Submit a Claim

Hospital & Surgical (Reimbursement)
CASHLESS ADMISSION
Hospital Income Plan
Cancer Plan
Critical Illness
Outpatient Claim

Simple steps for claims process

1

Download and fill in the claim form

GI_Health_Claim_Form
Life Medical Claim Form by Claimant
Life Medical Claim Form by Doctor

Here are the list of supporting documents for your claim:

  • Health Claim Form
  • Medical Report
  • Original Itemized Bill & Receipt
  • Investigation Report
2

Submit the completed claim form and the listed supporting documents to Generali Malaysia or your Agent

3

Upon receipt of full documents, Generali Malaysia will revert with claim decision within claim service benchmark

4

E-claim payment within our claim service benchmark

Note:
The above steps are applicable for-  
a) Admission to non-panel hospitals.
b) Outpatient treatment due to minor injury sustained in an accident.
c) Outpatient treatment prior to admission and/or follow-up treatment after discharge from the hospital.
d) Day surgery whereby you are not required to stay overnight at the hospital.
e) Outpatient cancer treatment and outpatient kidney dialysis.
f) Hospitalisation outside Malaysia.

Simple steps for claims process

admission
dicharge
1

A) Non-Elective / Non-Pre Planned:
Member to produce IC, Admission Letter & Medical Card to the admission counter

B) Elective / Pre-Planned:
Member to present the IC, Medical Card & Admission letter to the admission counter.

(Please inform on the actual admission date, Hospital Name and request for Pre-Planned arrangement)

Click here for our Panel Hospitals

2

A) Non-Elective / Non-Pre Planned:
Hospital verifies card and name via our 24x7 call center / web-system

B) Elective / Pre-Planned:
Hospital will assist to prepare relevant documents & medical reports

3

Hospital sends relevant documents with Admission Request Form

4

A) Non-Elective / Non-Pre Planned:
Call Center validates & authenticate info, issues Guarantee letter or Decline letter within 1 hour upon receipt of relevant documents

B) Elective / Pre-Planned:
Call Centre validates info, issues Pre-Approved GL or Decline letter within 1 hour upon receipt of relevant documents. Member to contact Call Centre / Hospital on the status of Guarantee letter.

5

A) Non-Elective / Non-Pre Planned:
Member gets admitted into hospital

B) Elective / Pre-Planned:
Member proceed to the admission counter and pre-approved GL is ready for member's admission

If a Guarantee Letter is declined, you may proceed with payment and then file a claim after discharge.

1

Patient ready to be discharged

2

Hospital prepares itemized bills and gathers all relevant reports

3

Hospital sends itemize bills and all relevant reports

Step 1 to Step 3 take pproximately 2 to 4 hours

4

Our Call Center validates, audits & processes bills from hospital, issues Final Guarantee Letter within 1 hour upon receipt of full documents from hospital

5

Hospital receives Final Guarantee

6

Patient pays for uncovered charges (if any)

7

Patient discharged

For all reimbursement (pay and file) claims, please notify us within 30 days of the event. Ensure that you submit a complete claim form along with original receipts, itemized bills, imaging or blood test results, and any other relevant documentation necessary for processing.

Simple steps for claims process

1

Download and fill in the claim form

GI_Health_Claim_Form
Life Medical Claim Form by Claimant
Life Medical Claim Form by Doctor

Here are the list of supporting documents for your claim:

  • Health Claim Form
  • Medical Report
  • Original Itemized Bill & Receipt
  • Investigation Report
2

Submit the completed claim form and the listed supporting documents to Generali Malaysia or your Agent

3

Upon receipt of full documents, Generali Malaysia will revert with claim decision within claim service benchmark

4

E-claim payment within our claim service benchmark

Simple steps for claims process

1

Download and fill in the claim form

GI Health Claim Form (Cancer Plan)
Life Claimant Statement (Non Death)
Life Critical Illness - Cancer Claim (By Doctor)
Life Consent Form

Here are the list of supporting documents for your claim:

  • Cancer Claim Form
  • Completed medical report by treating doctor
  • Certified copy of histopathology report (s)
  • Other diagnostic report (if any)
2

Submit the completed claim form and the listed supporting documents to Generali Malaysia or your Agent

3

Upon receipt of full documents, Generali Malaysia will revert with claim decision within claim service benchmark

4

E-claim payment within our claim service benchmark

Simple steps for claims process

1

Submit the completed claim form and the listed supporting documents to Generali Malaysia or your Agent

Life Claimant Statement (Non Death)
Life Critical Illness - Heart Related (By Doctor)
Life Critical Illness - Brain and Nerve (By Doctor)
Life Critical Illness - Other Illnesses (By Doctor)
Life Consent Form
2

Submit the completed claim form and the listed supporting documents to Generali Malaysia or your Agent

3

Upon receipt of full documents, Generali Malaysia will revert with claim decision within claim service benchmark

4

E-claim payment within our claim service benchmark

Simple steps for claims process

1

Download and fill in the claim form

GI_Health_Claim_Form
Supporting Documents Check List
2

Submit completed claim form and original supporting documents within 30 days after medical visit via:

3

Upon receipt of complete documentation and information, Generali Malaysia will revert with claim decision within claim service benchmark.

4

E-claim payment within our claim service benchmark.

Note:
IHP Mobile App outpatient claims is applicable for SmartMedi Outpatient claims only.

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