Top VHIS winner¹

1. vPrime Medical Plan won the Grand Award of "Most Innovative Product/Service Award - Voluntary Health Insurance Scheme" in Hong Kong Insurance Awards 2021 & 2022. FWD VHIS series won the Excellence Award and Outstanding Awards from "VHIS plans series" for consecutive 5 years from 2021 to 2025 by Bloomberg Businessweek.

2. 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. 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 product brochure for the definitions of "Medically Necessary" and "Reasonable and Customary".

3. vPrime Medical Plan is a Flexi Plan certified by the Hong Kong Special Administrative Region Government (the “Government”) under the Voluntary Health Insurance Scheme (“VHIS”)(Certification number: F00045) and is underwritten by FWD Life Insurance Company (Bermuda) Limited (incorporated in Bermuda with limited liability)(“FWD Life”) (VHIS provider registration number is 00036).

4. 10Life calculates the estimated average coverage ratio and assigns the rating based on the public information shared by insurance companies. For more details, please refer to the 10Life website. The information provided is based on the data from the 10Life website which has not been independently verified by FWD. FWD makes no representations or warranties and accepts no responsibility or liability as to the accuracy, completeness or fitness for any particular purpose of the information. FWD Life shall not be responsible or liable for any loss or damages arising from the use of or reliance on such information.

5. If you are a Hong Kong taxpayer, you may be eligible for tax deduction of up to HK$8,000 per Insured Person per year of assessment for premium you paid for yourself and your specified relatives. Tax deduction is subject to the latest rules and regulation of Inland Revenue Department of Hong Kong Special Administrative Region. Please refer to the website of the Inland Revenue Department (“IRD”) of Hong Kong Special Administrative Region (www.ird.gov.hk/eng/) and VHIS (www.vhis.gov.hk/en/) or contact the IRD directly for any tax related enquiries. FWD and the intermediaries do not provide tax advice. You should always consult with a professional tax advisor if you have any doubts.

6. 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.
   The list of designated Day Case Procedures and Designated Healthcare Services Providers (hereafter “List”) is published on FWD’s website (www.fwd.com.hk/en/support/medical-support). The List 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 List. The Policy Holder and/or Insured Person is recommended to refer to FWD’s website for the latest List before receiving the designated Day Case Procedure(s).
   For details, please refer to Section 4 of Part 1, Part 2 and Part 3 of the Supplement – Other benefits under the Policy provisions.

7. Source: Willis Towers Watson: 《2025 Global Medical Trends Survey》

8. Source: Hospital Authority - Waiting Time for Stable New Case Booking at Specialist Out-patient Clinics, 31 December 2024. The abovementioned data referred to the longest waiting time (weeks) among all districts in Hong Kong, and divided by 4 to illustrate in months.

9. Source: Cancer Information – Survey: Mistakenly believing cancer treatment in the public hospitals was not costly.

10. Deductible shall mean a fixed amount of Eligible Expenses or expenses that, in a Policy Year, the Policy Holder must pay before FWD shall reimburse the remaining Eligible Expenses or remaining expenses.

11. Based on the VHIS plan comparison conducted among FWD and the major insurance companies in Hong Kong in January 2025, only vPrime Medical Plan is offering 6 deductible options which is the most in the market.

12. Source: Hong Kong Adventist Hospital.

13. Designated crises shall include Cardiac Impairment Caused by Cardiomyopathy, Cardiac Impairment Due To Primary Pulmonary Arterial Hypertension, Chronic Liver Disease, Coronary Artery Bypass Operation, End Stage Lung Disease, Fulminant Hepatitis, Heart Attack (Acute Myocardial Infarction), Kidney Failure, Major Organ Transplantation, Open Heart Valve Surgery, Parkinson’s Disease, Severe Rheumatoid Arthritis, Specified Cancer, Stroke, Surgery to Aorta and Terminal Illness. For details of the benefit, including the definition of the designated crises, please refer to the Supplement – First-dollar coverage – Deductible waived for designated crises of the Policy provisions.
    The “first-dollar coverage – Deductible waived for designated crises” under the Supplement – First-dollar coverage – Deductible waived for designated crises under the Policy provisions of the Plan shall not be applicable to the Medical Services arising from any designated crisis that the Policy Holder or Insured Person is aware of, or shall be reasonably aware of within the first ninety (90) days from the Policy Effective Date of the Policy. The Policy Holder or Insured Person shall be reasonably aware of a designated crisis where-
    (a) the designated crisis has been diagnosed;
    (b) the designated crisis has manifested clear and distinct signs or symptoms; or
    (c) medical advice or treatment has been sought, recommended or received for the designated crisis.
    For the avoidance of doubt, the "first-dollar coverage – Deductible waived for designated crises" under the Supplement – First-dollar coverage – Deductible waived for designated crises under the Policy provisions of the Plan shall not be applicable to any Policies where the selected Deductible option is zero dollar ($0).

