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Medical
EBeyond Medical Insurance Solution
Medical protection that stays with you through your career and life stages1
Get your quote now
Limited-time Enrollment Opportunity
During the promotion period, eligible customers^ (including employees and their children) only need to answer two simple health questions ^^ for an opportunity to enroll in the EBeyond Medical Insurance Solution – EBoost Plan (“the Plan”) and easily upgrade their existing healthcare protection.
Promotion Period: 8 August 2026 to 30 September 2026
Terms and conditions apply. For more details, please refer to the promotion flyer.
^Please refer to promotion flyer regarding the definition of the Eligible Customer(s).
^^Simple health underwriting/simple health questions are only available to eligible customers who satisfy the application requirements for simple health underwriting under the eBeyond Medical Insurance Solution. Where EBeyond Medical Insurance Solution is available under other campaigns or promotions with different application criteria or health underwriting approaches, the relevant offers may be referred to in the applicable promotional materials.
Free Alzheimer's Disease Screening
Free Alzheimer’s Disease Screening is suitable for Eligible Insureds aged 40 or above and features a pTau217 blood test (a biomarker) and two
Terms and conditions apply.
Why needs EBeyond?
Medical costs continue to increase, but your group medical coverage may not accompany you into retirement...
Medical Inflation Index in the Asia-Pacific Region4
You may encounter the following situations:
Existing coverage may end immediately
No seamless medical coverage transition
Who needs EBeyond?
EBeyond at-a-glance
Standalone Plan
Age 1 (from 15 days) – 70 (age next birthday)
Guaranteed yearly renewable5 to age 101 (age next birthday)
- Based on Insured Person’s attained age at issue
- Renewal5 premiums are non-guaranteed and will be determined annually and according to the Insured Person’s attained age at the time of renewal5
To Age 101 (age next birthday)
This platform offers Monthly and Annual premium payment mode
HKD
Worldwide
(Except for psychiatric treatments, network benefits27, and cash benefit for room and board Confinement below entitled ward class in a private Hospital in Hong Kong, all benefits shall be applicable worldwide.)
Plan A: Standard Ward Room
Plan B: Standard Semi-Private Room
Plan C: Standard Private Room
Plan A:
Network:
$200,000 per Policy Year
Non-network:
$150,000 per Policy Year
Plan B:
Network:
$350,000 per Policy Year
Non-network:
$300,000 per Policy Year
Plan C:
Network:
$700,000 per Policy Year
Non-network:
$600,000 per Policy Year
Network: 90%; Non-network: 80%
100%
Plan A: $30,000 per Policy Year
Plan B: $60,000 per Policy Year
Plan C: $90,000 per Policy Year
Full cover6
Full cover6
Full cover6
Full cover6
Full cover6
Full cover6
Full cover6
Full cover6
Full cover6
Full cover6
Full cover6
Full cover6
Full cover6
- Subject to 1 visit per day
- 1 prior outpatient visit or Emergency consultation per Confinement/Day Case Procedure
- 10 follow-up outpatient visits per Confinement/Day Case Procedure (within 45 days after discharge from Hospital or completion of Day Case Procedure)
Full cover6
- Maximum 30 days per Policy Year, subject to services provided by 1 Registered Nurse per day
- Within 30 days after discharge from Hospital following surgery or admission to Intensive Care Unit
Full cover6
Full cover6
Full cover6
Full cover6
Full cover6
Plan A: $10,000 per Policy Year
Plan B: $15,000 per Policy Year
Plan C: $20,000 per Policy Year
Plan A: $50,000 per Policy Year
Plan B: $100,000 per Policy Year
Plan C: $150,000 per Policy Year
Plan A: $1,000 (once per 5 Policy Years)
Plan B: $1,500 (once per 2 Policy Years)
Plan C: $2,000 (once per 2 Policy Years)
- Covers expenses for travel, fitness or wellness course or health
check-up after the Policy has been in force for at least 2 (for Plan
B and Plan C) or 5 (for Plan A) consecutive years from the Policy
Date
Plan A: $50,000 per Policy
Plan B: $75,000 per Policy
Plan C: $100,000 per Policy
- Covers treatment costs for medications and/or non-drug therapies for
Insured Person diagnosed with Alzheimer’s Disease, provided that the
Policy has been in force for 2 consecutive years from the Policy Date
Plan A: $1,500 (once per 5 Policy Years)
Plan B: $3,000 (once per 5 Policy Years)
Plan C: $4,000 (once per 5 Policy Years)
- Payable on reimbursement basis for Insured Person aged 51 or above (age next birthday) who has undergone early detection tests for Alzheimer’s disease, provided that the Policy has been in force for 2 consecutive years from the Policy Date
Plan A: $10,000
Plan B: $15,000
Plan C: $20,000
Plan A: $10,000
Plan B: $15,000
Plan C: $20,000
- Designated Day Case Procedure(s) performed at a Designated Healthcare Services Provider: $1,600 per procedure
- Designated Day Case Procedure(s) performed in mainland China: $1,600 per procedure
- For any Day Case Procedure(s) other than designated Day Case Procedure(s) performed at a Designated Healthcare Services Provider or in mainland China; or any Day Case Procedure(s) performed at a non-Designated Healthcare Services Provider outside mainland China: $800 per procedure
Plan A: N/A
Plan B & C: $800 per day
- After the Policy has been in force for two (2) consecutive years from the Policy Date, the Policy Owner will have the right to convert the EBoost Plan to EBridge Plan (Plan 1 or any other plan level covering the same or a lower ward class, to which the supplementary major medical benefit (if applicable) may also be attached) without health underwriting of the Insured Person. This conversion option can be exercised at the Policy Anniversary immediately following the Insured Person reaching Age 45, 50, 55, 60 or 65 (age next birthday).
- This right can only be exercised once and is irrevocable.
If you do not make any claims in 2 or more consecutive Policy Years, immediately prior to Renewal5, you will be eligible for the no claims premium discount14. Please refer to the following table for discount on the Renewal5 premium.
| No claims period immediately prior to the Policy's Renewal5 | No claims premium discount14 (Discount on Renewal5 premium) |
|---|---|
| 2 consecutive Policy Years | 10% |
| 3 consecutive Policy Years | 10% |
| 4 consecutive Policy Years | 10% |
| 5 consecutive Policy Years and thereafter | 15% |
Notwithstanding the above condition, any benefits paid under the following items for any designated Day Case Procedure(s) performed at any Designated Healthcare Services Providers12, which are performed on the Insured Person during the no claims period, shall not affect the eligibility for no claims premium discount14 –
- Room and board;
- Miscellaneous charges;
- Surgeon’s fee;
- Anaesthetist’s fee;
- Operating theatre charges; and/or
Pre- and post-Confinement/Day Case Procedure outpatient care (excluding Chinese medicine treatments).
CANcierge33
Dementia Support Program33
Second Medical Opinion Services33
International SOS 24-hourWorldwide Assistance Services33
Worldwide
(Except for psychiatric treatments, network benefits27, and cash benefit for room and board Confinement below entitled ward class in a private Hospital in Hong Kong, all benefits shall be applicable worldwide.)
