For details about claims, please refer to the SRB-Claims [Eng] [Chi] (Updated: 2 Aug 2018)
OnePlatform Internal Document
CS eform
Principal Document
(A) Death Benefit Checklist
(Accidental Cause of Death Only) Completed Claim Form with all necessary documents must be submitted to Sun Life within 90 days from date of the death of the life insured.
| Basic Claims Requirements | - Life Insurance Claim-Claimant's Statement ([L4]) (Completed by the named-beneficiary)
- Attending Physician's Statement - Life Insurance ([A2]) (Completed by the named-beneficiary) - CRS Self Certification Form ([C5]) - Original Death Certificate / Notarial Death Certificate/ Presumption of Death Certificate issued by High Court: - Certified True Copy HKID of the deceased and the beneficiary - Relationship proof between the Deceased and the Beneficiary - Original Policy Provision or Declaration of lost of the Policy - Police / Traffic Accident report or the Traffic Accident Liability Agreement (for accidental death) - Autopsy / Death Report (Must for Accidental Death and may be required for Natural Death) - Travel Document - Cancellation of HKID Card Certificate (to be issued by The Immigration Department of HKSAR) (Applicable to death occurred overseas or for insured have right for residence outside of HK or Macau region - Cancellation of the Household Registration (註銷戶籍/居留證明) (Applicable to death occurred overseas or for insured have right for residence outside of HK or Macau region, e.g. in Mainland China) |
| Additional Requirements | 1. If Death occurred in Mainland China, require both of the Death Certificate and the Notaial Death Certificate
2. If the insured is missing, need to submit the Original Death Certificate and the Presumption of Death Certificate issued by High Court (accept Certified True Copy) 3. If the insured was admitted to the Hospital in the Mainland China prior to death, the following documents are required： - Admission Record -1st page (住院病案首頁) /Discharge Summary (醫院總結) / Medical report (醫療報告) - All Laboratory report ( accept copy) - Medical Certificate of the Cause of death (居民死亡醫學証明書(醫院簽發)) |
(B) Accident (SunCare) Benefit Checklist
Claimants must submit the completed claim form with all claims requirements to Sun Life within 90 days of the accident.
| Basic Claims Requirements | - Accident Benefit Claim Form ([A3]):
Part I ( to be completed by the Claimant) Part II ( to be completed by the Attending Doctor) - Laboratory report, Ultrasound, X-ray, CT Scan, MRI, physiotherapy or occupational report (accept copy) - Sick Leave Certificate with clear diagnosis - Original Receipts (accept Certified True Copy of the Receipt issued by the first insurer for balance claim) - HK ID card copy of the Policy Owner (if no record in our Company before) |
| Additional Requirements | Sun Life as the 2nd insurer (insured only claim the balance), the following documents are required: |
| - Accept Claim Form Part II (APS) of 1st Insurer
- Original Receipt or Certified True Copy issued by the 1st Insurer if for balance claim - Payment Breakdown issued by 1st Insurer |
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| For injury caused by Road Traffic Accident, the following additional documents are required: | |
| - Policy Statement (Oral Statement given by the insured or insured's family members) / Police Report / Traffic Accident Report (if any)
- If the Road Traffic Accident happened in Mainland China, then the "Road Traffic Accident Liability Agreement" (道路交通事故責任認書) must be submitted |
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| For injury happened in Public transportation system / public facilities: | |
| - Confirmation letter issued by the concerned Public Transport Organization (if necessary)
- Policy Statement (Oral Statement given by the insured or insured's family members) / Police Report / Traffic Accident Report (if any) |
(C) Hospital Income (HI) Benefit Checklist
Claimants must submit the completed claim form with all claims requirements to Sun Life within 90 days of the Hospitalization
| Basic Claims Requirements | - Hospitalization Benefit Claim Form ([H1]):
Part I (to be completed by the insured) Part II (APS) (to be completed by the attending doctor) - All Laboratory report, Ultrasound, X-ray, CT Scan , MRI or pathology report ( accept copy) - Medical Certificate with clear Diagnosis - Hospital Discharge Summary (If the Insured confined in Hospital Authority hospital) - Certified True Copy of the original receipt issued by the 1st insurer - HK ID card copy of the Policy Owner (if no record in our Company before) |
| Additional Requirements | If Sun Life is the 2nd insurer (for balance claim), the following is the additional requirements: |
| - APS issued by the Attending Doctor under the 1st Insurer's Claim Form
- Certified True Copy of the original receipt issued by the 1st insurer - Payment breakdown issued by the 1st insurer |
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| If Hospitalization at the Hospitals in Mainland China, the following additional documents are required: | |
| - Admission Record – first page (住院病案首頁)
- All laboratory test report (檢查報告) - Daily Treatment expenses listing / breakdown details (每日治療費用清單/明細表) - Original Receipt or Certified True Copy of the original receipt issued by the 1st insurer and the payment breakdown - Doctor's Advice ( 醫囑單/臨時醫囑單) - Daily Medical Record Booklet (每日醫療報告簿) |
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| If admission due to Traffic Accident, the following documents are required: | |
| - Policy Statement (Oral Statement given by the insured or insured's family members) / Police Report / Traffic Accident Report (if any)
- Discharge Summary - If the Road Traffic Accident happened in Mainland China, then the claimant should ask for the "Road Traffic Accident Liability Agreement" issued by the local police in Mainland China (道路交通事故責任認定書) |
(D) Total Disability Benefit / Waiver of Premium Benefit Checklist
Completed Claim Form with all necessary documents must be submitted to Sun Life within 6 months / 180 days from date of disability.
| Basic Claims Requirements | - Disability Benefit Claim Form ([D4]):
Part I (to be completed by Insured) Part II (Attending Physician's Statement of Disability to be completed by the attending doctor) - Laboratory, Ultrasound, X-ray, CT scan, MRI and Pathological Report (accept copy) - Medical Sick Leave Certificate with clear diagnosis - Employer Confirmation – to confirm the sick leave period (absence from work) due to disability (accept copy) - Physiotherapy / Occupational Therapy Reports (accept copy) - HK ID card copy of the Policy Owner (if no record in our Company before) |
| Additional Requirements | If disability arising from injury on duty at work or Road Traffic Accident, the following documents may be required |
| - Workmen's Compensation Assessment Certificate (Form 5/7) (apply to Industrial / Occupational injury)
- Oral Statement / Police Statement Report - If the Road Traffic Accident happened in Mainland China, then the "Road Traffic Accident Liability Agreement" (道路交通事故責任認定書) must be submitted |
(E) Critical Illness Benefit Checklist
Completed Claim Form together with all necessary documents must be given to Sun Life within 90 days from the date of diagnosis of critical illness or performing relevant surgery.
| Basic Claims Requirements | - Critical Illness Benefit Claim Form Part I ([C6]) ( to be completed by Insured)
- Claim Form Part II (Attending Physician Statement to be completed by the Attending Physician, please download forms from SunSurf > Life Admin >All Life Business Administration Forms(ILO)) - Laboratory, Ultrasound, X-ray, CT Scan, MRI and Pathological Report (accept copy) - HK ID card copy of the Policy Owner (if no record in our Company before) |
| Additional Requirements | Claims Arising in China |
| - In-patient Summary/ Daily Medical Record
- Medical Receipts (accept copy) - Statement of Accounts with daily expenses detail breakdown - Doctor's Medical Treatment Advice |
FAQ / Guideline
Sun Life Customer Hotline: 21038118 →press “1” → press “