Prime Care & Premier Care Claims
Hospitalisation Claim Form (Claimant's Statement)
Attending Physician Statement *
- Supporting laboratory, histology and radiology reports from the hospital
- Original Final Hospital Bills / Medical Bills
- For Prime Care, photocopies of bills are acceptable for claiming Inpatient Benefits.
- For Premier Care, photocopies of bills are only acceptable if claim has been filed with and paid by other insurers. However, you will need to submit a copy of the settlement letter/details from the other insurers.
- For Prime Care, photocopies of bills are only acceptable for claiming Additional Benefits if claim has been filed with and paid by other insurers. However, you will need to submit a copy of the settlement letter/details from the other insurers.
- Copy of Assured's NRIC and Life Assured's NRIC or Birth Certificate
- Copy of passport showing the date of departure from Singapore if the Medical Condition is sustained outside Singapore.
AXA Life Insurance Singapore
8 Shenton Way, AXA Tower
#B1-01 Singapore 068811
** Clinical Abstract Application form is required to be signed and submitted in the event that further medical reports are required to be obtained.
- Payment to be made to Policyholder, Assignee or Trustee based on the party applicable on the policy.
- For any CPF funded policy in the event of a TPD and Major illness claim, the applicable insurance proceeds will be paid back to Policyholder's respective CPF account.