Plan 1: No restriction
Plan 2: Standard Ward Room
Plan 3: Standard Semi-Private Room
Plan 4: Standard Private Room
Plan 1:
Network: $465 per day
Non-network: $420 per day
Plan 2:
Network: $1,020 per day
Non-network: $925 per day
Plan 3:
Network: $1,760 per day
Non-network: $1,600 per day
Plan 4:
Network: $3,520 per day
Non-network: $3,200 per day
Plan 1:
Network: $2,200 per day
Non-network: $2,000 per day
Plan 2:
Network: $2,860 per day
Non-network: $2,600 per day
Plan 3:
Network: $4,400 per day
Non-network: $4,000 per day
Plan 4:
Network: $5,500 per day
Non-network: $5,000 per day
Plan 1:
Network: $330 per day
Non-network: $300 per day
Plan 2:
Network: $550 per day
Non-network: $500 per day
Plan 3:
Network: $990 per day
Non-network: $900 per day
Plan 4:
Network: $1,980 per day
Non-network: $1,800 per day
Plan 1:
Network: $465 per day
Non-network: $420 per day
Plan 2:
Network: $1,020 per day
Non-network: $925 per day
Plan 3:
Network: $1,760 per day
Non-network: $1,600 per day
Plan 4:
Network: $3,520 per day
Non-network: $3,200 per day
Plan 1:
Network: $3,080 per Disability2
Non-network: $2,800 per Disability2
Plan 2:
Network: $7,150 per Disability2
Non-network: $6,500 per Disability2
Plan 3:
Network: $8,250 per Disability2
Non-network: $7,500 per Disability2
Plan 4:
Network: $13,750 per Disability2
Non-network: $12,500 per Disability2
Plan 1:
Network: $9,020 per Disability2
Non-network: $8,200 per Disability2
Plan 2:
Network: $13,475 per Disability2
Non-network: $12,250 per Disability2
Plan 3:
Network: $21,230 per Disability2
Non-network: $19,300 per Disability2
Plan 4:
Network: $33,385 per Disability2
Non-network: $30,350 per Disability2
Plan 1:
Network: $330 per day
Non-network: $300 per day
Plan 2:
Network: $550 per day
Non-network: $500 per day
Plan 3:
Network: $880 per day
Non-network: $800 per day
Plan 4:
Network: $1,210 per day
Non-network: $1,100 per day
Plan 1:
Network: $231 per day
Non-network: $210 per day
Plan 2:
Network: $385 per day
Non-network: $350 per day
Plan 3:
Network: $616 per day
Non-network: $560 per day
Plan 4:
Network: $847 per day
Non-network: $770 per day
Plan 1:
N/A
Plan 2:
Network: $33,000 per Disability2
Non-network: $30,000 per Disability2
Plan 3:
Network: $44,000 per Disability2
Non-network: $40,000 per Disability2
Plan 4:
Network: $55,000 per Disability2
Non-network: $50,000 per Disability2
Per surgical procedure, subject to surgical category for the surgery/procedure in the Schedule of Surgical Procedures and reimbursement rules18 –
Plan 1:
Complex:
Network: HK$46,200
Non-Network: HK$42,000
Major:
Network: HK$19,800
Non-Network: HK$18,000
Intermediate:
Network: HK$9,900
Non-Network: HK$9,000
Minor:
Network: HK$3,850
Non-Network: HK$3,500
Plan 2:
Complex:
Network: HK$77,000
Non-Network: HK$70,000
Major:
Network: HK$33,000
Non-Network: HK$30,000
Intermediate:
Network: HK$16,500
Non-Network: HK$15,000
Minor:
Network: HK$7,150
Non-Network: HK$6,500
Plan 3:
Complex:
Network: HK$107,800
Non-Network: HK$98,000
Major:
Network: HK$46,200
Non-Network: HK$42,000
Intermediate:
Network: HK$23,100
Non-Network: HK$21,000
Minor:
Network: HK$9,900
Non-Network: HK$9,000
Plan 4:
Complex:
Network: HK$138,600
Non-Network: HK$126,000
Major:
Network: HK$59,400
Non-Network: HK$27,000
Intermediate:
Network: HK$29,700
Non-Network: HK$54,000
Minor:
Network: HK$12,650
Non-Network: HK$11,500
35% of Surgeon's fee payable34
35% of Surgeon's fee payable34
Plan 1:
Network: $275 per visit
Non-network: $250 per visit
Plan 2:
Network: $330 per visit
Non-network: $300 per visit
Plan 3:
Network: $385 per visit
Non-network: $350 per visit
Plan 4:
Network: $440 per visit
Non-network: $400 per visit
- Subject to 1 visit per day
- 1 prior outpatient visit or Emergency consultation per Confinement/Day Case Procedure
- 10 follow-up outpatient visits per Confinement/Day Case Procedure (within 45 days after discharge from Hospital or completion of Day Case Procedure)
Plan 1:
Network: $330 per visit
Non-network: $300 per visit
Plan 2:
Network: $550 per day
Non-network: $500 per day
Plan3:
Network: $880 per day
Non-network: $800 per day
Plan4:
Network: $1,210 per day
Non-network: $1,100 per day
- Maximum 30 days per Disability2, subject to services provided by 1 Registered Nurse per day
- Within 30 days after discharge from Hospital following surgery or admission to Intensive Care Unit
Plan 1: $1,800 per Disability2
Plan 2: $5,000 per Disability2
Plan 3: $6,500 per Disability2
Plan 4: $14,000 per Disability2
Plan 1:
$5,000 per Disability2
Plan 2:
$15,000 per Disability2
Plan 3:
$20,000 per Disability2
Plan 4:
$25,000 per Disability2
Network: $22,000 per Disability2
Non-network: $20,000 per Disability2
- Coinsurance6 is not applicable to Prescribed Diagnostic Imaging Test performed during Confinement
- Prescribed Diagnostic Imaging Test performed in a setting for providing Medical Services to a Day Patient is subject to 30% Coinsurance6
Plan 1:
Network: $55,000 per Disability2
Non-network: $50,000 per Disability2
Plan 2:
Network: $88,000 per Disability2
Non-network: $80,000 per Disability2
Plan 3:
Network: $143,000 per Disability2
Non-network: $130,000 per Disability2
Plan 4:
Network: $220,000 per Disability2
Non-network: $200,000 per Disability2
Plan 1:
Network: $110,000 per Disability2
Non-network: $100,000 per Disability2
Plan 2:
Network: $220,000 per Disability2
Non-network: $200,000 per Disability2
Plan 3:
Network: $385,000 per Disability2
Non-network: $350,000 per Disability2
Plan 4:
Network: $550,000 per Disability2
Non-network: $500,000 per Disability2
Plan 1: $8,000 per Disability2
Plan 2: $10,000 per Disability2
Plan 3: $15,000 per Disability2
Plan 4: $20,000 per Disability2
Plan 1: $30,000 per Policy
Plan 2: $50,000 per Policy
Plan 3: $100,000 per Policy
Plan 4: $150,000 per Policy
Plan 1: $800 (once per 5 Policy Years)
Plan 2: $1,000 (once per 5 Policy Years)
Plan 3: $1,500 (once per 2 Policy Years)
Plan 4: $2,000 (once per 2 Policy Years)
- Covers expenses for travel, fitness or wellness course or health check-up after the Policy has been in force for at least 5 (for Plan 1 and Plan 2) or 2 (for Plan 3 and Plan 4) consecutive years from the Policy Date
Plan 1: $20,000 per Policy
Plan 2: $50,000 per Policy
Plan 3: $75,000 per Policy
Plan 4: $100,000 per Policy
- Covers treatment costs for medications and/or non-drug therapies for Insured Person diagnosed with Alzheimer’s Disease, provided that the Policy has been in force for 2 consecutive years from the Policy Date
Plan 1: $800 (once per 5 Policy Years)
Plan 2: $1,500 (once per 5 Policy Years)
Plan 3: $3,000 (once per 5 Policy Years)
Plan 4: $4,000 (once per 5 Policy Years)
- Payable on reimbursement basis for Insured Person aged 51 or above (age next birthday) who has undergone early detection tests for Alzheimer’s disease, provided that the Policy has been in force for 2 consecutive years from the Policy Date
Plan 1: $5,000
Plan 2: $10,000
Plan 3: $15,000
Plan 4: $20,000
Plan 1: $5,000
Plan 2: $10,000
Plan 3: $15,000
Plan 4: $20,000
Plan 1: $150 per day
Plan 2: $300 per day
Plan 3: $500 per day
Plan 4: $900 per day
(i) Designated Day Case Procedure(s) performed at a Designated Healthcare Services Provider: $1,600 per procedure
(ii) Designated Day Case Procedure(s) performed in mainland China: $1,600 per procedure
(iii) For any Day Case Procedure(s) other than designated Day Case Procedure(s) performed at a Designated Healthcare Services Provider or in mainland China; or any Day Case Procedure(s) performed at a non-Designated Healthcare Services Provider outside mainland China: $800 per procedure
$800 per day
Per surgery, subject to the categorisation of such surgery under the Schedule of Surgical Procedures –
Plan 1: N/A
Plan 2: $3,000 per major surgery; $6,000 per complex surgery
Plan 3: $4,000 per major surgery; $8,000 per complex surgery
Plan 4: $6,000 per major surgery; $10,000 per complex surgery
Plan 1: N/A
Plan 2: $6,000 per Disability2
Plan 3: $8,000 per Disability2
Plan 4: $10,000 per Disability2
- The Insured Person is Confined in a Hospital in Hong Kong during which he/she is admitted to Intensive Care Unit for at least 3 consecutive days and the Eligible Expenses incurred during such Confinement period are payable in accordance with the Terms and Benefits; and
- This benefit is payable once only during the whole Confinement period and is subject to once per Disability2.
