Your policy Things to remember
This is your personal accident insurance policy and it - You and the policyholder must reveal all facts you or
contains details of benefits, conditions and exclusions the policyholder know or ought to know which may
relating to each insured person. The policy will form the affect the insurance cover the policyholder is
basis on which we will settle all claims. It is only valid if applying for. If not, your policy may not be valid.
you have paid the appropriate premium in full and we - We do not cover claims arising from sickness or
have issued you with a schedule. pre-existing medical conditions.
- We may refuse to pay your claim if you do not tell
Any statement, information or declaration the
us that you have changed your occupation.
policyholder or you have given on behalf of the insured
people, including any declaration made over the phone, - You must not be an undischarged bankrupt and have
or by fax, email or the internet at the time of application, not committed any act of bankruptcy within the last
will form the basis of the contract. 12 months.
The schedule and any further endorsements are all part
of the policy.
Please keep this document in case you need to refer to
Act of terrorism means an act (which may include using
or threatening force or violence) by any person or group,
committed for political, religious, ideological or similar
Who is eligible? purposes, with the aim of influencing any government or
to put the public, or any section of the public, in fear.
Robberies or other criminal acts mainly committed for
This policy is only available to you if you: personal gain and acts arising mainly as a result of
- hold a valid Singapore identification document such personal relationships will not be considered as an act of
as a Singapore National Registration Identification terrorism.
Card (NRIC), Employment Pass, Work Permit, Long Act of terrorism also includes any act which is confirmed
Term Visit Pass or Student Pass; by the relevant government as an act of terrorism. Using
- are living or working in Singapore, or away from nuclear, chemical or biological substances or weapons as
Singapore for no more than 180 days at any one a means of force or violence will also be considered an
time; act of terrorism.
- are between 15 days old and 65 years old (we may
Accident or accidental means a sudden, unexpected
continue cover for you up to 75 years old at a
event which happens during the period of insurance and
reduced sum insured and we may apply new terms;
which must be the only cause of injury.
depending on our decision and if you pay an extra
Age means your current age at the start date of the
- have fully paid your premium. policy.
Assistance company means the company we have
appointed to provide you with various emergency
PL/Personal Accident/201208 Page 1 of 9
Chinese medicine practitioner means a legally licensed Losing means permanent and total loss of use, or loss by
herbalist, acupuncturist or bone-setter who is registered having part of the body (as listed in the scale of
and can practise within the scope of their licence under compensation table) cut or torn off, as confirmed by our
the laws of the country. This cannot be you, your family medical practitioner.
member, partner, business partner, employer, employee
or agent. Losing hearing means permanent and total loss of
hearing, as confirmed by our medical practitioner.
Chiropractor means a legally licensed practitioner in
chiropractic medicine who is registered and can practise Losing a limb means permanent and total loss of, or loss
within the scope of their licence under the laws of the of use of, a hand at or above the wrist or a foot at or
country. This cannot be you, your family member, above the ankle. This must be confirmed by our medical
partner, business partner, employer, employee or agent. practitioner.
Dental treatment means treatment necessary to restore Losing sight means total and permanent loss of use of an
sound and natural teeth and which is made necessary eye which means you are absolutely blind in that eye
due to an accident. and which is beyond cure either by surgical or other
treatment. This must be confirmed by our medical
Endorsement means an authorised amendment to this practitioner.
Losing speech means permanent and total loss of the
Family member means your husband or wife, children, ability to speak and which is beyond cure either by
parents, brothers and sisters, parents-in-law, surgical or other treatment, as confirmed by our medical
brothers-in-law, sisters-in-law, grandparents, practitioner.
grandparents-in-law, daughters-in-law, sons-in-law or
grandchildren. Medical practitioner means any person registered and
legally qualified as a doctor by a medical degree in
Hijack or hijacked means someone who takes, by force western medicine and authorised by the medical
or threat of force or violence, a vehicle in which you are licensing authority of that country to provide medical or
travelling. surgical service within the scope of their licence and
training. The medical practitioner should not be you,
Home country means any country of which you are a your family member, partner, business partner,
citizen. employer, employee or agent.
