Form A.ai - Insurance Info

WHAT IS THE MOTOR CLAIMS GUIDE?
Motor Claims Guide is a comprehensive guide developed by the Malaysian insurance and
takaful industry containing key information regarding motor insurance/ takaful.
The Motor Claims Guide aims to help the public better understand the overall claims
settlement process by making transparent key information.
How Does A Motor Policy Protect You?
A motor insurance policy / takaful certificate
(collectively referred to as “motor policy”)
provides financial protection to you in the
event your vehicle is involved in a road accident
or is stolen. However, there are limits to the
extent of financial protection provided, so it is
important that you understand the scope of
protection under each type of motor policy.
Illustrated below are the types of motor
policies available in Malaysia and scope of
financial protection provided by an insurance
company / takaful operator (collectively
referred to as “insurer”):
EXTENT OF COVER
Comprehensive policy
Third Party, Fire and Theft policy
Third Party policy
Provides financial protection for:
Responsibility for death
or injury to all parties
outside of your
vehicle (third party)
in an accident
Responsibility for
damage to other
person’s (third party)
vehicle or property
Loss/Damage to
your vehicle due to
accidental fire or theft
Loss/Damage to
your vehicle due to
accident
Third Party Bodily
Injury or Death claim
Third Party Property
Damage claim
Fire claim OR Theft
claim
No Fault Own
Damage claim OR
Own Damage claim
You have a right to appoint a lawyer to advise you on your legal rights
1
ADD-ON COVERS
To widen the scope of protection of a motor policy, vehicle owners may purchase add-on covers at
additional premium/ contribution. Below are some examples of these add-on covers:
Type of add-on covers
Protects against...
Flood
Damages to your vehicle in event of a flood
Windscreen
Sudden breakage of windscreen not resulting from a road accident
Legal liability to passenger
Your passenger(s) suing you for injury caused to them (except
your own family members)
Legal liability of passenger
People outside of your vehicle suing you for injuries caused by your
passenger(s)
Compensation for Assessed
Repair Time
Inability to use your vehicle while it is being repaired
Personal Accident (separate
policy)
Any injury to you or your passenger (including family members)
You have a right to appoint a lawyer to advise you on your legal rights
2
WHAT CAN YOU CLAIM FOR?
The types of compensation which may be claimed under a motor policy depends on the type of
motor policy applicable and prevailing laws:
If you are a vehicle owner and have a:
Types of compensation which may
be claimed (depending on the policy
applicable and prevailing laws)
Comprehensive policy
Third Party, Fire
and Theft policy
Third party
policy
Theft of your vehicle
Make a Theft claim against
your own insurer/ takaful
operator
Make a Theft or
Fire claim against
your own insurer
Not eligible to
claim
Damage to your vehicle/
property due to road
accident
If other person caused the
accident: Make a Third Party
Property Damage claim (TPPD)
against the other person’s
insurer/ takaful operator; or
Make a Third
Party Property
Damage claim
(TPPD) against
the other person’s
insurer/ takaful
operator
Make a Third
Party Property Damage
claim (TPPD)
against the
other person’s
insurer/ takaful
operator
Property
damage
If you caused the accident:
Make an Own Damage claim
against your own insurer/
takaful operator
Compensation for
Assessed Repair Time
(CART) (Compensation
awarded only to drivers
found not responsible for
accident)
If you are a pedestrian / owner
of non-vehicular
property that
was involved in
an accident
Make a Third
Party Property Damage claim
(TPPD) against
the other person’s
insurer/ takaful
operator
Make loss of use claim against the other person’s insurer/ takaful
operator; OR
Make a claim with your own insurer if you have purchased CART
add-on cover
Pain, suffering and loss
of amenities from injury
sustained
Bodily
injury /
Death
(list is not
exhaustive)
Medical expenses / nursing costs
Loss of earnings / Loss of
future earnings / earning
capacity.
