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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.
Information you will need
1

NRIC number

2

Policy

Policy number

Sum insured

3

Accident details

Date of accident

Place of accident





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Insured's Details

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First, tell us about yourself

Information that you provid will be treated with utmost privacy

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Oops please enter valid NRIC number
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enter valid email
enter valid address

What’s your policy detail?

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What’s your occupation?

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Do you have other insurance that will cover this loss?

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Have you ever made a claim under any PA policy before?

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Accident Details

When did the accident happen?

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enter valid date

Where did the accident happen at?

Optional

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Describe the Accident in detail

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What are the witnesses’ names?

(optional)

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What’s the name of hospital/clinic taken to?

If you were not hospitalised, state the name of the clinic (Optional)

What’s your treatment type?

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If you were admitted, tell us when

Optional

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enter valid date

Were you confined to House or Hospital by Doctor’s orders as the sole result of the injuries?

Optional

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Do you have other insurance that will cover this loss?

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State number of days you expect to be confined due to Doctor’s orders

enter valid work days

State number of days you expect to be confined due to Doctor’s orders

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