Claim Forms

Refer to our user guide and download the forms you need from our listing.

Your claims will be processed within 14 working days upon receiving the complete claim document and you will be updated on your claim status via SMS.

Refer to the Frequently asked questions below for more information.

Insurance claim forms

Frequently asked questions

How long does it takes to process a claim?

The estimated timeframe is within 14 working days upon receiving the complete claim document.

How can I check the claim status?

Claim status will be updated via SMS. Please approach our servicing agent or contact customer service at 03-2771 0228 for further assistance.

Doctor’s statement

Crisis cover claim - Cancer, Heart & Musculoskeletal

Doctor's Statement Cancer 

Doctor's Statement Heart Related Conditions

Doctor’s Statement Bone, Joint, Muscle and Connective Tissue Related Conditions

  • Cancer

  • Early Stage Cancer (Prostate/Thyroid/

  • Bladder/CLL/Melanoma)

  • Carcinoma-in-situ (Breast/ Cervix Uteri/ Uterus/ Ovary/ Fallopian Tube/ Vagina)

  • Mastectomy For Carcinoma-In-Situ Breast

  • Prostatectomy For Stage 1 Prostate Cancer

  • Hysterectomy (surgical Uterus Removal)

  • Salpingectomy (surgical Fallopian Tube Removal)

  • Oopherectomy (surgical Ovary(ies) Removal)

  • Partial Colectomy/Gastrectomy with End-to-end Anastomosis

  • Cystectomy For Carcinoma-In-Situ Urinary Bladder/ Papillary Carcinoma Of The Bladder


  •  Coronary Artery Disease Requiring Surgery/ By-Pass Surgery
  • Other Serious Coronary Artery Disease

  • Angioplasty & Other Invasive Treatments

  • Keyhole Coronary By-Pass Surgery

  • Minimally Invasive Direct Coronary Artery Bypass Grafting (MIDCAB)

  • Enhanced External Counterpulsation Procedure

  • Transmyocardial Laser Therapy

  • Heart Attack/ Acute Myocardial Infarction

  • Heart Valve Replacement/ Surgery

  • Percutaneous Heart Valve Surgery

  • Surgery of AortaMinimally invasive surgery to Aorta

  • Large Asymptomatic Aortic Aneurysm/ Dissection

  • (Hypertrophic) Cardiomyopathy

  • Pericardiectomy (with Surgery)

  • Insertion of Pacemaker

  • Insertion of Cardiac Defibrillator

  • Infective Endocarditis (Early/Late)

  • Eisenmenger's Syndrome (Early/Late)


  • Paralysis/ Paralysis of Limbs/Loss of Use of One Limb
  • Loss Of Limbs/Fingers

  • Surgical Reattachment Of Amputated Limb

  • Loss Of A Single Hand/ Foot By Amputation

  • Limb Amputation Due To Type 2 Diabetic Complications

  • Muscular Dystrophy (Moderate / Severe)

  • Rheumatoid Arthritis (Moderate / Severe / Chronic)

  • Joint Replacement Due to Severe Osteoarthritis

  • Total Knee/ Hip Replacement

  • Osteoporotic Fracture Requiring Surgery

  • Osteoporotic Fracture Of The Hip/ Vertebra

  • Osteogenesis Imperfecta

  • Poliomyelitis (Moderate / Severe)

  • Progressive Scleroderma (Early / Late)

  • Progressive Scleroderma With CREST Syndrome

  • Major Burns/ Third Degree Burns

  • Mild/ Moderately Severe Burns

  • Grafting Due To Burn


Crisis cover claim - Kidney, Liver, Lung, Gastrointestinal, Brain & Nerve

Doctor's Statement Kidney, Liver, Lung & Gastrointestinal Related Conditions

Doctor's Statement Brain and Nerve Related Conditions

  • End Stage Kidney Failure
  • Chronic Severe Renal Impairment

  • Severe Diabetic Nephropathy resulting in Kidney Failure

  • Systemic Lupus Erythematosus (SLE) with with Lupus Nephritis or Severe Kidney Complications

