TM MaidShield

Maid Insurance Protection

for you and your indispensable assistant

POLICY OWNERS PROTECTION SCHEME This policy is protected under the Policy Owners Protection Scheme which is administered by the Singapore Deposit Insurance Corporation (SDIC). Coverage for your policy is automatic and no further action is required from you. For more information on the types of benets that are covered under the scheme as well as the limits of coverage, where applicable, please contact us or visit the General Insurance Association (GIA) or SDIC websites (www.gia.org.sg or www. sdic.org.sg).

Tokio Marine Insurance Singapore Ltd. 20 McCallum Street #09-01 Tokio Marine Centre Singapore 069046 Tel: (65) 6221 6111 Email: tmis@tokiomarine.com.sg Website: www.tokiomarine.com.sg GST Reg. No.: M2-0000023-4 Company Reg. No.: 192300014M TMiS/MSH/0413

iring a domestic helper is not always easy. Making sure that you are not overly burdened by the mandatory costs and medical bills when unpleasant surprises happen is equally worrying. TM MaidShield ensures that you and your domestic helper are well taken care of when accident or illness strikes. Now, you can truly enjoy a peace of mind, both domestically and nancially!

Temporary Domestic Help Benet *

We will pay you a daily benet to hire temporary domestic help when your domestic helper is hospitalised.

Termination Expenses
Get reimbursed for the expenses that you paid in terminating your domestic helpers services if she is unable to continue her employment due to an accidental injury or illness as certied by a medical practitioner.

Special Benets
Personal Accident
To ensure that you full your obligations mandated by Ministry of Manpower (MOM), we provide your domestic helper worldwide round-the-clock coverage for accidental death or permanent disablement. In addition, we cover your domestic helper for medical expenses incurred due to accidents, including outpatient treatment by a Chinese Physician and for Dengue Fever.

Letter of Guarantee to Ministry of Manpower

You are required to deposit S$5,000 as security to MOM. In place of it, we will issue a Letter of Guarantee to MOM as security bond on your behalf and you do not need to fork out any cash.

Waiver of Counter Indemnity (Optional)

Should MOM forfeit the S$5,000 security bond, you are required to reimburse us the full bond amount. However, in the event that your domestic helper disappears unexpectedly not due to your fault, you will only need to reimburse us S$250.

Hospital and Surgical Expenses

As an employer, you are responsible for your domestic helpers medical costs. With TM MaidShield, be assured that if your domestic helper is hospitalised due to an accidental injury or illness, we will cover her hospital and surgical expenses incurred in a Class C or B2 ward of a Singapore government or restructured hospital. We extend to cover Day Surgery as well as 90 days Pre and PostHospitalisation treatment.

Letter of Guarantee to Philippine Embassy (Optional)

(as required by The Philippine Overseas Labour Ofce)
Instead of you having to deposit cash of either S$2,000 or S$7,000 with Philippine Overseas Labour Ofce as security, we will issue a Letter of Guarantee as security bond on your behalf.

Repatriation Expenses
In the unfortunate event that your domestic helper passed away or is unable to continue her employment because of an accidental injury or illness, we will pay for the expenses to repatriate her (or her remains) to her home country, including burial and cremation costs. We will pay even if her death, injury or illness is caused by suicide. MEET your intermediary.

Interested?
Please scan here for more product information.

CLICK ON to www.tokiomarine.com.sg CALL US at 6221 6111.

*Only available under Plan B.

