• Claims Filing Process (Apart from Death Benefit Claims)

    We always want every convenience for you on every process, including in the process of claiming our products.

Filing a claim if the insured has suffered loss of a limb(s) or eyesight as stipulated in the policy. 

 

Total or Partial Disability Claim Filing Procedures: 

 

  • The claimant is Policy Holder. 

 

Documents required: 

 

  • Claim Form (Sequis Life Form). 
  • Power of Attorney Letter from Claimant (Sequis Life format). 
  • Doctor Information Form (Sequis Life Form).
  • Copy of the identity of the Insured and Claimant. 
  • X-rays results for loss of limbs. 
  • Statement of Accident from the police in the case of a traffic accidents, and from the workplace in the case of a work accident. 
  • If the acceptance of the claim benefit will be authorized to another party, it can only be authorized to the spouse/parent/child, and must submit a power of attorney on the stamp of 6000 provided with a copy of the identity of the grantor and proxy, accompanied by a letter of statement from the head of the sales offices/agency (Sequis Life Form). 

Forms:

Form B - Partial Disability

Claim Form

Submission of claims if the Insured suffers one of the critical illnesses and the policy has a valid Critical Illness Rider. 

 

Critical Illness Claim Procedures (CI/DD/EPCIR/EPCIP/WPDD/PBDD/LPR and other criticall illness products):

  • The claimant is the Policy Polder.

Documents required:

  • Claim Form (Sequis Life Form). 
  • Form of power of attorney from claimant (Sequis Life Format). 
  • Doctor Information form according to the type of disease (Sequis Life Form). 
  • Original policy (will be returned after the claim is processed). 
  • Copy of Policyholder Identification and Claim Submission. 
  • Medical history and examination results during treatment e.g. lab results, X-rays, CT scans, and others that support the disease diagnosis.
  • A Statement of Accident from the police in the case of a traffic accident, and from work in the case of a workplace accident. 
  • If the acceptance of the claim benefit will be authorized to another party, it can only be authorized to the spouse / parent / child, and must submit a power of attorney on the stamp of 6000 provided with a copy of the identity of the grantor and proxy, accompanied by a letter of statement from the head of the sales offices / agency (Sequis Life Form).

Forms:

Claim Form

Doctor Medical Letter Transplant

Doctor Medical Letter Speech Loss

Doctor Medical Letter Rheumatoid Arthritis

Doctor Medical Letter Parkinson

Doctor Medical Letter Pancreas

Doctor Medical Letter Neuro 7 Severe Epilepsy

Doctor Medical Letter Neuro 6 Benign Brain Tumor

Doctor Medical Letter Neuro 5 Stroke Head Trauma

Doctor Medical Letter Neuro 4 Paralysis

Doctor Medical Letter Neuro 3

Doctor Medical Letter Neuro 2

Doctor Medical Letter Neuro 1

Doctor Medical Letter Muscle

Doctor Medical Letter Lung

Doctor Medical Letter Lossing Limb Diabetic Amputation

Doctor Medical Letter Kidney

Doctor Medical Letter Kidney Lupus Nephritis

Doctor Medical Letter Liver

Doctor Medical Letter Kawasaki Progressive Scleroderma

Doctor Medical Letter Idiopatic Scoliosis

Doctor Medical Letter HIV

Doctor Medical LetterĀ Heart 6 Rheumatic Valvular

Doctor Medical Letter Heart 5 Valve Surgery

Doctor Medical Letter Heart 4 MCI

Doctor Medical Letter Heart 3 Coronary Surgery

Doctor Medical Letter Heart 2 Aorta Surgery

Doctor Medical Letter Heart 1

Doctor Medical Letter Crohn's Ulserativecolitis

Doctor Medical Letter Deafness

Doctor Medical Letter Diabetic Retinopathy

Doctor Medical Letter Cancer

Doctor Medical Letter Burn

Doctor Medical Letter Blindness

Doctor Medical Letter Aplastic Anemia

Doctor Medical Letter Alzheimer Demensia

Submission of claims if the Insured or the Policy Holder has a total and permanent disability or the policyholder dies.

 

Procedure for Premium Claim Submission:

 

  • Claim submitted by the Policyholder, unless the risk occurred is the Policyholder died then the person who submitted is the beenficiary of Policy HolderForm (Form Sequis Life). 
  •  

Documents required: 

 

  • Claim Form (Form Sequis Life). 
  • Power of Attorney Letter from claimant (family) (Sequis Life format). 
  • Doctor Information Form (Form Sequis Life). 
  • Photocopy of Policy Holder Identity and Claim Submission that are still valid. 
  • Letter of Acquisition of Policyholder prepared on the seal by the Insured or the Heirs.
  • Accident Certificate from the police when a traffic accident, from the place of work in the event of an accident.

 

Forms:

Form A - Function Loss

Claim Form

Sequis Services

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