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Family Takaful Claim Form for Individual Family Takaful Plan (Malaysia) Mobile App

Quickly complete and submit claims from any mobile device with this Family Takaful Claim Form for Individual Family Takaful Plan (Malaysia) app. Includes participant details, type of claim, claimant declaration and more.

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Take a peek inside the Family Takaful Claim Form for Individual Family Takaful Plan (Malaysia) Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

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    1. Takaful Certificate No / No Sijil Takaful

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    2. Name / Nama

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    3. New NRIC No / No KP Baru

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    Old IC No/Passport No/Company Registration No / No KP Lama/No Pasport/No Pendaftaran Syarikat

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    4. Correspondence Address / Alamat Surat-menyurat

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    5. Telephone / Telefon

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    Handphone / Telefon Bimbit

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    Facsimile No / No Faksimili

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    6. E-Mail Address / Alamat E-mel

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    7. Name of Member/Employee covered by this certificate / Name ahli/kakitangan yang dilindungi di ...

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    8. Selected Benefit Category, if applicable / Kategori mafaat yang disertai, sekiranya berkenaan

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    Death / Kematian

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    Permanent Total Disability / Keilatan Kekal Sepenuhnya

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    Permanent Partial Disability / Keilatan Kekal Sebahagian

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    Temporary Total Disability / Keilatan Sementara Sebahagian

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    Temporary Partial Disability / Keilatan Sementara Sebahagian

  • Ico checkbox

    Critical Illness / Penyakit Kritikal

  • Ico checkbox

    Medical Expenses / Perbelanjaan Perubatan

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    Hospitalisation Benefit / Manfaat Hospital

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    Funeral Expenses / Perbelanjaan Pengkebumian

  • Ico checkbox

    Bereavement Benefit / Khairat Kematian

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    Academic Excellence Award / Anugerah Kecemerlangan Akademik

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    Others, please specify / Lain-Lain, sila nyatakan

  • Ico statictext

    Please complete the specified claim forms and submit supporting documents listed in the form / Si...

  • Ico statictext

    Please note that the Company may require additional supporting documents to be submitted after th...

  • Ico statictext

    Part 3 : Declaration by Participant and/or Claimant / Perakuan Peserta dan/atau Pihak Yang Menuntut

  • Ico statictext

    I/We hereby declare that, to the best of my/our knowledge, the above statements and facts are tru...

  • Ico statictext

    This for was completed by someone else, I/we hereby declare that all statements provided by them ...

  • ...and More!

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