More Benets At A Glance

Covers dental treatment due to accidental injury. Reimburses you for your domestic helpers wages and government levy when she is hospitalised. Covers the loss of your money or property caused by your domestic helpers dishonesty. * Covers expenses for ambulance services to the hospital when your domestic helper is injured or ill. Covers your domestic helpers legal liability towards third party due to her negligence. * Pays a daily recuperation benet to your domestic helper when she is hospitalised. Reimburses you for the medical expenses incurred if your domestic helper requires outpatient kidney dialysis and cancer treatment. * Pays a lump sum benet to your domestic helper upon her death, even if it is due to suicide. *

Schedule of Benets
Essential Covers
1. Personal Accident (A) Accidental Death or Permanent Disablement (B) Outpatient Medical Expenses for Accidents (a) Treatment by Chinese Physician (b) Treatment for Dengue Fever 2. 3. 4. 5. 6. 7. 8. 9. Hospital & Surgical Expenses (per year) Wages & Levy Compensation (per day up to 60 days) Recuperation Benet (per day up to 60 days) Temporary Domestic Help Benet (per day up to 30 days) Termination Expenses Repatriation Expenses Outpatient Kidney Dialysis & Cancer Treatment Special Grant

Maximum Benets
per policy period

Plan A
$40,000 $1,000 $150 $150 $15,000 $30 $20
Not Covered

Plan B
$40,000 $2,500 $250 $250 $20,000 $30 $20 $15 $250 $10,000 $1,500 $1,500 $15,000 $2,500 $5,000 $370

$250 $10,000
Not Covered Not Covered Not Covered Not Covered

10. Domestic Helpers Liability 11. Fidelity Guarantee 12. Letter of Guarantee to MOM Premiums for 26 months (before GST)

$5,000 $330

Optional Covers
13. Waiver of Counter Indemnity for Letter of Guarantee to MOM

Premiums for 26 months

(before GST)

$50

To apply for this insurance, please furnish the following documents:

1. A copy of your employment pass or work permit if you are a foreigner. 2. A copy of the In-Principal Approval Letter or Renewal Letter from MOM. 3. A copy of your domestic helpers passport. 4. A copy of the witness and local guarantors NRIC.

14. Letter of Guarantee to Philippine Embassy (a) $2,000 Guarantee (applying through an accredited maid
agency)

$70 $90

(b) $7,000 Guarantee (for direct hiring)

This brochure is for general information only and is not a contract of insurance. Please refer to the policy wordings for the precise terms, conditions and exclusions.

*Only available under Plan B.

Important Notes: 1. All amounts are shown in Singapore Dollars. 2. Your domestic helper must be below 65 years old at the commencement of this insurance. 3. We will not pay claims that occur within the rst 14 days from the start date of the policy for the following: (a) Dengue Fever under Personal Accident cover; (b) Illness under Hospital and Surgical Expenses cover; and (c) Outpatient Kidney Dialysis & Cancer Treatment cover. 4. This insurance generally does not cover: (a) Your domestic helpers pre-existing condition or disability unless she has been insured with us under this insurance continuously for the last 12 months. (b) When your domestic helper is on home leave and vacation leave. (c) Suicide or attempted suicide while sane or insane (not applicable to Repatriation Expenses and Special Grant covers), self-inicted injury, pregnancy and childbirth. There are other conditions where the benets under this insurance will not be payable. Please refer to the policy wordings for details. 5. Premiums rates are non-guaranteed and may be reviewed from time to time. 6. You or we may cancel the policy by giving each other prior notice in writing. Please refer to the policy wordings for the cancellation conditions and applicable charges.

TM MaidShield TM MaidShield
Intermediarys Name and Code:

