PRUshield electronic Letter Of Guarantee (eLOG)

A2:

If the customer is covered under PRUShield only (without PRUExtra), the per policy year deductible and co-insurance will not be included in the eLOG request. Upon issuance of the eLOG, the life assured is still required to pay the deductible and co-insurance upfront.

At the time of discharge, the hospitals have full discretion over the hospital bill payment terms (whether in full or partial) by the policyholder despite the utilisation of eLOG.

Example - Customer has PRUShield only

Example - Customer has PRUShield and PRUExtra

A3:

• Customers’ PRUShield (and PRUExtra, if applicable) policies are accepted on standard terms and have been in-force for at least 12 months from the date of inception or date of reinstatement, whichever is later.
• Only for Singaporeans or Singapore Permanent Resident

A4:

The following groups are not eligible:

• PRUShield Foreigner Plans
• Policies on substandard terms
• Policies with outstanding claims or recovery of claims in record
• Policies with unpaid premiums within the grace period
• Policies incepted less than 1 year

A5:

Request for eLOG should be made at the Hospital's admission office, usually during the financial counselling by the hospital. Customers do not have to request for eLOG from Prudential directly. The admission staff in the hospital would be able to determine if the customer is eligible for eLOG from the eLOG system. For those who are eligible, the hospital would be able to generate the eLOG. For those who are not eligible, no eLOG will be generated and granted.

The issuance of eLOG is also subject to the life assured's signing against the MediSave Claim Authorisation Form (MCAF) at the hospital.

A6:

Yes, in the following situations:

• The required deposit exceeds the eLOG limit; or
• The actual hospital bill is not covered by PRUShield policy; or
• For non-medical / treatment - related items which are not covered under PRUShield.
• Plans with 5% co-pay portion
• No PRUExtra plans

A7:

Prudential reserves the right to refuse renewal of the customer's PRUShield (and PRUExtra, if applicable) policy if the outstanding claim amount owing is not paid. This would be made known to the customer when the eLOG is issued.

A8:

eLOG is only applicable at the following participating Medical Institutions.

A9.

eLOG facility is only available for inpatient hospital treatments and Day Surgery.

Exclusions:

• Outpatient treatments such as consultation/ review, chemotherapy, renal dialysis and pre- and post-hospitalisation treatment
• Overseas treatment
• Treatments that are listed in the PRUShield policy general exclusions listed in the following:
• All expenses incurred by a life assured for the period of Hospital Confinement if admission into a Hospital is before the Cover Start Date of the policy.
• Treatment or diagnosis of any Serious Illness for which the life assured received medical treatment (including follow-up and consultations) during the period of twelve months prior to the Cover Start Date of the policy.
• Any pre-existing illnesses, diseases or impairments from which the life assured is suffering from prior to the Cover Start Date of the policy, unless they were declared in the proposal and specifically accepted by us. A pre-existing condition is the existence of any signs or symptoms for which treatment, medication, consultation, advice or diagnosis has been sought or received by the life assured or would have caused an ordinary prudent person to seek treatment, diagnosis or cure, prior to the Cover Start Date of this benefit or the date of reinstatement (if any), whichever is later.
• Treatment relating to birth defects, including hereditary conditions and congenital sickness or abnormalities.
• Mental illness and personality disorders.
• Pregnancy, or any form of hospitalization or treatment relating to pregnancy, childbirth, abortion or miscarriage.
• Infertility, sub-fertility, assisted conception or any contraceptive treatment.
• Treatment of sexually transmitted diseases.
• Acquired Immunodeficiency Syndrome ("AIDS"), AIDS related complex or infection by Human Immunodeficiency Virus ("HIV").
• Treatment of self-inflicted injuries, or injuries resulting from attempted suicide.
• Treatment directly or indirectly arising from drug or alcohol misuse.
• Cosmetic or plastic surgery.
• Dental treatment.
• Ambulance fee.
• Sex change operations.
• Purchase of kidney dialysis machine, replacement organ, iron-lung, prosthesis and other special appliances including the location, transport and associated administration costs of such special appliances.
• Optional items which are outside the scope of treatment.
• Private nursing charges and nursing home services.
• Vaccination.
• Treatment of Injuries arising from direct participation in civil commotion, riots or strikes.
• Treatment of Injuries arising directly or indirectly from nuclear fallout, terrorism, war and related risks.
• Medical services/hospitalisation primarily for screening, diagnosis, X-ray examinations, and general physical or medical check-up.
• Treatment of illness or Injury resulting from the life assured engaging in any hazardous activities or sports in a professional capacity; or where the life assured would or could earn or earns income or remuneration in these hazardous activities or sports.
• Treatment of illness or Injury caused by any hazardous activities or sports unless carried out legally under the supervision of licensed organisations.
• Treatment relating to obesity; weight reduction; weight improvement or procedures relating to weight management.
• Violation or attempted violation of law, resistance to lawful arrest or any resultant imprisonment;
• Non-medical items such as, but not limited to, parking fees, Hospital Administration and Registration fees, laundry, rental of television, newspaper, medical report fees.
• Rest cures, hospice care, home or outpatient nursing or palliative care, convalescent care in convalescent or nursing homes, sanatoriums or similar establishments, outpatient rehabilitation services such as counselling and physical rehabilitation.
• Alternative or complementary treatments including Traditional Chinese Medicine (“TCM”) or a stay in any healthcare establishment for social or non-medical reasons.
• Experimental or pioneering medical or surgical techniques, clinical trials for drugs or medical devices not approved by the Ministry of Health.
• Elective Hospital Confinements, medical treatments or medical services which are not Medically Necessary.
• Any genetic testing and preventive treatments or procedures.
• All medical expenses incurred by life assured if the approved guaranteed claim amount has exceeded the Policy Year Limits as set out in the policy Benefits Schedule.
• All medical expenses incurred by the life assured if the date of admission or day surgery occurs during grace period of the PRUshield and/or PRUextra policy where premiums are not paid.

A10.

The eligibility of the eLOG does not mean that Prudential admits or approves any claim made under PRUShield for the hospitalisation. Each claim will still be assessed by Prudential after the final hospital bill is e-filed to Prudential.

In the event that the claim is not payable under PRUShield, the policyholder has to make full payment owing to the hospital

A11.

The eLOG is subject to acceptance by the hospital. It does not guarantee a waiver of deposit or cashless facility.

A12.

No. As the eLOG is generated by the participating hospitals on the day of admission or surgery, neither the Prudential Financial Consultant nor the customer is required to call Prudential in advance to request for the LOG.

A13.

Yes.

A14.

The excess deposit would have to be borne by the life assured.

Example

A15.

In that case, no eLOG will be issued under PRUShield policy.