How to make an insurance claim?

Whether you experienced a personal accident, a car collision or an unfortunate medical diagnosis, our claim handling team is there for you 24/7. With Roojai, you can claim online, call over the phone or use our mobile app. We believe that quality insurance claim support is a chance to keep our promise to you, and ensure that we are always there for you, when you need us.

Vehicle Insurance Claim Health Insurance Claim

How to claim insurance with Roojai

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Car insurance claim

Basic steps to claim insurance coverage for car:

  1. Immediately after your road accident, damage to car or any other loss related to your insured vehicle, call Roojai claim number at 02 582 8866 - if anyone is injured, call an ambulance before calling Roojai
  2. If possible, prepare your personal and vehicle documents in case our claim specialists or the police require them to process your case.
  3. If you have the Roojai Mobile App, you can make a live video claim through the app immediately. If you have not yet installed the app, you will have to wait for Roojai’s surveyor to arrive at the car accident scene. - Do not try to determine who is at fault, share any documents or pay any compensation to anyone else involved.
  4. Prepare the required claim forms and documents as listed below depending on your type of claim
  5. Submit your claim documents to Roojai within the specified claim consideration period. Roojai will conduct an investigation and as part of our claim check process, we may ask for additional documents to support your claim settlement.

When will Roojai pay compensation for car claims? - Claim consideration period

The company will pay compensation:

  • within 15 days from the compensation agreement date for voluntary insurance claims; and
  • within 7 days from the compensation agreement date for compulsory insurance claims.

(The compensation agreement date is the date when all documents have been provided, the claims have been validated, and the compensation has been agreed upon.)

For additional details please check the car insurance and motorcycle insurance policy terms and conditions.

What is needed to submit a car claim? - Required documents for the insurance claim process

Here is the list of required documents to process your claim. Prepare them in advance to speed up the claim process. In some circumstances, some additional information may be required.

Required documents in case of damage to the insured vehicle
  • Road accident report
  • Copy of car registration manual
  • Evidence of damages issued by the surveyor
  • Copy of the insurance policy schedule
  • Copy of the driver license of the individual driving during the accident
Required documents in case of damaged or cracked windscreen
  • Road accident report
  • Copy of car registration manual
  • Evidence of damages issued by the surveyor
  • Copy of the insurance policy schedule
  • Copy of the driver license of the individual driving during the accident
Required documents in case of car theft
  • Road accident report
  • Copy of identity card or passport of the car owner
  • Copy of police report and the outcome of police proceedings
  • Letter of power of attorney from financial institutions,in case the car is under finance
  • All keys
  • Original copy of the insurance policy / policy schedule
  • The application form of transfer request issued by Department of Land Transport Original car registration manual
  • Original car registration manual
Required documents in case of third-party property damage

Third-party vehicle damages

  • Evidence of damages issued by surveyor
  • Copy of the driving license of the third-party driver
  • Car repair quotation or receipt
  • Copy of identity card or passport of the car owner

Third Party property damages

  • Repair quotation or receipt (for reimbursement)
  • Copy of identity card of the property owner
Required documents in case of third-party death and bodily injuries

Bodily Injury

  • Copy of third party insurance policy certificate (if any)
  • Copy of the driving license of the third-party driver
  • Copy of identity card or passport of the injured person
  • Copy of police report
  • Original medical invoice(s)
  • Medical certificate

Death

  • Copy of identity card or passport of the deceased
  • Copy of death registration certificate
  • Copy of identity card of the legitimate heir
  • Copy of bank book of the claimant or legitimate heir
Required documents in case of death and bodily injuries (Compulsory motor insurance)

Bodily Injury

  • Copy of police report
  • Copy of identity card or passport of the injured person
  • Original medical invoice(s)
  • Medical certificate (if any)

Death

  • Copy of death registration certificate
  • Copy of identity card of the legitimate heir

Permanent disability

  • Disabled card

Health insurance claim

Basic steps to claim insurance coverage for health:

  1. Immediately after your personal accident or medical diagnosis, call Roojai claim number at 02 582 8855 - ext. 2 - if you are in need of medical help, call an ambulance before calling Roojai
  2. Inform the hospital staff that you will need a medical certificate and copies of all medical treatment documents
  3. Prepare the required claim forms and documents as listed below depending on your type of claim.
  4. Submit your claim documents to Roojai within the specified claim consideration period. Roojai will conduct an investigation and as part of our claim check process, we may ask for additional documents to support your claim settlement.

When will Roojai pay compensation for health claims? - Claim consideration period

The company shall pay compensation within 15 days from the date that the company has obtained complete and accurate evidence of loss or damages. In the event of the insured person’s death, the company shall pay to the beneficiary named in the schedule and/or in the renewal warranty.

In the case that there is any suspicion that a claim does not comply with the insurance coverage agreement of the policy, such a period may be extended as necessary but not exceeding 90 days from the date that the company receives claim evidence in a complete and correct manner.

