1. Who can certify claims documents?
i) Prudential Branch Officers
ii) Commissioner of Oaths
iii) Notary Public
iv) Advocate and Solicitor
v) Justice of Peace
vi) Ketua Balai Polis
2. Where can I obtain the claims form required for submission?
You may contact your agent or Customer Service at 03-21160228 or you can also write to us at customer.mys@prudential.com.my.
3. How do I submit my claim?
You may submit the completed forms and supporting documents to us via your agents or directly to us.
4. What happens after i submit my claim?
Once a claim had been submitted to us, we will assess it based on the terms and conditions of the policy.
When a decision had been made or in the event that we require further clarification or details, we will notify you in writing.
5. How do I check on the progress of my claims submission?
Once a claim has been submitted to us, you may contact your agent, Customer Service at 03-21160228 or write to us at customer.mys@prudential.com.my for more information on your claims progress.
6. Can I appeal for a reassessment?
You may write in your appeal, together with relevant supporting documents for us to reassess your claims again.
7. How long will I have to wait for my claims cheque?
The time taken will depend on the completeness of the documentation received.
8. Whose name will the claims cheque be issued under?
For death claims, the claims cheque will be issued to the beneficiary / or the assignee of the policy. For life claims, the claims cheque will be issued to the assured / policy owner or the assignee of the policy.
9. If my employer / other insurer does not covered my medical expenses in full, can I claim the balance under my Prudential policy?
Yes, you may submit your claims documentation to us and we will assess it in accordance with your policy terms and conditions. Please refer to the amount that was not covered by your employer / other insurers for the document requirements.
10. What is Pre Hospitalization?
Pre Hospitalization refers to the expenses incurred at the clinic / hospital prior to your admission to the hospital.
Eg: You consulted your nearby clinic for fever and your doctor referred you to be admitted to the hospital for dengue fever. In this scenario, you may claim for the clinic consultation payment under Pre Hospitalisation.
Important note : Only applicable for expenses incurred up to 30 days prior to hospitalization
11. What is Post Hospitalization?
Post Hospitalization refers to the expenses incurred at the specialist clinic/ hospital after your admission and subsequent discharge from the hospital.
Eg: After your discharge from the hospital, you go for follow-up with your doctor. In this scenario, the payment for the follow up will be part of the post hospitalisation expenses.
Important note:
i) Only applicable for expenses incurred 90 days after the hospitalisation. For PMM4, PMM5 and PRUhealth plans, please note that medication prescribed which exceeds the post-hospitalisation period will not be payable.
ii) For PRUhealth plan, follow-up treatment must be by the same attending physician.
Tips : If your follow up is with a different doctor, please ask the doctor to indicate on the receipt the diagnosis and the type of treatment endorsed by the doctor.
12. What is Emergency and Accident Treatment (EAT)?
EAT refers to consultation and medical expenses incurred upon an accident. For example, you suffer injuries due to an accidental fall and seek treatment for the injuries sustained.
Important note: Only applicable if medical treatment is sought within 48 hours from the accident and for expenses incurred within 30 days from the date of the accident.
Tips: If your medical bills are below RM 500.00, please ask the doctor to indicate the date of accident, nature of accident and the type of treatment on the receipt.
13. What is Co-Insurance?
Co-Insurance is a cost sharing arrangement between you and the insurer whereby you will need to pay a specified percentage of the cost of your eligible benefit.
14. If I am admitted overseas, will I still be able to claim back the expenses incurred?
For overseas medical expenses, please submit in your claim and we shall assess it accordingly as per the terms and conditions stated in your annexure.
Note: The above information serves as a guide. In the event that you have any queries on the above, kindly contact your agent/Customer Service at 03-21160228 or write to us at customer.mys@prudential.com.my.
Go to Claims Glossary
i) Prudential Branch Officers
ii) Commissioner of Oaths
iii) Notary Public
iv) Advocate and Solicitor
v) Justice of Peace
vi) Ketua Balai Polis
2. Where can I obtain the claims form required for submission?
You may contact your agent or Customer Service at 03-21160228 or you can also write to us at customer.mys@prudential.com.my.
3. How do I submit my claim?
You may submit the completed forms and supporting documents to us via your agents or directly to us.
4. What happens after i submit my claim?
Once a claim had been submitted to us, we will assess it based on the terms and conditions of the policy.
When a decision had been made or in the event that we require further clarification or details, we will notify you in writing.
5. How do I check on the progress of my claims submission?
Once a claim has been submitted to us, you may contact your agent, Customer Service at 03-21160228 or write to us at customer.mys@prudential.com.my for more information on your claims progress.
6. Can I appeal for a reassessment?
You may write in your appeal, together with relevant supporting documents for us to reassess your claims again.
7. How long will I have to wait for my claims cheque?
The time taken will depend on the completeness of the documentation received.
8. Whose name will the claims cheque be issued under?
For death claims, the claims cheque will be issued to the beneficiary / or the assignee of the policy. For life claims, the claims cheque will be issued to the assured / policy owner or the assignee of the policy.
9. If my employer / other insurer does not covered my medical expenses in full, can I claim the balance under my Prudential policy?
Yes, you may submit your claims documentation to us and we will assess it in accordance with your policy terms and conditions. Please refer to the amount that was not covered by your employer / other insurers for the document requirements.
10. What is Pre Hospitalization?
Pre Hospitalization refers to the expenses incurred at the clinic / hospital prior to your admission to the hospital.
Eg: You consulted your nearby clinic for fever and your doctor referred you to be admitted to the hospital for dengue fever. In this scenario, you may claim for the clinic consultation payment under Pre Hospitalisation.
Important note : Only applicable for expenses incurred up to 30 days prior to hospitalization
11. What is Post Hospitalization?
Post Hospitalization refers to the expenses incurred at the specialist clinic/ hospital after your admission and subsequent discharge from the hospital.
Eg: After your discharge from the hospital, you go for follow-up with your doctor. In this scenario, the payment for the follow up will be part of the post hospitalisation expenses.
Important note:
i) Only applicable for expenses incurred 90 days after the hospitalisation. For PMM4, PMM5 and PRUhealth plans, please note that medication prescribed which exceeds the post-hospitalisation period will not be payable.
ii) For PRUhealth plan, follow-up treatment must be by the same attending physician.
Tips : If your follow up is with a different doctor, please ask the doctor to indicate on the receipt the diagnosis and the type of treatment endorsed by the doctor.
12. What is Emergency and Accident Treatment (EAT)?
EAT refers to consultation and medical expenses incurred upon an accident. For example, you suffer injuries due to an accidental fall and seek treatment for the injuries sustained.
Important note: Only applicable if medical treatment is sought within 48 hours from the accident and for expenses incurred within 30 days from the date of the accident.
Tips: If your medical bills are below RM 500.00, please ask the doctor to indicate the date of accident, nature of accident and the type of treatment on the receipt.
13. What is Co-Insurance?
Co-Insurance is a cost sharing arrangement between you and the insurer whereby you will need to pay a specified percentage of the cost of your eligible benefit.
14. If I am admitted overseas, will I still be able to claim back the expenses incurred?
For overseas medical expenses, please submit in your claim and we shall assess it accordingly as per the terms and conditions stated in your annexure.
Note: The above information serves as a guide. In the event that you have any queries on the above, kindly contact your agent/Customer Service at 03-21160228 or write to us at customer.mys@prudential.com.my.
Go to Claims Glossary
