Personal | Personal Accident

Hospital Cash Claim

We note the unfortunate event which has transpired.

Complete and submit your personalized claim form and we will get started with your claim. Asterisks (*) Indicate the required information that is compulsory to complete the submission.

Policy and insured information
Incident details

Home / Personal Hospital Cash Claim

Policy and Insured Information

First name

Surname

Identification number

AIG policy number

Contact number

Alternative contact number

Email address

Residential address

Address line 1

Address line 2

Address line 3

Address line 4

Postal code

Do you have a broker? Yes No

Broker completing the claim form? Yes No

Brokerage name

* Brokerage branch

* Broker name

Broker contact number

* Broker email

* Broker’s claim number

* Broker’s policy number

Home / Personal Hospital Cash Claim

Incident Details

* Provide us with the date and time of the incident

* Was the hospital stay a result of accident or illness? Accident Illness

Detailed description of the incident

* Date of admission

* Date of discharge

Hospital name

Hospital's phone number

Attending doctor details

Doctor's phone number

Has the accident occurred while participating in a competition arranged by a sport club or association or training? Yes No