Plan 1&2: N/A
Plan 3&4: $800 per day
If you do not make any claims in 2 or more consecutive Policy Years, immediately prior to Renewal5, you will be eligible for the no claims premium discount14. Please refer to the following table for discount on the Renewal5 premium.
| No claims period immediately prior to the Policy's Renewal5 | No claims premium discount14 (Discount on Renewal5 premium) |
|---|---|
| 2 consecutive Policy Years | 10% |
| 3 consecutive Policy Years | 10% |
| 4 consecutive Policy Years | 10% |
| 5 consecutive Policy Years and thereafter | 15% |
Notwithstanding the above condition, any benefits paid under the following items for any designated Day Case Procedure(s) performed at any Designated Healthcare Services Providers12, which are performed on the Insured Person during the no claims period, shall not affect the eligibility for no claims premium discount14 –
- Room and board;
- Miscellaneous charges;
- Surgeon’s fee;
- Anaesthetist’s fee;
- Operating theatre charges; and/or
Pre- and post-Confinement/Day Case Procedure outpatient care (excluding Chinese medicine treatments).
CANcierge33
Dementia Support Program33
Second Medical Opinion Services33
International SOS 24-hourWorldwide Assistance Services33
Worldwide
(Except for network benefit27, all benefits shall be applicable worldwide)
EBridge Plan – Plan 2: Standard Ward Room
EBridge Plan – Plan 3: Standard Semi-Private Room
EBridge Plan – Plan 4: Standard Private Room
EBridge Plan – Plan 2:
Network:
$138,000
Non-network:
$115,000
EBridge Plan – Plan 3:
Network:
$204,000
Non-network:
$170,000
EBridge Plan – Plan 4:
Network:
$336,000
Non-network:
$280,000
Network: 10%; Non-network: 15%
EBridge Plan – Plan 2:
Network: $1,020 per day
Non-network: $925 per day
EBridge Plan – Plan 3:
Network: $1,760 per day
Non-network: $1,600 per day
EBridge Plan – Plan 4:
Network: $3,520 per day
Non-network: $3,200 per day
- Payable only after the number of days exceeds the limit (i.e. 150 days per Disability2 as specified under benefit item 1 of I. Hospitalisation benefits in EBridge Plan – Benefit Schedule above)
Reasonable and Customary charges
EBridge Plan – Plan 2:
Network: $1,020 per day
Non-network: $925 per day
EBridge Plan – Plan 3:
Network: $1,760 per day
Non-network: $1,600 per day
EBridge Plan – Plan 4:
Network: $3,520 per day
Non-network: $3,200 per day
- Payable only after the number of days exceeds the limit (i.e. 150 days per Disability2 as specified under benefit item 4 of I. Hospitalisation benefits in EBridge Plan – Benefit Schedule above)
Reasonable and Customary charges
Reasonable and Customary charges
Up to 50% of the maximum benefit limit of supplementary major medical Benefit per Disability2
Up to 50% of the maximum benefit limit of supplementary major medical Benefit per Disability2
Up to 50% of the maximum benefit limit of supplementary major medical Benefit per Disability2
-
Where requested by FWD upon submission of a claim, the Policy Owner or the Insured Person must declare whether the Insured Person is covered under any group medical scheme provided by other licensed insurance companies. Claim payments shall first be made under such group medical policy of the Insured Person (if any). Any unpaid portion of the Eligible Expenses and/or expenses shall then be claimable under this Policy, subject to the Terms and Benefits of this Policy.
-
(a) The applicable benefit limits shall be counted anew for each Confinement or Day Case Procedure for the same Disability provided that the Confinement or Day Case Procedure does not occur within 90 consecutive days following the Last Date of the previous Confinement or Day Case Procedure concerning the same Disability.
(b) Where the Insured Person is Confined or receives any Day Case Procedure involving more than 1 Disability, all Disabilities involved in the same Confinement or Day Case Procedure would be subject to 1 applicable benefit limit.
For details, please refer to Section 1(e) of Part 6 of the Terms and Benefits of the Policy provisions. -
Annual benefit limit for I. Hospitalization benefits, II. Surgical benefits and benefit items 1 to 8 of III. Other medical benefits. Annual Benefit limit for non-network are HK$150,000 (Plan A), HK$300,000 (Plan B) and HK$600,000 (Plan C).
-
Annual benefit limit for I. Hospitalization benefits, II. Surgical benefits and benefit items 1 to 8 of III. Other medical benefits. Annual Benefit limit for non-network are HK$150,000 (Plan A), HK$300,000 (Plan B) and HK$600,000 (Plan C).Source: Willis Towers Watson: 《2026 Global Medical Trends Survey》
-
FWD shall renew the Policy at each Policy Anniversary up to the Age of 101 (age next birthday) of the Insured Person as long as the requirements as stated in the renewal provisions of the Terms and Benefits of the Policy provisions are met, in particular the change in the Place of Residence and change in the occupation of the Insured Person as mentioned in Section 3 of Part 4 of the Terms and Benefits of the Policy provisions. FWD shall have the right to re-underwrite the Terms and Benefits of the Plan due to a change in the Place of Residence of the Insured Person or change in the occupation of the Insured Person upon Renewal. FWD shall carry out the re-underwriting solely in respect of the change in the Place of Residence or change in occupation of the Insured Person. The re-underwriting result may be more advantageous or adverse to the Policy Owner and the Insured Person.
FWD reserves the right to revise the Terms and Benefits by giving the Policy Owner a written notice of the revised Terms and Benefits not less than 30 days prior to the Policy Anniversary. -
Full cover shall mean no itemised benefit sublimit, the actual amount of Eligible Expenses and other expenses charged after deducting the remaining Deductible (if any) and is subject to the Annual Benefit Limit, reimbursement percentage and the number of days limit (where applicable). Full cover applies to selected benefit items only, while other benefit items are not fully covered and are subject to respective benefit item’s limits. Please refer to Benefit Schedule and Policy provisions for details. Full cover is limited to Reasonable and Customary charges or expenses incurred as a result of services which are Medically Necessary. Please refer to the “Important Words” section for the definitions of “Medically Necessary” and “Reasonable and Customary”.
-
Deductible shall mean a fixed amount of Eligible Expenses or expenses that, in a Policy Year, the Policy Owner must pay before FWD shall reimburse the remaining Eligible Expenses or remaining expenses.
