Get Hospitalsurance Claim Form

Submitting a HospitalSurance Claim Form online can streamline the process of receiving your insurance benefits. This guide provides step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully fill out your claim form.

1. Click ‘Get Form’ button to obtain the HospitalSurance Claim Form and open it in your editing tool.
2. Fill out Section A: Insured Information. Include the name of the insured in English, along with their usual address and contact details. Also, provide the HSBC account number for claim disbursement.
3. Complete Section B: Patient Information. Enter the full name of the insured patient, their date of birth, and occupation. If the patient is not the insured, include supporting documentation proving the relationship.
4. In Section C: Claim Information, describe the injury or sickness in detail. If the claim is due to an accident, provide specifics about the circumstances. Answer whether the patient has seen a doctor for similar conditions in the past and include relevant dates and doctor information.
5. Document the period of hospital confinement by filling in the dates of admission and discharge, along with the name and address of the hospital.
6. For patients hospitalized outside of Hong Kong, fill out the additional information required regarding their usual address, purpose of the trip, and destination.
7. If the patient has been confined to an intensive care unit, note the duration of their stay in that unit.
8. Address Section D: Attending Physician's Statement, ensuring it is filled completely by the attending physician. This section can be filled at the claimants' expense.
9. Complete the Declaration and Authorization section at the end of the form, signing it accurately. Ensure to understand and agree to the Personal Information Collection Statement.
10. After completing the form, review all sections for accuracy. Save your changes, and when ready, download, print, or share the form as necessary to submit to AXA General Insurance Hong Kong Limited.

Start filling out your HospitalSurance Claim Form online today for swift claims processing.