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Before you Begin

To ensure a smooth claims process, please ensure the issued form must be completed and submitted within seven (7) days of receipt.
Medical Insurance Claim
1

NRIC number

2

Policy

Policy number

Date of Enrolment/Cover

3

Major Medical Claim

Date of accident

Place of accident





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Insured's Details

What is your policy detail?

Please enter a valid name.
Oops, looks like we can't find your policy. Please enter a valid policy number. Or did you forget your policy number? (underline redirect to account page)

What is the best way to contact you?

Please enter a valid name.
Oops, looks like we can't reach you with the number you've provided. Please enter a valid phone number, use numbers only. 
Please enter a valid address

What is the claimant's full name?

Optional

Please enter a valid name.

Accident Details

When was the date of incident

Please enter the date of incident. Please ensure the year chosen is between 1900 and 2022

What is the place of incident

Please enter the date of incident. Please ensure the year chosen is between 1900 and 2022

How did the accident occur?

Please explain your issue, so that we can get the appropriate staff to contact you. Please enter less than 1000 characters.

What is the nature of sickness?

Please enter a valid nature of sickness.

When did the sickness symptoms first began?

Please enter the date of incident. Please ensure the year chosen is between 1900 and 2022

When was the first treatment date?

Please enter the date of incident. Please ensure the year chosen is between 1900 and 2022

When was the previous treatment?

Please enter the date of incident. Please ensure the year chosen is between 1900 and 2022

Review

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