Death claim

Download forms:

Claim form & authorization

• Note: To be completed by the valid claimant

Attended Physician’s statement - Death claim

• Note: To be completed by the last attended doctor/physician for a death that took place.

Documents required: 

Original or certified true copy of Death certificate

• Note: Issued by the local authorities (Commune/Sangkat) or Cambodian embassy abroad (if the case is overseas).

Original contract provision or declaration of lost policy contract

• Not applicable for e-Contract.

Evidence of medical treatment and diagnosis documents 

• Note: All medical treatment documents such as Doctor certificate, histopathology report, and all laboratory results.

Proof of identity documents of Life insured and beneficiary(ies) or the person(s) claiming the benefits

• Copies of ID/Passport with fresh-ink signature.

Proof of the claimant’s relationship to the deceased

• Proof of relationship to the deceased such as family book, residential book, birth/wedding certificate.
• Note: Will not require if it is provided previously.

Unnatural death or death occurred overseas

• Competent police/authorities report (if the death caused by accident).
• Newspaper clipping (if any).
• Autopsy & coroner report (if the death resulted by suicide or homicide or any specific unnatural cause of death).
• Certified true copy of burial/cremation documents (if the death occurred overseas).