1. What should I do to make a claim?

•  Make sure that you and your family's insurance are still active
•  Follow the claim procedures written on your insurance policy.
•  Send a written notice to PT Asuransi CIGNA. Please take note of the deadline set from the date of the event resulting in the claim. Ask for the appropriate claim-submission form if you don't have any.
•  Thoroughly fill in the claim form. Answer all questions. Attach your supporting documents. Return your claim form within the period specified.
•  Write your bank's name, branch and account number for claim payment.

Please send the complete claim documents to:
PT Asuransi CIGNA
Menara Kadin Indonesia , 6th Floor
Jl. HR Rasuna Said Blok X –5 Kav. 02 – 03
Jakarta 12950
Tel. 021 – 5299 6017 / 0804-1-808080
Fax. 021 – 5299 6007
Attn. Claim Department

 

2. What documents are required in order to make a claim?

Different documents are required, depending on the type of insurance you may have. Insurance claims are generally classified as follows:

Hospitalization and Surgery Claims

1. Treatment 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. Original/legalized accident account issued by the police (in case of accident)

 

Death Claim

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. For credit card protection: billing statements – 3 months before and 1 month after death
10. For credit card protection: bank's claim submission and loan ledger/loan amortization

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. Laboratory test results/medical support documents (original/legalized copy)
6. Bank's cover letter
7. Loan ledger/loan amortization
8. Accident report issued by the police (in case of accident)

 

3. How long will it take to receive a claim payment?

Payment for a valid claim will be made no less than 14 working days after submission of complete documentation (no further investigation is necessary ).

4. What kind of information is necessary for me to know if want to make a claim?

Make sure that the claim does not include pre-existing conditions and excluded items, and is not submitte d within the 15-day deferment period (stated in the insurance policy).

5. Can I send photocopies of the required documents in order to send a claim?

 When sending a claim, the only original copy required is the completed claim form. You may send photocopied and legalized supporting documents.

Download Form	Descriptions	Size	Action
Hospital Income Claim Form	If you want to claim hospital benefit, please download this form	19 kb	> download