Knowing how to make an insurance claim correctly is as important as having the coverage. A wrong or incomplete claim can result in delays, partial payment, or rejection. Here is the step-by-step guide for each main type of insurance claim in Malaysia.
Medical Insurance Claim (Cashless)
1. Verify you are at a panel hospital. 2. Present your insurance card or policy number at admission. 3. Sign the letter of guarantee (LOG) request — the hospital sends to insurer directly. 4. Insurer approves LOG for covered treatment amount. 5. At discharge, pay only the excess/co-pay and non-covered items. 6. Keep all receipts and discharge summary.
Medical Insurance Claim (Reimbursement)
1. Pay hospital bills upfront. 2. Collect: original bills, official receipts, discharge summary, attending doctor's report. 3. Submit claim form + documents to insurer within 30–90 days (check your policy). 4. Insurer processes within 14–30 working days. 5. Payment made to your bank account.
Life Insurance Claim Process
1. Notify insurer immediately (within 30 days of death). 2. Documents: death certificate, policy document, certified IC copies of deceased and claimant, medical report if illness-related death. 3. Insurer investigates within 14 days. 4. Payment to named beneficiary within 30 days of complete documentation.
Motor Insurance Claim
1. Take photos immediately at accident scene. 2. Get police report within 24 hours. 3. Submit claim form + police report + photos to insurer within 7 days. 4. Bring car to approved workshop. 5. Insurer assesses and approves repair or pays total loss.
If Your Claim Is Rejected
1. Request written explanation from insurer. 2. Appeal to insurer's internal appeal unit. 3. If unresolved, escalate to OFS (Ombudsman for Financial Services) — free to use, binding on insurers for claims up to RM250,000.