Critical Illness Claims
To be completed by the last attending doctor if the critical illness occurred within the policy certificate’s first first three years.
To be completed by the last attending doctor if the critical illness occurred within the policycertificate’s first three years. (Please click the Form Link above and download from the Critical Illness claims-attending physician's report section)
To be completed by the participant. If there’s more than one participant, all participants must sign the document
To be completed by the participant. If there’s more than one participant, all participants must sign the document
Note: This allows us to collect any medical records related to your claim, in accordance with your consumer rights and our contractual agreement
*Note: Photocopy of documents MUST be duly certified by authorised parties, i.e. FWD Takaful Berhad Head Office Executive/Manager or Public Notary or Advocate & Solicitor or Commissioner of Oath or Justice of Peace or Ketua Balai Polis or District Officer or Medical Officer.
In addition, for claims incurred outside Malaysia, the confirmation of claim event and all other related documents issued by the Foreign Authority must be certified by Malaysian Embassy or Public Notary at the incident country. If you have returned to Malaysia, the documents can be certified by relevant country's Embassy in Malaysia.
Send to:
FWD Takaful Berhad (731530-M) , Level 21, Mercu 2,
No.3, Jalan Bangsar, KL Eco City
59200 Kuala Lumpur
Submit to: FWD Takaful Berhad (731530-M), Level 21, Mercu 2,
No.3, Jalan Bangsar, KL Eco City
59200 Kuala Lumpur
Medical Allowance Claims
To be completed by the last attending doctor.
To be completed by the participant. If there’s more than one participant, all participants must sign the document.
To be completed by the participant. If there’s more than one participant, all participants must sign the document.
Note: This allows us to collect any medical records related to your claim, in accordance with your consumer rights and our contractual agreement.
*Note: Photocopy of documents MUST be duly certified by authorised parties, i.e. FWD Takaful Berhad Head Office Executive/Manager or Public Notary or Advocate & Solicitor or Commissioner of Oath or Justice of Peace or Ketua Balai Polis or District Officer or Medical Officer.
In addition, for claims incurred outside Malaysia, the confirmation of claim event and all other related documents issued by the Foreign Authority must be certified by Malaysian Embassy or Public Notary at the incident country. If you have returned to Malaysia, the documents can be certified by relevant country's Embassy in Malaysia.
Send to:
FWD Takaful Berhad (731530-M) , Level 21, Mercu 2,
No.3, Jalan Bangsar, KL Eco City
59200 Kuala Lumpur
Submit to: FWD Takaful Berhad (731530-M), Level 21, Mercu 2,
No.3, Jalan Bangsar, KL Eco City
59200 Kuala Lumpur
Medical Reimbursement Claims
Please complete a claim form, consent form and obtain a physician’s report.
To be completed by the last attending doctor
To be completed by the participant. If there is more than one participant, all must sign the document.
To be completed by the participant. If there is more than one participant, all must sign the document.
Note: This allows us to collect any medical records related to your claim, in accordance with your consumer rights and our contractual agreement.
*Note: Photocopy of documents MUST be duly certified by authorised parties, i.e. FWD Takaful Berhad Head Office Executive/Manager or Public Notary or Advocate & Solicitor or Commissioner of Oath or Justice of Peace or Ketua Balai Polis or District Officer or Medical Officer.
In addition, for claims incurred outside Malaysia, the confirmation of claim event and all other related documents issued by the Foreign Authority must be certified by Malaysian Embassy or Public Notary at the incident country. If you have returned to Malaysia, the documents can be certified by relevant country's Embassy in Malaysia.
Send to:
Claims Department [Ground Floor] Mediexpress (Malaysia) Sdn. Bhd. Parklane Commercial Hub Block F-G-7, No. 21 Jalan SS 7/26 47301 Petaling Jaya, Selangor
Loss of life Claims
To be completed by the last attending doctor.
2. Death claim form Part 1
To be completed by the claimant. If there’s more than one claimant, all claimants must sign the document.
To be completed by the claimant. If there’s more than one claimant, all claimants must sign the document.
To be completed by the participant. If there’s more than one participant, all participants must sign the document.
Note: This allows us to collect any medical records related to your claim.
In addition, for claims incurred outside Malaysia, the confirmation of claim event and all other related documents issued by the Foreign Authority must be certified by Malaysian Embassy or Public Notary at the incident country. If you have returned to Malaysia, the documents can be certified by relevant country's Embassy in Malaysia.
Send to:
FWD Takaful Berhad (731530-M) , Level 21, Mercu 2,
No.3, Jalan Bangsar, KL Eco City
59200 Kuala Lumpur
Submit to: FWD Takaful Berhad (731530-M), Level 21, Mercu 2,
No.3, Jalan Bangsar, KL Eco City
59200 Kuala Lumpur
Total permanent disability claims
a. To be completed by the last attending doctor.
a. To be completed by the participant. If there’s more than one participant, all participants must sign the document.
To be completed by the participant. If there’s more than one participant, all participants must sign the document.
Note: This allows us to collect any medical records related to your claim, in accordance with your consumer rights and our contractual agreement.
In addition, for claims incurred outside Malaysia, the confirmation of claim event and all other related documents issued by the Foreign Authority must be certified by Malaysian Embassy or Public Notary at the incident country. If you have returned to Malaysia, the documents can be certified by relevant country's Embassy in Malaysia.
Send to:
FWD Takaful Berhad (731530-M) , Level 21, Mercu 2,
No.3, Jalan Bangsar, KL Eco City
59200 Kuala Lumpur
Submit to: FWD Takaful Berhad (731530-M), Level 21, Mercu 2,
No.3, Jalan Bangsar, KL Eco City
59200 Kuala Lumpur
Temporary Total & Permanent Disability Claims
a. To be completed by the last attending doctor.
a. To be completed by the participant. If there’s more than one participant, all participants must sign the document.
To be completed by the participant. If there’s more than one participant, all participants must sign the document.
Note: This allows us to collect any medical records related to your claim, in accordance with your consumer rights and our contractual agreement.
In addition, for claims incurred outside Malaysia, the confirmation of claim event and all other related documents issued by the Foreign Authority must be certified by Malaysian Embassy or Public Notary at the incident country. If you have returned to Malaysia, the documents can be certified by relevant country's Embassy in Malaysia.
Send to:
FWD Takaful Berhad (731530-M) , Level 21, Mercu 2,
No.3, Jalan Bangsar, KL Eco City
59200 Kuala Lumpur
Submit to: FWD Takaful Berhad (731530-M), Level 21, Mercu 2,
No.3, Jalan Bangsar, KL Eco City
59200 Kuala Lumpur