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Loss of Life
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Total Permanent Disability
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Dismemberment, loss of sight, loss of hearing, or speech
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- Health and Accident Insurance Claim Form, fully completed.
- Letter of appointment for the Administrator of the Estate (if any).
- Copy of the deceased's ID card or Passport.
- Copy of House Registration with the "Deceased" stamp.
- Copy of the Death Certificate.
- Copy of the Death Certification (issued by the hospital).
- Copy of the Autopsy Report. If sent to the Institute of Forensic Medicine, please attach the "Detailed Autopsy Report."
- Blood alcohol test result of the insured. (If no test was performed, attach a confirmation letter from the investigating officer and the forensic/attending physician).
- Copy of the Daily Case Report/Police Log, certified true copy.
- Copy of the police investigation report regarding the incident and cause of death.
- Copy of the Beneficiary’s ID card, certified true copy.
- Copy of the Beneficiary’s House Registration, certified true copy.
- Evidence of Name/Surname Change (if applicable).
- Bank Account Application and Copy of Bank Statement showing the balance prior to the incident, covering at least the last 3 months, certified true copy.
- For Minor Beneficiaries: Copy of Birth Certificate (if no ID card), House Registration of the minor, and ID Card/House Registration of parents or court-appointed legal guardian.
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- Health and Accident Insurance Claim Form, fully completed.
- Copy of ID Card or Passport of the insured, certified true copy.
- Copy of House Registration of the insured, certified true copy.
- Complete Medical History/Treatment Records.
- Photographs of the Insured clearly showing the disability or damaged organs.
- Disability ID Card or official Disability Certification (issued by the Ministry of Social Development and Human Security).
- Medical Certificate/Certification of Disability confirming the insured is permanently and totally unable to perform any duties of their regular occupation or any other occupation for life, issued by the attending physician or a government hospital physician.
- Evidence of Name/Surname Change (if applicable).
- Bank Account Application and Copy of Bank Statement showing the balance prior to the incident, covering at least the last 3 months, certified true copy.
- Copy of the Daily Police Report, certified true copy.
- Blood Alcohol Test Result of the insured (If no test was performed, attach a confirmation letter from the Investigating Officer and the Forensic/Attending Physician).
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- Accident and Health Insurance Claim Form, fully completed.
- Physician’s Report confirming the permanent and total loss of function/use of the organ(s) due to an accident with no possibility of recovery.
- Photographs of the Insured clearly showing the lost organ(s).
- Disability ID Card or official Disability Certification (issued by the Ministry of Social Development and Human Security).
- Original Medical Treatment Receipts.
- ID Card and House Registration of the insured. For Minors: Copy of Birth Certificate, House Registration of the minor, and ID Card/House Registration of parents or court-appointed legal guardian.
- Evidence of Name/Surname Change (if applicable).
- Copy of Daily Police Report and official police investigation results regarding the incident.
- Blood Alcohol Test Result (If no test was performed, attach a confirmation letter from the Investigating Officer and the Forensic/Attending Physician).
- Complete Medical History from the date of the accident to the present.
- Bank Account Application and Copy of Bank Statement showing the balance prior to the incident, covering at least the last 3 months, certified true copy.
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