Accident and Disability Claim

Documents you will need

Submit the following documents within 90 days from the date of your accident.

Documents you’ll need

  • ID copy of life assured and policyowner

  • Copy of supporting document(s), e.g. sick leave certificate, labour assessment certification, X-ray report, police statement, etc.

  • Original medical receipt(s), with the following information clearly indicated:

    • Consultation date

    • Name of patient

    • Diagnosis

    • Breakdown of charges

  • Copy of discharge summary

  • A copy of referral letter from your attending Registered Doctor for the claims of Chiropractor/Physiotherapy/Occupational therapy, Diagnostic X-ray, Laboratory Tests, Home Nursing Service

  • Copy of written recommendation by registered Physician/ Physiotherapist /Occupational therapist for purchasing/renting of medical appliances

  • Complete and sign accident claim form

Please note

  • Part 2 of the claim form must be completed and signed by the life assured’s attending registered physician, at your own cost.

  • Part 3 of the claim form must be completed and signed by the life assured’s employer (for non-self-employed individuals who are claiming temporary disability benefit for over 10 days).

 

Submit the following documents within 180 days from the start date of your disability.

Documents you’ll need

  • ID copy of Life Assured and Policyowner

  • Copies of sick leave certificate with clear diagnosis

  • Copies of supporting document(s), e.g. laboratory report, physiotherapy report, etc.

  • Evidence of gross earnings, e.g. inland revenue tax assessment, salary proof, etc. (for Disability Income Benefit claim only)

  • Complete and sign the disability claim form

Please note

Part 1 of the claim form must indicate your cheque currency (for US currency cheques, please indicate if it’s a local or overseas cheque)

Part 2 of the claim form must be completed and signed by the life assured’s attending registered physician, at your own cost.

Submit the following documents within 90 days from the start date of your dysfunction.

Documents you’ll need

  • ID copy of Life Assured and Policyowner

  • Copies of sick leave certificate with clear diagnosis

  • Copies of supporting document(s), e.g. laboratory report, physiotherapy report, etc.

  • Evidence of gross earnings, e.g. inland revenue tax assessment, salary proof, etc. (for Disability Income Benefit claim only)

  • Complete and sign the Long Term Care Claim Form

Please note

Part 1 of the claim form must indicate your cheque currency (for US currency cheques, please indicate if it’s a local or overseas cheque)

Part 2 of the claim form must be completed and signed by the life assured’s attending registered physician, at your own cost.

Frequently asked questions

Need help with the forms? We’ve prepared some sample claim forms to assist you.

Sample accident claim form

Sample disability claim form

These samples are for reference only. They do not guarantee successful claims or constitute any contract or any part thereof between Prudential Hong Kong Limited and any other parties.

Yes, you can request for certified true copy of medical receipt(s) by filling the Form of Request For Certified True Copy Of Medical Receipt(s). You have to submit the signed and completed form together with the original medical receipt(s) at the same time. You must specify the delivery option. Correspondence address must be provided if the certified true copy is delivered by post. Mainlander may request for returning original medical receipt if it is issued by mainland hospital. Please contact your Financial Consultant for details.

Yes, it is mandatory in order for us to assess your claim. Unfortunately, you bear the cost of consultation. However, should your condition meet a selected criteria, we can do without this part of the claim form. Do reach out to your financial consultant for more details.

Before we reach a decision to pay the claim, you are obliged to pay the premiums to keep the policy in force. After we had admitted the Waiver of Premium claim, we will then refund the premium paid for the waiver period.

Claim forms to download

Frequently asked questions

Need help with the forms? We’ve prepared some sample claim forms to assist you.

Sample accident claim form

Sample disability claim form

These samples are for reference only. They do not guarantee successful claims or constitute any contract or any part thereof between Prudential Hong Kong Limited and any other parties.

Yes, you can request for certified true copy of medical receipt(s) by filling the Form of Request For Certified True Copy Of Medical Receipt(s). You have to submit the signed and completed form together with the original medical receipt(s) at the same time. You must specify the delivery option. Correspondence address must be provided if the certified true copy is delivered by post. Mainlander may request for returning original medical receipt if it is issued by mainland hospital. Please contact your Financial Consultant for details.

Yes, it is mandatory in order for us to assess your claim. Unfortunately, you bear the cost of consultation. However, should your condition meet a selected criteria, we can do without this part of the claim form on discretion. Do reach out to your financial consultant for more details.

Before we reach a decision to pay the claim, you are obliged to pay the premiums to keep the policy in force. After we had admitted the Waiver of Premium claim, we will then refund the premium paid for the waiver period.

Submission instructions

Mail us your completed forms & relevant documents
Our mailing address
P.O. Box No. 28058, Gloucester Road Post Office, Hong Kong

Send claim form and relevant documents to your financial consultant and they will manage the claims for you

Frequently asked questions

Need help with the forms? We’ve prepared some sample claim forms to assist you.

Sample accident claim form

Sample disability claim form

These samples are for reference only. They do not guarantee successful claims or constitute any contract or any part thereof between Prudential Hong Kong Limited and any other parties.

Yes, you can request for certified true copy of medical receipt(s) by filling the Form of Request For Certified True Copy Of Medical Receipt(s). You have to submit the signed and completed form together with the original medical receipt(s) at the same time. You must specify the delivery option. Correspondence address must be provided if the certified true copy is delivered by post. Mainlander may request for returning original medical receipt if it is issued by mainland hospital. Please contact your Financial Consultant for details.

Yes, it is mandatory in order for us to assess your claim. Unfortunately, you bear the cost of consultation. However, should your condition meet a selected criteria, we can do without this part of the claim form. Do reach out to your financial consultant for more details.

Before we reach a decision to pay the claim, you are obliged to pay the premiums to keep the policy in force. After we had admitted the Waiver of Premium claim, we will then refund the premium paid for the waiver period.

Our Claims Promise

Our commitment to you is to pay your claim as quickly as possible, with compassion and care.

Learn more
Our Claims Promise

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