Hong Leong Assurance Berhad 198201014849

Claims Procedure

How do I submit a claim?

Step 1  Notify, Complete and Submit the Required Form
  • Submit your claim notification through our mobile app or
  • Contact your agent or customer service to notify claim within 14 days from event date.
  • Complete the required forms and attach any relevant documents. You can obtain the forms directly from any Hong Leong Assurance (HLA) branch, from your servicing agent or download them through HLA corporate website. Click
  • Submit the completed forms and relevant documents to your agent, HLA Head Office or nearest branch.
Step 2  Claim Processing
  • Claims with complete document, we will proceed accordingly. For incomplete documents, we will notify you in writing and send a requirement letter within 7 working days from date of notification.
  • We will provide an update on the progress of the claim every 14 working days.
Step 3  Claim Approval
  • The service level agreement for claims submitted with complete documentation are:

Major claims1 – 7 to 16 working days*
Minor claims2 – 6 working days<

Note:
Major claims1: Death claim, Dread Disease claim, Old Age Disablement claim, Total & Permanent Disability claim, Congenital Anomalies claim, Facial Reconstructive Surgery claim and Pregnancy Care or Pregnancy Complication claim (This list is non exhaustive and serves as a guide.)

Minor claims2: Dismemberment/ disablement claim, Indemnity claim, Hospital & surgical claim, Hospital benefit - childbirth claim, Hospitalisation benefit claim, Double hospital benefit claim, Outpatient claim
 
*Depending on the type of policy i.e. with or without unit redemption

How to enquire if I wish to check the claim status or further clarify any doubts in claim decision?

You may check the status of your claim via the following options:
  1. Login to .
  2. Contact Customer Service Hotline at 03-7650 1288.
  3. Contact the claim submission branch or any HLA branch nationwide. Claim submission branch refers to the branch where the claim documents were submitted.
  4. Send an email to customerservice@hla.hongleong.com.my.

If I am not satisfied with the claim decision, how can I submit an appeal or complaint?

If you are not satisfied with the decision of the claim, you can submit an appeal or complaint to our Customer Service Improvement Unit with documents to support the appeal/complaint. Post, email or fax your letter to:
 
Hong Leong Assurance Berhad
Level 3, Tower B, PJ City Development,
No. 15A, Jalan 219, Seksyen 51A,
46100 Petaling Jaya, Selangor
Email: customerservice@hla.hongleong.com.my
Fax: 03-76501991

Or submit your feedback through our website at www.hla.com.myAlternatively, if you require assistance on your complaint, you may call us at 03-76501288 from Mondays to Fridays, 9.00am to 6.00pm.
 
We aim to resolve the issue in an equitable, objective and timely manner and will make a decision within 14 working days from the date of the receipt of your complaint.  For complicated cases, we will provide an update on the progress every 14 working days.
If you are not satisfied with the response or the decision of our Company, you can submit complaint either to Ombudsman for Financial Services (OFS) within 6 months from the date of our Company's final decision. If your complaint does not fall within the scope of OFS, you may submit your complaint to Bank Negara Malaysia (BNM).

The following are the contact details for OFS and BNM.
Ombudsman for Financial Services
(Formerly known as Financial Mediation Bureau)
Level 14, Main Block
Menara Takaful Malaysia
No. 4, Jalan Sultan Sulaiman
50000 Kuala Lumpur.
Tel: 03-22722811
Fax: 03-03-22721577
Email: enquiry@ofs.org.my
 
Bank Negara Malaysia
Laman Informasi Nasihat dan Khidmat (LINK)
Tingkat Bawah, Blok C
Bank Negara Malaysia
Peti Surat 10922
50929 Kuala Lumpur
Tel: 1300 88 5465 or 03-21741717
Fax: 03-21741515
Email: bnmtelelink@bnm.gov.my

Where can I obtain the claim requirement letter?

Once a claim notification has been submitted to us, we will assess it and determine should we require further claim documents. We will then notify you in writing and send the claim requirement letter. You can also request a copy of the requirement letter from your servicing agent who can download the letter via their e-Channel Portal.

Who can certify the claim documents?

Certification of documents as “Original Sighted” can be done by Solicitors, HLA Head Office and Branch Executive / Manager, Agency Manager / Unit Manager.
                                
