Claims
Accident
Claim Form – Accident Claim Form
- Claim Form Part I: duly completed by the policyowner (If the insured is age 18 or above, the claim form should also be signed by the insured)
- Claim Form Part II: duly completed by the insured’s attending physician at the claimant’s own expense
- Original medical receipt(s) and Statement(s) of Charges
- Copy of Discharge Summary / Discharge Slip (if applicable)
- Copy of Laboratory / X-ray / CT scan/ MRI / Pathological Report(s)
- Copy of Admission Note, Discharge Summary, Discharge Certificate, Daily Medical Record & Temperature Sheet of hospital in Mainland China (if applicable)
- Copy of Sick Leave Certificate with clear diagnosis
- Copy of Physiotherapy / Occupational Therapy Report(s)
- Copy of X-ray / Physiotherapy / Occupational Therapy/ Chiropractic Treatment referral letter by Registered Medical Practitioner
- Copy of Compensation Breakdown from other insurer/ party (if applicable)
- Copy of identity proof document of the insured and policyowner
** The Company may request for the submission of extra information/ documents on case by case basis**
- Copy of medical receipt(s) and Statement(s) of Charges (Optional)
- Copy of Discharge Summary / Discharge Slip (if applicable)
- Copy of Laboratory / X-ray / CT scan/ MRI / Pathological Report(s)
- Copy of Admission Note, Discharge Summary, Discharge Certificate, Daily Medical Record & Temperature Sheet of hospital in Mainland China (if applicable)
- Copy of Sick Leave Certificate with clear diagnosis
- Copy of Physiotherapy / Occupational Therapy Report(s)
- Copy of X-ray / Physiotherapy / Occupational Therapy/ Chiropractic Treatment referral letter by Registered Medical Practitioner
- Copy of Compensation Breakdown from other insurer/ party (if applicable)
- Copy of identity proof document of the insured and policyowner
** The Company may request for the submission of extra information/ documents on case by case basis**
Notify the Company within 20 days from the date of accident and submit the documents to the Company within 90 days from the date of accident by
- your Insurance Consultant;
- mailing to “Tahoe Life Insurance Company Limited, Life Administration Department –Claims Team: 15/F, Cityplaza One, 1111 King’s Road, Taikoo Shing, Hong Kong”; or
- visiting our customer service centre at Suites 1901-03, 19/F Cityplaza One, 1111 King’s Road, Taikoo Shing, Hong Kong
Hospitalization
Claim Form – Hospitalization Claim Form
- Claim Form Part I: duly completed by the policyowner (if the insured is age 18 or above, the claim form should also be signed by the insured)
- Claim Form Part II: duly completed by the insured’s attending physician at the claimant’s own expense
- Original hospital receipt(s) and Statement(s) of Charges
- Copy of Discharge Summary / Discharge Slip (if applicable)
- Copy of Laboratory / X-ray / CT scan / MRI / Pathological Report(s)
- Copy of Admission Note, Discharge Summary, Discharge Certificate, Daily Medical Record & Temperature Sheet of hospital in Mainland China (applicable to admission in Mainland China)
- Copy of referral letter by Registered Doctor/ Hospital
- Copy of Compensation Breakdown from other insurer/ party (if applicable)
- Copy of identity proof document of the insured and policyowner
** The Company may request for the submission of extra information/ documents on case by case basis**
- Copy of hospital receipt(s) and Statement(s) of Charges
- Copy of Discharge Summary/ Discharge Slip (if applicable)
- Copy of Laboratory / X-ray/ CT scan/ MRI/ Pathological Report(s)
- Copy of Admission Note, Discharge Summary, Discharge Certificate, Daily Medical Record & Temperature Sheet of hospital in Mainland China (applicable to admission in Mainland China)
- Copy of referral letter by Registered Doctor/ Hospital
- Copy of Compensation Breakdown from other insurer/ party (if applicable)
- Copy of identity proof document of the insured and policyowner
** The Company may request for the submission of extra information/ documents on case by case basis**
Notify the Company within 30 days from the date of admission and submit the documents to the Company within 90 days from the date of admission by
- your Insurance Consultant;
- mailing to “Tahoe Life Insurance Company Limited, Life Administration Department – Claims Team: 15/F, Cityplaza One, 1111 King’s Road, Taikoo Shing, Hong Kong”; or
