ Transplantation

The cost of operations for the transplantation of the kidneys, heart, liver, lung or bone marrow where the
Insured Person is the recipient.

We do not pay for the costs of acquiring the organ or expenses incurred by the donor. No other type of
benefit insured by the Policy provides cover in connection with Organ Transplantation.

Emergency Medical Evacuation and Repatriation

This benefit applies while You are travelling:

1 Outside the Home Country or Usual Country of Residence on holiday or business not exceeding
three (3) consecutive months per trip and
2. Within the Home Country or Usual Country of Residence

a. Emergency Medical Evacuation

We will only pay for evacuation or repatriation arrangements if it is prior approved and
authorised by Our 24-hour Emergency Assistance Centre.

b. Repatriation

We will pay the expense necessarily and unavoidably incurred in returning the Insured Person
to the nearer of the Home Country or Usual Country of Residence following Emergency
Medical Evacuation provided that such additional costs are medically Necessary and
approved in advance by US or Our Medical Services.

c. Emergency Medical Advice and Assistance

In emergencies, the Insured Person may call Our 24-hour Emergency Assistance Centre at
(65) 6322 2567 any time for medical advice, and evaluation from attending co-ordinator doctor

paver.1
Aviva: Public 4
 in order to locate suitable medical services anywhere in the world or to provide referral to
Physicians or Hospitals to personal assessment and/or treatment as medically appropriate.
d. International Travel Assistance Services

While the Insured Person is travelling, the 24 hr Emergency Assistance Centre can provide
the following administrative assistance and services:
1. Visa, immunisation, vaccination, special medication and weather information services
prior to departure
2. Retrieval and redirection of lost luggage
3. Replacement and delivery of essential lost travel documents such as passport, travel
tickets, and credit cards; and/or
4. Emergency message transmission and interpreting service

Special Benefits

a. Accidental Miscarriage

Expenses incurred for Accidental Miscarriage that require in-hospital or outpatient treatment by a
Registered Medical Practitioner shall be payable up to the maximum limit specified in the Benefit
Schedule.

b. Death Benefit

Upon receipt of due proof, in the form specified by the Company, of death of an Insured Person, an
amount determined in accordance with the Benefit Schedule shall be payable. The benefit will be
doubled if death is due to an accident (if applicable, subject to a maximum of $10,000).

WHO ARE ELIGIBLE?

i) All full-time active employees up to age 75

ii) Spouse of eligible employee who is below the age of 75 and not divorced or legally separated
from eligible employee
iii) An unmarried and unemployed child of the eligible employee who is between the age of 1 day
and 25 years.

BENEFIT OPTIONS

The benefit options indicated in the Product Summary do not necessarily reflect your
accepted sum assured by insurer, as your chosen sum assured maybe subjected to
underwriting depending on the rules & policies of the Flex program.

Hospital &
Core Benefit Optional Benefits
Surgical

paver.1
Aviva: Public 5
 Single Bed Restructured Employee & Spouse
Single Bed Restructured Employee & Child
Single Bed Restructured Employee & Family
Two Bed
Single Bed Private Employee only
All Employees Restructured
Single Bed Private Employee & Spouse
Employee Only
Single Bed Private Employee & Child
Single Bed Private Employee & Family

Major Medical Core Benefit Optional Benefits

Single Bed Restructured $60k GMM Employee & Spouse

Single Bed Restructured $60k GMM Employee & Child
Single Bed Restructured $60k GMM Employee & Family
Two Bed
Restructured
All Employees Single Bed Private $100k GMM Employee only
$40,000 GMM
Single Bed Private $100k GMM Employee & Spouse
Employee Only
Single Bed Private $100k GMM Employee & Child
Single Bed Private $100k GMM Employee & Family

KEY PRODUCT PROVISIONS

1) EXCLUSIONS

The following are some key provisions found in the policy contract of this plan. This is only a brief
summary and you are advised to refer to the actual terms and conditions in the policy contract.
Please consult your financial advisor or insurance intermediary should you require further
explanation.

(i) Intentional, self-inflicted injury sustained as a result of a criminal act of the Insured Person or
attempted suicide of the Insured Person whether he is sane or insane; psychological,
emotional or mental problems or conditions of the Insured Person; alcoholism or drug addiction
of the Insured Person.
(ii) Congenital anomalies or genetic defects, including hereditary conditions of the Insured Person
present at or existing from the time of his birth regardless of when the Insured Person
discovered or underwent treatment or surgical procedure for the same.
(iii) Treatment relating to birth control, infertility and impotency; treatment or surgical procedures
done at fertility clinics, in-vitro fertilization clinics, reproductive assistance clinics or centres
and reproductive medicine clinics or centres; treatment occasioned by or resulting from
pregnancy, childbirth, abortion, and all complications arising from any of the same, except from
miscarriage.
(iv) Any dental work or treatment, oral surgery, orthodontics and orthognathic surgery; temporo-
mandibular joint disorder except for the cost of surgery required as a result of an injury
sustained by the Insured Person in an Accident.
(v) Eye examination, surgical procedure for correction of eye refraction, procurement or use of
contact lenses or eye glasses; surgical procedure for correction of squint or other eye
misalignment if Insured Person is above 8 years old; cosmetic or plastic surgery except to the
extent that such surgery is necessary for the repair of damage caused solely by bodily injuries
sustained in an Accident.

