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    • Form Library

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    Critical Illness Claim Form

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    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

    Authorization Form

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    Maybank Direct Debit Authorization Form

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    Settlement Form (May 2017)

    Assignment of Policy as Collateral Security for Mortgage Loan

    Mode of payment 

    Request for Change Form

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    Health Certificate

    Change of Address Form

    Visa Master / Auto Debit Authorization

    Application for Contingent Owner

    Absolute Assignment

    AIA Vitality Servicing Form

    AIA Vitality - DirectDebit Authorization Form

    Application For Withdrawal Of Income Accumulation Rider

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    W-9 Form (For US person)

    Bond of Indemnity

    Consent Form

    Contact Us
    AIA Bhd.
    1300-88-1899
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    603 2056 1111
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    1300-88-8922
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    1300-88-1899
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    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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