Loss of dependency
Make a Third Party Bodily Injury or Death (TPBID) claim against
the other person’s insurer/ takaful operator
Funeral expenses
Bereavement
IMPORTANT NOTICE
You must ensure that the insured value of your vehicle is adequate. If the sum insured of your vehicle is lower than its market value at the
point of purchasing insurance, your vehicle is deemed to be underinsured. If your vehicle is underinsured, compensation for damages to your
vehicle will be proportionately lower.
A Passenger Liability cover only provides protection to the passengers in your vehicle who are not your family members. You are advised to
purchase a Personal Accident policy for yourself as well as for your family members so that you and your family members are protected should
you be the party at fault in a road accident.
You have a right to appoint a lawyer to advise you on your legal rights
3
WHAT YOU SHOULD DO IF YOU MEET
WITH A ROAD ACCIDENT
1. Be calm, polite and courteous. DO NOT admit
liability or offer any settlement or payment.
2. Note down as much of the following in the
Accident Notification Form (Form A)
provided in this claims guide:•the personal particulars of the driver(s)
involved in the road accident - name(s),
IC number(s), address(es), driving licence
number(s) and telephone contact(s) (if
possible)
•the name of the insurer of the other
vehicle(s)
•make/model and registration number(s)
of the other vehicle(s) involved in the road
accident
•registration number of tow truck(s) (if any)
3.Make a simple diagram of the accident
scene in Form A. This will help you when
making a police report later on, as you will
also be required to do so.
4.Snap photos and note down the extent of the
damage(s) to the vehicles/property involved (if
the situation permits)
5.Immediately call either your insurer’s roadside
assistance service (if provided) or Accident
Assist for assistance. Accident Assist will ask
you some simple questions about the accident
and if necessary, will assist in arranging for
a panel tow truck to assist you and to tow
your vehicle to the nearest panel workshop.
Accident Assist will be able to also advise you
on the nearest panel workshop which you may
go to in order to repair your vehicle.
As an alternative to calling your insurer or
Accident Assist to inform about the road
accident, you may also fill in Form A and
submit it to either your own insurer and/or
Persatuan Insurans Am Malaysia (PIAM) or
Malaysian Takaful Association (MTA) within
7 days of the date of the road accident.
PIAM and MTA may be contacted at:
Persatuan Insurans Am Malaysia
3rd Floor, Wisma PIAM
150, Jalan Tun Sambanthan
50470 Kuala Lumpur
Tel No.: 03-22747395 Fax No.: 03-22745910
Email: [email protected]
Malaysian Takaful Association
21st, Menara Takaful Malaysia,
No. 4, Jalan Sultan Sulaiman,
50000 Kuala Lumpur
Tel No.: 03-20318160
Fax No.: 03-20318170
Email: [email protected]
com.my
6.Make a Police Report of the road accident.
You are required by law to lodge a police
report as soon as practicable, and in any
case within 24 hours of a road accident /
theft of your vehicle
7.Cooperate with the investigator/loss adjuster
appointed by the insurer to undertake an
independent:
a.assessment of the repairs recommended
by the panel workshop; or
b. investigation of the theft of your vehicle.
You have a right to appoint a lawyer to advise you on your legal rights
4
HOW TO MAKE A MOTOR CLAIM?
In order to make a claim, compile as much of the following documents as possible and submit them
to the insurer (refer to the table below) within the stipulated timeframe:
• Own Damage, No-Fault Own Damage1 and Theft claims:
­- Within 7 days of the date of accident/loss if you are not physically disabled or hospitalized
following the event.
­- Within 30 days or as soon as practicable if you are physically disabled or hospitalized as a
result of the event.
• Other claims:
­- As soon as practicable
However, claimants may subsequently be requested by the insurer to furnish additional documentation
Type of Claim
Submit to OWN insurer
No.
1
Documents to be submitted
1.
Claim Form
(provided by insurers)
2.