-
Coinsurance shall mean a percentage of Eligible Expenses the Policy Owner must contribute. For the avoidance of doubt, Coinsurance does not refer to any amount that the Policy Owner is required to pay if the actual expenses exceed the benefit limits under these Terms and Benefits.
-
Determined at FWD's sole discretion based on designated factors including but not limited to whether there is supplementary major medical bene t under the Eligible Group Medical Insurance Scheme
-
Per a comparison made by FWD on 6 July 2026 among the medical plans of key insurers available in Hong Kong, first-dollar conversion option, Golden years Hospital companion care, Additional benefit for Alzheimer’s Disease treatment and Alzheimer’s Disease preventive care benefit are first-in-market. The above statements are made by FWD based on currently available market information and its understanding thereof, and FWD shall not be liable for any errors or omissions.
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Eligible Group Medical Insurance Scheme(s) shall mean group medical insurance schemes with hospitalisation benefits sold through FWD’s distribution channels, including group medical insurance schemes underwritten by FWD Life Insurance Company (Bermuda) Limited (incorporated in Bermuda with limited liability) (“FWD”) or Bolttech Insurance (Hong Kong) Company Limited (“Bolttech”), and other group medical insurance schemes approved by FWD. For the avoidance of doubt, group medical insurance schemes offering outpatient benefits only shall not be categorised as Eligible Group Medical Insurance Schemes. FWD reserves the right to change the definition of Eligible Group Medical Insurance Schemes from time to time without prior notice and at its sole discretion.
Eligible Member means a member (including an employee and his/her dependants) covered under an Eligible Group Medical Insurance Scheme who fulfils the applicable application criteria. Such criteria shall be determined by FWD from time to time at its sole discretion. The relevant eligibility criteria are set out in the "Enrollment Guidelines" section of this product brochure and are provided for reference only. FWD reserves the right to revise or amend any such criteria at its sole discretion and without prior notice. -
Designated Healthcare Services Provider shall mean a healthcare services provider that has entered into valid written agreements with FWD, with a healthcare network (including but not limited to medical clinic, day case procedure centre or Hospital with a setting for providing Medical Services to a Day Patient) which provides Medical Services to the Insured Person. (1) The list of Designated Healthcare Services Providers for network benefit in Hong Kong (“List 1”) and (2) the list of designated Day Case Procedures and Designated Healthcare Services Providers (“List 2”) (collectively “Lists”) are published on the FWD’s website (https://www.fwd.com.hk/en/support/medical-support). The Lists may be added, deleted, amended or replaced from time to time at FWD’s sole discretion without prior notification. Any change shall be deemed as effective as of the effective date as stated in the Lists. The Policy Owner and/or Insured Person is recommended to refer to FWD’s website for the latest Lists before receiving the Medical Services (including designated Day Case Procedure(s)) or other services. Please refer to Sections 1(c) and 4(e)(iv) of Part 6 of the Terms and Benefits of the Policy provisions for details.
-
Refer to Cash benefit for Day Case Procedure.
-
Where the supplementary major medical benefit is attached after the Policy has come into force, the no claims premium discount applicable to the Renewal premium of such supplementary major medical benefit shall be calculated by reference to the date of attachment, provided that the conditions set out in Sections 6(a) and 6(b) of Part 3 of the Terms and Benefits of the Policy provisions are satisfied. Such calculation shall be subject to the terms and conditions as determined by the Company at its sole discretion from time to time and the prevailing rules adopted by the Company.
-
The information is for reference only and is a general statement based on observation of market situation and/or various publicly available information from different sources of third parties of which FWD believes to be reliable but has not been independently verified. To the fullest extent permitted by law, FWD makes no express or implied representations, statements or warranties as to the accuracy, suitability, completeness or validity of such information (including its suitability for any particular purpose), and disclaims liability for errors or omissions in such information. Under no circumstances shall FWD be liable for any loss or damages arising from the use of or reliance on the information (including any liability to third parties). You are advised to assess for yourself the accuracy, suitability, completeness or validity of such information (including its suitability for any particular purpose). For any queries, please seek independent professional advice.
-
FWD shall have the right to ask for proof of recommendation e.g. written referral or testifying statement on the claim form by the attending doctor or Registered Medical Practitioner.
-
If Eligible Expenses and/or expenses are incurred on the same day for (i) private nursing services provided by a Registered Nurse, which are payable under benefit item 7 of I. Hospitalisation benefits, and (ii) inpatient care services provided by a Healthcare Assistant, which are payable under benefit item 8 of I. Hospitalisation benefits, only the session with the higher fee payable shall be reimbursed for that day. The item that is not reimbursed on that day will not be counted towards the maximum number of days limit of the relevant benefit item. For details, please refer to Sections 4(a)(vii) and 4(a)(viii) of Part 6 of the Terms and Benefits of the Policy provisions.
-
Applicable when the Policy has been in force for 2 consecutive years from the Policy Date.
-
Eligible Expenses incurred for psychiatric treatments, cash benefit for Confinement in general ward in a public Hospital in Hong Kong, cash benefit for Confinement in Intensive Care Unit in Hong Kong and cash benefit for room and board Confinement below entitled ward class in a private Hospital in Hong Kong shall only be payable for Confinement in Hong Kong.
For the purpose of network benefits:
(Applicable to EBridge Plans, including supplementary major medical benefit) Where benefits are reimbursed at the limits and Coinsurance (if applicable) specified as “network” in the Benefit Schedule, the relevant Medical Services or services must be performed at a Designated Healthcare Services Provider in Hong Kong for the “network” limits and Coinsurance (if applicable) to apply.
(Applicable to EBoost Plans) Where benefits are subject to the “network” Annual Benefit Limit and reimbursed at the “network” reimbursement percentage as stated in the Benefit Schedule, the relevant Medical Services or services must be performed at a Designated Healthcare Services Provider in Hong Kong for the “network” Annual Benefit Limit and “network” reimbursement percentage to apply. -
Except for psychiatric treatments, network benefits, and cash benefit for room and board Confinement below entitled ward class in a private Hospital in Hong Kong, all benefits shall be applicable worldwide.
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The benefits described in the Terms and Benefits of the Policy provisions are subject to the restriction in the choice of ward class as stated in the Benefit Schedule and Section 1(d) of Part 6 of the Terms and Benefits of the Policy provisions.
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Applicable for I. Hospitalisation benefits, II. Surgical benefits and bene t items 1 to 8 of III. Other medical benefits.
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Applicable for I. Hospitalisation benefits, II. Surgical benefits and III. Other medical benefits.
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Based on the standard premium (excluding premiums for any riders, premium discounts and levy), calculated on an annual payment mode for an insured person aged 31 (age next birthday). Standard premiums are non-guaranteed and will be determined annually based on the insured person's attained age at the time of renewal.
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If 2 or more surgical procedures performed on the Insured Person arise from the same or related Disability, or from any complications thereof, the surgical procedures for such Disability shall be reimbursed in accordance with the rules specified below –
a) For the surgical procedure with the highest Surgeon’s fee payable, such fee shall be payable subject to 100% of the benefit limit of the relevant surgical category as specified in the Benefit Schedule;
b) For the surgical procedure with the second highest Surgeon’s fee payable, such fee shall be payable subject to 50% of the benefit limit of the relevant surgical category as specified in the Benefit Schedule; and
c) For the surgical procedure(s) with the third highest Surgeon’s fee payable and thereafter, the relevant Eligible Expenses shall be payable subject to 25% of the benefit limit(s) of the relevant surgical category(ies) as specified in the Benefit Schedule.
