Downloads
Local Student
GROUP PERSONAL ACCIDENT POLICY (GPA)
(EXAMPLE) CLAIM FORM GPA – MAIN FORM (PAGE 1 & PAGE 2)
1. CLAIM FORM GPA – MAIN FORM (PAGE 1 & PAGE 2)
2. CLAIM FORM GPA – MEDICAL REPORT (PAGE 3)
3. CLAIM FORM GPA – ARAHAN BAYARAN (PAGE 4) – For LOCAL STUDENT
4. CLAIM FORM GPA – PAYMENT INSTRUCTION FORM
4. PAYMENT INSTRUCTION FORM V1
5. CLAIM FORM GPA – DOC CHECKLIST (EN) (PAGE 5)
International Student
GROUP PERSONAL ACCIDENT POLICY (GPA)
(EXAMPLE) CLAIM FORM GPA – MAIN FORM (PAGE 1 & PAGE 2)
1. CLAIM FORM GPA – MAIN FORM (PAGE 1 & PAGE 2) – For student
2. CLAIM FORM GPA – MEDICAL REPORT (PAGE 3)
3. CLAIM FORM GPA – ARAHAN BAYARAN (PAGE 4) – For Student
4. CLAIM FORM GPA – PAYMENT INSTRUCTION FORM
4. PAYMENT INSTRUCTION FORM V1
5. CLAIM FORM GPA – DOC CHECKLIST (EN) (PAGE 5)
Checklist for Submission of GHS claims
Details: For Category 2: Inpatient & Category 3: Emergency Outpatient Services only
Etiqa Pre-Admission Form (Government Hospital)
Details: To request GL for admission in government hospital
