PRUShield Claims

Integrated Shield plans are meant to be the last payors for medical treatment. As reported in the press, rising medical costs have resulted in rising premiums. This has impacted consumers like yourself. You can do your part to keep premiums affordable through this process. This is part of a wider approach Prudential is undertaking to ensure premiums remain affordable and customers do not have to compromise on gaining access to quality health care.

Firstly, it is best when you are initially seeking specialist and/or hospital treatment, to claim from your employer’s group insurance cover. Most companies require a referral from a general practitioner when seeking specialist’s or hospital treatment. To do so, you need to notify your HR, where you will receive a letter of guarantee (LOG) and subsequently, you will need to collate the various receipts and bills for submission to your group insurer or HR department.

If you have claimed from PRUShield initially, you can seek reimbursement from your employer’s group insurer. The documents you need are as follows:

1. Group Insurance online claims portal or application. You may need to complete the Group insurance claim form if there is no claims portal or app. The form can be obtained from your HR department or can also be downloaded from most group insurers’ websites.
2. Hospital (or Inpatient) Discharge Summary.
3. Referral letter from general practitioner to specialist/hospital.
4. Pre- and post-hospitalisation bills.
5. Original final and detailed hospital bill.
6. Medical report - You may submit the group insurance claim with the hospital discharge summary. The group insurer may waive the medical report if the claim amount is below a certain threshold.
7. PRUShield claim settlement letter - This letter is sent by Prudential to customers for every approved claim, with details on claims payment made.

These will be submitted to your HR department who will liaise with your employer’s group insurer for appropriate reimbursements. Once you have made the submissions, you can notify us via our PRUShield Recovery hotline at 6539 8268 (Mondays to Fridays, 8:30am to 5:30pm. If you are dialling from overseas or via a payphone, please call +65 65398268.) or contact your Financial Consultant.

Once you have submitted the required documents to the group insurer or to your HR department, you can notify us via your Financial Consultant. We will send you a letter when we have received and processed the reimbursement from your employer’s group insurer. The token of appreciation will be issued within 2 weeks via PayNow or e-vouchers, where applicable.

Do note that the token of appreciation is only applicable to successfully recovered amounts from your employer’s group insurer of more than $250. The token of appreciation is not applicable for recovery of pre/post hospital bills.

If a customer is treated for a few conditions at the same time during the same hospitalisation, that is defined as one event, and as such, the token of appreciation payable will be determined by the successful recovery claim amount from the employer’s group insurer.

If a customer is treated for a condition in January, and developed a new, unrelated condition and is treated in June, it will be considered as two separate events. In this instance, two corresponding tokens of appreciation will be payable, pending the successful recovery claim amount from the employer’s group insurer.

This is defined as one event; one token of appreciation will be payable in this instance. The token of appreciation is not applicable for recovery of pre/post hospital bills.