Hospital means an establishment which is registered Occupation means your full-time or part-time gainful
under the relevant national laws and regulations to care employment or any other work for pay or profit as
for and treat sick and injured people as bed-paying shown in the schedule.
patients and which:
- has organised facilities for diagnosis, treatment and Period of insurance means the period of cover as shown
major surgery; in the schedule.
- provides nursing services by registered nurses 24
Permanently disabled or permanent disability means
hours a day;
suffering from one of the items of disablement listed in
- is under the supervision of one or more medical the scale of compensation table in this policy, and which
practitioners; and was caused only by an accident, as long as:
- is not mainly a clinic, a secure place to care for - the disability lasts for 12 months in a row from the
alcoholics or drug addicts, a nursing or rest or date of accident; and
convalescent home or a home for the elderly or
- our medical practitioner confirms that it is not going
to improve after 12 months.
Injury means damage or harm caused to the body by an
Permanent total disability means total disability caused
external force suffered during the period of insurance
only by an accident that:
and which is caused only by an accident.
- stops you from working in any job for a salary or
Insured person means the individual (or individuals) wage or stops you from carrying out any business
named in the schedule as the person (or people) who is whatsoever; and
insured under this policy. - lasts for 12 months in a row from the date of the
- our medical practitioner confirms that it is not going
to improve after 12 months.
PL/Personal Accident/201208 Page 2 of 9
Policy means this document, including any information
provided or declaration made by the policyholder for
and on behalf of the insured person (or people), the What your policy covers
schedule and any endorsements we have issued under
This policy will protect you financially when a death or
Policyholder means the person named and who has injury happens during the period of insurance.
made a declaration on behalf of insured person and paid
the premium as shown in the schedule. The amount we will pay depends on the conditions and
maximum benefit limits of your plan as set out in the
Policy year means a period of 12 months from the start schedule.
date as shown in the schedule and each further
consecutive period of 12 months for which the policy
applies from or for any period of cover as agreed A Main benefits
between the policyholder and us.
Pre-existing medical condition means any injury or
Section 1 – Accidental death
sickness, including any complications which may arise:
If you are involved in an accident and due only to this
a which you knew about before the start of your accident you die within 12 months from the date of the
policy; accident, we will pay your legal personal representative
b which you have received diagnosis, consultation, up to the maximum limits as shown in section 1 of the
medical treatment or prescribed drugs for within 12 schedule.
months before the start of your policy; or
c for which you have been asked to get medical What we do not pay under section 1
treatment or medical advice by a medical
practitioner within 12 months before the start of Besides the general exclusions listed in part 2 of the
your policy. general conditions, we will also not pay any claim
directly or indirectly caused by the following.
Public transport means any regularly scheduled aircraft, 1 A disability or death that is caused by sickness (for
bus, ferry, hovercraft, hydrofoil, ship, train, tram or example, a heart attack or stroke) and not by an
underground train which has fixed and established injury.
routes and is operated by a licensed carrier or operator 2 Any physical disability which existed before the start
to transport fare-paying passengers. This does not of the policy.
include taxis and all other methods of transport that are
chartered or arranged as part of a tour even if they are
Section 2 – Permanent disability
Sickness means worsening physical health not caused by
an accident, for which you need the treatment of a If you are involved in an accident which causes you an
medical practitioner. injury and due only to this accident you become
permanently disabled within 12 months from the date
Schedule means the document which proves that you of the accident, we will pay you up to the maximum
have the insurance cover, listing among other things, limits as shown in section 2 of the schedule using the
details of the insured person (or people), the scale of compensation table as shown below.
policyholder, the benefits, the sum insured and the
period of insurance covered under this policy. Scale of compensation
Item Description of disability Percentage of
Temporary disability or temporarily disabled means an sum insured as
injury which directly disables and prevents you from shown under
taking part in any occupation temporarily and which is section 2 in the
the only cause of the disablement. schedule
a Permanent total disability 100%
We, our, us, and NTUC Income means NTUC Income
Insurance Co-operative Limited. b Losing sight of both eyes 100%
c Losing two limbs 100%
You, your and yours means the insured person (or
people) referred to in the schedule. d Losing sight of one eye, 50%
except perception of light
e Losing one limb 50%
PL/Personal Accident/201208 Page 3 of 9
f Losing speech 50% We will reduce any compensation due for accidental
death by any payment which we have already made to
g Losing hearing in both ears 50% you under the scale of compensation within the same
h Losing four fingers and thumb 50% policy year.
of one hand
We will not pay you extra compensation for any specific
i Losing four fingers of one hand 40% item which is part of a greater item due under this
j Losing hearing in one ear 20% policy. For example, we will pay you for losing your
upper limb, but we will not pay you again for losing
k Losing a thumb your finger or thumb.
