Bagan Specialist Centre

Make an appointment

Accident Medical Reports

RM80.00

Personal Accident insurance or PA insurance is an annual policy which provides compensation in the event of injuries, disability or death caused solely by violent, accidental, external and visible events. It is different from life insurance and medical & health insurance. This is also can be claimed under SOCSO , EPF and/or Jabatan Kebajikan Masyarakat. An accident claim can be claimed by an insured if the policy included accident claim. A form from your insurance provider can be sent to us for our consultant to fill up the “ Part II “ or “ Attending Physician Statement “ in order for you to submit your claim (s). You will find an accident insurance policy from several insurance companies in Malaysia. In case there is an injury due to an accident that requires immediate treatment, the policy will ensure coverage for the costs in this case. Please ensure all these documents below are completed before send your application to your insurance provider.
  1. Accident Claim Form Part I & II
  2. Original itemised bill and payment receipts
  3. X-ray report, MRI report or other reports related to the injury
Example of Form:
  1. Please ensure insurance form for consultant to fill up must be “Attending Physician Statement “ .
  2. Consent must be signed by patients’ ONLY. Refer our consent attached.
  3. If form is submitted by agent, an authorize letter signed by patients’ also required.
  4. A report will be completed within 14 working days* and delivery by courier will take 3 working days to arrive at your respective address.
*Terms and conditions applied. Refer to T&C section Downloads BSC – Consent for release of information 

Please Provide All 3 (in pdf | max 5mb)
  *Consent/ Authorization Form
  *Claim Form
  *Copy Of Patient NRIC

*Consent / Authorization Form | *Claim Form | *Copy of patient NRIC

Find Doctors

Select Doctor Specialty


This will close in 0 seconds