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Insurance Claim Form (Singapore)

Insurance Claim Form (Singapore)

INSURANCE CLAIM FORM

Submitted to: [Insurer]

Policy Number: [Policy Number]

Type of Claim: [Claim Type]

Policy Period: [Policy Start Date] to [Policy End Date]

1. CLAIMANT DETAILS

Name: [Claimant Name]

NRIC/FIN/Passport: [Claimant NRIC]

Contact number: [Claimant Phone]

Email: [Claimant Email]

Address: [Claimant Address]

2. INCIDENT / LOSS DETAILS

Date of incident: [Incident Date]

Location: [Incident Location]

Estimated loss amount: S$[Estimated Loss]

Police report filed: [Police Report]

Police report number: [Police Report No]

Description of incident / loss:

[Incident Description]

3. SUPPORTING DOCUMENTS SUBMITTED

[Supporting Documents]

Payment details: Account in the name of [Bank Account Name], account/PayNow: [Bank Account].

4. DECLARATION

I, [Claimant Name], declare that the information given in this claim form is true and complete to the best of my knowledge and belief. I understand that the submission of a fraudulent insurance claim is a criminal offence under the Penal Code 1871 and may result in prosecution and/or policy cancellation. I consent to the insurer verifying the information provided and contacting relevant third parties (hospitals, police, repairers) to process this claim, in accordance with the Personal Data Protection Act 2012.

Claimant signature: ___________________________

Date: ___________________________

Claimant

________________

Signature

Date: ________________

Maintained by Vladislav Sergienko, Founder·Template last modified: ·Report an error

What Is a Insurance Claim Form (Singapore)?

An Insurance Claim Form in Singapore is the formal document a policyholder or claimant submits to an insurer to initiate the claims process following an insured event, loss, or liability. Singapore contract law (based on English common law, received under the Application of English Law Act 1993) underpins the contractual relationship between insurer and policyholder, while the Insurance Act 1966 (Cap. 142) and MAS Guidelines on Fair Dealing regulate how insurers process and settle claims in the Singapore market.

Singapore insurance claims span multiple product categories regulated by MAS: life insurance (death, critical illness, total permanent disability), general insurance (motor, property, marine, travel), and health insurance (MediShield Life, Integrated Shield Plans, and employer group policies). Each category follows distinct claims procedures prescribed by the insurer's policy terms and conditions, but the foundational requirement — a completed claim form with supporting documentation — applies universally.

MAS Notice 120 on Conduct of Business requires insurers and their intermediaries to process claims fairly, promptly, and without unreasonable delay. The General Insurance Association of Singapore (GIA) publishes claims handling guidelines that member insurers must follow, including prescribed response timeframes: acknowledgement within five business days of claim receipt, and settlement or denial within 30 business days after all documentation has been submitted.

For motor insurance claims, the Motor Insurers' Bureau of Singapore (MIB) operates the NCD (No-Claim Discount) Protection Scheme and handles claims involving uninsured or untraced motorists on Singapore roads. The Singapore Traffic Police report, obtainable from the Singapore Police Force, is a mandatory supporting document for motor accident claims.

Life insurance claims in Singapore must comply with the Life Insurance Association Singapore (LIA) Code of Practice. Section 59 of the Insurance Act requires insurers to pay death benefits within a specified period after receiving proof of death (typically a death certificate issued by the Registry of Births and Deaths under the Registration of Births and Deaths Act, Cap. 267). The Central Provident Fund Board (CPFB) processes claims on CPF-linked insurance products, including Dependants' Protection Scheme (DPS) and Home Protection Scheme (HPS) policies administered by CPF-appointed insurers.

Health insurance claims involving MediShield Life — the national basic health insurance scheme administered by the CPF Board — follow prescribed procedures under the MediShield Life Scheme Act 2015. Integrated Shield Plan (IP) claims are processed by the private insurer (AIA, Great Eastern, NTUC Income, Prudential, or Singlife) with automatic deduction of the MediShield Life component.

The Personal Data Protection Act 2012 (PDPA) governs the collection and processing of personal data in insurance claims, including medical records, police reports, and financial documentation. The PDPC expects insurers and claimants to handle sensitive data in accordance with the consent and purpose limitation obligations under Sections 13 and 18 of the PDPA.

The Financial Industry Disputes Resolution Centre (FIDReC) provides an independent dispute resolution mechanism for insurance claim disputes between policyholders and insurers. FIDReC handles complaints where the insurer denies a claim, disputes the quantum, or delays settlement beyond the GIA-prescribed timeframes. Policyholders may file a complaint at no cost for claims within FIDReC's jurisdictional limits — $100,000 for general insurance and $200,000 for life insurance.

The Workplace Safety and Health Act (Cap. 354A) intersects with insurance claims where the insured event involves a workplace accident. Employers must report workplace injuries to MOM within defined timeframes, and the MOM incident report supports the insurance claim filed with the employer's work injury compensation insurer.

When Do You Need a Insurance Claim Form (Singapore)?

An Insurance Claim Form in Singapore becomes necessary whenever a policyholder experiences an event covered by their insurance policy and seeks financial compensation or benefit payment from the insurer.

Motor vehicle accidents on Singapore roads require immediate reporting to the Singapore Police Force under Section 84 of the Road Traffic Act (Cap. 276) and subsequent filing of a motor insurance claim with the policyholder's general insurer. The General Insurance Association of Singapore (GIA) Accident Reporting Centre network provides designated facilities for reporting and documenting vehicle damage within 24 hours of the accident.