Motor Bodily Injury/Death claims cover letter
(refer to Letter B)
3.
Original copy of police reports
• Made by you directly after accident
• Police letter informing which party is compounded for
road traffic offence
4.
Copy of NRIC of driver
5.
Copy of driving licence of:
• driver
• policyholder
6.
Vehicle registration card
7.
Bill of repair costs of your own vehicle or property
8.
Any document in evidence of your income
Own Damage and
No-Fault Own
Damage
Theft
claim
Submit to OTHER party’s insurer
Third Party
Property
Damage
(TPPD) claim
-
-
-
Third Party
Bodily Injury
or Death
(TPBID) claim
-
-
-
-
-
-
-
-
-
A No-Fault Own Damage claim is a benefit for private cars with Comprehensive policy and is only applicable if you are in an accident with
another private car with Comprehensive policy. It is an alternative to filing a Third Party Property Damage claim. Under a No-Fault Own
Damage claim, you can seek compensation against your insurer instead of the other person’s insurer for the damages the other person
has caused to your vehicle in event of a road accident. This is a benefit to you as it saves you the hassle of dealing with the other person’s
insurer.
You have a right to appoint a lawyer to advise you on your legal rights
5
Type of Claim
No.
Documents to be submitted
Submit to OWN
insurer
Own Damage
and No-Fault
Own Damage
9.
Photos of (if possible):
• accident scene
• damages to vehicle at accident scene
• injuries suffered
Theft
claim
Submit to OTHER party’s
insurer
Third Party
Property
Damage
(TPPD) claim
Third Party
Bodily Injury
or Death
(TPBID) claim
-
-
-
-
-
If injured (TPBI claim):
10.
Initial medical report
(specialist reports may be submitted later)*
-
-
-
11.
Bill of initial medical treatment received
-
-
-
If death (fatal claim):
12.
A copy of death certificate
-
-
-
13.
Bill of funeral expenses
-
-
-
14
Copy of NRIC of dependents
-
-
-
Note: If you have not obtained your initial medical report, you may
consent for such report to be made available. Your consent for this report
to be made available may be provided in the medical report application
form which is available at hospitals, a sample of which may be seen at the
following address: http://hbtu.moh.gov.my/cms/wp-content/uploads/2011/09/
MedicalReport_Consent-Form.pdf
You have a right to appoint a lawyer to advise you on your legal rights
6
CONSUMER ADVISORY
1. In making a motor claim involving third party bodily injury and death or third party property
damage, you may pursue your claim directly with the other vehicle’s insurer or appoint a
lawyer to act on your behalf at any time.
2. Should you choose to pursue your claim directly with the other vehicle’s insurer, you should
ensure that the compensation that you are to receive from the insurer is adequate. Please
exercise care and where necessary seek expert advice in reaching any settlement for
compensation with the other vehicle’s insurer as such settlement is likely to be final.
3. If you are of the view that the compensation being offered to you is inadequate, you may
further negotiate with the other vehicle’s insurer or may wish to consult a lawyer.
You have a right to appoint a lawyer to advise you on your legal rights
7
IMPORTANT MATTERS YOU SHOULD
KNOW WHEN MAKING A CLAIM
If you are making an Own Damage claim:
When you make an Own Damage claim under
your Comprehensive policy, your insurer may
also include additional charges, including:
­• Betterment – Portion of repair charges to be
borne by owners of vehicles aged 5 years and
above if new franchise parts are used in repairs
instead of parts of the same age as the vehicle.
­•­ Excess – A proportion of the total repair cost
that you are to bear yourself as per the terms
& conditions of the motor insurance policy.
­­• Endorsement 2(f) (private cars only) – You
will bear RM400.00 of each claim made by
you, if at the time of the accident your vehicle
was driven by a person:
- who is under the Age of 21 years; or
- who is the holder of a Provisional Driving
Licence (L-Licence); or
- who is the holder of a Probationary
Driving Licence (P-Licence); or
- who is not named in the motor policy; or
- named in the motor policy who is less than
the age of 21 years and/or the holder of a
Provisional Driving Licence (L-Licence) and/
or the holder of a Probationary Driving
Licence (P-Licence).