- 2 phalanges 25%
- 1 phalanx 10% What we do not pay under section 2
l Losing one index finger
- 3 phalanges 15% Besides the general exclusions listed in part 2 of the
- 2 phalanges 10% general conditions, we will also not pay any claim
- 1 phalanx 5% directly or indirectly caused by the following.
1 A disability or death that is caused by sickness (for
m Losing any one other finger example, a heart attack or stroke) and not by an
- 3 phalanges 10% injury.
- 2 phalanges 7%
2 Any physical disability which existed before the start
- 1 phalanx 3%
of the policy.
n Losing metacarpals
- first or second 3%
- third, fourth or fifth 2% Section 3 – Medical expenses for injury
o Losing all toes of one foot 15% due to an accident
p Losing a great toe
- 2 phalanges 5% a If you suffer an injury and need to get medical
- 1 phalanx 3% treatment, we will pay for the costs of medical,
surgical, hospital, dental treatment and nursing
q Losing any one other toe 3% fees, recommended or asked for by a medical
practitioner for you to be treated, up to the limit
shown in the schedule or up to a period of 12
r Head - Damage as a months from the date of the accident, whichever
percentage of total body comes first.
- equal to or greater than 8% 100% b We will also pay for the reasonable and necessary
- equal to or greater than 5% 75% expenses for treatment by a Chinese medicine
but less than 8% practitioner or chiropractor, up to a sub-limit of 10%
- equal to or greater than 2% 50% of the section limit shown in the schedule or up to a
but less than 5% period of 12 months from the date of the accident,
whichever comes first.
s Body - Damage as a
percentage of total body
The total we will pay under sections 3a and 3b will not
be more than the limit shown in the schedule for each
- equal to or greater than 20% 100%
- equal to or greater than 15% 75%
but less than 20%
What we do not pay under section 3
- equal to or greater than 10% 50%
but less than 15%
Besides the general exclusions listed in part 2 of the
We will not pay you any compensation if the disability general conditions, we will also not pay any claim
is not listed in the scale of compensation. directly or indirectly caused by the following.
The total of all percentages of the sum insured due 1 Medical treatment for sickness (for example, a heart
under this section will not be more than 100% during attack or a stroke) and not for an injury.
any one policy year. 2 Any physical disability which existed before the start
date of the policy.
PL/Personal Accident/201208 Page 4 of 9
B Optional benefits Section 7 – Emergency medical evacuation
and sending you home
Section 4 – Weekly cash
Emergency medical evacuation
If you suffer an injury and become temporarily disabled,
we will pay you a cash benefit as shown in the schedule a If you are in a life-threatening condition because of
for each full week of temporary disability as confirmed an injury you suffered while outside Singapore and
by a medical practitioner, up to 104 weeks in a row. our assistance company believes it is medically
necessary to move you to the nearest medical
What we do not pay for under section 4 facility for treatment (whether overseas or in
Singapore), we will pay for the necessary expenses
Besides the general exclusions listed in part 2 of the to move you. This applies to using an air ambulance,
general conditions, we will also not pay any claim surface ambulance, regular air transport, railroad,
directly or indirectly caused by the following. land or sea transport or any other appropriate
1 If your temporary disability lasts for less than seven method to move you to the nearest medical facility
days in a row. for treatment.
