Claimant's Statement Disability Claim Form Medical Certificate & TPD Form

Required documents

  • Completed and signed Claimant's Statement Disability Claim Form

  • Original Policy Contract

  • Copy of ID card

  • Medical certificates 

  • Medical appointment cards

  • Physician's statement

  • NPF Forms/Social Security Card

  • Police report (in case of accident)

Send us the completed form with the original required documents

by post or drop it at your nearest NIC branch.