You will lose your No Claim Discount (NCD)
entitlement at the next renewal of your motor
policy.
If you are making a No-Fault Own Damage
claim:
You will not lose your NCD entitlement.
However, you will be subject to the same
charges under an Own Damage claim
(Betterment, Excess and Endorsement 2(f)).
You may then write to the other party’s insurer
seeking reimbursement for all of the above
charges except betterment.
However, if the accident is found to be caused by
you, your No-Fault Own Damage claim will
be converted into an Own Damage claim. In
this case, you will lose your NCD entitlement at
the next renewal of your motor policy.
If you are making a theft claim:
• To ensure that the investigation is thorough and
to allow possible recovery by police authorities,
your insurer may require a reasonable process
time of the following time frame
­- 6 months from the date of notification of
theft; and/or
­- when official police investigations have been
completed, whichever is earlier.
• After notifying your insurer of the theft of your
vehicle, if you are informed that your vehicle is
recovered:
­- do NOT take possession of your vehicle from
any authority/party unless authorised by the
police; or
­- immediately notify your insurer/agent so that
your insurer may make proper arrangements
to recover your vehicle and conduct an
independent survey of your vehicle.
• Under a normal Comprehensive motor policy,
insurers will pay you compensation equal to
the present market value of your vehicle at the
point of theft or the sum insured/ sum covered
of the vehicle (whichever is less). If you wish to
be compensated on sum insured/ sum covered
basis, please ask your insurer about the possibility
of converting your Comprehensive policy to an
Agreed Value Comprehensive policy.
You have a right to appoint a lawyer to advise you on your legal rights
8
If you are making a Third Party Bodily Injury
claim or a Dependency claim:
• If you and/or passengers in your vehicle are
injured in an accident, you and/or passengers
in your vehicle may claim compensation for
injuries sustained from the insurer of the
other vehicle. Compensation will only be paid
by the insurer of the other vehicle’s driver in
the event the insured/ covered driver is found
to have caused the accident.
• If you and/or passengers in your vehicle were
to succumb to injuries in a road accident,
your and/or your passengers’ dependents
(spouse, children and parents) may make a
dependency claim against the insurer of the
other vehicle. Compensation will only be paid
by the insurer of the other vehicle’s driver in
the event the insured/ covered driver is found
to have caused the accident.
• A dependency claim may be made provided
the deceased was gainfully employed prior
to the accident. Such a claim is by the
deceased’s dependents for loss of financial
support minus certain deduction as the
dependents would now be deprived of the
deceased’s earnings or income on which they
had depended prior to the accident which
caused his demise.
• If you are found to be responsible for the
accident, you and your passengers will
not be able to receive any compensation
from the insurer of the other vehicle.
If you are found to be partially responsible,
you and/or your passengers may receive only
partial compensation.
If you are making a Third Party Property
Damage claim:
• If your property (including vehicle) is damaged
in a road accident caused by the other party,
you may claim for compensation from the
other party’s insurer.
• The insurer may provide compensation for the
following items:
-­ Cost of repairs to your property to return it
to its previous state
­- Cost of replacing your property with
another that is alike in terms of age, value
and/or condition
­- Cost of loss of use of your vehicle i.e.
charges for rental car (up to a specified limit)
For further information, you may refer to Accident Assist at 1-300-22-1188 or visit the PIAM website at
www.piam.org.my or MTA website at www.malaysiantakaful.com.my
You have a right to appoint a lawyer to advise you on your legal rights
9
Contact numbers of general insurers and takaful operators in Malaysia (as at March 2013)
No. Name of insurer
Tel. No.
Fax. No.