14. 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.

15. Refer to Cash benefit for Day Case Procedure.

16. Refer to Cash benefit for top-up subsidy. 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.

17. Refer to Cash benefit for room and board Confinement below entitled ward class in a private Hospital in Hong Kong. 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.

18. Refer to Cash benefit for Major and complex surgeries, subject to the categorisation of such surgery under the Schedule of Surgical Procedures. The Eligible Expenses incurred during such Confinement period are payable in accordance with the Terms and Benefits.

19. Refer to Cash benefit for Confinement in Intensive Care Unit in Hong Kong. If 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.

20. FWD shall guarantee the Renewal at each policy anniversary up to the Age of 100 (attained age) of the Insured Person. As long as FWD maintains the registration as a VHIS provider, FWD guarantees that the Terms and Benefits will not be less favourable than the latest version of the Standard Plan Terms and Benefits published by the Government at the time of Renewal. FWD reserves the right to revise the Terms and Benefits, subject to the prior approval and re-certification by the Government, upon Renewal by giving a 30 days advance notice.

21. Eligible policies means in-force vPrime policies issued to the Policy Holder which are also eligible for the above individual no claims premium discount on the Renewal date.

22. Applicable to Renewal premium.

23. As of 31 March 2025.

24. This benefit/service is optional and does not form part of the Terms and Benefits of the VHIS Certified Plan – vPrime Medical Plan (Certification Number: F00045). You have the right to opt-out this benefit/service. Please inform FWD in writing if you do not want to receive this free additional benefit/service.

25. PREMIER THE ONEcierge, Second Medical Opinion Services, International SOS 24-hour Worldwide Assistance Services, Cross-border Cancer Management Program, life enrichment program for Stroke, Mainland China-focused Services, EC Healthcare’s diversified health assistance services and FWD Care recovery plan (“the Plan”) are provided by third party service provider(s) which are not guaranteed renewable. Terms and conditions apply. FWD makes no representation, warranty or undertaking as to the availability and quality of the service. FWD shall not accept any responsibility or liability for their services, opinions, treatment, negligence, omission or failure to act by such third-party service providers. FWD reserves the right to replace any of such service provider or cease and/or suspend the provision of such services without prior notice. This service is optional. The provision of such service and your acceptance of the same shall constitute a separate contract between you and the third party service provider and does not form part of the Terms and Benefits of vPrime Medical Plan. FWD does not provide any medical advice and you should consult your own medical advisors for professional advice. FWD Care recovery plan is provided in Hong Kong only. The Recovery Nurses under the Plan will make their best effort to arrange support services. The availability of these services cannot be guaranteed and will be subject to the availability of service providers. The Recovery Nurses and service providers have the sole discretion in deciding the types and frequency of support services on a case-by-case basis. The Recovery Nurses are healthcare professionals employed by third-party service provider and not FWD employees, agents or representatives. FWD shall not be responsible for or liable to their actions, negligence or omission. For details of the services, please refer to the leaflet of FWD Professional Health Assistance Services and FWD Care recovery plan. Life enrichment program for Stroke is only available in Hong Kong. For details of the above services or programs, please refer to the relevant service leaflet. The waiting period of subsequent claim for life enrichment program for Stroke is 1 year. For details of life enrichment program for Stroke, please refer to the Section 2 of Part 1 of the Endorsement – Special benefit for infant, life enrichment program for Stroke and child development benefit under the Policy provisions.

