| Payment by Insurer | Payment by employer | Remaining Benefit Limit Per Policy Year |
Scenario 1 (H&S bill: S$20,000) | First S$15,000 + 75% of the remaining i.e. S$15,000 + S$3,750 = S$18,750 | 25% of S$5,000 = S$1,250 | S$60,000 – S$18,750 = S$41,250 |
Scenario 2 (H&S bill: S$70,000) | First S$15,000 + 75% of the remaining amount (75% of S$55,000):
S$15,000 + S$41,250 = S$56,250 | 25% of S$55,000 = S$13,750 | S$60,000 - S$56,250 = S$3,750 |
Scenario 3 (H&S bill: S$100,000) | Full S$60,000
Note that for this scenario, Chubb will cover up to S$60,000 based on the maximum Benefit Limit, instead of S$15,000 + 75% of S$85,000 = S$78,750) | Remaining S$40,000 | S$60,000 - S$60,000 = S$0 *You will cover any H&S bill incurred by your FDW until it resets in the following year |
Scenario 4 (H&S expense of S$15,000 (Bill 1) and a S$20,000 from a subsequent follow-up procedure (Bill 2) in the same Policy Year) | Bill 1 - Full S$15,000
Bill 2 - 75% of S$20,000 = S$15,000 | Bill 1 – NIL Bill 2 - 25% of S$20,000 = S$5,000
| S$60,000 - S$30,000 = S$30,000 |
Scenario 5 (H&S expense of S$15,000 (Bill 1) and a S$20,000 from a subsequent follow-up procedure (Bill 2) in the next Policy Year*) | Bill 1 - Full S$15,000
Bill 2 - 75% of S$20,000 = S$15,000 | Bill 1 - NIL Bill 2 - 25% of S$20,000 = S$5,000
*Co-payment applies even if Bill 2 occurs in the next Policy Year, as the treatment arose from the same condition from the previous Policy Year | S$60,000 - S$30,000 = S$30,000
The Benefit Limit for the next Policy Year remains at S$60,000 |