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Enjoy hassle-free admission at our panel hospitals with the Allianz Medical Card.

To learn more about our pre-scheduled hospital admission process and requirements, please refer to the FAQ.

Please allow a waiting time of several hours for the hospital to process the discharge and bills. For additional enquiries, kindly refer to the FAQ.

Please call Allianz’s Customer HealthCare Administration:

Once we have received all the necessary documents, we will process your claim within 7 working days. Upon approval, payment will be issued within 5 working days.

For claim status enquiries:

  • Claimant’s Statement (Hospitalisation and Surgical Claim) 
    Download form
  • Claimant’s NRIC (Both Sides) / Passport Copy, duly certified (if not submitted previously)
  • E-Payment Authorisation Form (if not submitted previously)
    Download form
  • Medical Report (Hospitalisation Claim)
    Download form
  • Original Receipts
  • Original Final Tax Invoices
  • Itemised Bills / Detailed Bills indicating:
    - Doctor’s Fee
    - Medicine Charges (including medicine name, unit price, prescribed quantity and supply duration)
    - Test/Investigation Charges
  • Diagnostic Reports, for example:
    - Magnetic Resonance Imaging (MRI)
    - X-ray
    - Histopathology Examination (HPE)
    - Blood Test
    - Computed Tomography (CT) Scan
    - Coronary Angiogram
    - Electrocardiography (ECG)
  • For Overseas Treatment (not required for Singapore and Brunei) please include:
    Proof of Life Assured leaving Malaysia:
    - Life Assured’s Passport Copy indicating date of departure from Malaysia
    - Boarding Pass
    - Travel Ticket Details

    Following supporting documents in English:
    - Medical Report
    - Original Receipts
    - Original Final Tax Invoices / Final Bills
    - Itemised Bills / Detailed Bills
    - Diagnostic Reports

  • Claimant’s Statement (Hospitalisation and Surgical Claim)
    Please indicate "Hospital Income Benefit" on Claimant's Statement.
    Download form
  • Claimant’s NRIC (Both Sides) / Passport Copy, duly certified (if not submitted previously)
  • E-Payment Authorisation Form (if not submitted previously)
    Download form
  • Medical Report (Hospitalisation Claim)
    Download form
  • Inpatient Bills indicating:
    - Date of admission and discharge
    - Number of days of Room and Board charged by hospital
  • Diagnostic Reports for example
    - Magnetic Resonance Imaging (MRI)
    - X-ray
    - Histopathology Examination (HPE)
    - Blood Test
    - Computed Tomography (CT) Scan
    - Coronary Angiogram
    - Electrocardiography (ECG)

  • Claimant's Statement (Outpatient Treatment Claim)
    Download form
  • Claimant’s NRIC (Both Sides) / Passport Copy, duly certified (if not submitted previously)
  • E-Payment Authorisation Form (if not submitted previously)
    Download form
  • Original Receipts
  • Original Final Tax Invoices
  • Itemised Bills / Detailed Bills indicating:
    - Doctor’s Fee
    - Medicine Charges (including medicine name, unit price, prescribed quantity and supply duration)
    - Test / Investigation Charges
  • Diagnostic Reports, for example:
    - Magnetic Resonance Imaging (MRI)
    - X-ray
    - Histopathology Examination (HPE)
    - Blood Test
    - Computed Tomography (CT) Scan
    - Coronary Angiogram
    - Electrocardiography (ECG)
  • For Outpatient Accident Treatment only:
    - Medical Report (Accident Claim)
    Only necessary when total claim amount exceeds RM500. If total claim amount is RM500 or below, diagnosis, date and cause of accident have to be endorsed by the treating doctor on the bills (with signature and clinic’s official stamp)
    Download form
  • For Overseas Treatment (not required for Singapore and Brunei) please include
    Proof of Life Assured leaving Malaysia:
    - Life Assured’s Passport Copy indicating date of departure from Malaysia
    - Boarding Pass
    - Travel Ticket Details

    Following supporting documents in English:
    - Medical Report
    - Original Receipts
    - Original Final Tax Invoices/Final Bills
    - Itemised Bills/Detailed Bills
    - Diagnostic Reports

*Note: Outpatient Dengue or Enteric Fever Treatment is only coverable for MediSafe Infinite, MediSafe Infinite Xtra and MediEssential Plans.

