Get Etiqa Form

Filling out the Etiqa Form online is an essential step in submitting your hospitalization insurance claim. This guide will provide you with a clear and structured approach to completing the form accurately and effectively.

Follow the steps to complete your Etiqa Form online.

1. Click the ‘Get Form’ button to access the Etiqa Form and open it in the relevant online editor.
2. Begin by entering your details as the policyholder. Fill in your name, policy number, address, and contact numbers for both your office and residence.
3. Provide information about the person under treatment, including their full name, business or occupation, and date of birth.
4. Detail the nature of the illness or injury, as well as the date when it began.
5. Enter the name and address of the doctor whom the person first consulted regarding the illness or injury.
6. List the name and address of the patient's usual doctor for their medical needs.
7. Indicate whether the patient has previously suffered from the same illness or injury for which you are claiming.
8. State if you have previously claimed or received compensation under a different accident or hospitalization policy, providing necessary details.
9. If applicable, specify if the person is insured under any other policy and provide the names of the insurance companies and the amounts entitled to claim.
10. Claim the amount of expenses incurred by entering the total in the specified field. Ensure to attach the relevant receipted bills.
11. Review all the information provided for accuracy and completeness before proceeding.
12. Once everything is verified, save your changes. You may download, print, or share the completed form as necessary.

Complete your Etiqa Form online today for efficient processing of your hospitalization insurance claim.