How to Claim
Personal Accident Cover
For a Hospitalisation Claim:
- Complete Claim Form
- Detailed hospital account indicating date of admission, discharge and diagnosis.
- If a smart card ID has been issued, we cannot accept the green barcode ID and copies of the front and the back of the smart card ID are required.
- All diagnostic tests that were done with regards to this hospitalisation.
- Complete hospital file, including the medication charts, observation charts, doctor’s clinical notes, nurse’s notes, etc.
- A non-specific medical history from the patients’ family doctor prior to inception of the policy.
- A medical report from the treating doctor with specific reference to the first date diagnosed of the condition.
- A comprehensive clinical report from the treating specialist explaining why it was clinically necessary for the patient to remain in hospital for a period of X- days including the treatment.
- Pathology reports (FBC,-complete full blood count results, ESR, CRP results etc.)
- Radiology report includes: Either a X-ray of the chest or a CT scan of the chest.
- Hospital account reflecting diagnosis, admission & discharge dates.
- Payslip for the month that you were hospitalised.
For a Total Temporary Disability Claim:
- Complete Claim Form
- Certified copy of the insured’s ID.
- If a smart card ID has been issued, we cannot accept the green barcode ID and copies of the front and the back of the smart card ID are required.
- Confirmation of earnings.
- Employers report of incident (for injuries on duty).
- Initial, progress and final medical reports from the treating doctor.
- Resumption report from the employer.
- Medical certificates from the treating doctor/s indicating the TTD dates.
For a Total Permanent Disability Claim:
- Complete Claim Form
- Certified copy of the insured’s ID.
- If a smart card ID has been issued, we cannot accept the green barcode ID and copies of the front and the back of the smart card ID are required.
- Confirmation of earnings.
- Employers report of incident (for injuries on duty).
- Initial, progress and final medical reports from the attending doctors / specialists indicating the following:
- The injuries sustained in the accident.
- The prognosis and whether the condition is likely to improve with further treatment.
- When is the condition likely to stabilise.
- Indicate the functional impairments and express as a percentage (%) the extent of possible permanent disability.
- Is the insured likely to resume his usual or any occupation?
Please note that once these documents are submitted and claim registered, insurers may request further documentation to support the claim. These will be requested from you and will be for your own account.
