How to Claim

 

1. Claim Process

 

2. How to make claim

 

Claim Types Documents Duration
Disability

Disability due to accident

Requirement Documents

  • Claim event notice
  • Claim request
  • Life certificate (Original)
  • Married Certificate
  • Bank Account of claimant
  • Family book or residence book
  • Birth certificate and ID of LA
  • Birth certificate and ID of claimant
  • Authorization Letter (Both Khmer and English)
  • TPD evaluation letter
  • Police report
  • Medical report and medical summary of treatment

Claim team is responsible to assess the claim request within thirty (30) working days starting from the Claim Registration Date subject to its receiving all the necessary forms and documentary evidence.

Disability due to disease

Requirement Documents

  • Claim event notice
  • Claim request
  • Life certificate (Original)
  • Married Certificate
  • Bank Account of claimant
  • Family book or residence book
  • Birth certificate and ID of LA
  • Birth certificate and ID of claimant
  • Authorization Letter (Both Khmer and English)
  • TPD evaluation letter
  • Medical report and medical summary
Death

Death due to accident cause

Requirement Document

  • Authorization Letter (Both Khmer and English)
  • Birth certificate and ID of claimant
  • Birth certificate and ID of LA
  • Family book or residence book
  • Standing Order cancellation
  • Bank Account of claimant
  • Married Certificate
  • Life certificate (Original)
  • Claim request
  • Claim event notice
  • Death certificate
  • Copy of death certificate
  • Police report
  • Medical report and medical summary (if LA received treatment)

Death due to natural

Requirement Document

  • Authorization Letter (Both Khmer and English)
  • Birth certificate and ID of claimant
  • Birth certificate and ID of LA
  • Family book or residence book
  • Standing Order cancellation
  • Bank Account of claimant
  • Married Certificate
  • Life certificate (Original)
  • Claim request
  • Claim event notice
  • Death certificate
  • Copy of death certificate
  • Medical report and medical summary

 

3. Claim documents

 

 1. Claim Request (used by claimant) download  Claim Request sample download
 2. Claim Event Notice (used by agents) download  Claim Event Notice sample download
 3. Authorization Letter For Disability download  Police report sample download
 4. Authorization Letter For Death download  Medical summary sample  download
 5. TPD Case  Total Permanent Disability download

 

4. Contact Claim:

 

  • Email: [email protected]
  • Phone: 095 964 222
  • Monday to Friday, from 8:00AM to 5:30PM (Except on public holidays)
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