Claims

Claims Form
Attending Physician's Statement (APS) - Critical Illness (CI)
Attending Physician's Statement (APS) - Death Claim
Attending Physician's Statement (APS) - Female Product
Attending Physician's Statement (APS) - Total & Permanent Disability (TPD)

Claims Form

AIA Bhd.

Accident Claim Form

How to submit my form?

Corporate Solutions - Hospital And Surgical Claim (For Worksite Product)

Critical Illness Claim Form (Also Applicable for Female Product)

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Critical Illness Claim Form (Credit Life)

CRS Self Certification Form - Entity & Controlling Person

CRS Self Certification Form - Individual

Death Claim Form (Corporate Solutions)

Death Claim Form (Credit Life)

Death Claim Form (Individual Life)

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Hospitalisation Claim Form (Credit Life)

Hospitalisation Claim Form (For Individual)

Member Hospital and Surgical Claim Form (Corporate Solutions)

Member Outpatient Claim Form (Corporate Solutions)

PA Travel Claim Form

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Total & Permanent Disability Claim Form

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Total & Permanent Disability Claim/ Temporary Total Disability Claim Form (Credit Life)

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AIA General Berhad

Accident Claim Form

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E-Payment Application Form For General Insurance

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Death Claim Form

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Total and Permanent Disability Claim Form

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Consent For The Release Of Information Form

General Claim Form

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Motor Claim Form

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PA Travel Claim Form

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Group Personal Accident Claim Form (GPA)

Group Personal Accident – Travel Claim Form (GPA)

Group Personal Accident (GPA) Claimant Statement for Accidental Death and Disablement Total and Permanent Disability

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AIA PUBLIC Takaful Bhd.

CRS Self Certification Form - Entity & Controlling Person

CRS Self Certification Form - Individual

Critical Illness Claim Form (Credit Life)

Death Claim Form (Credit Life)

Hospitalisation Claim Form (Credit Life)

Total & Permanent Ability Claim Form / Temporary Total Disability Claim Form (Credit Life)

Accident Claim Form

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Death Claim Form (Individual Life)

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Hospitalisation Claim Form (For Individual)

Claim Form For Life (Group Term Life)

Corporate Solutions Hospital And Surgical Claim (For Worksite Product)

Critical Illness Claim Form

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Member Hospital and Surgical Claim Form

Member Outpatient Claim Form

Total and Permanent Disability Claim Form

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Attending Physician's Statement (APS) - Critical Illness (CI)

AIA Bhd.

APS - CI - AIDS Due to Blood Transfusion/Occupationally Acquired Human Immunodeficiency Virus (HIV) Infection

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APS - CI - Benign Brain Tumor

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APS - CI - Blindness/Total Loss of Sight or Deafness/Total Loss of Hearing or Loss of Speech

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APS - CI - Brain Surgery

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APS - CI - Cancer

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APS - CI - Chronic Aplastic Anaemia

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APS - CI - Chronic Liver Disease

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APS - CI - Coma

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APS - CI - Coronary Artery Disease Requiring Surgery/Other Serious Coronary Artery Disease/Angioplasty/Heart Attack

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APS - CI - Encephalitis or Bacterial Meningitis

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APS - CI - End Stage Kidney Failure

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APS - CI - End Stage Lung Disease or Major Organ/Bone Marrow Transplant or Major Burns or Terminal Illness

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APS - CI - Fulminant Viral Hepatitis

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APS - CI - Heart Valve Surgery

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APS - CI - Loss of Independent Existence

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APS - CI - Major Head Trauma

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APS - CI - Medullary Cystic Disease

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APS - CI - Multiple Sclerosis or Poliomyelitis

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APS - CI - Muscular Dystrophy or Motor Neuron Disease

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APS - CI - Paralysis/Paraplegia

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APS - CI - Parkinson's Disease or Alzheimer's Disease/Irreversible Organic Degenerative Brain Disorders

How to submit my form?

APS - CI - Primary Pulmonary Arterial Hypertension/Surgery to Aorta/Severe Cardiomyopathy

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APS - CI - Stroke

How to submit my form?

