Employee Top Up Medical Insurance

Existing MSIG Group Medical Insurance members:

• Simple application
• No underwriting is required

Non-MSIG group medical insurance members:

• Spouse, children, parents and siblings of an existing MSIG Group medical scheme member who are not a member of a MSIG Group Medical scheme currently
• A health declaration is required and subject to MSIG’s approval

Existing MSIG Group Medical Insurance members:

• Same level or lower than your existing group member’s current benefit
• No further benefit upgrades or transfers will be permitted throughout the lifetime

For Group Medical policy with no specific benefit level

For optional outpatient benefit plan

Note: This is a partial list of exclusions and is not exhaustive. For the complete list of exclusions, please refer to the policy wording.

1. Expenses incurred for treatments, procedures, medications, tests or services which are not Medically Necessary.
2. Any charges in respect of services for:
   a) Beautification or cosmetic purposes, unless necessitated by Injury caused by an Accident, and the Insured Person receives the Medical
   Services within ninety (90) days of the Accident; or
   b) Correcting visual acuity or refractive errors that can be rectified by fitting of spectacles or contact lenses, including but not limited to
   eye refractive therapy, LASIK and any related tests, procedures and services.
3. Expenses incurred for dental treatment and oral and maxillofacial procedures performed by a dentist, except for the following:
   a) Emergency Treatment and surgery during Confinement arising from an Accident, or
   b) The Insured Person is diagnosed with oral-related Cancer and Carcinoma in Situ.
4. Expenses incurred for experimental or unproven medical technology or procedure in accordance with the common standard, or not approved
   by the recognised authority, in the locality where the treatment, procedure, test or service is received.
5. Prescription drugs used in connection with weight reduction, smoking cessation, treatment of baldness and experimental drugs.
6. Congenital Conditions, hereditary conditions or Developmental Conditions.
7. Pre-existing Conditions, except that in respect of an Insured Person who applies for Registration while being insured under a group medical
   policy of the Company, Pre-existing Conditions shall be covered from the date on which the Insured Person has been insured for 12
   consecutive months under (i) such group medical policy of the company; and/or (ii) this Policy.
   For the avoidance of doubt, if an Insured Person is insured for less than 12 consecutive months under an MSIG group medical policy
   before the Original Commencement Date, the period for which he is insured under such group medical policy immediately before the
   Original Commencement Date and the period for which he is insured under this Policy from the Original Commencement Date shall be taken
   into consideration when the company determines if the Insured Person has been insured for 12 consecutive months under this paragraph 7.
   MSIG will not cover the Pre-existing Conditions of an Insured Person who is not insured under an MSIG group medical policy when he applies
   for Registration. MSIG shall not cover such Pre-existing Conditions at any time during this Policy.
   For existing group members covered under the company’s group medical plan, pre-existing conditions covered in the group medical policy
   shall continue to be covered under this Policy, subject to the benefit limits as stated in the Schedule and after the Insured Person has been
   continuously covered under the group medical policy and/or this Policy for a total period of twelve (12) consecutive months.
   MSIG will carry forward any exclusion applied to the Insured Person under the existing MSIG group policy to the Employee Top Up Medical
   Insurance Plan.
8. Expenses directly or indirectly arising from Human Immunodeficiency Virus (HIV) related Disability, including Acquired Immune Deficiency
   Syndrome (AIDS) and/or any mutation, derivations or variations thereof, which proceeds from an HIV infection occurring before the Effective
   Date. For purposes of this exclusion, an HIV related Disability emerging within 5 years of the Effective Date will be conclusively presumed to
   proceed from an HIV infection occurring before the Effective Date, in the absence of clear and convincing evidence to the contrary.
9. Expenses incurred relating to maternity conditions and its complications, including but not limited to diagnostic tests for pregnancy or
   resulting childbirth (including surgical delivery), abortion or miscarriage; birth control or reversal of birth control; postnatal care; sterilisation
   or sex reassignment of either sex; infertility including in-vitro fertilisation or any other artificial method of inducing pregnancy; or sexual
   dysfunction including but not limited to impotence, erectile dysfunction or pre-mature ejaculation, regardless of cause.
10. Expenses incurred for prophylactic treatment or preventive care, including but not limited to general check-ups, routine tests, screening
    procedures for asymptomatic conditions, screening or surveillance procedures based on the health history of the Insured Person and/or his
    family members, Hair Mineral Analysis (HMA), immunisation or health supplements. For the avoidance of doubt, this exclusion does not apply to:
    a) treatments, monitoring, investigation or procedures to avoid complications arising from any other Medical Services provided;
    b) removal of pre-malignant conditions; and
    c) treatment for prevention of recurrence or complication of a previous Disability.
11. Eligible Expenses which have been reimbursed under any law or regulations, medical program, insurance policy or any other sources
    provided by any government, company or other third party.
12. Inpatient Medical Services or outpatient Chinese Medicine Practitioner consultation directly or indirectly arising from Mental Illness and
    Emotional Disorder.
13. Proprietary Chinese medicine as defined under the Chinese Medicine Ordinance (Cap. 549) of the laws of Hong Kong.
14. Expenses incurred for the purchase of artificial limbs and prosthetic devices, except those prosthetic devices implanted in the Insured
    Person during surgery.
15. Procurement or use of special braces, appliances, hearing aids, wheelchairs, crutches or any other similar equipment.