26. Disability subsidy benefit shall be payable up to maximum 24 months per Incident.

27. This benefit shall be payable for the Eligible Expenses incurred for the benefit items described in benefit items under (a) to (i) of I. Basic benefits in the Benefit Schedule where a surgical procedure is performed by a Surgeon during Confinement or in a setting for providing Medical Services to a Day Patient as a result of the following pregnancy related complications arising during antepartum stages of pregnancy or childbirth – (a) ectopic pregnancy; (b) molar pregnancy; (c) disseminated intravascular coagulopathy; (d) pre-eclampsia; (e) miscarriage; (f) threatened abortion; (g) medically prescribed induced abortion; (h) foetal death; (i) postpartum hemorrhage requiring hysterectomy; (j) eclampsia; (k) amniotic fluid embolism; or (l) pulmonary embolism of pregnancy. This benefit shall only be payable provided that the date of diagnosis of such pregnancy complication is at least twelve (12) months after (i) the Policy Effective Date (if pregnancy complications benefit is offered on the Policy Effective Date) or (ii) the Renewal Date (if the pregnancy complications benefit is first offered on such Renewal).

28. This additional benefit is available if the Insured Person or Insured Person’s spouse gives birth to a child after the Policy has been in force for 2 consecutive Policy Years from the Policy Effective Date (“Covered Child”). Two years coverage by a designated medical insurance plan for the Covered Child shall be offered without further evidence of insurability and at no additional charge. Once the coverage for the Covered Child is in effect and if the Covered Child suffers from Disability during the coverage period, FWD shall pay the benefits based on the terms and benefits of the designated medical insurance plan. The benefit amount shall not be deducted from this Policy and shall not affect the coverage available to the Insured Person under this Policy. The Policy Holder shall inform FWD in writing of the birth of the Covered Child within 180 days of the birth and provide the birth certificate of the Covered Child issued by the relevant competent authority of a lawful jurisdiction. This benefit is subject to the terms and benefits of the designated medical insurance plan and FWD’s prevailing rules and regulations which are determined by FWD from time to time at its sole discretion. For more details, please refer to Section 1 of Part 1 of the Endorsement – Special benefit for infant, life enrichment program for Stroke and child development benefit under the Policy provisions.

29. If the Policy has been in force for 5 consecutive Policy Years from (i) the Policy Effective Date (if child development benefit is offered on the Policy Effective Date) or (ii) the Renewal Date (if the child development benefit is first offered on such Renewal), this benefit will be payable once every 5 consecutive Policy Years and up to Age 25 (attained age) of the Insured Person if the Insured Person undertakes any of the Child Development Activities in the next Policy Year following the five-year period. Any unused benefit will be forfeited and cannot be carried forward or refunded by cash. “Child Development Activities” shall mean any one of the following activities:
    (a) child development assessment;
    (b) training therapy; or
    (c) health check-up.
    For more details, please refer to Section 3 of Part 1 of the Endorsement – Special benefit for infant, life enrichment program for Stroke and child development benefit under the Policy provisions.

30. Cashless Facility Service is an administrative arrangement to pay the covered expenditures when the Insured Person receives approved medical procedures in a network hospital or a specialist medical service centre, but not a benefit item under policy of vPrime, and it is not a guaranteed successful arrangement. FWD Life reserves the right to terminate or vary the service in its sole discretion without further notice. FWD Life would pay the medical cost to the relevant hospital or specialist medical service centre on behalf of the Insured Person after successful arrangement of the Cashless Facility Service. If there is deductible balance (if applicable) of the policy of vPrime, policy holders are required to pay such balance when admitted to the hospital or at the specialist medical service centre. If the medical cost paid by FWD Life is higher than the maximum amount of benefit, FWD Life would seek reimbursement from policy holders for such amount. The Cashless Facility Service is provided by external third party service provider(s) which are not guaranteed renewable. FWD Life shall not be responsible for any act, negligence or omission of medical advice, opinion, service or treatment on the part of them. FWD Life reserves the right to amend, suspend or terminate the service without further notice.

31. Assumed that there is no deductible balance under vPrime which was applied by the customer when the Insured Person receives the treatment, the expenses incurred by the surgery and/or hospitalisation are eligible expenses, and the remaining limits of the plan (including but not limited to the benefit limit(s) of its benefit item(s) and/or the annual benefit limit under the plan) is still sufficient to pay for the claim.

