Mitsui Sumitomo Insurance (China) Company, Limited
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Injury Insurance   

 Claim Procedure

 Documents List for Claims

◎ IPA claim form and claim application form (with official chop)
◎ The employment contract or other relevant documents which can prove the relationship between the insured and policy holder
◎ The insured’s identity card
◎ Medical records/reports offered by the medical organization which appointed or recognized by the MSI (China)
◎ original medical receipts (only aiming at the claim which attaches the term of IPA Medical Expenses)
◎ hospital discharge notes (only aiming at the claim which attaches the term of IPA Hospital Allowance)
◎ If the disability listed in the policy is occured, the insured should provide certificate issued by the relative authority appointed or recognized
     by the MSI (China).
◎ In case of fatal accident, please provide the registration certificate and identity card of the insured and his/her beneficiary (if the insured
     was announced dead, please bring forward death certificate by court). The certificate of death and registration cancellation also should
     be submitted by the medical organization which appointed or recognized by the MSI (china) and police.
◎ other documents which relate to the reason, nature and extent of the accident


Please kindly be noted all above mentioned are just for your reference. It maybe need you to provide extra documents aiming at particular case. By then we will explain to you according to different situation.
Thank you for your understanding and support.


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Mitsui Sumitomo Insurance (China) Company, Ltd.
34F,Shanghai World Financial Center,100 Century Avenue,Pudong New Area,Shanghai 200120
Tel:021-68777800    Fax:021-68776066