Please complete the related claim form, and send it to us with the original medical receipt(s) and letter of referral (if applicable) within 90 days of the medical service. (Address: Corporate Solutions Department, 12/F, AIA Financial Centre, 712 Prince Edward Road East, Kowloon)
Please note your request for returning your original receipt in the blank area of the claim form when making the claim.
A referral letter must be issued by a registered doctor of western medicine and is valid for 180 days. It means the patient has to receive the medical service no later than 180 days after the referral letter is issued.
Yes, you need to submit a letter of referral issued by a registered doctor for all specialist services.
Yes, please make the claim by following the general procedure with the required documents below:
- Sick leave certificate issued by the hospital; and
- Receipt from the hospital, on which you can note the diagnosis, e.g. high blood pressure, gastritis etc.
Adjustment factor is a percentage applied to the calculation of the benefit amount.
- Under the medical benefit (e.g. StepUp Medical Protection Plan, Journey Protect Medical Plan): If the Insured is confined in a type of room in a hospital which is at a higher level than the room type corresponding to the plan level chosen, the benefit amount will be paid according to the benefits schedule of the plan, and the adjustment factor stated below will also apply:
Room Type EntitlementReceived Treatment inAdjustment FactorWardSemi-Private50%WardStandard Private25%WardVIP / Deluxe / Suite0%Semi-PrivateStandard Private50%Semi-PrivateVIP / Deluxe / Suite0%Standard PrivateVIP / Deluxe / Suite50%
- Under the Supplementary Major Medical (SMM) Benefit:
If the insured's average daily room and board charges incurred during hospitalisation are higher than the daily room and board limit set forth in the benefits schedule of the plan, the adjustment factor will apply and calculate as follows:
Adjustment factor = Daily room and board limit set forth in benefits schedule / Average daily room and board charges incurred during hospitalisation
The adjustment factor applied to the calculation of SMM Benefit (if applicable) will be as follows:
SMM Benefit = [eligible expenses x adjustment factor – deductible amount per disability] x coinsurance
Yes, please complete the related outpatient or hospitalisation claim form, and send it to us with the original medical receipt(s) within 90 days of the medical service. (Address: Corporate Solutions Department, 12/F, AIA Financial Centre, 712 Prince Edward Road East, Kowloon)