  • Claimant’s Statement (Accident Claim)
    Download form
  • Claimant’s NRIC (Both Sides) / Passport Copy, duly certified (if not submitted previously)
  • E-Payment Authorisation Form (if not submitted previously)
    Download form
  • Police Report (if any)
  • Medical Report (Accident Claim)
    Only necessary when total claim amount exceeds RM500. If total claim amount is RM500 or below, diagnosis, date and cause of accident have to be endorsed by the treating doctor on the bills (with signature and clinic’s official stamp)
    Download form
  • Original Receipts
  • Original Final Tax Invoices
  • Itemised Bills / Detailed Bills indicating:
    - Doctor’s Fee
    - Medicine Charges (including medicine name, unit price, prescribed quantity and supply duration)
    - Test/Investigation Charges
  • Radiology Reports for example:
    - Magnetic Resonance Imaging (MRI)
    - X-ray
    - Computed Tomography (CT) Scan
  • For Overseas Treatment (not required for Singapore and Brunei) please include the following supporting documents in English:
    - Medical Report
    - Original Receipts
    - Original Final Tax Invoices/Final Bills
    - Itemised Bills/Detailed Bills
    - Radiology Reports

  • Claimant’s Statement (Accident Claim)
    Download form
  • Claimant’s NRIC (Both Sides) / Passport Copy, duly certified (if not submitted previously)
  • E-Payment Authorisation Form (if not submitted previously)
    Download form
  • Police Report (if any)
  • Medical Report (Accident Claim)
    Download form
  • Medical Certificate or Sick Leave (minimum 7 days)
  • Radiology Reports for example:
    - Magnetic Resonance Imaging (MRI)
    - X-ray
    - Computed Tomography (CT) Scan

  • Claimant’s Statement (Accident Claim)
    Download form
  • Claimant’s NRIC (Both Sides) / Passport Copy, duly certified (if not submitted previously)
  • E-Payment Authorisation Form (if not submitted previously)
    Download form
  • Photograph of Dismemberment
  • Police Report (if any)
  • Medical Report (Accident Claim)
    Download form
  • X-ray Film and Radiologist Report
  • All relevant investigation reports to support the dismemberment

  • Claimant’s Statement (Total and Permanent Disability / Critical Illness Claim)
    Download form
  • Claimant’s NRIC (Both Sides) / Passport Copy, duly certified (if not submitted previously)
  • E-Payment Authorisation Form (if not submitted previously)
    Download form
  • Original Policy Contract
  • For MRTA/Credit Loan Claim please include Bank’s Outstanding Loan Statement for the latest 3 months
  • Please include the following documents (if any):
    - Social Security Organisation (SOCSO) Claim Documents
    - Employees Provident Fund (EPF) Claim Documents
    - Police Report
    - Newspaper Cutting
    - Employment Termination Letter
  • Medical Report (Total and Permanent Disability Claim)
    Download form
  • Diagnostic Reports for example:
    - Magnetic Resonance Imaging (MRI)
    - X-ray
    - Histopathology Examination (HPE)
    - Blood Test
    - Computed Tomography (CT) Scan
    - Coronary Angiogram
    - Electrocardiography (ECG)

  • Claimant’s Statement (Total and Permanent Disability / Critical Illness Claim)
    Download form
  • Claimant’s NRIC (Both Sides)/Passport Copy, duly certified (if not submitted previously)
  • E-Payment Authorisation Form (if not submitted previously)
    Download form
  • Original Policy Contract
  • Please include the Required Documents for Relevant Illness.

