What type of Claim do you want to submit?
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Select Claim type
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Hospital & Surgery Claims and Hospital Cash Plan
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Critical Illness Claims
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Death Claims
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Total & Permanent Disability Claims
Hospital & Surgery Claims and Hospital Cash Plan
Follow these simple steps to expedite the claim submission process.
Prepare and complete the required documents
Claim Application Form
Attending Physicians Statement
Power of Attorney to Request Medical Data
Original receipt of treatment fee
Legalized of treatment fee details
Legalized of medical resume
Legalized of Laboratory examination results and diagnostic test (if any)
Copy of Policy Holder / Beneficiary(s) ID card
Investigation Report from the Local Police / Visum et Repertum if caused by accident.
Use our PDF forms
Submit the completed Claim form and required documents through your servicing adviser, or mail them to Us at:
Claim Department
PT Tokio Marine Life Insurance Indonesia
International Financial Centre Tower 2, Level 33A
Jl. Jenderal Sudirman Kav.22-23, Jakarta 12920
Need Assistance? Contact Us!
(Monday to Friday: 08.30 AM to 05.30 PM)
Critical Illness Claims
Follow these simple steps to expedite the claim submission process.
Prepare and complete the required documents
Claim Application Form
Attending Physicians Statement
Power of Attorney to Request Medical Data
Critical Illness Forms
Legalized of medical resume
Legalized copy of Laboratory examination results and diagnostic test (if any)
Copy of Policy Holder/Beneficiary(s) ID card
Investigation Report from the Local Police / Visum et Repertum if caused by accident.
Use our PDF forms
Submit the completed Claim form and required documents through your servicing adviser, or mail them to Us at:
Claim Department
PT Tokio Marine Life Insurance Indonesia
International Financial Centre Tower 2, Level 33A
Jl. Jenderal Sudirman Kav.22-23, Jakarta 12920
Need Assistance? Contact Us!
(Monday to Friday: 08.30 AM to 05.30 PM)
Death Claims
Follow these simple steps to expedite the claim submission process.
Prepare and complete the required documents
Claim Application Form
Attending Physicians Statement
Power of Attorney to Request Medical Data
Copy of family card/other legal documents that shows the insurable interest
Copy of Policy Holder/Beneficiary(s) ID card
Legalized of death certificate from authorized institution or from Embassy of the Republik of Indonesia (KBRI) If dies at overseas.
Chronology of death (if dies at home or when going to hospital)
Investigation Report from the Local Police / Visum et Repertum if caused by accident.
Insured death of certificate which has been authorized by the court, states the Insured has died (if the Insured was miss in accident)
Use our PDF forms
Submit the completed Claim form and required documents through your servicing adviser, or mail them to Us at:
Claim Department
PT Tokio Marine Life Insurance Indonesia
International Financial Centre Tower 2, Level 33A
Jl. Jenderal Sudirman Kav.22-23, Jakarta 12920
Need Assistance? Contact us !
(Monday to Friday: 08.30 AM to 05.30 PM)
Total & Permanent Disability Claims
Follow these simple steps to expedite the claim submission process.
Prepare and complete the required documents
Claim Application Form
Attending Physicians Statement
Attending Physicians Statement Total Disability
Power of Attorney to Request Medical Data
Legalized of medical resume
Legalized of Laboratory examination results and diagnostic test (if any)
Copy of Policy Holder/Beneficiary(s) ID card
Investigation Report from the Local Police / Visum et Repertum if caused by accident.
Use our PDF forms
Submit the completed Claim form and required documents through your servicing adviser, or mail them to Us at:
Claim Department
PT Tokio Marine Life Insurance Indonesia
International Financial Centre Tower 2, Level 33A
Jl. Jenderal Sudirman Kav.22-23, Jakarta 12920
Need Assistance? Contact Us!
(Monday to Friday: 08.30 AM to 05.30 PM)
Not sure what Claim to submit?
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