- visiting our customer service centre at Suites 1901-03, 19/F Cityplaza One, 1111 King’s Road, Taikoo Shing, Hong Kong
Death
- Claim Form Part I: duly completed by the claimant/ beneficiary
- Claim Form Part II: duly completed by the insured’s attending physician at the claimant’s own expense (applicable to policy which has been effective less than 2 years from policy issue or reinstatement date, whichever is later)
- Certified true copy of identity proof document of the insured and the beneficiary
- Original Policy or Completion of Section F – “Declaration of the loss of Policy” with counter-sign
- Original or Certified true copy of Death / Notarial Certificate
- Identity Card Cancellation Certificate (RPO53A) from Registration of Persons Office (Immigration Department) (if applicable)
- Post Mortem or Coroner’s report (if applicable)
- Cancellation proof of the insured’s household registration (if applicable)
- Foreign Tax Reporting and Withholding Obligation and Declaration Form (if the claimant is a U.S. person or holds U.S. indicia e.g. telephone number/ any address etc.)
- Self-Certificate (if any of the residential/ correspondence address, ID/ passport / telephone number of the claimant is “Non Hong Kong”)
** The Company may request for the submission of extra information/ documents on case by case basis**
- Certified true copy of identity proof document of the insured and the claimant / beneficiary
- Original Policy or Completion of Section F – “Declaration of the loss of Policy” of Claim Form Part I
- Original or Certified true copy of Death / Notarial Certificate
- Identity Card Cancellation Certificate (RPO53A) from Registration of Persons Office (Immigration Department) (if applicable)
- Post Mortem or Coroner’s report (if applicable)
- Copy of police report/ traffic accident report/ police statement (if applicable)
- Newspaper clipping (if any)
- Cancellation proof of the insured’s household registration
- Foreign Tax Reporting and Withholding Obligation and Declaration Form (if the claimant is a U.S. person or holds U.S. indicia e.g. telephone number/ any address etc.)
- Self-Certificate (if any of the residential/ correspondence address, ID/ passport / telephone number of the claimant is “Non Hong Kong”)
** The Company may request for the submission of extra information/ documents on case by case basis**
Notify the Company as soon as possible upon the insured’s death and submit the documents to the Company by
- your Insurance Consultant;
- mailing to “Tahoe Life Insurance Company Limited, Life Administration Department – Claims Team: 15/F, Cityplaza One, 1111 King’s Road, Taikoo Shing, Hong Kong”; or
- visiting our customer service centre at Suites 1901-03, 19/F Cityplaza One, 1111 King’s Road, Taikoo Shing, Hong Kong
Critical Illness
Claim Form – Critical Illness Claim Form (Part I)
- Claim Form Part I: duly completed by the policyowner (If the insured is age 18 or above, the claim form should also be signed by the insured)
- Claim Form Part II for the claimed illness: duly completed by the insured’s attending physician at the claimant’s own expense (Note: If the claim form part II of your claimed illness cannot be located from the website, please contact your Insurance Consultant or contact our Customer Services Officer for assistance)
- Copy of identity proof document of the policyowner and insured
- Copy of histopathological report
- Copy of laboratory, ultrasongram, X-Ray and / or MRI report(s)
- Copy of hospital discharge summary / sick leave certificate with diagnosis
** The Company may request for the submission of extra information/ documents on case by case basis**
Notify the Company within 60 days from the date of diagnosis and submit the documents to the Company within 90 days from the date of diagnosis by
- your Insurance Consultant;
- mailing to “Tahoe Life Insurance Company Limited, Life Administration Department – Claims Team:15/F, Cityplaza One, 1111 King’s Road, Taikoo Shing, Hong Kong”; or
- visiting our customer service centre at Suites 1901-03, 19/F Cityplaza One, 1111 King’s Road, Taikoo Shing, Hong Kong
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| Hospital List | (Hospital List available in Chinese version only) |
