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    • Form Library

    • AIA Bhd.
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    • Claims
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    • Claims Form
    • Attending Physician's Statement (APS)

    Accident Claim Form

    Claimant Statement for Life (Corporate Solutions)

    Claimant's Statement Critical Illness and Female Product Claim (filled by the assured) 

    Claimant's Statement Total and Permanent Disability Claim

    Credit Life-Critical Illness Claim Form

    Critical Illness Claim Form

    Credit Life-Death Claim Form

    Credit Life-Hospitalisation Claim Form

    Credit Life-Total & Permanent Disability Claim/ Temporary Total Disability Claim Form

    CRS Self Certifcation Form - Entity & Controlling Person 

    CRS Self Certification Form-Individual

    Claimant’s Statement – Death Claim

    eClaims Guide : Claims submission for AIA Employee Benefits Members

    Individual Hospitalization Claim Form

    Member Hospital and Surgical Claim Form (Corporate Solutions)

    Member Outpatient Claim Form (Corporate Solutions)

    PA Travel Claim Form

    Total & Permanent Disability Claim Form

    Attending Physician's Statement - Death claim

    Attending Physician’s Statement - Critical IlIness - AIDS Due to Blood Transfusion/Occupationally Acquired Human Immunodeficiency Virus (HIV) Infection

    Attending Physician’s Statement - Critical IlIness - Benign Brain Tumor

    Attending Physician’s Statement - Critical IlIness - Blindness/Total Loss of Sight or Deafness/Total Loss of Hearing or Loss of Speech

    Attending Physician’s Statement - Critical IlIness - Brain Surgery

    Attending Physician’s Statement - Critical IlIness - Cancer

    Attending Physician’s Statement - Critical IlIness - Chronic Aplastic Anaemia

    Attending Physician’s Statement - Critical IlIness - Coma

    Attending Physician’s Statement - Critical IlIness - Coronary Artery Disease Requiring Surgery/Other Serious Coronary Artery Disease/Angioplasty/Heart Attack

    Attending Physician’s Statement - Critical IlIness - Encephalitis or Bacterial Meningitis

    Attending Physician’s Statement - Critical IlIness - End Stage Kidney Failure

    Attending Physician’s Statement - Critical IlIness - Chronic Liver Disease

    Attending Physician’s Statement - Critical IlIness - End Stage Lung Disease or Major Organ/Bone Marrow Transplant or Major Burns or Terminal Illness

    Attending Physician’s Statement - Critical IlIness - Fulminant Viral Hepatitis

    Attending Physician’s Statement - Critical IlIness - Heart Valve Surgery

    Attending Physician’s Statement - Critical IlIness - Loss of Independent Existence

    Attending Physician’s Statement - Critical IlIness - Major Head Trauma

    Attending Physician’s Statement - Critical IlIness - Medullary Cystic Disease

    Attending Physician’s Statement - Critical IlIness - Multiple Sclerosis or Poliomyelitis

    Attending Physician’s Statement - Critical IlIness - Muscular Dystrophy or Motor Neuron Disease

    Attending Physician’s Statement - Critical IlIness - Paralysis/Paraplegia

    Attending Physician’s Statement - Critical IlIness - Parkinson's Disease or Alzheimer's Disease/Irreversible Organic Degenerative Brain Disorders

    Attending Physician’s Statement - Critical IlIness - Primary Pulmonary Arterial Hypertension/Surgery to Aorta/Severe Cardiomyopathy

    Attending Physician’s Statement - Critical IlIness & Female Product - Systemic Lupus Erythematosus (S.L.E.) with Lupus Nephritis

    Attending Physician’s Statement - Critical IlIness - Stroke

    Attending Physician’s Statement - Female Product - Disseminated Intravascular Coagulation (D.I.C.)

    Attending Physician’s Statement - Female Product - Down's Syndrome

    Attending Physician’s Statement - Female Product - Ectopic Pregnancy / Molar Pregnancy / Eclampsia

    Attending Physician’s Statement - Female Product - Reconstructive Surgery of Breast Cancer Benefit/Breast Lumpectomy/Mastectomy

    Attending Physician’s Statement - Female Product - Spina Bifida

    Attending Physician’s Statement - Female Product - Tetralogy Fallot

    Attending Physician’s Statement - Female Product - Carcinoma-in-situ (CIS) of Cervix or Carcinoma-in-situ (CIS) of Breast

    Attending Physician’s Statement - Total & Permanent Disability Claim

    Authorisation Form

    Request for Photocopy of Document Form

    Change of Contact Details

    Change of Correspondence Address

    Correspondence Address Verification

    EPF Request Form

    Maybank Direct Debit Authorization Form

    Public Bank Direct Debit Authorization Form

    Settlement Form (May 2017)

    Assignment of Policy as Collateral Security for Mortgage Loan

    Mode of payment 

    Large Amount Top Up, Increase in Regular Premium or Future Premium Deposit Option (FPDO) Questionnaire

    Conversion Privilege For I-Income (Fully Paid Up Option)

    Application For Contingent Owner

    Request for Cash Surrender / Cancellation - Traditional Policy or Universal Life

    Reinstatement of GIWL Policy

    Request for Change Form

    Nomination, Appointment and Revocation Form

    Change of Address Form

    Customer Due Diligence Form

    Absolute Assignment

    AIA Vitality Servicing Form

    AIA Vitality - DirectDebit Authorization Form

    Application For Withdrawal Of Income Accumulation Rider

    Conditional Assignment

    Declaration For Lost Policy or Premium Receipt Book or Medical Card Replacement

    Direct Credit Instruction Form

    Education Excellence Award

    Education Loan Application

    FATCA Declaration

    Citibank Direct Debit Authorization Form

    Fully Paid Up Option Form

    Health Certificate

    Instruction Form for Dividend / FPDF / Reversionary Bonus / Guaranteed Cash Payment

    Instruction Form for Investment Linked Plans

    Policy Loan Agreement

    Premium Payment Option and Authorisation of Premium Loan Form

    Release of Absolute Assignment

    Visa Master Auto Debit

    CRS Self Certification Form-Individual

    CRS Self Certification Form-Entity & Controlling Person

    Cheque Amendment Request Form

    Section 23, Civil Law Act 1956 (CLA) Form

    Civil Law Act (CLA): Revocation/Appointment of New Trustee

    W-8BEN Form (For Individuals use)

    W-8BEN-E Form (For entities use)

    W-9 Form (For US person)

    Bond of Indemnity

    Consent Form

    Contact Us
    AIA Bhd.
    1300-88-1899
    For overseas customers
    603 2056 1111
    AIA PUBLIC Takaful Bhd.
    1300-88-8922
    AIA General Berhad
    1300-88-1899
    AIA Auto Assist/Roadside Assist
    1-800-88-8733
    CONTACT AIA
    AIA Bhd.
    1300-88-1899
    For overseas customers
    603 2056 1111
    AIA PUBLIC Takaful Bhd.
    1300-88-8922
    AIA General Berhad
    1300-88-1899
    Contact Address
    Customer Relations Unit Menara AIA, 99 Jalan Ampang 50450 Kuala Lumpur

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