Note: Certification of documents other than Birth Certificate, Identity card (for non-foreigner) and Passport (for foreigner) as “Original Sighted” by Unit Manager must be countersigned by the Agency Manager.
 

Can a claim for medical reimbursement be made with photocopied, duplicated copy, reprinted copy, certified true copy of bill and/or receipt?

Original bills and receipts are required for a medical reimbursement claim. However, should the original receipts and bills be lost / misplaced, kindly make a Statutory Declaration of the Loss of Original Receipt / Bill before Commissioner for Oaths and return it with the certified true copy of the receipts / bills by the issuing party.

Where can I obtain the form to declare loss of original receipts, bills and tax invoices?

The form can be obtained from HLA Head Office or any HLA branches.

If the employer or other insurance company does not cover the medical expenses in full, can the Policy Owner claim for the balance under the Hospital and Surgical plan in HLA?

Yes, in order to claim for the balance under Hospital and Surgical plan in HLA, please submit claim documents including the claim settlement advice / approval letter and copies of bills, official receipts and tax invoices certified by the other paying party (e.g. insurance company or employer).
 

Outpatient Cancer Treatment

9.1 How do I submit an Outpatient Cancer Treatment claim?
Submit the original bills, receipts and tax invoices to HLA Head Office or the nearest HLA branch with relevant claim forms such as notification form and Medical Attendant Report on Outpatient Cancer Treatment and provide us with your bank details for us to perform direct credit.

9.2 If my employer or other insurance company does not cover the Outpatient Cancer Treatment in full, can I claim the balance under the Hospital and Surgical plan in HLA?
Yes, in order to claim the balance under Hospital and Surgical plan in HLA, please submit the claim documents including the claim settlement advice / approval letter and copies of bills, official receipts and tax invoices certified by the other paying party (e.g. insurance company or employer).
 

Outpatient Kidney Dialysis

10.1 How do I submit an Outpatient Kidney Dialysis claim?
Submit the original bills, receipts and tax invoices to HLA Head Office or the nearest HLA branch with relevant claim forms such as notification form and provide us with your bank details for us to perform direct credit.

10.2 If my employer or other insurance company does not cover the Outpatient Kidney Dialysis in full, can I claim the balance under the Hospital and Surgical plan in HLA?
Yes, in order to claim the balance under Hospital and Surgical plan in HLA, please submit the claim documents including the claim settlement advice / approval letter and copies of bills, official receipts and tax invoices certified by the other paying party (e.g. insurance company or employer).    
 

How to submit the request for reimbursement of medical report fee?

Customer who had assisted HLA in obtaining medical report may request for reimbursement of the medical report fee by submitting the necessary documents as listed below:
  1. Complete the Direct Credit / E-payment for Claim Payment in the Claim Application Form if not submitted during the claim submission.
  2. A photocopy of Bank Statement or Bank Passbook if not submitted during the claim submission. (Optional)
  3. Original sighted copy of Identity card (for non-foreigner) or passport (for foreigner), if not submitted earlier.
  4. The original receipt and tax invoice being proof of payment for the medical report.

Who is the rightful payee of the claim?

The claim will be issued to the rightful payee based on the following categories and priority:
 
Living claim  i.e. Hospitalisation & Surgical claim,Total & Permanent Disability claim, Weekly Indemnity claim, Dread  Disease claim, Hospitalisation Benefit claim
  1. Absolute assignee.
  2. Policyholder.
  3. Executor or administrator of the estate of the policyholder, if the policyholder dies before he received claim payment.
 
 
 
Death claim – Policyholder’s death
(i)   Assignee.
       (ii)  With nomination.
  1. Competent nominee for both trust and non-trust nominee.
  2. If the nominee is a trust nominee who is incompetent to contract, pay to the appointed trustee; if there is no appointed trustee, pay to the parent of the incompetent nominee as presumed trustee.
  3. If the nominee is a non-trust nominee who is incompetent to contract, pay to Public Trustee or a trust company nominated by the policyholder or obtain a Letter of Administration or Grant of Probate.
       (iii)  Without nomination.
  1. Pay to policyholder’s spouse, child and parent in accordance with Distribution Act provided that the policyholder never leaves a Will.
  2. If policyholder leaves a Will, pay in accordance with Grant of Probate.
  3. If no Will, no spouse, no child and no parent, pay in accordance with Letter of Administration.
 
