Submit a medical claims - Clinical

If your company provide a GP claims to you, this claims 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.
 

(a) My  medical coverage cover outpatient treatments

Great! This means the medical insurance you have cover outpatient treatments that are done without staying in the hospital. Present the medical card provided to any panel clinic. 
 
To find a nearby panel clinic, advice your employee to click MyBenefits > Find clinics/Hospital in 
   
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(b) My  medical coverage did not cover outpatient treatments

If your employee's medical plan did not cover for outpatient, you still can go to any clinic and claims. 
  
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

  • 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. 
 

Additional information

  • 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 
 
  • 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.
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