GENERAL A claim shall be a demand for a right as a consequence of the compliance of pre-defined terms of the agreement.
SPECIFIC A Life Insurance Claim shall be a demand from the Policy holder/assignee to the Insurer for the payment of an amount of Sum Insured (UP) or Cash Balance as a consequence of the compliance of terms of the insurance agreement.
BASES OF CLAIM
Death of the Beneficiary.
The policyholder ceases premium payment and terminates the insurance agreement when the policy has incurred a cash balance.
The insurance agreement has expired according to the period specified in the policy and the obligations of its holders have been complied with, or the policy has lapsed but already had cash balance (expiry of paid-up contract).
The Beneficiary has an accident.
The Beneficiary, due to a disease, requires inpatient or outpatient medical care.
TYPES OF CLAIM
Claim for death.
Claim for policy/Cash Balance redemption.
Claim for contract expiry.
Medication.
Claim for inpatient and outpatient.
Claim for Death The claim arises when the beneficiary or applicant specified in the policy has passed away while the policy is in force.
Claim for Redemption The claim arises when the policy has incurred cash balance, while the policyholder terminates its insurance agreement.
Claim for Contract Expiry The claim arises when the period of insurance agreement has expired, while the policy is in force (the premium has been paid for the contract period).
Claim for Accident The claim arises when the applicant has an accident and the policy is still in force.
Claim for Inpatient and Surgery Insurance + Outpatient The claim arises due to the applicant has a disease and requires inpatient or simply outpatient medical care.
A. INDIVIDUAL INSURANCE CLAIM A.1. Claim for Death
Original policy or duplicate policy in case the original is lost or certificate in lieu of policy/acknowledgement of indebtedness in case the original policy is pledged as loan security.
Original receipt of the last premium payment.
Certificate of death from Lurah/Kepala Desa (Sub-District/Village Head) legalized by Camat (District Head), or Death Certificate.
Certificate from the Police or competent authority in case the beneficiary passed away by an accident.
Claim application for death.
Claim questionnaire.
Medical certificate from Physician/Hospital in case the beneficiary passed away during medical care of the Physician/Hospital.
Copy of family card (as applicable).
Power of attorney from the assignee in case of multiple assignees and temporarily prevented.
Letter of decision on guardian from the District Court in case the assignee has not been in legal age, while the parents have passed away.
Letter of decision on heir from the District Court in case the Policy Holder appointed to receive the benefit has passed away.
A.2. Claim for Contract Expiry
Original policy or duplicate policy in case the original is lost or certificate in lieu of policy or acknowledgement of indebtedness in case the original policy is pledged as loan security.
Original receipt of the last premium payment.
Claim application.
Copy of identification of the Policy Holder.
Note: In the event that the original or duplicate policy is lost, the Policy Holder shall prepare a statement of lost Policy, duly stamped and supported by Police report.
A.3. Claim for Redemption
Original or duplicate policy.
Original receipt of the last premium payment issued by AJB Bumiputera 1912.
Filling out and submitting claim application.
Identification/ID Card/ Driver's License of the policy holder/beneficiary.
B. COLLECTIVE INSURANCE CLAIM B.1. Claim for Death
Original policy or duplicate policy in case the original is lost or certificate in lieu of policy.
Copy of receipt of the last premium payment.
Certificate of death from Lurah/Kepala Desa (Sub-District/Village Head) legalized by Camat (District Head), or Death Certificate.
Certificate from the Police or competent authority in case the beneficiary passed away by an accident.
Claim application for death (Ask.12).
Claim questionnaire.
Copy of loan certificate (Credit Insurance only).
Medical certificate from Physician/Hospital in case the beneficiary passed away during medical care of the Physician/Hospital. (Ask. 12a).
B.2. Claim for Contract Expiry
Original policy or duplicate policy in case the original is lost or certificate in lieu of policy.
Copy of receipt of the last premium payment.
Claim application.
Copy of identification of the Applicant.
Note: In the event that the original or duplicate policy is lost, the Policy Holder shall prepare a statement of lost Policy, duly stamped and supported by Police report.
B.3. Claim for Redemption
Original or duplicate policy.
Original receipt of the last premium payment issued by AJB Bumiputera 1912.
Filling out and submitting claim application.
Identification/ID Card/ Driver's License of the applicant.
B.4. Claim for Medication due to Accident
Claim application from the Policy Holder.
Copy of the Policy.
Copy of the last premium payment.
Receipt of medication and care expenses.
Verbal process from the Police in case of accident.
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