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How to Make a Claim

Your claim is our priority- we strive to ensure that all valid claims are paid promptly. We encourage our customer to submit all necessary claim documents to us soonest possible to help speed up the claim process. 

For your easy reference, please refer to the procedures & forms listed below to make a claim.

Death Claim 

Documents required:
  • Claimant's Statement (LF1021)
  • Death Claim - Physician's Statement (LF1017) <waive if death after 2 years from policy inception or reinstatement>
  • Request for Medical Report & Authorization to Release Information (LF1029)
  • Request E-Banking Facility Form (LF1046)
  • Original Policy Contract
  • Certified true copy of Death Certificate
  • Certified true copy of Claimant's IC/ Passport/ Birth Certificate
  • Certified true copy of Insured's IC/ Passport/ Birth Certificate
  • Copy of Full Post Mortem Report (for accidental death benefit)
  • Copy of Policy Report (for accidental death benefit)

Total & Permanent Disability (TPD) Claim 

Documents required:           

  • TPD Claimant's Statement
  • TPD Medical Report
  • Request for Medical Report & Authorization to Release Information (LF1029)
  • Request E-Banking Facility Form (LF1046)
  • Original Policy Contract
  • Copy of test report/ result such as laboratory result, X-ray/ MRI/ CT Scan etc.
  • Copy of Police Report (for accidental benefit)

Dismemberment Claim 

Documents required:

  • Claimant's Statement for Accidental Injury
  • Attending Physician's Statement for Accidental Injury
  • Request for Medical Report & Authorization to Release Information (LF1029)
  • Request E-Banking Facility Form (LF1046)
  • Original Policy Contract
  • Copy of test report/ result such as laboratory result, X-ray/ MRI/ CT Scan etc.
  • Copy of Police Report                                                                                                                                                                                                

Critical Illness Claim 

Documents required:

  • Critical Illness Claimant's Statement 
  • Attending Physician's Statement for the Covered Event
  • Request for Medical Report & Authorization to Release Information (LF1029)
  • Request E-Banking Facility Form (LF1046)
  • Original Policy Contract
  • Copy of test report/ result such as laboratory result, ECG, X-ray/ MRI/ CT Scan, Biopsy etc.                                                                                                                                                                                             

Accident Indemnity Claim 

Documents required:

  • Accident Indemnity Claim Form (LF4005)
    1. Claimant (Policyholder) to complete Page 1 and 2
    2. Attending Physician's Statement, Page 3 and 4
  • Request for Medical Report & Authorization to Release Information (LF1029) <if the accident is within 2 years from policy inception or reinstatement>
  • Request E-Banking Facility Form (LF1046)
  • Copy of medical certificate, discharge note, itemized bill (if any)
  • Copy of test report/ result such as X-ray/ MRI/ CT scan etc (if any)
  • Copy of Police Report (if any)                                                                                                                                                                                 

Hospitalisation Claim 

Documents required:

Admission to hospital (Inpatient bill)

  • Hospital Claim Form (LF4003)
    1. Claimant (Policyholder) to complete Page 1 and 2
    2. Attending Physician's Statement, Page 3 and 4
  • Request for Medical Report & Authorization to Release Information (LF1029) <if the accident is within 2 years from policy inception or reinstatement>
  • Request E-Banking Facility Form (LF1046)
  • Original Admission Bill / Invoice (Summary and details itemized) <waive the detailed itemized if total amount is less than RM3,500.00>
  • Original Payment Receipts (total amount paid must be the same as the Invoice)
  • Copy of the referral letter from clinic or hospital (if any)
  • Certified true copy of passport (for oversea treatment)    

Pre and Post Hospitalization

  • Request E-Banking Facility Form (LF1046)
  • Original Payment Receipts
  • Original Detailed Itemized bill

Outpatient Emergency Accidental Injury

  • Accident Indemnity Claim Form (LF4005)
    1. Claimant (Policyholder) to complete Page 1 and 2
    2. Attending Physician's Statement, Page 3 and 4 (can be waived if the total amount incurred is less than RM150.00 per accident, however the nature of injury and treatment must be indicated on the receipt by the treating doctor)
  • Request E-Banking Facility Form (LF1046)
  • Original Payment Receipts and itemized bill for the medical expenses incurred    

Hospital Benefit (No reimbursement benefit) & Government Cash Hospital Benefit

  • Hospital Claim Form (LF4003)
    1. Claimant (Policyholder) to complete Page 1 and 2
    2. Attending Physician's Statement, Page 3 and 4 or Certified true copy of Hospital Discharge Note or Discharge Summary
  • Request for Medical Report & Authorization to Release Information (LF1029) <if the accident is within 2 years from policy inception or reinstatement>
  • Request E-Banking Facility Form (LF1046)
  • Copy of Inpatient Bill   

Outpatient Benefit

  • Hospital Claim Form (LF4003)
    1. Claimant (Policyholder) to complete Page 1 and 2
    2. Attending Physician's Statement, Page 3 and 4 
  • Request for Medical Report & Authorization to Release Information (LF1029) <if the accident is within 2 years from policy inception or reinstatement>
  • Request E-Banking Facility Form (LF1046)
  • Original Receipt and itemized bill for the medical expenses incurred   

                                                                                                                              

Important Notes

  • TPD, Dismemberment or Critical Illness claim forms are not pre printed. Please refer to the nearest Branch Office or Head Office for assistance.
  • If claim occurs within 2 years from the policy inception or reinstatement date, please provide us with name/ address/ contact number of the Insured's regular attending doctor for our further due diligence. We will appreciate if a copy of appointment card/ outpatient card is provided.
  • Please complete the claim form by answering all questions and attach relevant documents required above.
  • All expenses incurred in getting claim documents is to be borne by the Claimant.
  • Certification of documents can be done by sighting the original documents by the authorised personnel (Manulife's Personnel or Agency Manager)

 

Download required form

Claimant's Statement (LF1021) & Death Claim - Physician's Statement (LF1017)

Request for Medical Report & Authorization to Release Information (LF1029)

Accident Indemnity Claim Form (LF4005)

Hospital Claim Form (LF4003)

Request E-Banking Form (LF1046)