Singapore legislation
Regulation 10
of Medi Shield Life Scheme (Private Medical Insurance Scheme) Regulations 2015
Regulation 10
Reimbursement by another person
Subregulation 1
Where —
an insured person’s claim under a medisave-approved plan, in respect of any medical treatment or services received by the insured person, has been paid from the Fund or by an insurer, or both, as the case may be; and
another person, who is under an obligation (contractual or otherwise) to pay or reimburse the insured person for charges incurred in respect of that medical treatment or service, has made the payment or reimbursement,an amount computed in accordance with the following formula becomes due and payable to the Fund or the insurer, or both (as the case may be) by the insured person on the date such payment or reimbursement is made by that other person:X + Y – Z,where Xis the total amount of the payment or reimbursement made by that other person;Yis the total amount of the claim paid from the Fund or by the insurer, or both, under the medisave-approved plan; andZis the total amount of the charges incurred by the insured person.
Subregulation 2
Where the insurer has received payment of any amount due and payable under paragraph (1), the insurer —
may retain the amount paid by the insurer under the plan in respect of that medical treatment or service, excluding the amount paid from the Fund; and
must transfer to the Board, in the manner directed by the Board, the lower of the following:
any remaining balance;
the amount paid from the Fund in respect of that medical treatment or service.
Subregulation 3
All amounts transferred to the Board under paragraph (2)(b) must be paid into the Fund.