Submit a medical claims

What is medical claims?

When you make a claim on an insurance policy, you are formally notifying the insurance company that you have suffered a loss or damage that you believe is covered by the policy and you are requesting action.
 
The insurer will review your claim and see if the event or circumstances are risks covered by the policy.
 
You will need to provide proof it is a genuine claim and the insurer will need to be certain the claim satisfies the terms and conditions of your insurance policy.
 
If your claim is accepted, the replacement or repair of your property or any payment by the insurer is called the benefit or payout.
 
The insurer will work out the value of the claim and provide the appropriate benefit specified in your insurance contract.
  

The claims process

Insurance companies try to make the claims process as smooth as possible, but the policyholder must go through a few steps in the claims process.
Before you start submitting a medical claim, there are few things you should understand clearly about types of Medical Claims:
 
Hospitalisation Claim - Pre Hospitalisation
 
Pre-hospitalisation expenses include various charges related to medical tests before an individual gets hospitalised. Doctors/physicians conduct a slew of tests to accurately diagnose the medical condition of a patient before prescribing treatment. It is important to note that the number of days which are covered, tends to vary depending upon the type of health insurance provider. However, in most cases, charges incurred by an individual in up to 90 days prior to his or her admission to any hospital fall within the ambit of pre-hospitalisation expenses. (depending on your insurance provider**) For instance, several tests such as blood test, urine test and X-ray among others are categorised as pre-hospitalisation expenses.
 
Hospitalisation Claim - In Hospital
 
If your insurance policy covers hospitalisation, here is how you can claim for your medical bills or daily hospitalisation benefit (depending on your plan).
 
Hospitalisation Claim - Post Hospitalisation
 
Post hospitalisation is additional cover benefits which the insurance company extends the policyholder whereby they provide cover for expenses covered for an illness or injury for a certain period before and after the treatment for that injury or illness is done. 
 
Clinical Claim - General Practitioner
 
This claim pays for the clinical outpatient consultation, medical fees, outpatient diagnostic x-ray and laboratory tests when the Insured Member visits a General Practitioner under the FWD panel of clinics or polyclinics.
 

1. Singapore

Oops! For Singaporean, please use Aviva ClaimConnect to submitting your medical claims. 
 

2. Malaysia

If you are well prepared and organised, and you have all the information that the insurance company needs to see, making a claim is usually straightforward and quick. You can make your claim progress much more smoothly if you take an organised, step-by-step approach. The following guidelines will help you to make sure that you don’t overlook any of the important steps in the process.
 

 

Step 1: Collect important documents from the hospital

To prevent unnecessary delays during your claim process, please prepare all the necessary documents: 
 

(a) All types of Hospitalisation Claims

  • Original Receipts
  • Original Final Tax Invoices
  • Itemised Bills/Detailed Bills indicating: 
    • Doctor’s Fee
    • Medicine Charges (including medicine name, unit price, prescribed quantity and supply duration)
    • Test/Investigation Charges
 
  • Diagnostic Reports (if any)
    • Magnetic Resonance Imaging (MRI)
    • X-ray
    • Histopathology Examination (HPE)
    • Blood Test
    • Computed Tomography (CT) Scan
    • Coronary Angiogram
    • Electrocardiography (ECG)
 
  • Medical Report fill up by attending doctor (if Hospitalisation Claim)

(b) Clinical Claims

  • Original receipt 
  • Details of charges (for bill above RM75) 

Step 2: Submit to your HR admin

Submit your claim as soon as possible once you get back to works to avoid any delayed of your claims payment. Your HR admin will contact Swingvy for the claim handling process to ensure payout all claims that are covered by the wording in your insurance policies. 
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