2 If the date of your first medical consultation or
treatment is more than seven days from the date of b If you need to return to Singapore for recuperation
the accident. or continued treatment after you have been moved
3 If you are unemployed at the time of the accident. to a medical facility outside Singapore as in 7a
above, we will also pay for the necessary expenses
our assistance company spends when they use air
ambulance, surface ambulance, regular air
Section 5 – Extra accidental death transport, railroad, land or sea transport or any
benefit for public transport other appropriate method to return you to
Singapore. If we can use your existing return ticket
a If there is an accident while you are on board public to Singapore, we will only pay for the administrative
transport as a fare-paying passenger, and this fees charged by the airline or travel agent for
accident is the only cause of your death within 12 changing your travel dates or destinations.
months from the date of the accident, the extra
accidental death benefit for public transport will c Our assistance company will make all decisions on
apply. the most appropriate method of transport and the
destination to move you to. The decision will be
b We will pay your legal personal representative the based only on the medical necessity and the severity
extra amount shown in the schedule. of your medical condition.
What we do not pay under section 5
Sending you home
Besides the general exclusions listed in part 2 of the
general conditions, we will also not pay any claim a If you die after suffering an injury while outside
directly or indirectly caused by the following. Singapore, we will pay for the necessary expenses
1 A disability or death that is caused by sickness (for our assistance company spends to return your body
example, a heart attack or a stroke) and not by an to Singapore or to your home country.
2 Any physical disability which existed before the start The total we will pay under section 7 will not be more
date of the policy. than the limit shown in the schedule for each policy
Section 6 – Daily hospital income
If you are staying in a hospital as an inpatient due to an
accident, we will pay the benefit as shown in the
schedule for each complete 24-hour period that you stay
as an inpatient in the hospital, for up to 50 days in each
policy year. This benefit will end once you are
discharged from the hospital.
PL/Personal Accident/201208 Page 5 of 9
f Suffocation by smoke, poisonous fumes, gas or
General conditions which drowning
apply to the whole policy If you suffer an injury or die from accidentally
breathing in smoke, poisonous fumes, gas or by
drowning, we will pay up to the limit described
1 Benefit extensions in the relevant section as shown in the schedule.
This extension is only valid if the event does not
a Act of terrorism cover arise because of your deliberate act.
If any of the losses covered under sections 1 to 7
arises from or in relation to an act of terrorism, g Miscarriage due to an accident
we will still cover the loss, up to the limit shown If you suffer a miscarriage or if you die from the
in the relevant section as shown in the schedule. miscarriage caused by an accident, we will pay
This extension is only valid if you did not take up to the limit described in the relevant section
part in the act of terrorism or make an as shown in the schedule. This extension is only
agreement with other people to carry out the valid if the event does not arise because of your
act. deliberate act.
b Riot, strike, civil commotion, hijack, murder
and assault 2 General exclusions
If you suffer an injury or die because of an
accident during a riot, strike, civil commotion, This policy does not cover claims directly or
hijack, murder or assault, we will pay up to the indirectly caused by or arising from:
limit shown in the relevant section as shown in a you deliberately injuring yourself, committing
the schedule. This extension is only valid if you suicide or attempting suicide while sane or
did not take part in any criminal act or make an insane, your criminal act, provoked assault,
agreement with other people to carry out these deliberate acts or putting yourself in danger
acts. (unless you are trying to save human life);
b the effect or influence of alcohol or drugs;
c pregnancy, childbirth, abortion, miscarriage
If your body is not found within 12 months after
(except as provided in general condition – 1g
the sinking, wrecking or destruction of the
above) or all complications or death arising from
public transport in which you are travelling
during the period of insurance, we will consider
you to be dead and pay the appropriate death d mental problems or insanity;
benefit shown in the schedule as described in e sexually transmitted infections, human
section 1. immunodeficiency virus (HIV) or any HIV-related
The payment of the death benefit is made to illness including acquired immunity deficiency
your legal personal representatives after they syndrome (AIDS) or any mutant derivatives or
have signed an undertaking to us to guarantee variations of this however they are caused;
that if you are subsequently found to be alive f medical or surgical procedure to treat your
they will, when asked, return to us the sums sickness;
that we have paid under this extension. g cosmetic (aesthetic) or plastic surgery or
treatment, or any treatment which relates to or
d Exposure is needed because of previous cosmetic
If you suffer an injury or die because you were treatment but, this exclusion does not apply to
exposed to natural elements due to an accident, reconstructive surgery if:
we will pay up to the limit shown in the relevant - it is carried out to restore function or
section in the schedule. appearance after an accident;
- it is done at a medically appropriate stage
e Food poisoning
after the accident; and
If you suffer or die from food poisoning during
- the cost of the treatment is approved by us
the period of insurance, we will pay up to the
in writing before it is done;
limit described in the relevant section as shown
in the schedule. This extension is only valid if the h pre-existing medical conditions or physical
event does not arise because of your deliberate problems which existed before the start of your
i you taking part in flying or other aerial activities
except as a fare-paying passenger in a licensed
PL/Personal Accident/201208 Page 6 of 9
j you taking part in any professional sports or in 4 Payment before cover warranty
any sports for which you would or could earn or
receive any form of pay; We (or our intermediary) must receive the full
k you taking part in any kind of speed contest or premium due on or before the start date of the
racing (other than on foot); insurance.
