Get Etiqa Hospitalisation Benefit Claim Form

Filling out the Etiqa Hospitalisation Benefit Claim Form online is a crucial step in securing your hospitalisation benefits. This guide will provide you with clear, step-by-step instructions on how to complete the form efficiently and accurately.

Follow the steps to successfully complete the claim form online.

1. Press the ‘Get Form’ button to access the Etiqa Hospitalisation Benefit Claim Form and open it for editing.
2. In Section A, fully answer every question. This includes entering the contract number, and the name and contact information of your broker or account manager. This information is essential for processing your claim.
3. Gather and attach the required supporting documents listed under ‘Instruction – Supporting documents required.’ These include a certified copy of the hospital bill, identification documents, and medical reports relevant to your claim.
4. Fill in the 'Participant’s Details' section accurately. Provide the participant's name, identification numbers, age, date of birth, marital status, and correspondence address. Make sure to include contact numbers and an email address as this information is crucial for communications.
5. If the claimant is different from the participant, complete the 'Claimant’s Details' section with the same thoroughness, including identification and contact information.
6. In the 'Hospitalisation’s Details' section, record all relevant information about the illness, including dates of diagnosis, symptoms, hospital admission, and discharge. Ensure that all dates are in the correct format.
7. List all medical practitioners and healthcare facilities that provided treatment related to the illness in the past three years. Include date of consultation, names of doctors, and contact information for the facilities.
8. If applicable, provide information about any additional insurance policies that may cover the participant’s health. This includes the name of the company, policy number, and coverage details.
9. Complete the bank account details section for direct payment to the claimant's account, ensuring all information is accurate to avoid payment issues.
10. Read and understand the declaration before signing. Your signature confirms that all provided information is true and complete, which is crucial for the processing of your claim.
11. Finalize the form by saving your changes. You will have options to download, print, or share the completed form for submission.

Take action now and complete your Etiqa Hospitalisation Benefit Claim Form online to secure your benefits.