For the same Disability, such rules shall be reset provided that the Confinement or Day Case Procedure occurs 90 consecutive days after the Last Date of the previous Confinement or Day Case Procedure in relation to the same Disability.
When determining the maximum Surgeon’s fee payable in relation to surgical procedures performed on the Insured Person, where 2 or more surgical procedures are performed on the Insured Person at the same time for different or unrelated Disabilities, such surgical procedures shall be reimbursed in accordance with the rules specified below –
a) For the surgical procedure with the highest Surgeon’s fee payable, such fee shall be payable subject to 100% of the benefit limit of the relevant surgical category as specified in the Benefit Schedule;
b) For the surgical procedure with the second highest Surgeon’s fee payable, such fee shall be payable subject to 50% of the benefit limit of the relevant surgical category as specified in the Benefit Schedule; and
c) For the surgical procedure(s) with the third highest Surgeon’s fee payable and thereafter, the relevant Eligible Expenses shall be payable subject to 25% of the benefit limit(s) of the relevant surgical category(ies) as specified in the Benefit Schedule.
For details, please refer to Section 4(b)(i) of Part 6 of the Terms and Benefits of the Policy Provisions. -
Unless otherwise specified, the Eligible Expenses incurred in respect of the same item shall not be recoverable under more than one benefit item in the table above. Eligible Expenses and/or expenses incurred shall be subject to the choice of healthcare services providers and restriction in the choice of ward class as specified in Sections 1(c) and 1(d) of Part 6 of the Terms and Benefits of the Policy provisions.
The benefit coverage, benefit amount and benefit limits, territorial scope of cover, choice of healthcare services provider, choice of ward class, Deductible (if any), Coinsurance (if any), the waiting period for unknown Pre-existing Conditions (if applicable) and the calculation of no claims premium discounts of this Plan will remain unchanged even if the Policy Year lasts for less than 12 months. -
“Network benefits” refer to the benefits payable for Medical Services or other services performed at a Designated Healthcare Services Provider in Hong Kong and are subject to the terms and conditions as specified in Sections 1(c)(i) to 1(c)(iv) of Part 6 of the Terms and Benefits of the Policy provisions. Otherwise, such benefits shall be referred to as “non-network benefits”.
“Network” benefit limits, Coinsurance, Annual Benefit Limit and reimbursement percentage (as the case may be) shall apply only to Medical Services or other services performed at a Designated Healthcare Services Provider in Hong Kong. In all other cases, including services performed outside Hong Kong or at a non-Designated Healthcare Services Provider, the applicable “non-network” terms shall apply.
(Applicable to EBridge Plans, including supplementary major medical benefit) For the purpose of determining the applicable limits and/or Coinsurance (if applicable) where “network” and “non-network” categories differ, the following shall apply:
Where Medical Services or other services are performed at a Designated Healthcare Services Provider in Hong Kong and the terms and conditions specified in Sections 1(c)(i) to 1(c)(iv) of Part 6 of the Terms and Benefits are fulfilled, the Eligible Expenses or expenses for the applicable benefit items shall be subject to the limits and Coinsurance (if applicable) specified as “network” in the Benefit Schedule. Otherwise, such Eligible Expenses or expenses shall be subject to the limits and Coinsurance (if applicable) specified as “non-network”.
In any event, the sum of the respective limits of the benefit items consumed under the “network” and “non-network” categories shall not exceed the limits specified as “network” in the Benefit Schedule.
(Applicable to EBoost Plans) For benefit items where the Annual Benefit Limit applies and/or where “network” and “non‑network” reimbursement percentages differ, the following shall apply:
Where Medical Services or other services are performed at a Designated Healthcare Services Provider in Hong Kong and the terms and conditions specified in Sections 1(c)(i) to 1(c)(iv) of Part 6 of the Terms and Benefits are fulfilled, the Eligible Expenses and expenses for the applicable benefit items shall be subject to the “network” Annual Benefit Limit and reimbursed at the “network” reimbursement percentage as stated in the Benefit Schedule. Otherwise, such Eligible Expenses or expenses shall be subject to the “non-network” Annual Benefit Limit and reimbursed at the “non-network” reimbursement percentage.
In any event, the aggregate benefits payable for the applicable benefit items in any Policy Year shall not exceed the “network” Annual Benefit Limit as specified in the Benefit Schedule.
For details, please refer to Sections 1(c) and 3 of Part 6 of the Terms and Benefits of the Policy provisions. -
This benefit shall be payable for the Eligible Expenses charged on the psychiatric treatments during Confinement in Hong Kong as recommended by a Specialist. The benefit shall be payable in lieu of benefit items 1 to 2 and 4 to 6 of I. Hospitalisation benefits, benefit items 1 to 3 of II. Surgical benefits, benefit items 1 (excluding Chinese medicine treatments), 5 and 6 of III. Other medical benefits in the Benefit Schedules of EBridge and EBoost Plans. Where the Eligible Expenses involve both psychiatric and non-psychiatric treatments and apportionment of the expenses is not available, the expenses in entirety shall be payable under this benefit if the Confinement is initially for the purpose of psychiatric treatments. If the Confinement initially is not for the purpose of psychiatric treatments, the expenses in entirety shall be payable under benefit items 1 to 2 and 4 to 6 of I. Hospitalisation benefits, benefit items 1 to 3 of II. Surgical benefits, benefit items 1, 5 and 6 of III. Other medical benefits in the Benefit Schedules of EBridge and EBoost Plans.
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This benefit shall be payable for the Reasonable and Customary charges of Emergency Treatment of the Insured Person’s sound natural teeth solely as a direct result of an Injury, if such treatment is provided within 3 months of the Accident causing such Injury by a registered dentist in a legally registered dental clinic. FWD shall not pay any benefits for any restorative or remedial work (for the purpose other than Emergency Treatment), prostheses, the use of any precious metals or any kind of orthodontics, or other dental surgery performed in a legally registered dental clinic unless the dental surgery is medically necessary. For the purpose of this benefit, medically necessary shall mean the medical service, procedure or supply which are necessary and is (a) consistent with the diagnosis and customary dental treatment; (b) recommended by a Registered Medical Practitioner, Surgeon or registered dentist for such emergency dental treatment and must be widely accepted professionally in Hong Kong or the relevant jurisdictions outside Hong Kong where the legally authorised medical service is provided to the Insured Person, as effective, appropriate and essential based upon recognised standards of the health care specialty involved; and (c) not furnished primarily for the personal comfort or convenience of the Insured Person or any medical service provider. Experimental, screening and preventive services or supplies shall not be considered as medically necessary for the purpose of this benefit. For more details and exclusion of this benefit, please refer to the Policy provisions.
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Tests covered here only include computed tomography (“CT” scan), magnetic resonance imaging (“MRI” scan), positron emission tomography (“PET” scan), PET-CT combined and PET-MRI combined.
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Treatments covered here only include radiotherapy, chemotherapy, targeted therapy, immunotherapy and hormonal therapy.
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This benefit shall be payable in the amount as specified in the Benefit Schedule for each day when the Insured Person is Confined in a room of a private Hospital in Hong Kong where the ward class is below the entitled ward class as specified in the Benefit Schedule during the whole Confinement period, provided that:
a) Such Confinement is considered Medically Necessary upon the recommendation of the Insured Person’s attending Registered Medical Practitioner; and
b) The Eligible Expenses incurred for such Confinement are payable under the Terms and Benefits of the Policy provisions. -
CANcierge, Second Medical Opinion Services, Dementia Support Program and International SOS 24-hour Worldwide Assistance Services are provided by third-party service providers which are not guaranteed renewable. FWD shall not be responsible for any act, negligence or omission of medical advice, opinion, service or treatment on the part of them. FWD reserves the right to amend, suspend or terminate the service without further notice. For details of the above services or programs, please refer to relevant service leaflet.
