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 benets that are covered under the scheme as well as the limits of coverage, where applicable, please contact us or visit the General Insurance Association (GIA) or SDIC websites (www.gia.org.sg or www. sdic.org.sg).
Tokio Marine Insurance Singapore Ltd. 20 McCallum Street #09-01 Tokio Marine Centre Singapore 069046 Tel: (65) 6221 6111 Email: tmis@tokiomarine.com.sg Website: www.tokiomarine.com.sg GST Reg. No.: M2-0000023-4 Company Reg. No.: 192300014M TMiS/MSH/0413
iring a domestic helper is not always easy. Making sure that you are not overly burdened by the mandatory costs and medical bills when unpleasant surprises happen is equally worrying. TM MaidShield ensures that you and your domestic helper are well taken care of when accident or illness strikes. Now, you can truly enjoy a peace of mind, both domestically and nancially!
Termination Expenses
Get reimbursed for the expenses that you paid in terminating your domestic helpers services if she is unable to continue her employment due to an accidental injury or illness as certied by a medical practitioner.
Special Benets
Personal Accident
To ensure that you full your obligations mandated by Ministry of Manpower (MOM), we provide your domestic helper worldwide round-the-clock coverage for accidental death or permanent disablement. In addition, we cover your domestic helper for medical expenses incurred due to accidents, including outpatient treatment by a Chinese Physician and for Dengue Fever.
Repatriation Expenses
In the unfortunate event that your domestic helper passed away or is unable to continue her employment because of an accidental injury or illness, we will pay for the expenses to repatriate her (or her remains) to her home country, including burial and cremation costs. We will pay even if her death, injury or illness is caused by suicide. MEET your intermediary.
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Schedule of Benets
Essential Covers
1. Personal Accident (A) Accidental Death or Permanent Disablement (B) Outpatient Medical Expenses for Accidents (a) Treatment by Chinese Physician (b) Treatment for Dengue Fever 2. 3. 4. 5. 6. 7. 8. 9. Hospital & Surgical Expenses (per year) Wages & Levy Compensation (per day up to 60 days) Recuperation Benet (per day up to 60 days) Temporary Domestic Help Benet (per day up to 30 days) Termination Expenses Repatriation Expenses Outpatient Kidney Dialysis & Cancer Treatment Special Grant
Maximum Benets
per policy period
Plan A
$40,000 $1,000 $150 $150 $15,000 $30 $20
Not Covered
Plan B
$40,000 $2,500 $250 $250 $20,000 $30 $20 $15 $250 $10,000 $1,500 $1,500 $15,000 $2,500 $5,000 $370
$250 $10,000
Not Covered Not Covered Not Covered Not Covered
10. Domestic Helpers Liability 11. Fidelity Guarantee 12. Letter of Guarantee to MOM Premiums for 26 months (before GST)
$5,000 $330
Optional Covers
13. Waiver of Counter Indemnity for Letter of Guarantee to MOM
$50
14. Letter of Guarantee to Philippine Embassy (a) $2,000 Guarantee (applying through an accredited maid
agency)
$70 $90
This brochure is for general information only and is not a contract of insurance. Please refer to the policy wordings for the precise terms, conditions and exclusions.
Important Notes: 1. All amounts are shown in Singapore Dollars. 2. Your domestic helper must be below 65 years old at the commencement of this insurance. 3. We will not pay claims that occur within the rst 14 days from the start date of the policy for the following: (a) Dengue Fever under Personal Accident cover; (b) Illness under Hospital and Surgical Expenses cover; and (c) Outpatient Kidney Dialysis & Cancer Treatment cover. 4. This insurance generally does not cover: (a) Your domestic helpers pre-existing condition or disability unless she has been insured with us under this insurance continuously for the last 12 months. (b) When your domestic helper is on home leave and vacation leave. (c) Suicide or attempted suicide while sane or insane (not applicable to Repatriation Expenses and Special Grant covers), self-inicted injury, pregnancy and childbirth. There are other conditions where the benets under this insurance will not be payable. Please refer to the policy wordings for details. 5. Premiums rates are non-guaranteed and may be reviewed from time to time. 6. You or we may cancel the policy by giving each other prior notice in writing. Please refer to the policy wordings for the cancellation conditions and applicable charges.
TM MaidShield TM MaidShield
Intermediarys Name and Code:
Application Form
Important Notice to Intermediary: Please note that this proposal may not be accepted if you procure it through any Foreign Domestic Worker Employment Agency not registered with us as a Trade Specic Agent.
Important Notice
1. Statement pursuant to Section 25(5) of the Insurance Act, Cap. 142 (or any future amendments to it), you must disclose in this application form, fully and faithfully, all the facts which you know or ought to know. Otherwise, the policy issued may be void. 2. This insurance is subject to full payment before cover commences. 3. This insurance will not be in force until the proposal has been accepted by us. 4. This brochure is for general information only and is not a contract of insurance. Please refer to the policy wordings for the precise terms, conditions and exclusions.
M M
Y Y Y Y
Marital Status:
M M
Y Y Y Y
Dated: D D
M M
Y Y Y Y
Period of Insurance
From: D D
Important Notice: Witness(es) must not be the (1) employer (2) local guarantor and (3) spouse of the employer and/or local guarantor. If you are a foreigner, we will need a third party local guarantor for the counter indemnity. Your Signature (Employer) Signature: Name: NRIC/Passport No.: Contact No.: Address: Witness Signature Signature: Name: NRIC/Passport No.: Contact No.: Address:
M M
Y Y Y Y
for 26 months
Important Notice to Third Party Guarantor: Please note that your obligation will not be negated by the Employers inability to indemnify us for any reasons whatsoever. Local Guarantors Signature Signature: Name: NRIC/Passport No.: Contact No.: Address: Witness Signature Signature: Name: NRIC/Passport No.: Contact No.: Address:
$70 $90
-Y
Y
Note: Policy will be issued upon receipt of approval from respective credit card company.