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Please download a claim form from our website, or contact our hotline for assistance.
All claims must be submitted within 60 days from date of service or date of discharge from hospital.
For Outpatient Claims
- Complete the Out-patient Claim Form
- Attach receipts with doctor’s signature and hospital/clinic chop to the Claim Form
- Must be original receipt (with diagnosis, date of service, breakdown of expenses)
- Make sure your (i.e. the patient’s) name is clearly shown on the receipt
- Attach doctor’s referral letter if required
For Hospitalization & Surgical Claims
- Complete the Hospitalization & Surgical Claim Form
- Part A – Complete and sign by patient
- Part B – Complete by attending physician/surgeon (waived for Government Hospital Admission)
- Attach itemized hospital statement, doctor slip, original deposit and final payment receipt to the claim form
- Attach the Discharge Summary for Government Hospitalization
- The above procedures should be applicable to overseas claims which must be translated in English or Chinese if it is in other languages.
- The above is a general claim guidelines. Further document / information may be required, if necessary.
- For inquiries, please contact our hotline at (852) 3187 6831 or email at firstname.lastname@example.org.
Hospitalization and Surgical Claim Form
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