APS - CI & Female Product - Systemic Lupus Erythematosus (S.L.E.) with Lupus Nephritis

How to submit my form?

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AIA PUBLIC Takaful Bhd.

APS - CI - AIDS Due to Blood Transfusion/Occupationally Acquired Human Immunodeficiency Virus (HIV) Infection

How to submit my form?

APS - CI - Benign Brain Tumor

How to submit my form?

APS - CI - Blindness/Total Loss of Sight or Deafness/Total Loss of Hearing or Loss of Speech

How to submit my form?

APS - CI - Brain Surgery

How to submit my form?

APS - CI - Chronic Aplastic Anaemia

How to submit my form?

APS - CI - Chronic Liver Disease

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APS - CI - Coma

How to submit my form?

APS - CI - Coronary Artery Disease Requiring Surgery/Other Serious Coronary Artery Disease/Angioplasty/Heart Attack

How to submit my form?

APS - CI - Encephalitis or Bacterial Meningitis

How to submit my form?

APS - CI - End Stage Kidney Failure

How to submit my form?

APS - CI - End Stage Lung Disease or Major Organ/Bone Marrow Transplant or Major Burns or Terminal Illness

How to submit my form?

APS - CI - Fulminant Viral Hepatitis

How to submit my form?

APS - CI - Heart Valve Surgery

How to submit my form?

APS - CI - Loss of Independent Existence

How to submit my form?

APS - CI - Major Head Trauma

How to submit my form?

APS - CI - Medullary Cystic Disease

How to submit my form?

APS - CI - Multiple Sclerosis or Poliomyelitis

How to submit my form?

APS - CI - Muscular Dystrophy or Motor Neuron Disease

How to submit my form?

APS - CI - Paralysis/Paraplegia

How to submit my form?

APS - CI - Parkinson's Disease or Alzheimer's Disease/Irreversible Organic Degenerative Brain Disorders

How to submit my form?

APS - CI - Primary Pulmonary Arterial Hypertension/Surgery to Aorta/Severe Cardiomyopathy

How to submit my form?

APS - CI - Stroke

How to submit my form?

APS - CI & Female Product - Systemic Lupus Erythematosus (S.L.E.) with Lupus Nephritis

How to submit my form?

APS - Cl - Cancer

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Attending Physician's Statement (APS) - Death Claim

AIA Bhd.

APS - Death claim

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AIA General Bhd.

APS - Death claim

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AIA PUBLIC Takaful Bhd.

APS - Death Claim

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Attending Physician's Statement (APS) - Female Product

AIA Bhd.

APS - Female Product - Carcinoma-in-situ (CIS) of Cervix or Carcinoma-in-situ (CIS) of Breast

How to submit my form?

APS - Female Product - Disseminated Intravascular Coagulation (D.I.C.)

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APS - Female Product - Down's Syndrome

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APS - Female Product - Ectopic Pregnancy / Molar Pregnancy / Eclampsia

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APS - Female Product - Reconstructive Surgery of Breast Cancer Benefit/Breast Lumpectomy/Mastectomy

How to submit my form?

APS - Female Product - Spina Bifida

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APS - Female Product - Tetralogy Fallot

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AIA PUBLIC Takaful Bhd.

APS - Female Product - Carcinoma-in-situ (CIS) of Cervix or Carcinoma-in-situ (CIS) of Breast

How to submit my form?

APS - Female Product - Disseminated Intravascular Coagulation (D.I.C.)

How to submit my form?

APS - Female Product - Down's Syndrome

How to submit my form?

APS - Female Product - Ectopic Pregnancy / Molar Pregnancy / Eclampsia

How to submit my form?

APS - Female Product - Reconstructive Surgery of Breast Cancer Benefit/Breast Lumpectomy/Mastectomy

How to submit my form?

APS - Female Product - Spina Bifida

How to submit my form?

APS - Female Product - Tetralogy Fallot

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Attending Physician's Statement (APS) - Total & Permanent Disability (TPD)

AIA Bhd.

APS - Total & Permanent Disability Claim

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AIA General Bhd.

APS - Total & Permanent Disability Claim

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AIA PUBLIC Takaful Bhd.

APS - Total & Permanent Disability Claim

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