22 January 2021
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Application Procedure
For new application please submit following document :
Copy of Valid ID (KTP/SIM/Passport /Kitas)
Birth certificate (for Insurer below 17 year)
Fully filled and Signed Application and Medical Questions
Medical Questioner for related illness (if any )
Claim Related Download Center For Individual
For USD Plan
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Claim Procedure for Health Insurance
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Claim Procedure for Travel Insurance
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Claims Submission Slip - USD
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Individu Outpatient/Inpatient Claim Form
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Dental Claim Form
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Oral Examination Report
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Claim Form for Travel Insurance
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Referral for Follow Up Care
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Treatment Plan for Chemotherapy Radiotherapy
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Treatment Plan for Physiotherapy Chiropractic Acupuncture
For IDR Plan
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Individu Outpatient/Inpatient Claim Form
Claim Related Download Center For Group
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Claims Procedure For Healthy Group
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Pengecualian Polis
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Persyaratan Santunan Kematian
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Dental Claim Form
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Group Outpatient & Inpatient Claim Form
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Maternity Claim Form
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Surat Kematian
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