InovaCare

Policy Number *

Please key in your 8 – 10 digit numeric policy number, without the alphabetical letters.

(A) Particulars of Insured (Pet Parent)

Name of Insured (Pet Parent) *

(As in NRIC/FIN/Passport)

Gender *

Male

Female

NRIC / FIN / Passport No *

Business / Occupation *

Business / Home Address *

Contact Person+ *

Email Address *

Contact Number (H) *

Contact Number (O)

Contact Number (HP)

(B) Particulars of Pet

Name of Pet *

Gender *

Male

Female

Microchip No *

Breed Type *

Type of Pet *

Dog

Cat

Date of Birth *

Age *

Reside same premise as Insured *

Yes

(C) Details of Claim

For Injury Cases
Please submit:

Complete vaccination records
Original medical bills / receipts
Medical certificates, if applicable, medical report / discharge summary
Police report, if applicable
Death certificates and letters of administration / probate, if applicable
Coroner's findings / post mortem report / toxicological report, if applicable
Documentary proof of relationship between deceased and claimant, if applicable.

For Illness
Please submit:

Complete vaccination records
Original medical bills / receipts
Medical certificates, if applicable, medical report / discharge summary
Death certificate and letters of administration /probate, if applicable
Coroner's findings / post mortem report / toxicological report, if applicable
Documentary proof of relationship between deceased and claimant, if applicable.

Accidental Injury

Place *

Date *

Time *

State fully what happened / Nature and Extent of Injury sustained *

Has your Pet previously suffered from an injury to the same part? *

Yes

Are there any more medical bills to be submitted? *

Yes

Sickness (if applicable)

Nature of Sickness / Symptom

Date First Began

Date First Treated

Has the sickness been treated previously?

Yes

If Yes, please state Name and Address of the Veterinarian

Date of previous treatment

Is the sickness due to breeding, spaying or neutering?

Yes

If Yes, please specify condition

Final Expenses Claim

Cause of Death

Reason for Euthanasia (if applicable)

Other Insurance or Compensation

Is the Pet presently also insured for Pet insurance under another Insurance Company? *

Yes

If Yes, please state Name of Insurance Company and Policy Number:

Is the Pet claiming from another Insurance Company/other sources? *

Yes

If Yes, please provide a copy of their settlement details:

(D) Supporting Documents

Original medical bills / receipts *
You may upload up to 10 files in GIF, JPG, JPEG, PNG or PDF format. The total file size should not exceed 15 MB. If you are unable to attach your file, please e-mail it to petclaims@inovacare.com and quote the policy number.

Medical Report / Discharge Summary *
You may upload up to 10 files in GIF, JPG, JPEG, PNG or PDF format. The total file size should not exceed 15 MB. If you are unable to attach your file, please e-mail it to petclaims@inovacare.com and quote the policy number.

(E) Medical Authorisation

I hereby authorise any veterinarian or other person who has attended or examined my pet to furnish to the Insurer or its representative any and all information on my pet's illness, injury, medical history, consultations, prescriptions or treatment, with copies of all hospital or medical records. A photocopy of this authorisation shall be considered as effective and valid as the original.

Signature of Insured (Pet Parent) *

After draw signature please confirm signature

(F) Mode of Payment (if applicable)

My preferred way to receive payment is *

Credit to my bank account

PayNow (Only for registered NRIC/FIN)
Please ensure your PayNow is registered with NRIC / FIN.

Bank Details

Account Holder *

NRIC / FIN /UEN Number *

Bank Name *

Bank Code *

Branch Code *

Bank Account Number (Please key in numbers only and omit any dashes ‘-’) *

Please confirm that your PayNow is registered with NRIC/FIN? *

Yes, confirm

No/Not Sure

PayNow Details

Please ensure you have registered for PayNow with your NRIC/FIN with one of the participating banks: https://www.abs.org.sg/consumer-banking/pay-now

If you have not registered for PayNow with your NRIC/FIN, please choose a different payment method to receive your payment.

Account Holder *

NRIC/FIN *

e.g. S1234567A(NRIC)

If your PayNow is not registered with NRIC/FIN or you are unsure which method had been used for PayNow registration, select "Credit to my bank account" instead.

(G) Declaration

Please note that you are submitting this claim to MSIG Insurance (Singapore) Pte. Ltd. Please see our full Terms of Use and Privacy & Cookies Policy on our website www.msig.com.sg.

By submitting this claim to us, you are deemed to have agreed to us collecting, using, disclosing and processing your personal data for the purpose of assessing your claim. We may also share your personal data with other Insurers and the General Insurance Association of Singapore (as well as their Third Party service providers) as part of the industry’s efforts for proper underwriting and proper administration of claims. This may include sharing the personal data for investigating fraud, exaggerated claims, and other criminal or improper acts.

I/We declare that the information given is true and correct to the best of my/our knowledge and belief. I/We understand that any false or fraudulent statements or any attempt to suppress or conceal any material facts shall render the policy void and the Insurer may refuse to pay the claim. *

Name *