PART 2 | INSURANCE COVER AND RELATED PROVISIONS |
3. Each insurance period of an individual’s insurance cover under the ESH Scheme is a period of 12 months starting on the date of commencement or renewal of the individual’s insurance cover under the former ElderShield Scheme, unless the insurance cover is cancelled or terminated on an earlier date —| (a) | before the transfer date; or | | (b) | on or after the transfer date in accordance with this Part. |
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| Commencement of insurance cover |
| 4. An individual’s insurance cover under the ESH Scheme is treated as having commenced on the date of commencement of the individual’s insurance cover under the former ElderShield Scheme. |
| 5. For the purposes of section 12(3)(a) of the Act, an insured person’s insurance cover under the ESH Scheme ends if the insurance cover is cancelled or terminated in accordance with regulation 6 or 7. |
| Cancellation of insurance cover |
6.—(1) The Board may cancel an individual’s insurance cover under the ESH Scheme if —| (a) | the Board finds that the insurance cover in respect of the individual has been issued in error (including because the individual dies on or before the date of commencement of the insurance cover, and the Board is notified of the individual’s death only after that date), and no claim has been accepted by the Administrator under section 16 of the Act in respect of the individual; | | (b) | the Board finds that the individual was severely disabled before the commencement of the individual’s insurance cover under the ESH Scheme; or | | (c) | the individual opts out of the ESH Scheme within 60 days beginning on the commencement of the individual’s insurance cover under the ESH Scheme, or within any other period as the Board may allow. |
| (2) The cancellation under paragraph (1) takes effect on the date of commencement of the insurance cover issued in respect of the individual concerned, as if the insurance cover had not been issued. |
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| Termination of insurance cover |
7.—(1) The Board may terminate an individual’s insurance cover under the ESH Scheme if —| (a) | the individual —| (i) | fails to make the required premium payment for the individual’s insurance cover at the expiry of 75 days after the renewal date of the individual’s insurance cover (called in this Part the grace period); and | | (ii) | has not made the minimum number of premium payments under the ESH Scheme such that the individual’s insurance cover under the ESH Scheme does not terminate by reason of the individual’s failure to pay the premium for any insurance period; |
| | (b) | the individual dies; | | (c) | the individual has fully claimed the benefits under the ESH Scheme; | | (d) | the individual has requested to terminate his or her insurance cover under the ESH Scheme; | | (e) | the individual’s insurance cover under the CSHL Scheme has commenced; [S 204/2024 wef 31/03/2024] | | (f) | the Board, with the Minister’s approval, considers that the exceptional circumstances for the reinstatement of the individual’s insurance cover under regulation 8(1)(c) no longer apply; [S 204/2024 wef 31/03/2024] | | (g) | the individual ceases to be a citizen of Singapore on or after 1 April 2024 and does not immediately become a permanent resident of Singapore; or [S 204/2024 wef 31/03/2024] | | (h) | the individual ceases to be a permanent resident of Singapore on or after 1 April 2024 and does not immediately become a citizen of Singapore. [S 204/2024 wef 31/03/2024] |
(2) In the circumstances set out in paragraph (1), the Board may terminate an individual’s insurance cover —| (a) | where sub-paragraph (a) of that paragraph applies — on the date immediately after the last insurance period in which the individual has made the required premium payment; | | (b) | where sub-paragraph (b) of that paragraph applies —| (i) | on the date immediately after the date on which the individual dies, if the individual has not made a successful claim under the ESH Scheme in accordance with section 16 of the Act; or | | (ii) | on the date immediately after the date on which the Board is notified of the individual’s death if the individual has made a successful claim under the ESH Scheme in accordance with section 16 of the Act; |
| | (c) | where sub-paragraph (c) of that paragraph applies —| (i) | if the month in which the last payout was made is not the same month in which the insurance period is to end — on the date immediately after the last day of the month in which the last payout was made; or | | (ii) | if the month in which the last payout was made is the same month in which the insurance period is to end — on the date immediately after the last day of the insurance period in which the last payout was made; |