Property damage from fire, flood, or natural events triggers building and contents insurance claims. The Singapore Civil Defence Force (SCDF) fire investigation report supports fire-related claims, while the Public Utilities Board (PUB) flood incident records document water damage for properties in designated flood-prone areas. Commercial property insurance claims for ACRA-registered businesses may involve business interruption coverage, requiring detailed financial records certified by a Singapore-registered public accountant.

Workplace injuries governed by the Work Injury Compensation Act (Cap. 354) require employers to file claims on behalf of injured employees. The Ministry of Manpower (MOM) administers the statutory work injury compensation scheme, and claims must be filed within 12 months of the accident or diagnosis of occupational disease under Section 11 of WICA.

Medical treatment at public hospitals (Singapore General Hospital, National University Hospital, Changi General Hospital) and polyclinics operated by SingHealth or National University Health System generates Integrated Shield Plan and MediShield Life claims. Hospital billing departments typically initiate pre-authorisation with the insurer before treatment and submit claims directly through the MediClaim electronic system.

Death of a policyholder triggers life insurance claims by the designated beneficiary. The claim requires a death certificate from the Registry of Births and Deaths, the original policy document, and a claim form completed by the beneficiary. CPF-linked insurance products (DPS, HPS) require additional CPFB documentation.

Travel insurance claims arise when Singapore residents experience trip cancellations, medical emergencies abroad, or baggage loss during overseas travel. The insurer typically requires supporting evidence from the overseas hospital, airline, or local police depending on the nature of the claim.

What to Include in Your Insurance Claim Form (Singapore)

An Insurance Claim Form compliant with the Insurance Act 1966 (Cap. 142), MAS fair dealing guidelines, and insurer-specific requirements should contain the following mandatory and recommended components. The forms-legal.com Singapore Insurance Claim Form template addresses each element with structured fields aligned to GIA and LIA claims handling standards.

The policy identification section records the policy number, type of insurance (life, general, health), insurer name, policy inception and expiry dates, and the sum insured or coverage limit. Accurate policy details allow the insurer's claims department to locate the relevant policy record and verify coverage status at the time of the claimed event.

The claimant identification section captures the policyholder's full legal name, NRIC or FIN number, contact address, telephone number, and email address. Where the claimant is not the policyholder — such as a third-party motor claim or a beneficiary's life insurance claim — the section distinguishes between the policyholder and the person submitting the claim, recording the relationship and legal authority to claim.

The incident or loss details section is the substantive core of the claim form. For property and general insurance claims, this section records the date, time, and location of the incident, a detailed description of the loss or damage, the estimated or assessed value of the loss, and whether any third party is involved or liable. For life and health claims, the section records the date of diagnosis or death, the medical condition or cause of death, and the treating physician or hospital details. Singapore courts have held that material misrepresentation in this section entitles the insurer to void the claim under the duty of utmost good faith.

The supporting documents section lists required attachments: police reports (obtainable from the Singapore Police Force e-services portal), medical reports from Singapore Medical Council (SMC)-registered practitioners, hospital bills from Ministry of Health (MOH)-licensed facilities, repair quotations from CASE-accredited workshops (for motor claims), death certificates from the Registry of Births and Deaths, and photographs of damage or loss. Each document type should be identified with a checkbox to confirm submission.

The declaration section requires the claimant's signature confirming that all information provided is true and complete, with an acknowledgement that fraudulent claims constitute a criminal offence under Section 420 of the Penal Code (Cap. 224). The declaration also authorises the insurer to obtain information from third parties — hospitals, employers, police — necessary to assess the claim.

A previous claims history section records any prior claims made under the same policy or related policies within the preceding three to five years. Insurers use this information for claims frequency analysis and NCD (No-Claim Discount) adjustments on motor and property policies.

The payment instructions section captures the claimant's preferred settlement method — direct credit to a Singapore bank account (DBS, OCBC, UOB, or other MAS-licensed bank), cheque payment, or assignment of payment to a third party (such as a hospital or repair workshop). GIRO arrangements and PayNow-linked NRIC payments are increasingly common for faster settlement.

A subrogation and recovery clause notifies the claimant that the insurer retains the right to recover claim payments from liable third parties under the doctrine of subrogation. The claimant agrees to cooperate with the insurer's recovery efforts, including providing evidence and attending court proceedings if required by the State Courts.

A consent and authorisation clause permits the insurer to obtain medical records, police reports, and employer records necessary to assess the claim. The PDPA requires the claimant's informed consent before the insurer contacts third-party data holders. The authorisation should specify the types of information the insurer may collect and the purposes for which the information will be used. Under Singapore law, Section 3 of the Trustees Act (Cap. 337) and Section 6 of the Wills Act (Cap. 352) govern the core requirements for this type of document.

Cite this page

Reference this free template in an article, syllabus, or research note:

APA

Forms Legal. (2026). Insurance Claim Form (Singapore) (Singapore) [Legal document template]. Forms Legal. https://forms-legal.com/singapore/personal/insurance/insurance-claim-form-singapore

MLA

"Insurance Claim Form (Singapore) (Singapore)." Forms Legal, 2026, https://forms-legal.com/singapore/personal/insurance/insurance-claim-form-singapore.

BibTeX
@misc{formslegal-insurance-claim-form-singapore,
  author       = {{Forms Legal}},
  title        = {Insurance Claim Form (Singapore) (Singapore)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/singapore/personal/insurance/insurance-claim-form-singapore}},
  note         = {Free legal document template. Based on Insurance Act 1966 (Cap. 142)}
}

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Frequently Asked Questions

Based on Insurance Act 1966 (Cap. 142) — Template last modified June 2026Verify the source →

This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer

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