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This benefit shall be payable for the cash benefit amount for each day of the Insured Person’s Confinement, provided that:
a) The Insured Person is Confined in the general ward of a public Hospital in Hong Kong that is run, operated, controlled or subsidised by the Government or the Hospital Authority of Hong Kong;
b) The Insured Person holds a valid Hong Kong identity card issued by the Immigration Department of Hong Kong; and
c) Eligible Expenses incurred for the Insured Person’s Confinement are payable under these Terms and Benefits
This benefit is payable only if the Confinement is recommended in writing by a Registered Medical Practitioner for Medically Necessary treatment of a Disability, and is subject to the limits as specified in the Benefit Schedule. -
For the Insured Person covered by any other hospital reimbursement plans offered by a licensed insurance company other than FWD, regardless of whether it is an individual or group policy, if the Eligible Expenses incurred for any Confinement of the Insured Person are payable under this Policy after any reimbursement has been paid by such other licensed insurance companies, this benefit shall be payable for each day of Confined period in Hospital, subject to the limits as specified in the Benefit Schedule.
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The percentage here applies to the Surgeon’s fee actually payable or the benefit limit for the Surgeon’s fee according to the surgical categorisation (subject to the reimbursement rules as specified in Section 4(b)(i) of Part 6 of the Terms and Benefits of the Policy provisions), whichever is the lower.
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For the avoidance of doubt, if the Insured Person undergoes more than 1 major or complex surgical procedure on the same day, this benefit shall only be payable once in respect of the surgical procedure with the highest surgical category
Credit risk
This Plan is an insurance Policy issued by FWD. The Application of this insurance product and all benefits payable under your Policy are subject to the credit risk of FWD. You will bear the default risk in the event that FWD is unable to satisfy its financial obligations under this insurance contract.
Exchange rate and currency risk
The Application of this insurance product with the Policy currency denominated in a foreign currency is subject to that foreign currency’s exchange rate and currency risk. The foreign currency may be subject to the relevant regulatory bodies’ control (for example, exchange restrictions). If your home currency is different from the Policy currency, please note that any exchange rate fluctuation between your home currency and the Policy currency of this insurance product will have a direct impact on the amount of premium required and the value of benefit(s) to be received. For instance, if the Policy currency of the insurance product depreciates substantially against your home currency, there is a negative impact on the benefits you receive from this Plan. If the Policy currency of the insurance product appreciates substantially against your home currency, your burden of the premium payment is increased.
Inflation risk
The cost of living in the future may be higher than now due to the effects of inflation. Therefore, the benefits under this Plan may not be sufficient for the increasing protection needs in the future even if FWD fulfills all of its contractual obligations.
Premium adjustment
The Standard Premium is non-guaranteed and will be determined annually based on the Age of the Insured Person at the time of Renewal7. The Standard Premium may increase significantly due to factors including but not limited to Age, medical inflation, and claims experience and policy persistency on an overall basis.
Premium term and non-payment of premium
The premium payment term of the Plan is up to the Policy Anniversary immediately preceding the 101st birthday of the Insured Person.
FWD allows a grace period of 30 days after the premium due date for payment of each premium. This Policy shall continue to be in effect during the grace period but no benefits shall be payable unless the premium is paid. If a premium is still unpaid at the expiration of the grace period, the Policy will be terminated from the date of the first unpaid premium was due. Please note that once the Policy is terminated on this basis, you will lose all of your benefits.
Termination conditions
The Policy shall be automatically terminated on the earliest of the followings:
(a) where the Policy is terminated due to non-payment of premiums after the grace period as specified in Section 13 of Part 2 or Section 3 of Part 3 of the Terms and Benefits of the Policy provisions; or
(b) the day immediately following the death of the Insured Person; or
(c) FWD has ceased to have the requisite authorisation under the Insurance Ordinance to write or continue to write the Policy.
If this Policy is terminated pursuant to Section 15 of the Terms and Benefits, the termination shall be effective at 00:00 hours of the effective date of termination.
Immediately following the termination of the Policy, insurance coverage under the Policy shall cease to be in force. No premium paid for the current Policy Year and previous Policy Years shall be refunded, unless specified otherwise.
Where the Policy is terminated pursuant to (a), the effective date of termination shall be the date that the unpaid premium is first due.
For more details, please refer to Section 15 of Part 2 of the Terms and Benefits of the Policy provisions.
Under the Terms and Benefits of the Policy provisions, FWD shall not pay any benefits in relation to or arising from the following expenses, unless otherwise specified.
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Expenses incurred for treatments, procedures, medications, tests or services which are not Medically Necessary.
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Expenses incurred for the whole or part of the Confinement solely for the purpose of diagnostic procedures or allied health services, including but not limited to physiotherapy, occupational therapy and speech therapy, unless such procedure or service is recommended by a Registered Medical Practitioner for Medically Necessary investigation or treatment of a Disability which cannot be effectively performed in a setting for providing Medical Services to a Day Patient.
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Expenses arising from Human Immunodeficiency Virus (“HIV”) and its related Disability, which is contracted or occurs before the Policy Date. Irrespective of whether it is known or unknown to the Policy Owner or the Insured Person at the time of submission of Application or reinstatement request document, including any updates of and changes to such requisite information (if so requested by FWD under Section 6 of Part 1 of the Terms and Benefits of the Policy provisions) such Disability shall be generally excluded from any coverage of the Terms and Benefits of the Policy provisions if it exists before the Policy Date. If evidence of proof as to the time at which such Disability is first contracted or occurs is not available, manifestation of such Disability within the first five (5) years after the Policy Date shall be presumed to be contracted or occur before the Policy Date, while manifestation after such five (5) years shall be presumed to be contracted or occur after the Policy Date.
However, the exclusion under the entire Section 3 of Part 7 of the Terms and Benefits of the Policy provisions shall not apply where HIV and its related Disability is caused by sexual assault, medical assistance, organ transplant, blood transfusions or blood donation, or infection at birth, and in such cases the other terms of these Terms and Benefits shall apply. -
Expenses incurred for Medical Services as a result of Disability arising from or consequential upon the dependence, overdose or influence of drugs, alcohol, narcotics or similar drugs or agents, self-inflicted injuries or attempted suicide, illegal activity, or venereal and sexually transmitted disease or its sequelae (except for HIV and its related Disability, where Section 3 of Part 7 of the Terms and Benefits of the Policy provisions applies).
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Any charges in respect of services for -
(a) beautification or cosmetic purposes, unless necessitated by Injury caused by an Accident and the Insured Person receives the Medical Services within ninety (90) days of the Accident; or
(b) correcting visual acuity or refractive errors that can be corrected by fitting of spectacles or contact lens, including but not limited to eye refractive therapy, LASIK and any related tests, procedures and services. -
Expenses incurred for prophylactic treatment or preventive care, including but not limited to general check-ups, routine tests, screening procedures for asymptomatic conditions, screening or surveillance procedures based on the health history of the Insured Person and/ or his family members, Hair Mineral Analysis (HMA), immunisation or health supplements. For the avoidance of doubt, this Section 6 of Part 7 of the Terms and Benefits of the Policy provisions does not apply to -
(a) treatments, monitoring, investigations or procedures with the purpose of avoiding complications arising from any other Medical Services provided;
(b) removal of pre-malignant conditions; and
(c) treatment for prevention of recurrence or complication of a previous Disability. -
Except as otherwise provided in Section 4(c)(iv) of Part 6 of the Terms and Benefits of the Policy provisions, expenses incurred for dental treatment and oral and maxillofacial procedures performed by a dentist except for Emergency Treatment and surgery during Confinement arising from an Accident. Follow-up dental treatment or oral surgery after discharge from Hospital shall not be covered.
