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Get Formulir Klaim Axa Mandiri

Tanpa keterangan medis (Dokter) yang diajukan oleh Tertanggung (pemegang polis/tiket tanda masuk) atas biaya sendiri. This report must be completed and returned within 14 (fourteen) days since the accident. A claim will not be processed further without submission of a medical certificate (Doctor) filed by the insured (the policyholder/admission ticket) at his own expense. 1. Nomor Polis Asuransi & Periode Pertanggungan Insurance Policy Number & Coverage Period /.

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