1. How do I file a claim?
-Online claim submission, please refer
here
-visit your nearest TMLM branch to submit the documents required. Please refer
here for
the list of required documents
-email us at customercare@tokiomarinelife.com.my
2. What happens next after I submit a claim?
Once a claim has been submitted to us, we will assess and determine if further documents
are required. If so, you will be notified in writing or you can refer
here for any letter issued.
3. How can I check the status of my claim?
You may check the status of your claim via the following options:
- track your claim
here
- contact Customer Service Hotline at 03-2603 3999
- email us at customercare@tokiomarinelife.com.my
- contact the claim submission branch or any TMLM branch nationwide. Please refer
here
4. Can I file medical reimbursement claim with photocopy, duplicated
copy or certified true copy of receipts?
Original receipt(s) is required to process medical reimbursement claim. However,
should the original receipt(s) be lost or misplaced, kindly make a declaration in
writing on loss of original receipt and submit it with a copy of the lost receipt(s)
certified by the issuing party. For medical reimbursement claim via e-Claims Submission,
original copy of receipts should be sent to your servicing agent or your nearest
TMLM branch in order for us to release the claim monies.
5. If my employer or other insurance company did not fully reimburse
the medical expenses incurred, can I file claim for the balance under medical plan
in TMLM?
Yes, you shall submit a duly completed Hospitalisation & Surgical Claim Form by
Claimant, a copy of Medical Attendance Report / Attending Physician Statement, a
copy of claim settlement letter issued by your employer or other insurer and a copy
of the bill(s) & receipt(s) certified by your employer or other insurer.
6. What is co-insurance?
Co-insurance refers to a cost sharing arrangement between you and the insurer as
stated in the policy annexure (if any). It is derived from a specified percentage
of the eligible claim amount.
7. How would the claim monies be paid?
In line with the effort of Bank Negara Malaysia in migrating from paper-based payments
to electronic payments, we will issue claim monies via e-Payment facility only.
e-Payment is defined as payment via direct deposit into the rightful payee’s bank
account. You are required to update us the bank account number of the rightful payee
while submitting the claim.
8. What will happen to the claim monies if the e-Payment facility
fails?
If claim monies cannot be credited into the rightful payee’s bank account due to
incorrect bank account number, joint bank account, closed or dormant bank account,
you will be notified and requested for another bank account number in order for
us to issue payment.
9. How long will it take to settle my claim?
The time taken depends on the completeness of the claim documents submitted. The
claim monies will be ready within 14 working days from the last document received
date. However, for contestable claim (policy in force for less than 2 continuous
years) which warrants investigation, it will take longer subject to the findings
gathered.
10. If I’m not satisfied with the claims decision, can I appeal
for reassessment?
If there is dissatisfaction with the claims decision, Policy Owner may write in
with relevant supporting documents for us to reassess the claim. Or alternatively,
submit your appeal
here
11. For any other enquiry, please refer here