1. ACE Jerneh Insurance Berhad
03- 2058 3000
03-2058 3333
2. AIG Malaysia Insurance Berhad
03-2118 0188
03-2118 0288
3. Allianz General Insurance Company (Malaysia) Berhad
03-2264 1188
03-2264 1199
4. American International Assurance Bhd
03-2056 1111
03-2056 2992
5. AmG Insurance Berhad
03-4047 8000
03-4043 8680
6. AXA Affin General Insurance Berhad
03-2170 8282
03-2031 7282
7. Berjaya Sompo Insurance Berhad
03-2117 2118
03-2144 7297
8. Etiqa Insurance Berhad
1300-13-8888
03-2296 1799
9. ING Insurance Berhad
1800-88-0303
03-2711 0175
10. Kurnia Insurans (Malaysia) Berhad
03-7875 3333
03-7875 9933
11. Lonpac Insurance Bhd
03-2262 8688
03-2715 1332
12. Zurich Insurance Malaysia Berhad
03-2146 8000
03-2142 5863
13. Multi-Purpose Insurans Bhd
03-2034 9888
03-2694 5758
14. MSIG Insurance (Malaysia) Bhd
03-2050 8228
03-2060 8086
15. Tune Insurance Malaysia Berhad
03-2070 2828
03-2072 4150
16. Overseas Assurance Corp. (Malaysia) Berhad
03-4259 7888
03-4813 2737
17. Pacific & Orient Insurance Co. Berhad
03-2698 5033
03-2693 8145
18. Progressive Insurance Bhd
03-2118 8000
03-2118 8101
19. Prudential Assurance Malaysia Berhad
03-2116 0228
03-2032 3939
20. QBE Insurance (Malaysia) Berhad
03-7861 8400
03-7873 7430
21. RHB Insurance Berhad
03-2180 3000
03-9281 2729
22. The Pacific Insurance Berhad.
03-2176 1188
03-2078 4928
23. Tokio Marine Insurans (Malaysia) Berhad
03-2783 8383
03-2026 9708
24. Uni.Asia General Insurance Berhad
03-2693 8111
03-2693 2893
Tel. No.
Fax. No.
1. Etiqa Takaful Berhad
1300-13-8888
03-2296 1799
2. Hong Leong MSIG Takaful Malaysia Berhad
03-7650 1800
03-7620 6730
3. MAA Takaful Berhad
03-6287 6666
03-6259 0088
1300-88-252-385
03-2274 0237
No. Name of takaful operators
4. Syarikat Takaful Malaysia Berhad
5. Takaful Ikhlas Sdn. Bhd.
03-2723 9696
03-2723 9998
6. CIMB Aviva Takaful Bhd.
1300-88-5055
03-2614 3550
7. HSBC Amanah Takaful (Malaysia) Sdn Bhd
1800-88-9659
03-2031 0833
8. Prudential BSN Takaful Berhad
03-2053 7188
03-2026 7688
You have a right to appoint a lawyer to advise you on your legal rights
10
Form A
Strictly without prejudice
It is not compulsory to fill in this form. Any information that you do give in this form will not amount to any admission of blame
I liability but is to provide the first details of the accident for purposes of notifying your insurer that an accident has occurred. You
have the right to appoint a lawyer of your own choice to advise you on your rights and any claim that you may make. You may
wish to consult a lawyer before you fill in this form. If you do choose to fill in this form, you will not be deemed to have waived
any of your legal rights, including making any claim for compensation as a result of the accident.
FORM A - ACCIDENT NOTIFICATION FORM
If you have not already contacted Accident Assist to notify of the accident, vehicle owners / drivers may submit this form to either
your own insurer and / or Persatuan Insurans Am Malaysia or the Malaysian Takaful Association within 7 days from the date of the
accident. This form may also be submitted by a person on behalf of the vehicle owner / driver. Pedestrian / cyclist involved in an
accident are encouraged to fill in this form and submit to Persatuan Insurans Am Malaysia or the Malaysian Takaful Association.
