Application Forms and Documents

You will find here below useful forms, such as application and claim forms.

Affordable Insurance In Cambodia

Application Forms

The application form is different for each product. ie Business Health Protect, Family Health Protect and Private Health Protect.

Application Form- Business Health Protect – EN

Application Form – Family Health Protect – EN

Application Form – Private Health Protect – EN

Application Form- Family Health Protect – KH

Application Form – Private Health Protect – KH

Documents and Claim Forms

In this section, you will find claim forms and addition forms that you may need during the life of your policy.

Claim Form – EN. You can also click here to file your claim online.

Claim Form – KH. You can also click here to file your claim online.

Add a member – EN for Family Health Protect

Add a member – KH for Family Health Protect

Direct Billing Claim Form (for Hospital partners)