PANDUAN CEPAT TUNTUTAN KEPERLUAN

1. Accident Claim Form Part I & II
2. Original itemised bill and payment receipts
3. X-ray report, MRI report or other reports related to the injury.

1. Individual Hospitalisation Claim Form Part I & II
2. If Part II is not completed, diagnosis to be endorsed by treating doctor is required.
3. Certified copy of Hospital Discharge Note or inpatient bill
   

1.  Individual Hospitalisation Claim Form Part I & II
2. Original itemised bill and payment receipts
3. For outpatient cancer treatment, to submit Histopathology report and Original bills/ receipts for follow-up clinical visits after discharge

For Overseas Treatment

1. Copy of Passport of Assured’s personal data and indicating Date of Departure from Malaysia and Arrival Overseas or copy of Flight Ticket/Boarding Pass
2. Original Detailed Admission Bill showing breakdown of each charges
3. Hospital Discharge Summary (if any)
4. Certified Medical Test Results e.g. MRI/ CT Scan, Dialysis card, Biopsy / Histopathology report
5. (Translation of foreign language into English version is required)

For Bill Partially Settled by Third Party

1. Copy of Settlement Advice issued by Third Party
2. Certified medical report by Third Party
3. Certified medical bills/receipts by Third Party
4. Certified medical test results by Third Party (if any)

For Emergency Outpatient Accidental Treatment or Daycare Procedure for amount not exceeding RM500:

1. If Part II is not given, certified Diagnosis and Type of Surgical Procedure (if applicable) by the attending doctor are required. For Pre/ post hospitalisation claim to indicate date of event
   

1. Claimant Statement – Critical Illness and Female Product Claim
2. Attending Physician’s Statement (by disease type)
3. Certified Medical Test Results e.g. MRI/ CT Scan, Dialysis card, Biopsy / Histopathology report (Please refer to the checklist in Claimant Statement for relevant medical test results)
4. Certified IC of the Assured
5. 5 copies of Consent Form and Patient’s card
6. Policy Contract (if any)
   

1. Claimant Statement – Death Claim
2. Certified Death Certificate
3. Claimant's proof of relationship to the Deceased (i.e. marriage certificate, birth certificate, etc.)
4. Certified IC of Claimant
5. Policy Contract / Bond of Indemnity with Stamp Duty

Additional documents for death occurring within 2 years from date of issue or reinstatement:

6. Attending Physician’s Statement - Death
   
7. 5 copies of Consent Form & Patient’s Card
   

Additional document for Accidental Death:


8. Certified Police Report
   
9. Certified Third Party Police Report (if any)
   
10. Certified Post-mortem & Toxicology report
    
11. Certified Burial Permit
    
12. Newspaper cutting (if any)
    

Additional document if death occurred in overseas:


13. Certified JPN Letter
    
14. Certified death certificate issued by the country where the Assured had passed away
    

1. Accident Claim Form Part I & II
2. Certified Diagnostic report(s), if any
3. X-ray film & certified imaging report(s)
4. Full length of photograph showing the loss / amputation
5. Certified IC of the Assured
6. Consent Form & Patient’s Card
7. Policy Contract (if any)

Additional documents for accidental cause:

8. Certified Police Report (if any)
9. Certified Third Party Police Report (if any)
   

1. Claimant Statement – Total & Permanent Disability Claim
2. Attending Physician’s Statement – Total & Permanent Disability
3. Certified Medical Test Results e.g. MRI/ CT Scan, Dialysis card & etc
4. Letter and medical report from Socso.
5. Medically boarded out letter from employer
6. Full length of photograph of Assured (for loss /
7. amputation / bed-ridden)
8. Certified IC of the Assured
9. 5 copies of Consent Form & Patient’s Appointment Card
10. Policy Contract

Additional documents for TPD due to accident:

11. Certified Police report & Newspaper cutting (if any)