Group Health & Personal Accident Insurance Claims

Claims Process

STEP 1

The policyholder notifies the company.
STEP 2

The company sends its claims adjuster or an independent adjuster for detailed inspection of the documents if it is a fatal accident claim. (if necessary).
STEP 3

In the case where the damages are minor and there are no suspicious incidents to report

The company will inform the policyholder or the claimant to submit the required documents for claims considerations.
STEP 4

Upon approval of the claim, the Company will notify the policyholder or the claimant on the proposed compensation amount. With reasons and supporting information, the payment date will then be determined.
STEP 5

In case if disputes were made towards the proposed compensation, an appointment will be made with the policyholder or the claimant to discuss, clarify or present additional details. Once the negotiations are over, the Company will pay the agreed compensation through bank transfer or cheque.
STEP 6

In cases where the company discovers that a coverage is not within the policy conditions, the company will send out a notification letter stating the reasons why the compensation could not be approved.
STEP 7

If the policyholder receives treatment in an in-network hospital, the company will receive documents directly from the hospital and pays the hospital bills in due.

Additional guidance of accident & health claims

A. Health & accident reimbursement claims

Claim form
Medical certificate/past medical history. Insured/beneficiary are responsible for document fees - if any.
Laboratory/pathology/investigation Result
Original receipt with breakdown/itemized invoice
Copy of ID/passport/birth certificate (for dependent only). All documents must be signed of true copy.
Copy of passbook
Signed consent form for release of medical history (upon request)

B. Hospital incentive/hospitalization cash benefit claims

Document as listed in (A) with copy of receipt and medical certificate. The original document of receipt & medical certificate is not required.

C. Incentive benefit of cancer & other critical illness claims

Document as listed in (A) with copy of receipt and medical certificate. The original document of receipt & medical certificate is not required. Signed consent form for release of medical history (upon request).
Laboratory/biopsy/pathology/investigation result

D. Incentive benefit of total disability – TPD & dismemberment claims

Claim form
Medical certificate/past medical history and rehabilitation report. Insured/beneficiary are responsible for document fees - if any.
Physician statement of disability’s evaluation with hospital stamp
Photos of disabled person/evidence of incident or damage
Police report with police's case summary (if any) on date of accident.
Laboratory result of blood alcohol level at the date of incident incurred
Copy of ID/passport/birth certificate (for dependent only). All documents must be signed of true copy.
Copy of passbook
Signed consent form for release of medical history (upon request)

E. Death Claims

Claim form
Death certificate and physician statement of the death with hospital stamp
Autopsy report/postmortem examination/forensic report
Laboratory result of blood alcohol level at the date of incident incurred
Evidence of incident/photos of damage
Medical report/past medical history
Police report and policy case summary
Copy of dead person's ID/passport/house registration with death stamp
Copy of beneficiary (s) ID/passport/house registration
Copy of the beneficiary's passbook

Contact us
Accident and Health Claims Department

Chubb Samaggi Insurance Public Company Limited
2/4 Chubb Tower, 12th Fl., Northpark Project, Vibhavadi-Rangsit Rd., Thung Song Hong, Laksi, Bangkok 10210.

Tel. 1758

Email: ClaimmailA&H@Chubb.com

Claim consideration period
a. Within 1-7 working days for a minor, uncomplicated damage claim that requires a few supporting documents for the claim process.

b. In the case of major damages or a complicated claim i.e. claim amounting to hundreds of thousands, or millions in Thai Baht of damages, requires a specialist team of adjusters to be involved in proving damages, requires necessary documents or evidence, has unclear/vague incidents, or with doubts, the Company may take time to verify the claim made. The Company will require close coordination with the policyholder to complete the process within the expected time frame.

Reimbursement period
Within 15 days from the date of signing the compensation contract

Disclaimers

The company reserves the right to make changes in services and conditions without prior notice.

donwload