• Home Insurance Claims Guide
• Life Assurance Claims Guide
• Motor Insurance Claims Accident Guide
• Hospital & Surgical Insurance Claims Guide

Home Insurance Claims Guide

• Report to police within 24 hours and obtain the police report when available.
• Report to broker / insurer advising circumstances, nature and extent of loss.
  
• Take necessary actions / precautions to prevent / minimize further loss / damage.
  
• The insurer may appoint an adjuster to conduct an investigation. Please preserve any evidence of loss / damage for investigation purposes.
  
• Forward to broker / insurer the following claim documents:-
  
  • Claim form duly signed and completed
  • Police Report
    
  • Fire Brigade Report (applicable for claims due to fire)
    
  • Original invoices of damaged items
    
  • Quotations and / or receipts of repairs or replacement of property / items
    
  • Photographs showing areas of damage
    

  The above guide is also applicable for All Risks Insurance Claims.

Life Assurance Claims Guide

Claim on Death

• Official notification must be made to broker / insurer immediately.
  
• Submit the Original Death Certificate, Original Policy, Claimant's and Doctor's Statement, *Accidental Death Benefit Form, *Post Mortem Certificate, *Coroner's Report and *Newspaper to broker / insurer. (*Applicable for Accidental Death only.)
  
• Broker / insurer will advise you of the amount of claim payable.
  

  Claim on Maturity

• The broker / insurer would forward a voucher and notify you of the maturity of your policy.
  
• Complete and return the voucher to the broker / insurer with the original policy, certified true copy of Identity Card and Birth Certificate.
  
• On receipt of your documents, the claim settlement would be sent to you.
  

  Claim on Total and Permanent Disablement Benefit (TPD)

• Official notification must be made to broker / insurer immediately.
  
• Complete and forward claim form together with detailed medical report within 120 days of disablement to broker / insurer. The medical report should include, date and complete description of disability as well as the chances of recovery.
  
• Further medical evidence may be required before any subsequent advance payment is due on the policy anniversary.
  
• If medical evidence indicates continued TPD, complete and forward permanent disability benefit claim form together with policy to broker / insurer.
  
• In the event of death occurring before the tenth and final annual advance payment are effected, the amount payable on death shall be the aggregate of annual advance installments remaining unpaid.

Motor Insurance Claims Accident Guide

• Report to the police within 24 hours.
  
• Report to the broker / insurer as soon as possible.
  
• Note down names, addresses, registration numbers of third parties involved and their insurance details.
  
• Note down names, addresses and telephone numbers of independent witnesses.
  
• Do not pay money to any third party without the insurer's written consent.
  
• Refer to the broker / insurer immediately all summonses, communications received from the police authorities.
  
• Forward broker / insurer immediately all correspondences from third parties unanswered.
  
• Remove damaged car to insurer's authorized workshop.
  
• Complete claim form and forward to broker / insurer with a copy of police report, registration card, road tax disc, driver's / insured's IC and driving license.
  

  For lodging Third Party Claims, the following procedures must be observed:-

• Obtain police sketch plan and investigation results.
  
• Notify third party in writing of your intention to claim and request him to notify his insurer.
  
• Obtain estimated cost of repairs from the authorized workshop.
  
• Forward estimated repair costs together with adjuster report and other supporting documents to broker / third party's insurer.
  

  Option For Comprehensive Policyholders for lodging Third Party Claims:-

• Forward to broker / own insurer, claim form, police report, driver's / insured's IC and driving license, estimated cost of repairs and a signed declaration confirming circumstances are true and solely due to negligence of third party.

Hospital & Surgical Insurance Claims Guide

• Notify your broker / insurer as soon as possible.
  
• Your broker / insurer will forward to you a copy of a claim form.
  
• Submit to broker / insurer the required documents:-
  
  • Claim form duly signed and completed.
    
  • Medical Report duly signed and completed by the attending physician.
    
  • Original bills and receipts incurred in respect of the hospitalization.

In a case where a Managed Care Organization is involved

• Notify the Managed Care Organization (MCO) immediately.
  
• The MCO will validate if the condition is covered by the policy and the best option for the required treatment.
  
• A letter of guarantee would be forwarded to the hospital by the MCO (hospital deposit is not necessary).
  
• Upon discharge from the hospital, the MCO will take over the settlement of validated medical bills.
  
• Any ineligible or excess expenses must be paid by the Insured upon discharge.

If you have any enquiries, please contact us at 03-26914244 or e-mail claims@anika.com.my

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