32. As of 31 March 2025.

33. For the private hospital list, FWD Life reserves the right to revise the list without prior notice, whilst every attempt has been made in the preparation of this list to ensure its accuracy and completeness, in the event of any discrepancy between the Chinese and English versions, the English version shall prevail, the hospital names and addresses are for reference only. FWD Life recommends customers to contact 24-hour Service Hotline +852 8120 9066 for the applicable hospital network before being admitted into any hospital or receiving any insurable medical treatment.

34. 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 restriction in the choice of ward class as specified in Section 2 of Part 1 of the Supplement – Limitation of benefits under the Policy provisions.

35. 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 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.

36. Except for (i) the cash benefit for designated Day Case Procedure which is performed at a Designated Healthcare Services Provider as stated in Section 4 of Part 1 of the Supplement – Other benefits and (ii) the cash benefit for room and board Confinement below entitled ward class in a private Hospital in Hong Kong as stated in Section 6 of Part 1 of the Supplement – Other benefits (if applicable) under the Policy provisions, all benefits described in these Terms and Benefits are not subject to any restriction in the choice of health care services providers, including but not limited to Registered Medical Practitioner and Hospital.
    The benefits described in (i) the cash benefit for designated Day Case Procedure which is performed at a Designated Healthcare Services Provider as stated in Section 4 of Part 1 of the Supplement – Other benefits and (ii) the cash benefit for room and board Confinement below entitled ward class in a private Hospital in Hong Kong as stated in Section 6 of Part 1 of the Supplement – Other benefits (if applicable) under the Policy provisions is subject to the restriction in the choice of healthcare services providers as stated in Sections 4 and 6 of Part 1 of the Supplement – Other benefits and the Benefit Schedule under the Policy provisions. The above restriction shall not apply to the terms and benefits within the scope of the Standard Plan Terms and Benefits. For the avoidance of doubt, the applicable Standard Plan Terms and Benefits shall be the version as is referred to under Sections 1(a), (b) or (c) of Part 4 of the Terms and Benefits under the Policy provisions.

37. Eligible Expenses incurred for any non-Emergency Treatments performed outside Asia shall be payable up to the benefit limits as stated in the benefit schedule attached to the Standard Plan Terms and Benefits. Psychiatric treatments, cash benefit for room and board Confinement below entitled ward class in a private Hospital in Hong Kong and cash benefit for Confinement in Intensive Care Unit in Hong Kong shall only be payable for Confinement in Hong Kong. Please refer to Section 1 of Part 1 of the Supplement – Limitation of benefits under the Policy provisions for details.

38. Asia shall include Afghanistan, Australia, Bangladesh, Bhutan, Brunei, Cambodia, Mainland China, Hong Kong, India, Indonesia, Japan, Kazakhstan, Kyrgyzstan, Laos, Macau, Malaysia, Maldives, Mongolia, Myanmar, Nepal, New Zealand, North Korea, Pakistan, the Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Tajikistan, Thailand, Timor-Leste, Turkmenistan, Uzbekistan and Vietnam.

39. The benefits described in the Terms and Benefits under the Policy provisions are subject to the restriction in the choice of ward class as stated in the Benefit Schedule and Section 2 of Part 1 of the Supplement – Limitation of benefits under the Policy provisions.
    The above restriction shall not apply to the terms and benefits within the scope of the Standard Plan Terms and Benefits under the Policy provisions. For the avoidance of doubt, the applicable Standard Plan Terms and Benefits shall be the version as is referred to under Sections 1(a), (b) or (c) of Part 4 under the Policy provisions.

40. 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.

41. Treatments covered here only include radiotherapy, chemotherapy, targeted therapy, immunotherapy and hormonal therapy.

42. 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 other benefit items under (a) to (k) of I. Basic benefits in the Benefit Schedule. 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 (a) to (k) of I. Basic benefits in the Benefit Schedule.

43. Donor’s benefit shall be payable up to 30% of the total transplantation cost (the sum of the surgical expenses charged for removing the organ or bone marrow from the donor and the Eligible Expenses of the surgical procedure performed on the Insured Person as a recipient) for the transplantation of heart, kidney, liver, lung or bone marrow.

44. This benefit is 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 authorized 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.

45. Source: HKSH Proton Therapy Centre fees and charges – charges for 30 or 35 fractions of Head and neck/Nasopharyngeal treatment. The exact number of fractions is determined by the doctor based on individual medical needs.

