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Medical Claim Procedures

Procedures:

Please contact your Prestige RM consultant immediately with the following document,
 

For Private Hospital:

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  • Original official final and itemized medical bill(s) (including but not limited to) Hospital Tax Invoices, attending physician bills, Pre & Post Hospital Tax Invoices, medical/specialist reports and settlement letter from other insurers if bill(s) partially paid
     

For Restructured Hospital:
 

  • Submit Inpatient Discharge Summary

  • Other supporting documents such as medical/specialist reports, settlement letter from other insurers if bill(s) partially paid
     

Please note the above list of documents is not exhaustive. Other documents may be requested if necessary.

Frequently Asked Questions:

  • Can I go to any physician or hospital I want?
    Yes, subject to limits and benefits as set out in the policy.
  • What is the grace period to submit a claim?
    Claims must be lodged within 30 days from date of occurrence. If the claim is submitted after 30 days, we will need valid reasons for delay in reporting.
  • Do you cover the cost of obtaining medical certificates needed to support the claim?
    No. Prestige RM does not pay for any medical report(s) obtained from hospital/clinic/doctor. Proof of illness/injury will be at the expense of the insured/claimant.
  • Can I email Prestige RM the scanned documents instead?
    No. The documents can be scanned and emailed to us for review however we will need the original copies to process the claim.
  • I am claiming from 2 insurance companies. What is the procedure?
    Please indicate to your Prestige RM consultant that you are lodging a claim with another insurance company, with a copy of the settlement advice and tax invoices (subject to policy terms & conditions). The reimbursement should not exceed the total amount that you have incurred.
  • How much can I claim from my policy?
    This depends on the benefit entitlement in your policy. Please refer to the Schedule of Benefits or your Prestige RM consultant.
  • I have multiple admissions in hospital. How do I submit the claim?
    Each admission or surgery must be accompanied by a Medical Claim Form. Claim form is not required for follow-up visits with the same doctor/hospital.
  • What is a deductible/co-insurance?
    The portion of costs for which insured person/claimant is responsible for. The deductible/co-insurance is applicable for each & every diagnosed medical condition for which a claim is made within any one policy year.
  • What is the minimum number of hours to be confined in hospital in order to lodge a claim?
    For day surgery cases, there is no minimum number of hours to be eligible for a claim. However, for non-surgical admissions, you can submit the claim for assessment when you are charged for a full day Room & Board.
  • When I utilize my Medisave account to pay for my treatment, how will my claim be reimbursed?"
    Payment made from a Medisave account will be refunded to the respective Medisave account accordingly.
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