YOUR PERSONAL DETAILS
1.
Are you?
Vehicle owner
Vehicle driver
Vehicle passenger
Pedestrian / Cyclist
Others (Pls. specify) :
2.
Name (as in NRIC)
:
3.
NRIC No.
:
4.
Contact. No.
:
5.
Email address (if Any)
:
6.
Latest residential address (only if different from NRIC)
7.
Registration no. of vehicle involved in an accident
:
8.
Registration no. of tow truck operator
:
(If notification is filed by other than persons involved in accident, please indicate the following)
9.
Relationship to person named in no. 2
:
10. Name (as in NRIC)
:
11. NIRC No.
:
12. Contact. No.
:
13. Email address (if any)
:
Spouse
Parent
Child
Sibling
Other (pls. specify)
14. Latest residential address (only if different from NRIC)
15. DETAIL OF YOUR PASSENGER (if known) :
Name
NRIC No.
Contact No.
Condition
:
:
:
:
No apparent injury
Visible injury
Deceased
Name
NRIC No.
Contact No.
Condition
:
:
:
:
No apparent injury
Visible injury
Deceased
Name
NRIC No.
Contact No.
Condition
:
:
:
:
No apparent injury
Visible injury
Deceased
16. DETAIL OF OTHER VEHICLE DRIVER / PEDESTRIAN / CYCLIST INVOLVED IN ACCIDENT (if known) :
Vehicle Registration No :
Name
:
NRIC No.
:
Contact No. :
Condition : No apparent injury
(at point of
Visible injury
accident)
Deceased
Vehicle Registration No :
Name
:
NRIC No.
:
Contact No. :
Condition : No apparent injury
(at point of
Visible injury
accident)
Deceased
Vehicle Registration No :
Name
:
NRIC No.
:
Contact No. :
Condition : No apparent injury
(at point of
Visible injury
accident)
Deceased
GENERAL ENQUIRIES
Yes
17. Were you injured in the accident?
No
18. Did you got to a clinic / hospital after the road accident?
Yes (pls specify the name of the clinic / hospital)
No
19. Have you made a police report?
Yes (pls specify branch)
No
20. SKETCH OF THE ACCIDENT
Date of Accident :
Location of Accident :
Time of Accident :
Road Condition :
Dry
Wet
Light Conditions :
Daylight
Dawn or dusk
Dark (lighted)
Dark (Unlighted)
Weather Condition :
Sunny / Clear
Raining
Drizzling
Foggy / Hazy
Please sketch in the boxes below, a simple diagram of the accident scene before and after the accident.
BEFORE ACCIDENT (OPTIONAL)
21. I,
AFTER ACCIDENT (OPTIONAL)
(name) state that the particulars stated in this form are, to the best of my knowledge and
that this form shall not be used in a court of law.
Signature
:
NRIC No.
:
Date
:
me
rred. You
have the right to appoint a lawyer of your own choice to advise you on your rights and any claim that you may make. You may
ed
any of your legal right, including making any claim for compensation as a result of the accident.
Letter B
Your name & address
The other driver’s insurance company’s
name & address
Att : Claims Manager
Date of letter
Dear Sir / Madam,
Re : Accident on
(date)
involving Vehicle No.
(other driver’s registration number)
and Vehicle No.
(your driver’s
registration number)
Reference is made to the above matter.
We / I would like to institute a bodily injury and death claim against your vehicle no.
(other driver’s registration number)
Enclosed herewith are the relevant documents for your further action :
Injury claim
Report to the police on accident
Police sketch plan and / or photos (if any)
Medical reports
Medical bills / receipts
Post mortem reports (if any)
Documentary proof of relationship (if dependents’ claiming)
Latest salary slip
Other :
Thank you.
Yours faithfully,
Name :
Identification card number :
Fatal claim