At Bupa, we strive to provide fast, convenient, accurate and simplified services in the areas of claims.

How does Bupa maximise your benefits and settle your claims faster?

Bupa pays especial effort to designing its medical insurance schemes so that members receive maximum benefits.

One feature is that the surgical benefit is paid per operation. That means if the benefit limit is $30,000, the medical expenses of the first operation are deducted from this. If a second operation is required, the same surgical benefit limit applies and the expenses will be deducted from it instead of from the remaining balance of the benefit limit in previous claim.

In contrast, most other medical insurance plans pay out the surgical benefit "per disability". That means if the patient is hospitalised within 90 days for the same disability, the surgical expenses will be deducted from the remaining balance of the benefit limit after a previous claim. Therefore, the actual claim amount paid is less. Below is an example to explain the difference in claims:

Ms Tsui, a member of CarePro¹, was diagnosed with breast cancer in September last year. She underwent two operations within three months and an examination to determine if the cancer had spread. Here are the details and claim result:

Although the two operations were done within 90 days, Bupa paid out her surgical claims under two different benefit limits separately and she needed to pay only the shortfall of about HK$20,000. If she had enrolled in other schemes which pay "per disability", even the first operation might have exceeded the benefit limit and she would probably have needed to pay HK$160,000 out of her own pocket for her second operation.

¹ Enrolled Hospital and Surgical Benefit (Private Room level) of Bupa CarePro health insurance scheme and Hospital Cash Benefit

Bupa lives up to our service commitment to settle your claims faster We paid more than 30,000 hospital claims and 1,000,000 clinical claims in 2009. Total paid amount was over HK$600 million. Members using the medical card do not need to pre-pay medical expenses and wait for claim settlement.