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Workmen Compensation Claims

The Pacific Insurance Berhad > Make A Claim > Workmen Compensation Claims

Workmen Compensation Claims

In the event of any occurrence which may give rise to a claim under this policy, the Insured shall:-

  • Give immediately notice to the Company with full particulars of the incident
  • Notify police if it is a vehicular accident or fatal accident
  • Co-operate with the adjusters when called upon

Documentation required:

  • Completed claim form
  • Medical report (Original)
  • Details of medical expenses incurred (original)
  • Police report if it is a vehicular accident or fatal accident
  • Memorandum of Agreement if it is a fatal accident
  • Wages records/vouchers for the last six months prior to the accidents
  • In the event of fatal accident:
    • Burial permit
    • Death Certificate
    • Post Mortem Report
  • For all item (exclude claim form) – where original not available, copy is acceptable but must be certified true copy by Commissioner of Oath or Original signed by Company Official.
  • Complete list of workers and salary paid.

If you require any assistance or forms for the above, kindly contact your agent or our Claim Department at 03 2633 8999 or write to us at customerservice@pacificinsurance.com.my