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Expenses incurred for Medical Services and counselling services relating to maternity conditions and its complications, including but not limited to diagnostic tests for pregnancy or resulting childbirth, abortion or miscarriage; birth control or reversal of birth control; sterilisation or sex reassignment of either sex; infertility including in-vitro fertilisation or any other artificial method of inducing pregnancy; or sexual dysfunction including but not limited to impotence, erectile dysfunction or pre-mature ejaculation, regardless of cause.
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Expenses incurred for the purchase of durable medical equipment or appliances including but not limited to wheelchairs, beds and furniture, airway pressure machines and masks, portable oxygen and oxygen therapy devices, dialysis machines, exercise equipment, spectacles, hearing aids, special braces, walking aids, over-the-counter drugs, air purifiers or conditioners and heat appliances for home use. For the avoidance of doubt, this exclusion shall not apply to rental of medical equipment or appliances during Confinement or on the day of the Day Case Procedure.
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Except as otherwise provided in Section 4(c)(i) of Part 6 of the Terms and Benefits of the Policy provisions, expenses incurred for traditional Chinese medicine treatment, including but not limited to herbal treatment, bone-setting, acupuncture, acupressure and tui na, and other forms of alternative treatment including but not limited to hypnotism, qigong, massage therapy, aromatherapy, naturopathy, hydropathy, homeotherapy and other similar treatments.
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Expenses incurred for experimental or unproven medical technology or procedure in accordance with the common standard, or not approved by the recognised authority, in the locality where the treatment, procedure, test or service is received.
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Expenses incurred for Medical Services provided as a result of Congenital Condition(s) which have manifested or been diagnosed before the Insured Person attained the Age of nine (9) years.
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Eligible Expenses which have been reimbursed under any law, or medical program or insurance policy provided by any government, company or other third party.
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Expenses incurred for treatment for Disability arising from war (declared or undeclared), civil war, invasion, acts of foreign enemies, hostilities, rebellion, revolution, insurrection, or military or usurped power.
Suicide
If the Insured Person commits suicide (whether sane or insane at that time) within 13 calendar months from the Policy Date, FWD’s liability under this Policy will be limited to the refund of premiums paid (without interest) less any outstanding insurance levy and any benefit which has been paid under this Policy.
The above list is not exhaustive and is for reference only. Please refer to the Policy provisions for the complete exclusions including but not limited to exclusions for accidental death benefit and Emergency outpatient dental treatment.
Your right under cooling-off period
If you are not fully satisfied with this Policy, you have the right to change your mind.
FWD trust that this Policy will satisfy your needs. However, if you are not completely satisfied, you have the right to cancel and obtain a full refund of the insurance premium paid by you and levy paid by you without interest by giving us written notice. Such notice must be signed by you and received directly by the office of FWD within 21 calendar days immediately following either the day of delivery of the Policy or a Cooling-off Notice to you or your nominated representative, whichever is the earlier. The notice is the one sent to you or your nominated representative (separate from the Policy) notifying you of your right to cancel within the stated 21 calendar day period. No refund can be made if a claim payment under the Policy has been made prior to your request for cancellation. Should you have any further queries, you may (1) call our Service Hotline on 3123 3123; (2) visit our FWD Insurance Solutions Centres; (3) email to cs.hk@fwd.com and We will be happy to explain your cancellation rights further.
Cancellation right
After the cooling-off period, you can request cancellation of these Terms and Benefits by giving 30 days prior written notice to FWD, provided that there has been no benefit payment under these Terms and Benefits during the relevant Policy Year.
Other insurance coverage
If you have taken out other insurance coverage besides the Plan, you shall have the right to claim under any such other insurance coverage or the Plan. However, if you or the Insured Person has already recovered all or part of the expenses from any such other insurance coverage, FWD shall only be liable for such amount of Eligible Expense, if any, which is not compensated by any such other insurance coverage.
Notwithstanding the above, where requested by FWD upon submission of a claim, the Policy Owner or the Insured Person must declare whether the Insured Person is covered under any group medical scheme provided by other licensed insurance companies. Claim payments shall first be made under such group medical policy of the Insured Person (if any). Any unpaid portion of the Eligible Expenses and/or expenses shall then be claimable under this Policy, subject to the Terms and Benefits of this Policy.
Notice to Claim
Medical claims
All claims incurred shall be submitted to FWD within 90 days after the date on which the Insured Person is discharged from the Hospital, or the date on which the relevant Medical Service is performed and completed. For this purpose,
(a) all original receipts and/ or original itemised bills together with the diagnosis, type of treatment, procedure, test or service provided shall have been submitted to FWD; and
(b) all relevant information, certificates, reports, evidence, referral letter and other data or materials as reasonably required by FWD shall have been furnished to FWD for processing of such claim.
You shall notify FWD if claims cannot be submitted within the above timeframe, otherwise FWD shall have the right to reject claims submitted after the above timeframe. All certificates, information and evidence that are reasonably required by FWD and which can be reasonably provided by you shall be furnished at the expenses of you.
Death/ accidental death claims
Death/ accidental death benefit is payable to beneficiary upon Insured Person’s death if the claimant submits the completed Death Claim Form, the Death Claim – Attending Physician’s Report completed by the last attending doctor (only applicable for death occurred within the first 3 Policy Years), due proof of the death and any other documents as reasonably required by FWD (including all relevant certificates, reports, evidence and other data or materials).
All such documents which can be reasonably provided by you shall be furnished at the expenses of you.
Declaration relating to the Foreign Account Tax Compliance Act and Automatic Exchange of Financial Account Information
FWD is obliged to comply with the following legal and/or regulatory requirements in various jurisdictions as promulgated and amended from time to time, such as the United States Foreign Account Tax Compliance Act, and the automatic exchange of financial account information regime (“AEOI”) followed by the Inland Revenue Department (the “Applicable Requirements”). These obligations include providing information of clients and related parties (including personal information) to relevant local and international authorities and/or to verify the identity of the clients and related parties. In addition, our obligations under the AEOI are to:
i. identify accounts as non-excluded “financial accounts” (“NEFAs”);
ii. identify the jurisdiction(s) in which NEFA-holding individuals and NEFA-holding entities reside for tax purposes;
iii. determine the status of NEFA-holding entities as “passive non-financial entities (NFEs)” and identify the jurisdiction(s) in which their controlling persons reside for tax purposes;
iv. collect information on NEFAs (“Required Information”) which is required by various authorities; and
v. furnish Required Information to the Inland Revenue Department.
The Policy Owner must comply with requests made by FWD to comply with the above Applicable Requirements.
Accident
shall mean a sudden and unforeseen event occurring entirely beyond the control of the Insured Person and caused by violent, external and visible means.
Age
shall mean the age next birthday of the Insured Person of this Policy, unless otherwise specified.
Confinement or Confined
shall mean an admission of the Insured Person to a Hospital that is recommended by a Registered Medical Practitioner for Medical Service and as an Inpatient as a result of a Medically Necessary condition.
Confinement shall be evidenced by a daily room charge invoiced by the Hospital and the Insured Person must stay in the Hospital continuously for the entire period of Confinement.
Congenital Condition(s)
shall mean (a) any medical, physical or mental abnormalities existed at the time of or before birth, whether or not being manifested, diagnosed or known at birth; or (b) any neo-natal abnormalities developed within 6 months of birth.
Day Case Procedure
shall mean a Medically Necessary surgical procedure for investigation or treatment to the Insured Person performed in a medical clinic, or day case procedure centre or Hospital with facilities for recovery as a Day Patient.
Disability
shall mean a Sickness or Disease or Injury, including any and all complications arising therefrom.
Eligible Expenses
shall mean expenses incurred for Medical Services rendered with respect to a Disability.