l an accident while you are driving or riding on a
motor race track; If we or the intermediary do not receive the
m an accident while you are riding on a motorcycle premium in full on or before the start date of
(but not as a passenger); unless we have agreed insurance, the policy will not be valid and we will
in writing to provide this cover; not pay any benefits.
n you taking part in any dangerous activities or
sports including caving, potholing, rock climbing
(except on man-made walls) or mountaineering 5 Paying benefits
which involves using ropes, any underwater
activities involving underwater breathing We will pay the benefits listed in this policy only if
apparatus, sky diving, cliff diving, bungee you have:
jumping, BASE (building, antenna, span, earth) a met general condition 4; and
jumping, paragliding, hang-gliding, parachuting, b given us satisfactory proof of the claim.
white-water rafting, dragon boating, hunting,
horse riding, polo, show jumping, mountain We will pay all benefits shown in the schedule to
biking unless we have otherwise agreed in you unless:
writing, but not including the following activities a you die as described in section 1 or section 5, in
carried out for leisure purpose under the which case we will pay the benefits to your legal
supervision of a licensed guide or instructor: personal representative; or
hot-air ballooning, ice or winter sports, hiking or
trekking if done outside Singapore; b you are evacuated as a result of a medical
emergency or sent home as described in section
o the consequences of war, revolution or any 7, in which case we will pay our assistance
similar event; company the expenses they pay in transporting
p radioactivity or damage from any nuclear fuel, you.
material or waste;
q you failing to take reasonable efforts to avoid When we pay the benefits as described above, we
injury or minimize claims under this policy; or will have no further legal responsibility to you under
r any accident which arises in the course of your this policy for the claim.
occupation if it falls within the following
categories or involves the following activities:
professional divers, professional sportspeople, 6 Misrepresentation
jockeys, marine salvage crew, oil riggers,
stevedores, people directly involved in making We will end this policy if the policyholder or you
or handling explosives. misrepresent or misdescribe any circumstance which
If we refuse to pay a claim as a result of any of the affects your health condition, occupation, country of
exclusions listed above and you disagree with our residence or pursuits or any information which may
decision, you are responsible for proving that we are affect our decision to accept your application.
legally responsible for the claim. If any part of any
exclusion is found to be invalid or we cannot enforce
it, it will not affect the rest of the exclusions. 7 Changes in circumstance
If there is any change in circumstances affecting
3 Cover your risk, you must give us immediate written notice
and pay any extra premium that we may ask for. In
This policy covers you while in Singapore and while particular, you must tell us about any change in your
outside Singapore for no more than 180 days in a health condition, occupation or the country where
row at a time from the date of departure from you are living in.
Singapore. If you plan to stay longer than 180 days
in a row outside Singapore, we may agree to extend
the cover, depending on our decision and the extra
PL/Personal Accident/201208 Page 7 of 9
8 Fraud 12 Claims conditions
You must not act in a fraudulent way. We will take a You must tell us as soon as possible, and in any
the action shown below if you, or anyone acting for case within 30 days, about any accident which
you: may give rise to a claim under this policy.
a make a claim under the policy knowing the b If you can recover all or part of the medical
claim to be false or fraudulently exaggerated in expenses from other sources, we will only pay
any way; you the amount that you cannot recover.
b make a statement to support a claim knowing c We pay all claims in Singapore dollars. If you
the statement to be false in any way; suffer a loss which is in a foreign currency, we
c send us a document to support a claim knowing will convert the amount into Singapore dollars
the document to be forged or false in any way; at the exchange rate which we will decide on at
or the date of the loss.
d make a claim for any loss or damage caused by
your deliberate act or with your knowledge.
