Due to company will update form version from times to times,
kindly download latest version direct from Gesica or Epartner.
If want to download from below link, kindly login E-Partner first.
– Great Lady Rider / Mother or Child Illness Claims Requirement Checklist
(Check List)
– Great Lady Rider/Mother or Child Illness Claim Form – Claimant’s Statement
(Fill in by CLIENT)
– Confidential Medical Certificate (Check Below List)
(Fill in by DOCTOR)
CTC = Certified True Copy
1. CTC of Child’s Birth Certificate
2. Hospital bill duly certified and doctor to endorse the date, cause & type of surgery performed (applicable to Caesarean claims)
– Confidential Medical Certificate (Cancer)
– Confidential Medical Certificate (Great Lady Rider / Mother or Child Illness)
1. CTC of All relevant diagnostic test results or reports
2. CTC of Hospital/Admission Bill(s)
1. Great Lady Rider/Mother or Child Illness Claim Form – Claimant’s Statement
2. Original copy of Letter of Authorisation / Consent X 3
3. CTC Life Assured’s NRIC
4. CTC All relevant diagnostic test results or reports
5. CTC of Hospital/Admission Bill(s)
If Life Assured is a non-Malaysian or event occurred outside Malaysia (except Singapore)
(i) CTC of Life Assured’s Full Passport Book