Filing an insurance claim shouldn’t add stress to an already difficult situation. Bank Negara Malaysia has pushed insurers to simplify procedures and speed up approvals, with many now offering digital platforms for submissions and real-time tracking.

Act Fast: What To Do Immediately

Motor Accidents

The 24-hour window is non-negotiable. Under Section 52(2) of the Road Transport Act, you must lodge a police report within 24 hours or face penalties: up to RM2,000 fine or six months imprisonment for first conviction, and up to RM4,000 fine and/or 12 months imprisonment for subsequent offences. Your insurer may also reject your claim entirely if you miss this deadline.

At the accident scene: take photos of all damage from multiple angles, exchange details with the other party (name, IC number, vehicle registration, insurance details), and call emergency services if needed. After making your police report, notify your insurer within 7 days.

Medical Claims

If you have a cashless policy, call your insurer to issue a Guarantee Letter to the panel hospital. If you have a reimbursement policy, keep all original receipts and submit within 30 days (though some policies allow up to 90 days, so check your policy terms).

Property Damage

Take photos before cleanup and contact your insurer immediately for adjuster inspection. Don’t start repairs without written approval.

Travel Insurance

File Property Irregularity Reports with airlines immediately for baggage issues, and contact your insurer’s 24-hour helpline for overseas medical emergencies.

Essential Documents You’ll Need

For Motor Claims

• Original police report and investigation results 
• NRIC and driving licence copies (must be valid at time of accident) 
• Vehicle registration card (geran) showing current road tax 
• Photos of damage and accident scene 
• Repair quotations from workshops 
• For theft: all vehicle keys and remote controls

For Medical Claims

• Original itemised bills and official receipts 
• Discharge summaries and medical reports 
• Diagnostic reports (X-rays, MRI scans, blood tests) 
• Medical card copy and policy schedule 
• GP referral letter (for specialist treatment) 
• For overseas treatment: passport copies, boarding passes, bills in English or with certified translations

For Property Claims

• Photos of damage before cleanup 
• Repair quotations 
• Proof of ownership (receipts, invoices) 
• Police report (if applicable for theft or vandalism)

For Travel Claims

• Property Irregularity Reports from airlines (baggage issues) 
• Airline’s written confirmation (flight delays) 
• Medical reports (treatment abroad) 
• Tour payment receipts (cancellations)

The Claims Submission Process

Start by notifying your insurer immediately via phone, app, or email. You’ll receive a claim reference number. Many insurers now use automated systems to assign an adjuster right away.

Next, submit all required documents through their online portal or at a branch. Your insurer will acknowledge receipt within 7 working days. If anything is missing, they’ll let you know within 14 working days.

For motor and property claims, an adjuster will inspect the damage to verify repair costs. This inspection typically happens within a few days of notification. The adjuster’s report then becomes the basis for your settlement amount.

From there, your insurer reviews the report to make an approval or rejection decision. Straightforward motor claims with complete documentation take 5 working days. Theft claims require a decision on whether to investigate within 1 working day, with a final decision within 60 days.

Once approved, motor repairs commence within 15 working days at authorised workshops. Medical reimbursement claims are processed within 7 working days from receipt of original bills. You’ll receive final payment after repair completion or when you sign the discharge voucher.

Throughout this process, your insurer should provide status updates every 14 working days, as set by Bank Negara Malaysia’s Policy Document on Claims Settlement Practices.

How Long Claims Take

Bank Negara Malaysia has established clear service standards:

• Motor Own Damage (non-complex): 5 working days for decision
• Motor repairs commence: 15 working days after approval
• Medical reimbursement: 7 working days from receipt of bills
• Theft investigations: Final decision within 60 days
• Status updates: Every 14 working days

Loss Of Use Compensation

If you’re not at fault, you can claim Compensation for Assessed Repair Time (CART) based on your engine capacity. The rates are fixed by PIAM (Persatuan Insurans Am Malaysia): RM30 per day for vehicles up to 1500cc, RM40 per day for 1500cc to 2000cc, and RM50 per day for anything above 2000cc.

If you drive a 1.6L Proton X50, which falls into the RM40 per day bracket, and the adjuster assesses 8 days for repairs, you’d receive RM320 from the at-fault driver’s insurer. This amount can help cover Grab rides or a basic rental car while your vehicle is being repaired.

CART is based on assessed repair time, not actual workshop days.

Why Claims Get Rejected And What To Avoid

Late reporting and incomplete documentation are the most common reasons for rejection. Always check your policy or ask your agent exactly what’s needed before submitting.

Policy exclusions catch many people out. Common ones include driving without a valid licence, driving under alcohol influence, using personal vehicles for e-hailing without the proper endorsement, pre-existing medical conditions within waiting periods, and unauthorised repairs.

Under-insurance triggers the Average Clause. If your car is worth RM80,000 but you insured it for only RM60,000 (75% of actual value), and you have RM40,000 damage, you’ll only receive RM30,000 (75% of the damage). You’d be short RM10,000 because you bore the risk equivalent to the premium you avoided paying. Understanding how comprehensive car insurance works helps you avoid this costly mistake.

Skipping Special Perils is risky if you live in flood-prone areas like parts of Selangor, Pahang, or Johor. This add-on covers floods, landslides, and windstorms that standard policies exclude. Without it, flood damage claims are automatically rejected.

Other common mistakes include dealing with unauthorised “tow truck vultures” at accident scenes (only use your insurer’s authorised panel workshops), accepting cash settlements from other drivers without proper reporting (additional damage may surface later with no recourse), and not keeping receipts for reimbursement claims. Original receipts are mandatory; keep them in a folder and photograph as backup.

If Your Claim Is Rejected

Request a formal rejection letter that specifies which policy clauses apply. Then file an internal appeal with the insurer’s Internal Dispute Resolution unit, providing additional evidence or clarification.

If that doesn’t work, you can escalate to the Financial Markets Ombudsman Service (FMOS) within 6 months of the insurer’s final decision. FMOS handles insurance disputes through a two-stage process: case management (mediation and negotiation) followed by binding adjudication if settlement isn’t reached.

Practical Tips

The claims process doesn’t have to be complicated. Keep digital copies of your policy documents on your phone and photograph your vehicle when you first insure it. When something happens, you’ll have everything you need at your fingertips.

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