Application Form

Counter Indemnity and Declaration

In lieu of the cash deposit that I/we would otherwise have to provide as security, Tokio Marine Insurance Singapore Ltd. (you) agrees to my/our request to provide the following (whichever is selected to be covered under the insurance plan): A Letter of Guarantee for S$5,000 to the Ministry of Manpower of Singapore and/or Controller of Immigration of Singapore; and/or An Insurance Bond for S$2,000 or S$7,000 (whichever amount is indicated in the insurance bond) to the Philippine Overseas Labour Ofce in Singapore, which guarantee(s) the payment on demand of any sum or sums not exceeding the amount stated in the Letter of Guarantee and/or Insurance Bond issued. In return, I/we agree and undertake as follows: 1. I/We will, at all times, unconditionally and irrevocably guarantee to jointly and severally compensate you for all claims, payments, demands, actions, suits, proceedings, losses, liabilities, costs and expenses whatsoever (including legal costs and expenses determined on a solicitor or client basis) which may be taken or made against you or which become payable by you under the Letter of Guarantee and/or Insurance Bond. 2. You will have absolute discretion to compromise all claims, payments, demands, actions, suits, proceedings, losses and liabilities whatsoever which may be taken or made against you under the Letter of Guarantee and/or Insurance Bond. 3. I/We shall accept the receipts, vouchers or any other evidence of all payments made by you or all liabilities or obligations incurred by you because of the Letter of Guarantee and/ or Insurance Bond as conclusive evidence of my/our liability to you. 4. This counter indemnity shall be a continuing indemnity and you may at any time have absolute discretion without giving any notice to me/us extend the validity of the Letter of Guarantee and/or Insurance Bond without discharging or impairing my/our liability under the indemnity. In addition, I/We declare that: 5. I/We am/are not a bankrupt; 6. The domestic helper is in good health and free from any physical impairment; 7. This proposal and any other written statements, information or declaration made by me/us or on my/our behalf are true and complete and they shall form the basis of the contract between me/us and you.

Important Notice to Intermediary: Please note that this proposal may not be accepted if you procure it through any Foreign Domestic Worker Employment Agency not registered with us as a Trade Specic Agent.

Important Notice
1. Statement pursuant to Section 25(5) of the Insurance Act, Cap. 142 (or any future amendments to it), you must disclose in this application form, fully and faithfully, all the facts which you know or ought to know. Otherwise, the policy issued may be void. 2. This insurance is subject to full payment before cover commences. 3. This insurance will not be in force until the proposal has been accepted by us. 4. This brochure is for general information only and is not a contract of insurance. Please refer to the policy wordings for the precise terms, conditions and exclusions.

Your Details (Employer)

Name (as shown in NRIC or Passport): NRIC/Passport No.: Postal Address: Contact No.: (Mobile) Email: Nationality: SB Transmission Reference No.: Sex: Male Female (Ofce) (Home) Date of Birth: D D

M M

Y Y Y Y

Marital Status:

Your Domestic Helpers Details

Name (as shown in Passport): Passport No.: Work Permit No.: Date of Birth: D D Nationality:

M M

Y Y Y Y

Dated: D D

M M

Y Y Y Y

Period of Insurance
From: D D

Your Payment Mode Cheque Payment

Cheque No.: $330 $370 Visa Card Holders Name:

Important Notice: Witness(es) must not be the (1) employer (2) local guarantor and (3) spouse of the employer and/or local guarantor. If you are a foreigner, we will need a third party local guarantor for the counter indemnity. Your Signature (Employer) Signature: Name: NRIC/Passport No.: Contact No.: Address: Witness Signature Signature: Name: NRIC/Passport No.: Contact No.: Address:

M M

Y Y Y Y

for 26 months

Choice of Covers and Premiums (before GST) Bank: Essential Covers

Plan A Plan B
(Cheque to be made payable to Tokio Marine Insurance Singapore Ltd.)

Credit Card Payment

Mastercard

PLUS Optional Covers

(i) Waiver of Counter Indemnity $50 for the Letter of Guarantee to MOM (ii) Letter of Guarantee to Philippine Embassy (a) $2,000 Guarantee or (b) $7,000 Guarantee Total Premium Payable:
(inclusive of GST)

Important Notice to Third Party Guarantor: Please note that your obligation will not be negated by the Employers inability to indemnify us for any reasons whatsoever. Local Guarantors Signature Signature: Name: NRIC/Passport No.: Contact No.: Address: Witness Signature Signature: Name: NRIC/Passport No.: Contact No.: Address:

Credit Card No.:

$70 $90

-Y
Y

Card Expiry Date: M M

Note: Policy will be issued upon receipt of approval from respective credit card company.