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ACPG Claims Guidelines



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   Insurance


INSURANCE

CLAIMS GUIDELINES
 

IN THE EVENT OF ANY OCCURRENCE WHICH MIGHT GIVE RISE TO A CLAIM UNDER THE POLICY, THE INSURED SHALL:

  1. Immediately notify the APG/ICnsurers by telephone as well as in writing, giving an indication as to the nature and extent of loss or damage.
  2. Notify the police immediately.
  3. Take all steps within power to minimize the extend of the loss or damage, and to take all practical/reasonable steps to recover the property lost.
  4. Co-operate with the adjusters when called upon.
  5. Do Not admit liability to Third Party.

NON-MOTOR CLAIMS SUPPORTING DOCUMENTS

A. WORKMEN’S COMPENSATION

  1. Medical chits certifying the period of disability or Form L90.

  2. Medical Report if the period of disability exceeds 14 days.

  3. Labour Assessment if the accident is reported to the Commissioner for Labour.

  4. Form G, H or P wherever applicable (form Commissioner for Labour).

  5. Wage record of the injured workman for the last six months or it is not available, wage record of another employee of similar occupation for the past six months.

  6. Where claims involving serious or fatal injuries to employee/s or where is suggestion of potential common law liability, there may be a need on our part to appoint adjusters to investigate the accident and witnesses’ statement wherever possible are required.

  7. Police report sketch plans and photographs, if involving vehicular accident.

  8. Post Mortem and death certificate if it is fatal case.

  9. Completed Claim Form.

B. PERSONAL ACCIDENT

  1. Police Report if involving a vehicle accident.

  2. Medical or Specialist Report wherever applicable.
    (No medical report is required for PA claims less than RM250 and Sinseh Treatment)

  3. Original Official Receipt for medical expenses.

  4. Photocopy of Identity Card (Both sides).

  5. If fatal cases, Post Mortem and Death Certificate.

  6. Letters of Administration (for individual person if there is no nomination).

  7. For serious injury or fatal cases, adjuster.

  8. Driving licence if the injured person is driving the vehicle.

  9. Completed Claim Form.

C. HOSPITAL AND SURGICAL INSURANCE

  1. Medical Report

  2. Bills / Invoices

  3. Receipt

  4. Other supporting documents

  5. Police Report (For road accident)

  6. Completed Claim Form

D. FIRE / HOUSEOWNERS / HOUSEHOLDERS CLAIMS

  1. Police report

  2. Fire Brigade Report

  3. Chemist Report (government) (if available)

  4. Sales / Purchase Invoices

  5. Stock Records

  6. Balance Sheet & Profit & Loss Account

  7. Quotation for repairs / replacement

  8. Photographs of damages sustained

  9. Photocopies of all licensed for business operations

  10. Audited accounts / Personal income-tax in respect of the business for the past 3 year

  11. Completed Claim Form

E. MONEY / BURGLARY CLAIMS

  1. Police Report.

  2. Receipts / Collection Records.

  3. Petty Cash records, receipt, collection record (if cash is covered under the policy).

  4. Cash Book / Ledger / Journal.

  5. Banking Slips.

  6. Other relevant documents.

  7. Photographs of premises where entry is gained into.

  8. Repair / Replacement bills for damages to premises, if covered.

  9. Purchase Invoices.

  10. Stock Cards (for stock claim).

  11. Completed Claim Form.

F. ALL RISKS / ENGINEERING CLAIMS

  1. Police Report, if any.

  2. Purchase Invoices.

  3. Quotation for repairs / replacement where applicable photographs depicting damages.

  4. Completed Claim Form.

G. GOOD IN TRANSIT CLAIM

  1. Police report lodged by driver / attendant.

  2. Delivery Order / Receipt

  3. Suppliers’ Invoices

  4. Packing Lists

  5. Repair / Replacement Bills

  6. Copy of the contract of Agreement

  7. Copy of Road-Tax Disc, Registration Card, Identification Card, Driving Licence

  8. Completed Claim Form

H. GOLFER’S CLAIM

  1. Photograph of damaged club / clubs

  2. Purchase Invoice / Repair Bill

  3. Club Membership Card

  4. For Hole-in-one Claim (i.e: Score Card, Letter from Golf Club confirming the same, Entertainment Expenses (original copy)

