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Auto Insurance Claim

Out-Patient In-Patient

Here’s how to file an Out-Patient Claim

Check Your Policy Coverage

It’s always a good idea to first check that your policy covers the claim. You may contact us or review your policy details.


Prepare and Complete All Required Documents

1. Completely accomplished, dated and signed Out Patients Claim Form

2. Completely accomplished, dated and signed Attending Physician’s Form

3. Certified True Copy of Complete medical/hospital records of insured from previous and recent consultations and confinements including but not limited to Medical Certificate, Admitting History Record, Clinical Abstract, Discharge Summary, lab result and all diagnostic results.

4. Copy of Insured’s government ID with date of birth, photo and signature

5. Proof of Bank Account (Please submit a copy of any of the following. Make sure your full name and account number are visible:
a. Statement of account
b. ATM card
c. Validated deposit slip
d. Passbook
e. Screenshot of your online bank account)


Log in to Online Portal and Submit Claim

Login to the Etiqa Online Shop Portal and submit this claim using our easy claims submission form.


Track your Claim Status

After submission, we’ll quickly review your documents and get in touch with you at the soonest possible time. Through our Etiqa Online Shop Portal, you’ll be able to track the status of your claim.

If you need to follow up on your request, please email us at claims@etiqa.com.ph


Here’s how to file an In-Patient Claim

Check Your Policy Coverage

It’s always a good idea to first check that your policy covers the claim. You may contact us or review your policy details.


Prepare and Complete All Required Documents

1. Completely accomplished, dated and signed Out Patients Claim Form

2. Completely accomplished, dated and signed Attending Physician’s Form

3. Certified True Copy of Complete medical/hospital records of insured from previous and recent consultations and confinements including but not limited to Medical Certificate, Admitting History Record, Clinical Abstract, Discharge Summary, lab result and all diagnostic results.

4. Copy of Insured’s government ID with date of birth, photo and signature

5. Proof of Bank Account (Please submit a copy of any of the following. Make sure your full name and account number are visible:
a. Statement of account
b. ATM card
c. Validated deposit slip
d. Passbook
e. Screenshot of your online bank account)


Download your Out Patient forms

Out Patient Claims Form

28.79 KB

Attending Physician’s Form

28.79 KB

General Claims Form

28.79 KB

Download your In Patient forms

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28.79 KB

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28.79 KB

File this claim now!

For Individual Customers

Do you have a personal insurance policy?

Make claims filing and tracking a breeze through our Etiqa Online Shop Portal accessible anytime, anywhere.

For Corporate Customers

Are you insured by your company?

Are you a corporate client? You may file this claim through the Etiqa Corporate Portal.

Ready to file?