13 What you need to provide when you
We may do the following. send us your claim
a We will not pay the claim.
b We will not pay any other claim which has been You or your legal representatives must supply all
or will be made under the policy. information, reports, original invoices and receipts,
evidence, medical certificates, documents (such as
c We may declare the policy invalid.
translation of a foreign-language document into the
d We can recover from you the amount of any English language), confirmed by oath if necessary,
claim we have already paid under the policy. we may need before we assess your claim. We may
e We will not refund your premium. refuse to refund any expense which you cannot
f We may not allow you to buy other policies provide original receipts or invoices for.
g We may report you to the police.
14 Free-Look period
We will give the policyholder 14 days from the time
9 Reasonable care
they receive this policy to decide whether to
continue with it. If they do not want to continue,
You must take all reasonable precautions to avoid
they may write to us to cancel this policy and get a
an injury and take all practical steps to minimize
full refund of the premium paid. We consider that
this policy has been delivered (and received) seven
days after we post it.
10 Other insurance
15 Cancellation and refund
If at the time of any incident which results in a claim
under this policy you have another insurance
We can cancel the policy by providing seven days’
covering the same loss, we will not pay more than
notice by post to the policyholder’s last-known
address. We will consider that they have received
(This does not apply to section 1 – accidental death, this cancellation notice on the same day if we
section 2 - permanent disability, section 4 – weekly deliver the notice by hand, fax or email.
cash, section 5 - extra accidental death benefit for
public transport or section 6 – daily hospital
11 Taking over your rights
We can take over any rights to defend or settle any
claim and to take proceedings in your name to
enforce your or our rights against any other person.
PL/Personal Accident/201208 Page 8 of 9
The policyholder may cancel this policy by telling us 19 Governing law
and the cancellation will apply from the date we
receive the notice of cancellation. For cancellation Singapore law will apply to this policy.
after 14 days from the date the policyholder
receives the policy and as long as there has been no
claim made under this policy, we will work out the
20 Feedback procedure
refund premium as follows.
Making yourself heard
Period of insurance We are committed to providing you with an
(in days) still left to run 85% of the exceptional level of service and customer care.
divided by the original period premium paid.
of insurance of the policy We realise that things can go wrong and there may
be times when you feel that we have not provided
the service you expected. When this happens, we
We will not refund any premium below $10 want to hear about it so that we can try to put
(depending on goods and services tax) if the things right.
policyholder cancels the policy.
Please send your feedback to:
We will refund all premium refunds to the email@example.com.
policyholder as shown in the schedule.
16 Ending the insurance
Our promise to you
The policy will end immediately when:
a we have paid 100% of the sum insured under
section 1 or section 5; We will:
b you no longer satisfy any of the eligibility • acknowledge your complaint promptly;
requirements set unless we have agreed in • investigate quickly and thoroughly;
writing to provide cover; or • keep you informed of our progress; and
c the policy has ended. We do not have to renew • do everything possible to deal with your complaint.
If you are not satisfied with our final decision on your
claim, you may refer your case to Financial Industry
17 Excluding third-party rights Disputes Resolution Centre Ltd (FIDReC), an independent
and impartial institution specialising in dealing with
A person or company who is not covered by this disputes between financial institutions and consumers.
policy has no right under the Contracts (Rights of Their website address is www.fidrec.com.sg.
Third Parties) Act (Chapter 53B) to enforce this
18 Currency and interest
All dollar amounts shown in the policy and schedule
are in Singapore dollars (S$). We will not add
interest to any amount we pay under this policy.
Policy Owners’ Protection Scheme
This policy is protected under the Policy Owners’ Protection Scheme which is administered by the Singapore
Deposit Insurance Corporation (SDIC). Coverage for your policy is automatic and no further action is required from
you. For more information on the types of benefits that are covered under the scheme as well as the limits of
coverage, where applicable, please contact NTUC Income or visit the GIA / LIA or SDIC websites (www.gia.org.sg or
www.lia.org.sg or www.sdic.org.sg).
PL/Personal Accident/201208 Page 9 of 9