46. All prior outpatient visits or Emergency consultations per Confinement/ Day Case Procedure (within 31 days before admission or Day Case Procedure, subject to 1 visit per day); one prior outpatient visit or Emergency consultation per Confinement / Day Case Procedure (more than 31 days before admission or Day Case Procedure); and all follow-up outpatient visits per Confinement/Day Case Procedure (within 90 days after discharge from Hospital or completion of Day Case Procedure, subject to 1 visit per day.

47. Refer to Post-Confinement/Day Case Procedure Chinese medicine treatment at HKD600 per visit. Maximum 15 follow-up outpatient visits per Confinement/Day Case Procedure (within 90 days after discharge from Hospital or completion of Day Case Procedure), but is subject to 1 follow-up outpatient visit per day.

• Per a comparison made by FWD on 2 February 2026 among the VHIS medical plans of key insurers available in Hong Kong, double up cash benefit for designated Day Case Procedures performed at a Designated Healthcare Services Provider or designated Day Case Procedure(s) performed in mainland China, cash benefit for major and complex surgeries, cash benefit for Confinement in Intensive Care Unit in Hong Kong and FWD x HKSH Medical Group Cross-border Cancer Management Program are first-in-VHIS-market.

With respect of any Eligible Expenses under the VHIS Certified Plans incurred on or after 1 Jan 2022, Eligible Expenses shall include value-added taxes and goods and services taxes (“VAT and GST”) (if any) charged or imposed on the relevant medical expenses incurred, subject to the Terms and Benefits applicable in the relevant Certified Plans. The relevant Supplement will be sent to all policy holders concerned upon policy renewal.
For more details, please feel free to contact your adviser or our Customer Service Hotline at 3123 3123.

Inclusion of public hospitals and private hospitals in Hong Kong in the definition of Hospital under VHIS policy terms & conditions

With effect from 1 March 2023, the definition of "Hospital" in Part 8 "Definition" of your VHIS policy terms and conditions shall be refined to make clear that it shall include public hospitals as defined in the Hospital Authority Ordinance (Cap. 113 of the Laws of Hong Kong) and hospitals for which a licence is issued under the Private Healthcare Facilities Ordinance (Cap. 633 of the Laws of Hong Kong), subject to other conditions of (b), (c) and (d) in the definition. The relevant Supplement will be sent to all policy holders concerned on or before the respective policy renewals from 1 March 2023.

For any queries, please contact us at our Customer Service Hotline 3123 3123 or contact your adviser.

Credit Risk

vPrime 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 vPrime. 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 vPrime 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 attained age of the Insured Person at the time of Renewal. The Standard Premium may increase significantly due to factors including but not limited to Age, medical inflation, and claims experience and policy persistency in the same Portfolio.

Premium Term and Non-Payment of Premium

The premium payment term of vPrime is up to the Age of 100 years (attained age) 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 the first unpaid premium was due. Please note that once vPrime 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.

Immediately following the termination of this 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.

Where the Policy is terminated pursuant to (b) or (c), FWD shall refund the relevant premium paid for the current Policy Year on a pro rata basis.

Moreover, the Policy shall also be terminated if you decide to cancel the Policy or not to renew the Policy in accordance with Section 3 of Part 2 or Section 1 of Part 4 of the Terms and Benefits of the Policy provisions, as the case may be, by giving the requisite written notice to FWD. If the Policy is terminated for cancellation after cooling-off period, the effective date of termination shall be the date as stated in the cancellation notice given by you. However, such date shall not be within or earlier than the 30-day notice period. If the Policy is not renewed, the effective date of termination shall be the renewal date immediately following the expiry of the Policy Year during which the Policy remains valid.

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.