Please request your treating doctor to fill in the medical report, and include other relevant investigation reports.

Angioplasty

  • Medical Report (Angioplasty)
    Download form
  • Coronary Angiogram Report
  • Angioplasty/Percutaneous Coronary Intervention (PCI) Report
  • Electrocardiography (ECG) Report

Cancer

  • Medical Report (Cancer)
    Download form
  • Histopathology Examination (HPE)/Biopsy Report
  • Bone Marrow Trephine/Aspiration Report (for Blood Cancers only)
  • All relevant investigation reports, for example, Blood Test, Laboratory Test, Computed Tomography (CT) Scan, Magnetic Resonance Imaging (MRI), Pap Smear and Mammogram (if any)

Coronary Artery By-Pass

  • Medical Report (Coronary Artery By-Pass Surgery)
    Download form

  • Surgical Report

Heart Attack

  • Medical Report (Heart Attack)
    Download form

  • Cardiac Enzyme (Creatine Kinase-MB (CK-MB), Troponin T, Troponin I) Test Results
  • Electrocardiography (ECG) Report
  • Echocardiogram Report (if any)
  • Coronary Angiogram Report (if any)

Kidney Failure

  • Medical Report (Kidney Failure)
    Download form
  • Kidney Dialysis Appointment Card
  • Copy of Kidney Dialysis Receipts (if any)
  • Kidney Function Test Results
  • If kidney transplantation has been performed, please include a copy of:
    - Surgical Report
    - Admission Bills
    - Discharge Summary

Other Coronary Artery Disease

  • Medical Report (Other Serious Coronary Artery Disease)
    Download form
  • Coronary Angiogram Report

Stroke

  • Medical Report (Stroke)
    Download form

  • Brain Magnetic Resonance Imaging (MRI)/Computed Tomography (CT) Scan Report

Please request your treating doctor to fill in the medical report, and include other relevant investigation reports.

AIDS

  • Medical Report (AIDS)
    Download form
  • Human Immunodeficiency Virus (HIV) Antibody Test Results
  • Western Blot Test Results
  • CD4 Cell Count Results
  • All relevant investigation reports, for example, Computed Tomography (CT) Scan, Magnetic Resonance Imaging (MRI), Biopsy (if any)

Bacterial Meningitis

  • Medical Report (Bacterial Meningitis)
    Download form
  • Brain and Spine Computed Tomography (CT) Scan/Magnetic Resonance Imaging (MRI) Report
  • All relevant investigation reports (if any)

Benign Brain Tumour

  • Medical Report (Benign Brain Tumour)
    Download form
  • Brain Computed Tomography (CT) Scan/Magnetic Resonance Imaging (MRI)/Biopsy Report

Blindness

  • Medical Report (Blindness)
    Download form
  • Visual Acuity Report on both eyes to be completed by ophthalmologist
  • All relevant investigation reports, for example, Brain Computed Tomography (CT) Scan/Magnetic Resonance Imaging (MRI) (if any)

Cardiomyopathy

  • Medical Report (Cardiomyopathy)
    Download form
  • Echocardiogram Report
  • Electrocardiography (ECG) Report
  • All relevant investigation reports (if any)

Coma

  • Medical Report (Coma)
    Download form
  • Glasgow Coma Scale throughout the whole period of coma
  • All relevant investigation reports, for example, Brain Computed Tomography (CT) Scan/Magnetic Resonance Imaging (MRI) (if any)

Deafness

  • Medical Report (Deafness)
    Download form
  • Audiometry and Sound Threshold Test Results for both ears, to be certified by ear, nose and throat (ENT) specialist
  • All relevant investigation reports, for example, Brain Computed Tomography (CT) Scan/Magnetic Resonance Imaging (MRI) (if any)

Encephalitis

  • Medical Report (Encephalitis)
    Download form
  • Brain Computed Tomography (CT) Scan/Magnetic Resonance Imaging (MRI) Report
  • All relevant investigation reports (if any)

