HOW TO PROPERLY SUBMIT A CLAIM

1. Make sure that you and your family have active protection.

2. Follow the instructions on how to submit a claim found on your policy.

3. Send a written notice to PT Asuransi CIGNA. Take note of the prescribed deadline from the date the event resulting a claim took place.

4. Ask for required appropriate forms if you do not have them.

5. Complete your claim forms. Answer all questions. Attach all necessary supporting documents.

6. Return your claim forms by the due date.

7. Payment on a valid claim will be made no less than 14 working days upon receipt of complete documents (no further investigation is required).

8. We will transfer the payment you are entitled to directly to your bank account – please provide your bank name and account number.

Please send your completed claim forms to:

PT Asuransi CIGNA
Menara Kadin Indonesia , 6 th Floor
Jl. H.R. Rasuna Said Blok X-5 Kav. 02-03
Jakarta 12950
Attn.: Claim Division
Tel: 021-52996017
Fax: 021-52996007

 

CLAIM SUBMISSION REQUIREMENTS

  Hospitalization and Surgery Claims for Individuals, Direct Marketing and Bancassurance

1. Hospitalization claim form (from CIGNA)
2. Doctor's certificate form (from CIGNA)
3. Original/legalized copy of hospital billing statements and details of transactions
4. Copy of laboratory results (if any)
5. Accident account issued by the police (in case of accident)

 

Death Claim for credit card holders

1. Death claim form (from CIGNA)
2. Doctor's certificate form (from CIGNA)
3. Copy of ID card
4. Copy of legalized family card
5. Original/legalized copy of death certificate from local authority
6. Original/legalized copy of death certificate from head of RT (neighborhood association) / RW (citizen association)
7. Original/legalized copy of accident report issued by the police (in case of accident)
8. Original/legalized copy of hospital's certificate (in case of death caused by illness)
9. Billing statements – 3 months before and 1 month after death

 

Hospitalization Claim for groups

1. Hospitalization claim form (from CIGNA)
2. Treatment resume (from hospital)
3. Original details of transactions (from hospital)
4. Copy of laboratory results (if any)

 

Death Claim for groups

1. Death claim form (from CIGNA)
2. Doctor's certificate form (from CIGNA)
3. Copy of ID card
4. Copy of legalized family card
5. Original/legalized copy of death certificate from local authority
6. Original/legalized copy of death certificate from head of RT (neighborhood association) / RW (citizen association)
7. Original/legalized copy of accident report issued by the police (in case of accident)
8. Original/legalized copy of hospital's certificate (in case of death caused by illness)
9. Attendance list 1 week before and after effecting the insurance

 

Death Claim for credit life

1. Death claim form (from CIGNA)
2. Doctor's certificate form (from CIGNA)
3. Copy of ID card
4. Copy of legalized family card
5. Original/legalized copy of death certificate from local authority
6. Original/legalized copy of death certificate from head of RT (neighborhood association) / RW (citizen association)
7. Original/legalized copy of accident report issued by the police (in case of accident)
8. Original/legalized copy of hospital's certificate (in case of death caused by illness)
9. Bank's claim submission letter
10. Loan ledger / loan amortization

 

Death Claim for individuals

1. Death claim form (from CIGNA)
2. Doctor's certificate form (from CIGNA)
3. Copy of ID card
4. Copy of legalized family card
5. Original/legalized copy of death certificate from local authority
6. Original/legalized copy of death certificate from head of RT (neighborhood association) / RW (citizen association)
7. Original/legalized copy of accident report issued by the police (in case of accident)
8. Original/legalized copy of hospital's certificate (in case of death caused by illness)

 

Revolving Credit permanent/temporary disability claim

1. Disability claim form (from CIGNA)
2. Doctor's certificate form (from CIGNA)
3. Copy of family card
4. Copy of ID card
5. Medical support documents
6. Billing statements 3 months before and 1 month after the incident
7. Accident report issued by the police (in case of accident)

 

Credit Life permanent/temporary disability claim

1. Disability claim form (from CIGNA)
2. Doctor's certificate form (from CIGNA)
3. Copy of family card
4. Copy of ID card
5. Medical support documents
6. Bank's cover letter
7. Outstanding/loan ledger
8. Accident report issued by the police (in case of accident)

 

Customer Service CIGNA

Phone : (021) 5299 6017

Email  : customer.services.indonesia@cigna.com