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Submit duly executed claim form within 30 days from date of service containing the following;Download Claim Forms

  • Name, membership number of client and facility visited
  • Reason for seeking reimbursement (since services can be authorized directly with provider without having to pay)
  • Bank details
  • Detailed medical report (for inpatient cases)
  • In case it’s a last expense/funeral claim, a copy of burial permit/death notification form will be required.
  • For reimbursements of overseas claims, letter of approval is normally issued prior to the services and hence a copy of that letter should be attached.
  • Itemized hospital bill will be required (for inpatient cases).
  • Original invoices and receipts of payment made (please keep copies)

  • Duly executed Claim Form
  • Original Medical expenses receipts
  • Pay slip for the last 3 months prior to the accident (employees)
  • Police Abstract (road traffic accidents/assault)
  • Death certificate (fatal road traffic accident)

  • Duly executed Claim Form
  • Original Medical expenses receipts
  • Agreement between employer and employee
  • Pay slip for the last 3 months prior to the accident (employees)
  • Police Abstract
  • Death certificate as applicable

  • Duly executed Claim Form
  • Original Medical expenses receipts
  • Police Abstract
  • Replacement quotation
  • Witness statement
  • Adjustment report


Download claim form

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