End Stage Liver Failure

  • Medical Report (End Stage Liver Failure)
    Download form
  • Computed Tomography (CT) Scan/Magnetic Resonance Imaging (MRI)/Biopsy/Ultrasound Liver Reports that showed Ascites, Portal Hypertension and Encephalopathy
  • Liver Function Test Results
  • All relevant investigation reports (if any)

End Stage Lung Disease

  • Medical Report (End Stage Lung Disease)
    Download form
  • All FEV 1 Test Results
  • Arterial Blood Gas Analysis on Partial Oxygen Pressure
  • All relevant investigation reports (if any)

Heart Valve Surgery

  • Medical Report (Heart Valve Surgery)
    Download form
  • Surgical Report

Loss of Independent Existence

  • Medical Report (Loss of Independent Existence)
    Download form
  • All relevant investigation reports, for example, Computed Tomography (CT) Scan, Magnetic Resonance Imaging (MRI), X-ray and Ultrasound

Major Burns

  • Medical Report (Major Burns)
    Download form
  • Total Body Surface Area Burn Assessment Report, as measured by “The Rule of 9” of The Lund and Browder Body Surface Chart
  • Photograph (if deemed necessary)

Major Head Trauma

  • Medical Report (Major Head Trauma)
    Download form
  • Brain Computed Tomography (CT) Scan/Magnetic Resonance Imaging (MRI) Report
  • All relevant investigation reports (if any)

Motor Neurone Disease

  • Medical Report (Motor Neurone Disease)
    Download form
  • Brain and Spine Computed Tomography (CT) Scan/Magnetic Resonance Imaging (MRI) Report
  • Electromyography (EMG) Report
  • Nerve Conduction Study Report (if any)

Multiple Sclerosis

  • Medical Report (Multiple Sclerosis)
    Download form
  • Brain Magnetic Resonance Imaging (MRI)/Computed Tomography (CT) Scan Report
  • Spine Lumbar Puncture Test Report (if any)
  • Evoked Potential Test Report (if any)
  • All relevant investigation reports (if any)

Parkinson’s Disease

  • Medical Report (Parkinson’s Disease)
    Download form
  • All relevant investigation reports, for example, Brain Computed Tomography (CT) Scan/Magnetic Resonance Imaging (MRI) (if any)

Primary Pulmonary Arterial Hypertension

  • Medical Report (Primary Pulmonary Arterial Hypertension)
    Download form
  • Cardiac Catheterisation Test Results
  • Echocardiogram Report
  • All relevant investigation reports (if any)

Surgery to Aorta

  • Medical Report (Surgery to Aorta)
    Download form
  • Surgical Report

Systemic Lupus Erythematosus (SLE) with Lupus Nephritis

  • Medical Report (SLE)
    Download form
  • Renal Biopsy Report
  • All relevant investigation reports, for example, Urinalysis, Anti-Nuclear Antibodies, Blood Count and Renal Function Test
  • Computed Tomography (CT) Scan/Magnetic Resonance Imaging (MRI) Report (if any)

Note: If the Critical Illness that you wish to claim for is not listed above, kindly contact your agent or Allianz’s Customer Service for more information.

  • Claimant’s Statement (Death Claim)
    Download form
  • Claimant’s NRIC (Both Sides) / Passport Copy, duly certified
  • Proof of Relationship, for example, Marriage Certificate or Birth Certificate
  • Death Certificate Copy, duly certified
  • Burial Permit Copy, duly certified
  • Original Policy Contract
  • For MRTA/Credit Loan Claim please include Bank’s Outstanding Loan Statement for the latest 3 months
  • Medical Report (Death Claim)
    Download form
  • For Accidental Death Benefit please include
  • The following documents (if any):
    - Detailed Post Mortem Report
    - Blood and Urine Analysis Report on Toxicology and Drug
    - Police Report
    - Detailed Police Investigation Report
    - Newspaper Cutting