Claims Supporting Docs

List of Supporting
Documents Required

Personal Accident

Information Requirement

Policy No.
Insured Name
Name of the Insured person (Patient)
Time, date and place of accident
Brief circumstances of accident
Contact person and telephone no.

Document Requirement

PA Claim form duly completed
Police report (if any)
ID Card/Employee ID card/
Work permit
Medical report/certificate, doctor’s prescription
Lab test result/X-ray film/CT Scan Result/Echo result
Original medical bills/receipts
Proof of earnings, e.g. salary slip/employment contract
Burial certificate/post mortem report, where applicable (in case of accidental death)
Death certificate ( in case of accidental death)
Other supporting documents reasonably required by us.

Healthcare

Information Requirement

Policy No.
Insured Name
Name of the Insured person (Patient)
Time, date and place of admission
Brief circumstances of illness/diagnosis
Contact person and telephone no

Document Requirement

HCI Claim form duly completed
A copy of employee card/
Cambodian ID card/family book
A copy of Insurance membership card
Medical Report/doctor’s
Certificate/doctor’s prescription
Lab test result/X-ray film/CT Scan Result/Echo result
Original Hospital Bills/Receipts
Burial certificate/post mortem report, where applicable (in case of death)
Death certificate ( in case of death)
Other supporting documents reasonably required by us

Motor Vehicle

Information Requirement

Policy no. of Insured
Plate Number of Insured’s Vehicle and Third Party’s (if any)
Time, date and place of accident
Nature/Extent of damage
Brief description of accident
Contact number of Insured/Driver and Third Party’s (if any)

Document Requirement

Own Damage / Theft
- MV claim form duly completed
- Certificate of Insurance
- Vehicle Registration Card
- Certificate of Motor Vehicle Technical Inspection
- ID card and Driver License of the Driver at the time of accident
- Police report (in case of Theft is a must)
- Vehicle’s Key (in case of Theft)
- Quotation for repair/replacement (if any)
Third Party Liability, Accident to Driver, Accident to Passenger
- Police report (if any)
- Quotation for repair/replacement (if any)
- Medical Report/Certificate
- Medical Receipts/Invoices, Lab
- Test Report, of the Insured/
- Driver/Passengers (Applicable to Authorized Driver and Passenger Liability Benefit)
- ID/passport, family book, employment contract (in the case of the accidental death)
- An original or certified copy of the Death Certificate/Burial Certificate (in the case of the accidental death)
- Other supporting documents reasonably required by us

Property All Risks / Fire

Information Requirement

Policy No.
Insured Name
Time, date and place of loss
Brief description of the loss
Description of items damaged and estimated loss amount
Person to contact and telephone no.

Document Requirement

Property Claim form duly completed
Police report
Fire brigade report
Police report (in case of Theft is a must)
Medical report/post mortem report (for fatal injury claim)
Repair bills/quotation for property damage
Consultant’s report on cause/nature/extent of damage
Proof of expenses incurred by Third Party
Particulars of claim from Third Party
Other supporting documents reasonably required by us

Contractor’s All Risks

Information Requirement

Policy No.
Insured Name
Time, date and place of loss accident
Brief circumstances of loss/ accident
Any other party involved
Contact person and telephone no.

Document Requirement

PUL Claim form
Any contract signed between Insured and Third Party
Proof of ownership such as land title of landlord, tenancy agreement
Repair/replacement bill / quotations of the affected items
Photographs of the damage
List of affected contents (contents claim)
Technical inspection report (lightning claim)
Meteorological report (windstorm claim)
Other supporting documents reasonably required by us

Public Liability

Information Requirement

Policy No.
Insured Name
Time, date and place of loss
Brief description of the loss
Description of items lost / damaged and estimated loss amount
Person to contact and telephone no.
Prospect of recovery against the party at fault

Document Requirement

Claim form duly completed
Contract documents, including bill of quantities (BOQ) and scope of work
List of parties to the contract, including principals, consultants, main contractor, sub-contractors agreement (where applicable), suppliers
Schedule of work showing the stage of completion prior to damage with photographs
Stock record, delivery orders, goods invoice/receipt, progress payment records (if any)
Consultant’s / internal report on extent of damage and suggested scope of repairs
Police report (in case of Theft is a must)
Quotation for repairs or replacement
Other supporting documents reasonably required by us

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