Medically Necessary
Medically Necessary shall mean the need to have medical service for the purpose of investigating or treating the relevant Disability in accordance with the generally accepted standards of medical practice and such medical service must –
(a) require the expertise of, or be referred by, a Registered Medical Practitioner;
(b) be consistent with the diagnosis and necessary for the investigation and treatment of the Disability;
(c) be rendered in accordance with standards of good and prudent medical practice, and not be rendered primarily for the convenience or the comfort of the Insured Person, his family, caretaker or the attending Registered Medical Practitioner;
(d) be rendered in the setting that is most appropriate in the circumstances and in accordance with the generally accepted standards of medical practice for the medical services; and
(e) be furnished at the most appropriate level which, in the prudent professional judgment of the attending Registered Medical Practitioner, can be safely and effectively provided to the Insured Person.
For the purpose of these Terms and Benefits, without prejudice to the generality of the foregoing, circumstances where a Confinement is considered Medically Necessary include, but not limited to –
(i) the Insured Person is having an Emergency that requires urgent treatment in Hospital;
(ii) surgical procedures are performed under general anaesthesia;
(iii) equipment for surgical procedure is available in Hospital and procedure cannot be done on a Day Patient basis;
(iv) there is significantly severe co-morbidity of the Insured Person;
(v) taking into account the individual circumstances of the Insured Person, the attending Registered Medical Practitioner has exercised his prudent professional judgment and is of the view that for the safety of the Insured Person, the medical service should be conducted in Hospital;
(vi) in the prudent professional judgment of the attending Registered Medical Practitioner, the length of Confinement of the Insured Person is appropriate for the medical service concerned; and/or
(vii) in the case of diagnostic procedures or allied health services prescribed by a Registered Medical Practitioner, such Registered Medical Practitioner has exercised his prudent professional judgment and is of the view that for the safety of the Insured Person, such procedures or services should be conducted in Hospital.
For the purpose of exercising his prudent professional judgement in (v) to (vii) above, the attending Registered Medical Practitioner shall have regard to whether the Confinement –
(aa) is in accordance with standards of good and prudent medical practice in the locality for the medical service rendered, and, in the prudent professional judgement of the attending Registered Medical Practitioner, not rendered primarily for the convenience or the comfort of the Insured Person, his family, caretaker or the attending Registered Medical Practitioner; and
(bb) is in the setting that is most appropriate in the circumstances and in accordance with the generally accepted standards of medical practice in the locality for the medical service rendered.
Pre-existing Condition(s)
shall mean, in respect of the Insured Person, any Sickness, Disease, Injury, physical, mental or medical condition or physiological degradation, including Congenital Condition, that has existed prior to the Policy Date. An ordinary prudent person shall be reasonably aware of a Pre-existing Condition, where –
(a) it has been diagnosed;
(b) it has manifested clear and distinct signs or symptoms; or
(c) medical advice or treatment has been sought, recommended or received.
Reasonable and Customary
FWD shall only cover charges or expenses which FWD believes are Reasonable and Customary. Reasonable and Customary shall mean, in relation to a charge for Medical Service, such level which does not exceed the general range of charges being charged by the relevant service providers in the locality where the charge is incurred for similar treatment, services or supplies for people with similar conditions, e.g. of the same sex and similar Age, for a similar Disability, as FWD reasonably determine in utmost good faith.
The Reasonable and Customary charges will never in any circumstance exceed the actual charges incurred. FWD may exercise the right to determine whether the charges for treatment, medical services and supplies are regarded as Reasonable and Customary with reference to treatment or service fee statistics and surveys in the insurance or medical industry; internal or industry claim statistics; gazette published by the Government; and/ or other pertinent source of reference in the locality where the treatments, services or supplies are provided.
FWD may exercise the right to adjust any benefit payable in relation to any charges which are not Reasonable and Customary.
Standard Semi-private Room
shall mean a room categorised as a semi-private room by a Hospital in Hong Kong. For Hospitals without the corresponding ward class categorisation or any Hospitals outside Hong Kong, a Standard Semi-private Room shall mean (i) a single or two-bedded room; or (ii) a room with maximum double occupancy, and with a shared bath/shower room in a Hospital. In any case mentioned above, a Standard Semi-private Room shall exclude any room of upper class with its own kitchen, dining or sitting room(s).
Standard Private Room
shall mean a room categorised as a private room by a Hospital in Hong Kong. For Hospitals without the corresponding ward class categorisation or any Hospitals outside Hong Kong, a Standard Private Room shall mean a room for Insured Person’s private use during the Confinement with its own private facilities including a bedroom and bath/shower room(s) only. In any case mentioned above, a Standard Private Room shall exclude any room of upper class with its own kitchen, dining or sitting room(s).
Standard Ward Room
shall mean a room categorised as a ward class lower than a Standard Semi-private Room including the room categorised as a general ward or standard room by a Hospital in Hong Kong. For Hospitals without the corresponding ward class categorisation or any Hospitals outside Hong Kong, a Standard Ward Room shall mean a room in a Hospital with more than 2 patient beds (not including companion bed).
EBeyond Medical Insurance Solution is underwritten by FWD Life Insurance Company (Bermuda) Limited (incorporated in Bermuda with limited liability) ("FWD Life/ FWD/We"). This eCommerce Platform is operated by FWD Financial Limited ("FWD Financial"). FWD Financial is an appointed and licensed insurance agency of FWD Life.
The product information in this website is for reference only and does not contain the full terms and conditions, key product risks and full list of exclusions of the policy. For the details of benefits and key product risks, please refer to the product brochure; and for exact terms and conditions and the full list of exclusions, please refer to the policy provisions of EBeyond.
Please make sure you are eligible for this product before applying:
• I (and the Insured person if applicable) am a permanent HKID card holder with a Hong Kong residential address.
• Currently in Hong Kong at the time of making this application.
• I will not or have no intention to live or work outside Hong Kong or home country over 183 days in the coming 12 months.
• I am not a holder of the People’s Republic of China Resident Identity Card.
Note: Online applicants will be requested to visit FWD Insurance Solutions Centres under the following circumstances: 1) Collection of policy documents upon issuance of policy; 2) Cancellation of policy during the cooling-off period; 3) Change of beneficiary; or 4) Full surrender. Under specific circumstances, we may request online applicants to visit FWD Insurance Solutions Centres for identity verification.
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If you are looking for a product that offers broader benefit coverage and higher benefit limits. Please contact us for more information.
Frequently Asked Medical Insurance Questions
Does the EBeyond Medical Insurance Solution cover proton therapy?
Yes. Proton therapy is a form of radiotherapy and is covered under "Prescribed Non-Surgical Cancer Treatments25" within Section III. Other medical benefits.
If the Insured Person is hospitalised for treatment of Alzheimer's Disease, are the related expenses only payable under the Additional benefit for Alzheimer's Disease treatment?
No. If the hospitalisation and treatment are considered medically necessary, the eligible expenses and/or related costs may be covered under the relevant benefits of I. Hospitalisation benefits, II. Surgical benefits, and III. Other medical benefits, subject to the Claims Department's final assessment based on the principles of "Reasonable and Customary" charges and "Medically Necessary" treatment.
The Additional Coverage for Alzheimer's Disease treatment is primarily intended to cover treatment cost for medications and/or non-drug therapies required following a diagnosis of Alzheimer's Disease.
A customer is around age 40 and the policy has been in force for over 2 years. Can the cost of an Alzheimer's Disease early risk assessment be reimbursed?
The Alzheimer's Disease preventive care benefit is only available to Insured Persons whose age next birthday is 51 or above.
If the Insured Person's age next birthday is still below 51 after the policy has been continuously in force for 2 years, reimbursement will only become available in the relevant policy year when the Insured Person reaches age next birthday 51 or above.