1. Expenses incurred for treatments, procedures, medications, tests or services which are not Medically Necessary.
2. 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.
3. Expenses arising from Human Immunodeficiency Virus (“HIV”) and its related Disability, which is contracted or occurs before the Policy Effective Date. Irrespective of whether it is known or unknown to the Policy Holder or the Insured Person at the time of submission of Application, including any updates of and changes to such requisite information (if so requested by FWD under Section 8 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 Effective 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 5 years after the Policy Effective Date shall be presumed to be contracted or occur before the Policy Effective Date, while manifestation after such 5 years shall be presumed to be contracted or occur after the Policy Effective Date. However, the exclusion under this Section 3 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.
4. 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 this Section 3 applies).
5. Any charges in respect of services for:
   (a) except as otherwise specified in Sections 1 and 2 of Part 1 of the Supplement - Enhanced benefits under the Policy provisions, beautification or cosmetic purposes, unless necessitated by Injury caused by an Accident and the Insured Person receives the Medical Services within 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.
6. 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 does not apply to:
   (a) treatments, monitoring, investigation 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.
7. 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.
8. Except as otherwise provided in Section 13 of Part 1 of the Supplement – Enhanced benefits under the Policy provisions, 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.
9. Except as otherwise provided in Section 7(a) of Part 1 of the Supplement – Enhanced benefits under the Policy provisions, 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.
10. Except as otherwise provided in Sections 7(b) and 12 of Part 1 of the Supplement - Enhanced benefits under 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.
11. 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.
12. Eligible Expenses which have been reimbursed under any law, or medical program or insurance Policy provided by any government, company or other third party.
13. 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.

The above list is not exhaustive and is for reference only. Please refer to the Policy provision for the complete exclusions including but not limited to exclusions for accidental death benefit, donor’s benefit, Emergency outpatient accidental treatment and Emergency outpatient dental treatment.

Tax deduction

Please note that the VHIS status of vPrime does not necessarily mean you are eligible for tax deduction available for VHIS premiums paid. vPrime’s VHIS status is based on the features of the product as well as certification by the Government and not the facts of your own situation. You must also meet all the eligibility requirements set out under the Inland Revenue Ordinance and any guidance issued by the Inland Revenue Department (“IRD”) of Hong Kong Special Administrative Region before you can claim these tax deductions. Please refer to the website of the IRD (www.ird.gov.hk/eng/) or contact the IRD directly for any tax related enquiries.

Any general tax information provided is for your reference only, and you should not make any tax-related decisions based on such information alone. You should always consult with a professional tax advisor if you have any doubts. Please note that the tax law, regulations or interpretations are subject to change and may affect related tax benefits including the eligibility criteria for tax deduction. FWD does not take any responsibility to inform you about any changes in the laws and regulations or interpretations, and how they may affect you. Further information on tax concessions applicable to VHIS may be found in VHIS’s website at www.vhis.gov.hk/en/.

Please note that these tax deduction benefits may not be applicable to you if you are a retiree who is not subject to salaries tax or tax under personal assessment.

Your Right under Cooling off Period

If you are not fully satisfied with this Policy, you have the right to change your mind. FWD trusts that this Policy will satisfy your needs. However, if you are not completely satisfied then you should (a) return the Policy, and (b) provide us with written notice signed by you, requesting cancellation. The Policy will then be cancelled and the premium paid and levy will be refunded.

Your request to cancel the Policy must be signed by you and received directly by our office at 11/F., FWD Tower, 979 King’s Road, Quarry Bay, Hong Kong within 21 days immediately following the day of Delivery of the Policy or the cooling-off notice to you or your nominated representative (whichever is the earlier). The cooling-off notice is the notice sent to you or your nominated representative (separate from the Policy) notifying you of your right to cancel within the stated 21-day period.

No refund can be made if a benefit payment has been made, is to be made or impending.
Should you have any further queries, you may (1) call FWD Service Hotline on 3123 3123; (2) visit FWD Insurance Solutions Centres; or (3) email to cs.hk@fwd.com and FWD 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 vPrime, you shall have the right to claim under any such other insurance coverage or vPrime. 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.

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 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 Holder 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.

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 judgment 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 judgment 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 Issuance Date or the Policy Effective Date, whichever is the earlier. 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 Ward Room
shall mean a room type in a Hospital that is below a Standard Semi-private Room.

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).

• (a) VHIS Office of the Government – for issues specific to the VHIS including product availability, features of Certified Plans and compliance with Code of Practice for Insurance Companies under the Ambit of the Voluntary Health Insurance Scheme;
• (b) Insurance Authority – for issues concerning the general conduct of insurance companies and intermediaries; and
• (c) Inland Revenue Department – for issues concerning claims for tax deduction.
• (d) FWD – Customers can make enquiries and lodge complaints with us in writing or via FWD Service Hotlines 3123 3123.
• (e) FWD Financial – Customers can make enquiries and lodge complaints with us via email at cs.ifwd.hk@fwd.com or Service Hotline 3123 3338. FWD Financial is an appointed insurance agency of FWD.