paver.1
Aviva: Public 6
 (vi) Treatment of xanthelasma, syringoma, acne, alopecia, cosmetic skin surgeries, inguinal hernia
and hydrocele and all complications arising from any of the same; except where the Insured
Person who is under treatment for inguinal hernia and hydrocele is more than 5 years old.
(vii) Services for the primary purpose of diagnosis, medical check-up, genetic or health screening
(irrespective of whether there is Hospital Confinement) and outpatient treatment for
physiotherapy, chemotherapy, immunotherapy, radiotherapy, renal treatment; alternative
medicine including acupuncture, chiropractice, and the like, rest cures, sanatoria care or
special nursing care of any treatment or services that are not medically necessary or
reasonably required for Illness or bodily injury caused by an Accident.
(viii) Treatment of sleep apnea, obesity, weight reduction or weight improvement regardless of
whether the same is caused (directly or indirectly) by a medical condition otherwise admissible
under the policy.
(ix) Circumcision (except where it is medically necessary) or treatment relating to the same.
(x) Venereal disease, AIDS, AIDS related complexes and all illnesses or diseases associated with
the HIV.
(xi) Disabilities resulting from direct participation in a strike, riot or civil commotion, insurrection, or
any act of war (whether declared or undeclared).
(xii) Implants (homograft, heterograft, artificial) and prothesis; procurement or use of wheel-chair,
dialysis machine any other hospital-type equipment.
(xiii) Expenses, administrative or other charges of a non-medical nature in connection with the
provision and/or performance of medical supplies and/or services.
(xiv) For Outpatient Kidney Dialysis and Cancer treatment and Group Major Medical, any pre-
existing conditions which have existed during the 12 months prior to the commencement of
insurance coverage of the insured Person whether known or unknown (as long as the cause
or pathology have already existed) will not be covered.
(xv) When an Insured Person is entitled to benefits payable under any employees’ compensation
legislation, government or public programme of medical benefits, or other group or individual
insurance, the benefits payable under this Policy shall be limited to the balance of expenses
not covered by benefits payable under such legislation, programme or other insurances, or
that computed in accordance with the Benefit Schedule of this Policy, whichever is lesser.

(You are advised to read the policy contract for the full list of exclusions)

2) NON GUARANTEED PREMIUM

Premiums and flex price tags payable for this plan are not guaranteed and may be increased at
Policy Renewal Date at the full discretion of the Company.

3) TERMS OF RENEWAL

This group policy contract may be renewed on the Policy Anniversary Date by payment of the total
annual premium, we can vary the premium and any other terms, conditions or exclusions in this
policy by giving written notice of such change to the Policyholder (employer).

4) CANCELLATION CLAUSE

We may terminate this group Policy on any Renewal Date by giving the Policyholder (employer) at
least 30 days’ prior written notice of termination. Whenever such cancellation occurs, the Company
shall return the unearned portion of premiums paid to the Policyholder (employer). The termination
of coverage shall be without prejudice to payment of claims arising prior to the date of termination.

5) WAITING PERIOD

Not applicable.

6) MISSTATEMENT

A. If the age or date of birth or other relevant facts relating to any Insured Person is misstated
and this affects the scale of benefits or other terms and conditions of this Policy, then we will
use the true age and facts to determine whether insurance coverage is in force and the
paver.1
Aviva: Public 7
 benefits payable under this Policy and if, in our opinion is necessary, an equitable adjustment
of premiums will be made and notice of the adjustment will be given to you.

B. Where a misstatement of age or other relevant facts has caused a person to be insured under
this Policy when he is otherwise ineligible for any insurance, or where such statement has
caused a person to remain insured when he would otherwise be disqualified in accordance
with the provisions of this Policy, his entire insurance coverage shall be void and there shall
be a refund of premiums paid. However, if there is a fraud on the part of the Insured Person,
premiums paid shall not be refunded.

7) FREE LOOK PERIOD

Not applicable.

IMPORTANT NOTICE

This is only product information provided by us and is designed to serve as a guide only. In the
event of clarification or dispute, the prevailing terms and conditions of the Group Insurance
contract with your employer shall apply.

paver.1
Aviva: Public 8