  • Medulla Cystic Disease

  • Nephrectomy/ Removal of one Kidney

  • End Stage Liver Failure

  • Fulminant Viral Hepatitis

  • Cirrhosis of the Liver

  • Autoimmune Hepatitis (Early / Chronic)

  • Partial Hepatectomy

  • Portal Vein Thrombosis

  • End Stage Lung Disease

  • Primary Pulmonary Arterial Hypertension

  • Surgical Removal of the Lungs (whole lung or lobes)

  • Status Asthmaticus

  • Surgical Insertion of a Vena-cava Filter

  • Heart Failure due to Chronic Lung Disease

  • Acute Necrotizing / Chronic Relapsing Pancreatitis

  • Biliary Tract Reconstruction Surgery

  • Chronic Primary Sclerosing Cholangitis

  • Chronic Crohn's Disease

  • Chronic Ulcerative Colitis

  • Adrenalectomy For Adrenal Adenoma

  • Chronic Adrenal Insufficiency

  • Apallic Syndrome

  • Akinetic Mutism / Locked In Syndrome

  • Encephalitis (With Recovery)

  • Meningitis (With Recovery / Reversible Neurological Deficits)

  • Tuberculous Myelitis / Meningeal Tuberculosis

  • Brain (Aneurysm) Surgery

  • Surgical Removal Of Pituitary Tumour

  • Insertion of Cerebral Shunt

  • Insertion of Ventriculoperitoneal Shunt

  • Endovascular Treatment of Cerebral AVM

  • Craniotomy for Treatment of Aneurysm/ AVM

  • Benign Brain Tumour

  • Surgical Excision of a Spinal Meningioma

  • Surgery for Drug Resistant (Severe) Epilepsy

  • Major Head Trauma (Mild / Severe)

  • Cervical Spinal Cord Injury (Accident)

  • Head Trauma (Accident) Requiring Re-constructive Surgery / Open Craniotomy

  • Surgical Repair of Depressed Skull Fracture

  • Motor Neuron Disease (Early / Severe)

  • Peripheral Neuropathy

  • Myasthenia Gravis (Less Severe / Severe)

  • Spinal Cord Disease/Injury Cause Bowel & Bladder Dysfunction

  • Multiple Sclerosis (Early / Severe)

  • Guillain-Barre Syndrome

  • Parkinson's Disease (Early / Moderate / Severe)

  • Progressive Supranuclear Palsy (Early / Late)

  • Diagnosis of Alzheimer's Disease or Dementia

  • Alzheimer's Disease or Dementia (Moderate / Severe)

  • Stroke

  • Stroke Treatment By Carotid Angioplasty & Stent

  • Carotid Artery Surgery

  • Surgery For Subdural Haematoma Due To Accident

  • Coma


Crisis cover claim - Eyes, Ear & Others


Doctor's Statement Eyes and Ears Related Conditions

Doctor's Statement Other Illnesses

  • Blindness/ Loss of Sight (Both Eyes)

  • Corneal Transplant

  • Loss of Sight in One Eye

  • Bilateral Severe Low Vision

  • Deafness/ Loss of Hearing

  • Cochlea Implant

  • Bilateral Severe Hearing Loss

  • Surgical Drainage for Cavernous Sinus Thrombosis

  • HIV Infection due to Blood Transfusion / Organ Transplant

  • HIV Infection due to Assault

  • Full Blown AIDS

  • Occupationally Acquired HIV / Hepatitis B or C Infection

  • Aplastic Anaemia (Acute or Chronic)

  • Myelodysplastic Syndrome or Myelofibrosis

  • Loss of Independent Existence

  • Loss of Speech

  • Tracheostomy

  • Facial Reconstructive Surgery

  • Type 2 Diabetic Retinopathy

  • Limb Amputation due to Type 2 Diabetic Complications

  • Major Organ Transplant or Bone Marrow Transplant

  • Pending Major Organ Transplant

  • Small Bowel Transplant

  • Terminal Illness