Life Insurance Claim Forms

Individual Claimant’s Statement

•  Hospitalisation and Surgical Claim
•  Outpatient Treatment Claim
•  Accident Claim
•  Total and Permanent Disability / Critical Illness Claim
•  Death Claim

Corporate Claimant’s Statement

•  Group Hospitalisation and Surgical Claim
•  Group Total and Permanent Disability Claim
•  Group Critical Illness Claim
•  Group Death Claim

E-Payment Authorisation Form

• E-Payment Authorisation Form

Medical Report

• Hospitalisation Claim
• Accident Claim
• Total and Permanent Disability Claim
• Death Claim

Medical Report for Common Critical Illnesses

• Angioplasty
• Cancer
• Coronary Artery By-Pass
• Heart Attack
• Kidney Failure
• Other Coronary Artery Disease
• Stroke

Medical Report for Other Critical Illnesses

• AIDS
• Bacterial Meningitis
• Benign Brain Tumour
• Blindness
• Cardiomyopathy
• Coma
• Deafness
• Encephalitis
• End Stage Liver Failure
• End Stage Lung Disease
• Heart Valve Surgery
• Loss of Independent Existence
• Major Burns
• Major Head Trauma
• Motor Neurone Disease
• Multiple Sclerosis
• Parkinson’s Disease
• Primary Pulmonary Arterial Hypertension
• Surgery to Aorta
• Systemic Lupus Erythematosus (SLE) with Lupus Nephritis