E-funeral Claim – Takaful Brunei Darussalam

E-funeral Claim

Deceased Details

Full Name * (as NRIC/ID)

ID Type *

ID Number *

Date of Death *

Causes of Death *

Participant / Claimant Details

Full Name * (as NRIC/ID)

ID Type *

ID Number *

Contact No.*

Relationship to Deceased *

Email*

Claim Documents

Copy IC of Deceased*
(Please upload the documents in ONE (1) single file)

Copy IC of Beneficiary*
(Please upload the documents in ONE (1) single file)

Form F- Medical Certificate of the cause of Death (Rule 8)*
(Please upload the documents in ONE (1) single file)

NOTE: Approval Funeral Expenses claim does not mean Death Benefit Covered is approved automatically.

DECLARATION AND AUTHORIZATION

I hereby declare that to the best of my knowledge and belief the foregoing particulars and information stated above are true and correct and that I have not concealed any particulars from TBA on any information within my knowledge connected with the loss/accident and if false statement of declaration be made in support of this claim, the claim shall be null and void.

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