Hong Leong Assurance Berhad 198201014849 (94613-X)

Documentation of the Respective Claim Types

Important Note

1. *Certification of documents as “Original Sighted” should only be done by either Solicitor, Commissioner for Oaths, HLA Head Office and Branch Executive / Manager, Agency Manager or Unit Manager.Certification by Unit Manager needs to be countersigned by Agency Manager.

2. **Certification of documents as “Original Sighted” should only be done by either Solicitor, Commissioner for Oaths, HLA Head Office and Branch Executive / Manager, Agency Manager or Unit Manager.

Death Claim

  1. Claim Forms:
    1. Death Claim Application Form duly completed by the person entitled to the policy moneys.
    2. Medical Attendant’s Report for Death Claim duly completed by a registered medical practitioner at the claimant’s own expense.
  2. Supporting Documents:
    1. Original sighted copy of Death Certificate*.
    2. Original Policy Contract / Deed of Assignment / Assurance Certificate.
    3. Other supporting documents to prove the eligibility of cover for Non-Employee Benefits type of Group Term Life Policy and Other Financial Institution Group Policy.
    4. Original sighted copy of last two (2) months’ Payslips* and Appointment Letter* (Applicable only for Employee Benefits policy).
    5. Original sighted copy of Post Mortem report* (if any).
    6. Original sighted copy of Police Report* if the cause of death was due to accident and if a report has been lodged to the police.
    7. Newspaper cuttings (if the incident is reported in the newspaper).
    8. Original sighted copy of deceased’s Birth Certificate** / Identity card (for non-foreigner)** / Passport (for foreigner)** / Patient Card.
    9. Proof of Relationship of the Claimant / Next-of-Kin / Policy Owner to the Deceased i.e. Original sighted copy of Birth Certificate** or Marriage Certificate*.
    10. Original sighted copy of the claimant’s Identity card (for non-foreigner)** or Passport (for foreigner)** is required for claim payment via Direct Credit / E-Payment.
    11. A photocopy of Bank Statement or Bank Passbook for Direct Credit / E-Payment.
    12. Direct Credit / E-payment Form duly completed by the person entitled to the policy moneys.

Living Claim inclusive of 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

  1. Claim Forms:
    1. Living Claim Application Form duly completed by the person entitled to the policy moneys.
    2. Medical Attendant’s Report duly completed by a registered qualified physician at the claimant’s own expense.
  2. Supporting Documents:
    1. Original Policy Contract / Deed of Assignment / Assurance Certificate.
    2. Other supporting documents to prove the eligibility of cover for Non-Employee Benefits type of Group Term Life Policy and Other Financial Institution Group Policy.
    3. Original sighted copy of last two (2) months’ Payslips* and Appointment Letter* (Applicable only for Employee Benefits policy).
    4. Original sighted copy of Police Report* if the cause of disability was due to accident and if a report has been lodged to the police.
    5. Original sighted copy of laboratory / test report* if diagnostic or investigation has been carried out.
    6. Original sighted copy of the Life Assured’s (event person) Identity card (for non-foreigner)** or Birth Certificate** or Passport (for foreigner)**.
    7. A photocopy of itemised in-patient bills and receipt (applicable only for Facial Reconstructive Surgery Claim).
    8. Original sighted copy of the Policy Owner’s Identity card (for non-foreigner)** or Passport (for foreigner)** is required for claim payment via Direct Credit / E-Payment.
    9. A photocopy of Bank Statement or Bank Passbook for Direct Credit / E-Payment.
    10. Direct Credit / E-payment Form duly completed by the person entitled to the policy moneys.

Hospitalisation Benefit / Hospital Income Benefit / Hospital & Surgical Claim

  1. Claim Forms:
    1. Hospitalisation Benefit / Hospital Income / Hospital & Surgical / Personal Accident / Dismemberment Claim / Loss of Travelling Documents Application Form duly completed by the person entitled to the policy moneys.
    2. Medical Attendant’s Report on Hospitalisation Benefit / Hospital Income / Hospital & Surgical / Personal Accident / Dismemberment Claim duly completed by a registered medical practitioner at the Claimant’s own expenses.
  2. Supporting Documents:
    1. Original itemised hospital bill for Hospital & Surgical claim.
    2. A photocopy of itemised hospital bill is required for Hospitalisation Benefit / Hospital Income Benefit claim.
    3. Original official receipts and tax invoices for Hospital & Surgical claim.
    4. Confirmation letter on incurred expenses being reimbursed by other party i.e. SOCSO, other Insurer, Employer (if applicable).
    5. Original sighted copy of Police Report* if the cause of disability was due to accident and if a report has been lodged to the police.
    6. A photocopy of event person’s Birth Certificate / Identity card (for non-foreigner) / Passport (for foreigner) / Patient Card.
    7. Original sighted copy of the Policy Owner’s Identity card (for non-foreigner)** or Passport (for foreigner)** is required for claim payment via Direct Credit / E-Payment.
    8. A photocopy of Bank Statement or Bank Passbook for Direct Credit / E-Payment.
    9. Direct Credit / E-payment Form duly completed by the person entitled to the policy moneys.

Hospital Benefit on Childbirth Claim​

  1. Claim Forms
    1. Hospitalisation Benefit on Childbirth Claim Application Form duly completed by the person entitled to the policy moneys.
  2. Supporting Documents:
    1. Original sighted copy of child’s Birth Certificate**.
    2. Original sighted copy of itemised hospital bill*.
    3. Original sighted copy of the Policy Owner’s Identity card (for non-foreigner)** or Passport (for foreigner)** is required for claim payment via Direct Credit / E-Payment.
    4. A photocopy of Bank Statement or Bank Passbook for Direct Credit / E-Payment.
    5. Direct Credit / E-payment Form duly completed by the person entitled to the policy moneys.

Personal Accident / Dismemberment Claim

  1. Claim Forms:
    1. Hospitalisation Benefit / Hospital Income / Hospital & Surgical / Personal Accident / Dismemberment Claim Application Form duly completed by the person entitled to the policy moneys.
    2. Medical Attendant’s Report on Hospitalisation Benefit / Hospital Income / Hospital & Surgical / Personal Accident / Dismemberment Claim duly completed by a registered medical practitioner at the Claimant’s own expenses.
  2. Supporting Documents:
    1. Original copies of itemised hospital bill(s) and receipt(s).
    2. A photocopy of X-ray report (if any).
    3. A photocopy of medical leave / light duty certificate(s).
    4. Newspaper cutting (if the incident is reported in the newspaper).
    5. Original sighted copy of Police Report* if the cause of disability was due to accident and if a report has been lodged to the police.
    6. A photocopy of event person’s Birth Certificate, Identity card (for non-foreigner), Passport (for foreigner).
    7. Original sighted copy of the Policy Owner’s Identity card (for non-foreigner)** or Passport (for foreigner)** is required for claim payment via Direct Credit / E-Payment.
    8. A photocopy of Bank Statement or Bank Passbook for Direct Credit / E-Payment.
    9. Direct Credit / E-payment Form duly completed by the person entitled to the policy moneys.