  5. Completed Claim Form

I. MACHINERY & EQUIPMENT ALL RISKS CLAIMS

  1. Police report, if any

  2. Purchase Invoices

  3. Quotation for repairs / replacements

  4. Photographs of damage

  5. Completed Claim Form

J. PUBLIC LIABILITY CLAIM

  1. Contract of Agreement between Insured.

  2. Police report lodged by insured / claimant.

  3. Internal report following the discover of the loss.

  4. Photograph surrounding the vicinity & loss.

  5. Completed Claim Form.

K. FIDELITY GUARANTEE CLAIM

  1. Police Report.

  2. Copy of Identity Card of Defaulter.

  3. Copies of letter of Appointment and termination of Defaulter.

  4. Salary / Bonus due to the Defaulter.

  5. Proof of money / stock defaulted.

  6. Name & address of guarantor/s, if any.

  7. The defalcator’s EPF No.

  8. Internal Report stating the following:-
    (a) The circumstances leading to the discovery and the follow-up investigation action taken with the parties involved.

  9. Completed Claim Form.

L. MARINE CLAIM

Marine Cargo

  1. Original Marine Policy or Certificate of Insurance. (If not available. Letter of Indemnity).

  2. Original Bill of Lading or Airway Bill (With reserve side) and / or other contract of carriage. (If not available. Letter of Indemnity).

  3. Lorry Delivery Note / Consignment Note.

  4. Supplier’s Invoice.

  5. Survey Report or other documentary evidence to show extent of loss of damage.

  6. Copies of correspondence exchange with the Carrier, Port Authority and Forwarding Agents regarding their liability for the loss / damage together with their reply.

  7. Claim Bill.

  8. Completed Claim Form.

Marine Hull

  1. Class Certificate

  2. Ship’s License

  3. Safety Equipment Certificate

  4. Loadline Certificate

  5. Certificate of Competency of Master

  6. Repair / Salvage Bills

  7. Completed Claim Form

ADDITIONAL DOCUMENTS (Depending on the type of loss)

  1. Non-Delivery of Short landed Certificate.
  2. Inward Survey (landing account).
  3. Outward Survey.
  4. Copy of custom declaration.
  5. Packing List.
  6. Repair / Replacement bills.
  7. Chemist’s or Laboratory Analysis Report.
  8. Weight Notes / tally sheets at loading port and final destination.
  9. Stowage Plan.
  10. Copy of Master’s Sea Protest.
  11. Certified copy of the ship’s log book.

MOTOR CLAIMS SUPPORTING DOCUMENTS

OWN DAMAGE / THEFT / TOTAL LOSS / CONSTRUCTIVE TOTAL LOSS

  1. Claim Form
  2. Statement of Accident – only use for motor cycle theft.
    - Insured
    - Driver
  3. Registration Card
  4. Police Report
  5. Insured’s I/C & Driving Licence
  6. Driver’s I/C & Driving Licence
  7. Road Tax Disc
  8. Policy Schedule
  9. Proposal Form
  10. Workshop Estimate
  11. Commercial Vehicle Transport Permit
  12. Hire Purchase Agreement
  13. Original Photographs
  14. Register Bill
  15. Other Bills

WINDSCREEN

  1. Claim Form
  2. Registration Card
  3. Insured’s I/C & Driving Licence
  4. Driver’s I/C & Driving Licence
  5. Policy Schedule
  6. Proposal Form
  7. Original Photographs
  8. Repair Bill

THIRD PARTY PROPERTY DAMAGE (TPPD) / BODILY INJURY (TPBI)

  1. Claim Form
  2. Police Report
  3. Insured’s I/C & Driving Licence
  4. Driver’s I/C & Driving Licence
  5. Registration Card
  6. Road Tax Disc
  7. Policy Schedule
  8. Proposal Form
  9. Commercial Vehicle Transport Permit
  10. Compound Notice
  11. Submit any T/P Claimant Letters, Notices or Summons immediately


   ACPG Management Sdn Bhd
   158-3-7, Blok 158, Kompleks Maluri,
   Jalan Jejaka, Taman Maluri, Cheras,
   55100 Kuala Lumpur.
   Tel: +603-9286 3323
   www.acpgconsultant.com
     
   
 
   
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