| | (d) | in the circumstances set out in sub‑paragraph (d) of that paragraph — on the date immediately after the last day of the last insurance period in which the individual has made the required premium payment; [S 204/2024 wef 31/03/2024] | | (e) | in the circumstances set out in sub‑paragraph (e) of that paragraph — on the day of the commencement of the individual’s insurance cover under the CSHL Scheme; [S 204/2024 wef 31/03/2024] | | (f) | in the circumstances set out in sub-paragraph (g) of that paragraph — on the date immediately after the date on which the individual ceases to be a citizen of Singapore and does not immediately become a permanent resident of Singapore; and [S 204/2024 wef 31/03/2024] | | (g) | in the circumstances set out in sub-paragraph (h) of that paragraph — on the date immediately after the date on which the individual ceases to be a permanent resident of Singapore and does not immediately become a citizen of Singapore. [S 204/2024 wef 31/03/2024] |
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| Reinstatement of insurance cover |
8.—(1) The Board may reinstate the insurance cover of an individual whose insurance cover under the ESH Scheme was terminated in accordance with regulation 7 if —| (a) | in the event the termination was in accordance with regulation 7(1)(a) — the individual applies to reinstate his or her insurance cover within 180 days after the expiry of the grace period or a longer period that the Board may allow; | | (b) | in the event the termination was in accordance with regulation 7(1)(e) — the individual’s insurance cover under the CSHL Scheme is subsequently cancelled; [S 814/2024 wef 30/10/2024] | | (ba) | in the event the termination (whether before, on or after 30 October 2024) was in accordance with regulation 7(1)(g) or (h) — the individual is reinstated as a citizen of Singapore or a permanent resident of Singapore; or [S 814/2024 wef 30/10/2024] | | (c) | the Board, with the Minister’s approval, considers that there are exceptional circumstances for the reinstatement of the individual’s insurance cover. |
| (2) In deciding whether to reinstate an individual’s insurance cover under paragraph (1), the Board may require the individual to attend a disability assessment by an assessor. |
| (3) Where the Board reinstates the insurance cover of an individual under paragraph (1)(ba), the insurance cover is reinstated on the date the individual is reinstated as a citizen of Singapore or a permanent resident of Singapore. [S 814/2024 wef 30/10/2024] |
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8A.—(1) This regulation applies in relation to an individual —| (a) | who, on or after 1 April 2024, ceases to be a citizen of Singapore and does not immediately become a permanent resident of Singapore, or who ceases to be a permanent resident of Singapore and does not immediately become a citizen of Singapore; | | (b) | whose insurance cover under the ESH Scheme was not issued in error, but was terminated (whether before, on or after 30 October 2024) under regulation 7(1)(g) or (h); and | | (c) | who is a severely disabled individual whose claim under section 16 of the Act has been accepted by the Administrator (whether before, on or after 30 October 2024). |
(2) The Board may pay a goodwill sum to —| (a) | the individual; or | | (b) | an approved payee nominated by the individual, or by the authorised applicant for the individual. |
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| (3) The goodwill sum may consist of one or more payments to be made at a frequency that the Board may determine. |
(4) The Board may suspend the payment of the goodwill sum where —| (a) | the Board is unable to make the payment because of insufficient information provided by the individual or the approved payee for such payment; or | | (b) | in the case of payment to an approved payee, the approved payee lacks mental capacity or has died, and no new approved payee was nominated by the individual, or by the authorised applicant for the individual, as the case may be. |
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| (5) If the circumstances for the suspension of payment under paragraph (4) no longer exist, the Board may resume the payment of any remaining amount of the goodwill sum even if the individual’s insurance cover is reinstated under regulation 8. |
(6) Upon reinstatement of the individual’s insurance cover under regulation 8, if the insured person is entitled to the payment of one or more insured sums on or after the date of such reinstatement —| (a) | the whole amount of the goodwill sum is treated as the payment of the number of monthly insured sums which corresponds to that whole amount (called the relevant insured sums); and | | (b) | the payment of any other insured sum under section 18(2) of the Act resumes only after the relevant insured sums are treated as paid under sub-paragraph (a). |
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[S 814/2024 wef 30/10/2024] |
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