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HOSPITALIZATION CLAIM FORM 住院賠償申請書. PART I (TO BE COMPLETED BY INSURED/CLAIMANT) 第一部份 ( 由受保人或申請人填寫) n. AIA International Limited. (Incorporated in Bermuda with limited liability) This case is a 本個案為: New Claim 首次索償. Further Claim 再度索償. Pending Claim 待決賠償.
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CLAIM FORM (GENERAL) This Form is issued without prejudice to any of the Stipulations or Constitutions of the Company’s Policy, and is not to be taken as an admission of liability on the part of the Company. This Form should be completed and returned
Please complete this Claim Form in Block Letters and provide all supporting documents to the Company within 30 days to avoid delay in claim process. The Company is entitled to request for further information, documents or other specific claim form to be
In case you want to claim for other benefits such as critical illness, disability benefits, etc., you have to complete an appropriate claim form of that respective claim type and file it in together with the necessary supporting evidence.
If如是,請提供社會保障編號yes, please provide your social security number. AIG HK is a subsidiary of US company and as such is required to report injury claims of U.S. citizens who may be eligible to receive “Medicare” (pursuant to the Medicare, Medicaid & SCHIP Extension Act of 2007).
CLAIM FORM 意外賠償申請書. PART I (TO BE COMPLETED BY INSURED/CLAIMANT) 第一部份 (由受保人或申請人填寫 ) AIA International Limited. (Incorporate d in Bermuda with limited liability) O0652041. This case is a 本個案為: Page 1 of 4. OPCLMF02.0515. PART II TO BE COMPLETED BY THE ATTENDING PHYSICIAN / SURGEON AT THE CLAIMANT'S OWN EXPENSES. 第二部份申請人自費由主診醫生/手術醫生填寫.
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