16. Non-medical services, including but not limited to guest meals, radio, telephone, photocopy, taxes (except the Value-Added Tax or Goods
    and Services Tax for medical services), medical report charges and the like.
17. Alternative treatment, including but not limited to moxibustion, acupressure, tian jiu, tui na, qi gong, ear reflexology, cupping, scaping,
    hypnotism, rolfing, massage therapy, aroma therapy, naturopathy, hydropathy, homoeopathy and osteopathy.
18. Organ transplant other than transplantation of a cornea, kidney, heart, liver, lung or bone marrow from one human to another, and excluding
    costs of acquisition and transportation of the organ and the cost of surgery to remove an organ for transplant from a donor.
19. Insomnia and counselling services.
20. Any Medical Services related to Chinese medicine, including but not limited to acupuncture, tui-na, bone-setting, and herbal medicine,
    incurred during Confinement.
21. Expenses incurred for Medical Services as a result of Disability arising from or consequential upon the dependence, overdose or influence of
    drugs, alcohol, narcotics or similar drugs or agents, self-inflicted injuries or attempted suicide, illegal activity, or venereal and sexually
    transmitted disease or its sequelae (except for HIV and its related Disability, where Section 8 of this Part 9 applies).
22. Injury, Sickness, Disease or Illness directly or indirectly resulting from or consequent upon high-risk occupations or activities, including but
    not limited to engaging in or taking part in:
    a. naval, military or air force service or operations;
    b. flying or travelling in an aircraft other than as a fare-paying passenger with a licensed carrier on a scheduled domestic or international
    route or on a duly licensed charter service.
    c. aqualung diving; bungee jumping; mountaineering; hang gliding; motor cycling; parachuting; parasailing; pot-holing; daring feats or
    stunts; racing other than on foot; skiing, tobogganing, sledging and ice skating, including ice hockey and any other sports requiring
    snow or ice to be played or work activities involving dangerous or contaminable substances;
    d. sport activity in a professional capacity or where the Insured Person would or could earn income or remuneration from engaging in
    such sport; and
    e. air crew.
23. Expenses incurred for the whole or part of the Confinement solely for general check-ups, diagnostic procedures, laboratory test or allied
    health services, including but not limited to physiotherapy, unless such procedure, test or service is recommended by a Registered Medical
    Practitioner for Medically Necessary investigation or treatment of a Disability which cannot be effectively performed in a setting for
    providing Medical Services to a Day Patient.
24. Rest cures and Medical Services or treatment in any home, spa, hydro-clinic, sanatorium or long-term care facility that is not a hospital as
    defined.
25. Any Medical Service or referral provided or performed by the Insured Person, Policyholder, an insurance intermediary, employer, employee,
    Immediate Family Member, or business partner(s) of the Policyholder and/or Insured Person. For the avoidance of doubt, this exclusion
    extends to any Medical Service, including but not limited to viral warts and skin lesions procedures, performed by:
    (a) any employee or Registered Medical Practitioner of the employer; or
    (b) any medical facilities, medical aesthetic centres, or entities providing medical or cosmetic services in which the employer, or any of its
    directors, shareholders, or beneficial owners (holding 25% or more of the Insured’s shares or voting rights), or any of its subsidiaries,
    affiliates, related entities or Insured Person, holds any ownership interest, financial interest, or other interest.
    Treatments or referrals that fall under this exclusion will be eligible for coverage only if expressly pre-approved in writing by the
    company.
    For this exclusion, “Immediate Family Member” means the Insured Person’s spouse, children, parents, parents-in-law, brothers or
    sisters, grandparents, grandchildren or legal guardian.
26. Conditions directly or indirectly caused by, resulting from or in connection with any of the following, regardless of any other cause or event
    contributing concurrently or in any other sequence to the loss:
    a) ionising radiations from or contamination by radioactivity from any nuclear fuel or from any nuclear waste or from the combustion of
    nuclear fuel.
    b) The radioactive, toxic, explosive or other hazardous or contaminating properties of any nuclear installation, reactor or other nuclear
    assembly or nuclear component thereof.
    c) Any weapon or device employing atomic or nuclear fission and/or fusion or other like reaction or radioactive force or matter.
    d) The radioactive, toxic, explosive or other hazardous or contaminating properties of any radioactive matter. The exclusion in this subclause
    does not extend to radioactive isotopes, other than nuclear fuel, when such isotopes are being prepared, carried, stored, or
    used for commercial, agricultural, medical, scientific or other similar peaceful purposes.
    e) Any chemical, biological, bio-chemical, or electromagnetic weapon.
27. Conditions directly or indirectly caused by, resulting from or in connection with any of the following, regardless of any other cause or event
    contributing concurrently or in any other sequence to the loss:
    a) war, invasion, acts of foreign enemies, hostilities or warlike operations (whether war be declared or not), civil war, rebellion, revolution,
    insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power; or
    b) any act of terrorism, including but not limited to
    i) the use or threat of force, violence and/or
    ii) harm or damage to life or to property (or the threat of such harm or damage) including, but not limited to, nuclear radiation and/or
    contamination by chemical and/or biological agents, by any person(s) or group(s) of persons, committed for political, religious,
    ideological or similar purposes, express or otherwise, and/or to put the public or any section of the public in fear; or
    c) any action taken in controlling, preventing, suppressing or in any way relating to a) or b) above.