Death claim – Non-policyholder’s death
  1. Absolute assignee.
  2. Policyholder.
  3. Executor or administrator of the estate of the policyholder, if the policyholder dies before he received claim payment.

Who is the rightful payee for Mortgage Decreasing Term Assurance (MDTA) / Credit Life / Hire Purchase?

The claim payment will be issued to the Policy Owner which is the Financial Institution (Bank).
 

What is the MDTA sum assured to be paid?

The MDTA sum assured will be paid according to the Table of Reducing Sum Assured of the Assurance Certificate.
 

What should I do if the claim cheque is lost in transit or staled?

For claim cheque that is lost in transit or has stale, you may change the method of payment to Direct Credit / E-Payment. Please provide us with the documents listed below which can be obtained from any HLA Head Office / Branches:
 
Cheque lost in transit
(i) Stop Cheque Request Form.
(ii) Complete the Direct Credit / E-payment for Claim Payment in the Claim Application Form.
(iii) A photocopy of Bank Statement or Bank Passbook. (Optional)
(iv) Original sighted copy of Identity card (for non-foreigner) or passport (for foreigner).
 
Stale cheque
(i) Complete the Direct Credit / E-payment for Claim Payment in the Claim Application Form.
(ii) A photocopy of Bank Statement or Bank Passbook. (Optional)
(iii) Original sighted copy of Identity card (for non-foreigner) or passport (for foreigner).
 

What is Direct Credit / E-Payment?

Direct Credit / E-Payment is defined as payment via direct deposit into the rightful payee’s bank account. You can enjoy the service free of any charges.
 

What documents are required for Direct Credit / E-Payment?

The following documents are required:
  1. Complete the Direct Credit / E-payment for Claim Payment in the Claim Application Form.
  2. A photocopy of Bank Statement or Bank Passbook. (Optional)
  3. Original sighted copy of Identity card (for non-foreigner) or passport (for foreigner).
Note: Hong Leong Assurance reserves the right to request for other documents if needed to transact the Direct Credit / E-Payment.
You can change your bank account information anytime by completing Direct Credit / E-payment for Claim Payment in the Claim Application Form to notify us of the change.
 

What will happen to claim payment which cannot be credited into the claimant’s account?

If funds cannot be credited into the claimant’s bank account due to, for example, incorrect bank account number, closed or inactive bank account, the claim payment will be issued via cheque to avoid unnecessary delay to the payment process.
 

How will the claim payment be made if the payee has been blacklisted by the Bank / adjudicated a bankrupt and unable to open a bank account?

The payee has to provide an official letter from Malaysia’s Department of Insolvency to allow payment to the rightful debtor or payee.
 

What is HLA360?

is a mobile application which allows you to submit claim through the app. With this app, claim process will be expedited. It eliminates the need of physical forms with the use of e-form and simplifies claim documentation.
 

How do I submit claim through HLA360?

Follow these 4 simple steps to submit claim:

Step 1    
Login to  mobile app

Step 2
Provide claim details

Step 3
Upload documents

Step 4
Submit claim after you enter the TAC No

 

What are the types of claim that are eligible for waiver of original documents through HLA360?

The type of claims that are eligible and threshold for waiver of original documents are:
Claim Type Claims Threshold for Waiver of Original Documents (RM)
Hospital Benefit for Childbirth 2,000.00
Hospital Benefit 300.00
Hospital and Surgical – Pre and Post Hospitalisation 300.00
Hospital and Surgical – Outpatient Physiotherapy 300.00
Weekly Indemnity 300.00

After submitting the claim through HLA360, do I still need to keep the original documents?

Yes, you need to keep the original copy of all uploaded claim documents for 180 days from the date of online claim submission as the Company reserves the right to request the original documents within the said period. Uploaded documents must be taken from the original copy.
 

What happens if I had lost the original documents?

The Company reserves the right to recover the claim payment from you/Policyholder if it finds that the original receipt/invoice have been claimed from other sources and/or invalid documents/information provided for claim payment.
 

Can I still submit claim through the app if my claim exceeds the claim threshold?

Yes, you can still submit claim through the app. As the claim had exceeded the threshold for waiver of original documents, you need to submit the original documents in support of the claim to us for processing after the online claim submission.