For additional details please check the cancer insurance and personal accident insurance policy terms and conditions.

What is needed to submit a health claim? - Evidence submission for the health insurance claim process

Compensation benefits from a personal accident

The company shall pay compensation as per the sum insured stated in the schedule and/or the renewal insurance certificate. By claiming for compensation, the insured person, the beneficiary or the representative of the said person, whichever the case may be, must furnish all necessary evidence as required at their own expense to the company.

The insured must submit the following documents within 30 days commencing from the discharge date or the outpatient treatment date:

  • The company’s completed claim form
  • Medical reports that state the symptoms, the results of diagnosis and medical treatment
  • Certified true copy of an ID card or passport of the insured person
  • Original receipt showing medical expenses or summary statement with receipt
  • Other documents requested by the company as necessary (if any)

The company will compensate the actual medical expenses incurred which are deemed reasonable according to medical necessity and medical standard, but not exceeding the sum insured stated in the insurance policy.

The original receipt must be presented. If the company does not reimburse the full medical expense, the company will return the original receipt, certifying the amount paid, so that the insured person can claim the remaining amount from other insurers (if any).

However, if the insured has received partial reimbursement from the government, other welfare/benefit schemes or other insurers, the insured must submit a copy of the receipt and the original statement with a certified amount paid by the government or other authorities to claim the remaining amount from the company.

How to get personal accident insurance coverage? - Compensation benefits using the Roojai Care Card

Roojai Care Card in MyAccount is a special privilege for Roojai personal accident insurance customers. You can receive medical treatment for accidents according to the sum insured in the policy. The steps are as follows:

  • Choose a hospital from over 400 network hospitals across Thailand.
  • Show your Roojai Care Card and your ID card or passport when you visit a hospital or medical clinic
  • Allow for the hospital to check the insurance policy information in the system.
  • Wait for the hospital to send medical treatment details to the company.
  • The company will review the insurance claim and inform the hospital of the compensation details.
  • Sign all necessary documents from the hospital and pay any outstanding balance that is outside the sum insured specified in the policy (if any).
In & Out-Patient Treatment
  1. The cashless hospitalization(IPD/OPD) option will be available only in Roojai network hospitals and for medical treatment of accident happened 60 days after the policy effective date. The policyholder doesn’t need to pay upfront when discharged from the hospital.
  2. For accidents during the first 60 days of the policy effective date, medical expenses must be paid in advance, and request reimbursement afterwards.
  3. The customer can present his/her digital Roojai Care Card with an ID document at the hospital for treatment eligibility confirmation. It is not eligible for overdue payment.
  4. If the treatment is received in a facility outside the Roojai hospital network, only the reimbursement option is available.
Disability benefits from a personal accident

The company will pay compensation in accordance with the sum insured stated in the policy schedule. The insured person must submit the following documents at their own expense within 30 days of diagnosis by a physician that the Insured suffers from total permanent disability or permanent dismemberment.

  • The company’s completed claim form
  • Attending physician’s summary certifying the insured person has suffered from permanent disability or permanent dismemberment.
  • A copy of an ID card or passport of the insured
  • Other documents requested by the company as necessary (if any)
Hospital daily income benefits from a personal accident

In case of any injury causing the insured person to be hospitalised, the company shall pay the daily income compensation during hospitalisation in the amount indicated in the policy schedule. By claiming for compensation, the insured person, the beneficiary or the representative of the said person, whichever the case may be, must submit the following documents to the company within 30 days commencing from the inpatient treatment date as required at their own expense:

  • The company’s completed claim form
  • Medical reports that identify the conditions of requiring prolonged hospitalization
  • Certified true copy of the insured’s ID card
  • Photo of the insured and the injured body part
  • Other documents requested by the company as necessary (if any)
Death benefits from a personal accident

If the insured person, or representative of such person, depending on circumstances didn't claim for compensation benefits and then the insured died from an accident, the beneficiary, or representative of such person, depending on circumstances, must submit the following documents or evidence at their own expense to the company within 30 days from the date.

  • The company’s completed claim form
  • Certified true copy of the insured person’s death certificate
  • Certified true copy of autopsy &dissection report
  • Certified true copy of daily police report, investigation report, judgment in case of lawsuit (certified true copy by the police officer handling the case)
  • Certified true copy of the insured person’s ID card or passport and house registration stamped “deceased”
  • Certified true copy of the beneficiary’s ID card or passport and house registration
  • Other documents requested by the company as necessary (if any)

The company will compensate only one item of loss which has the highest payable amount. During the policy period, the total compensation will not exceed the sum insured stated in the insurance policy. If the company has not paid the full sum insured, the company will continue to provide coverage until the end of the policy period for the remaining sum insured.

Compensation benefits from cancer

The company shall pay compensation as per the sum insured stated in the schedule and/or the renewal insurance certificate after which, the cancer insurance coverage under this policy will be terminated. The insured person, or representative of such a person, depending on circumstances, must submit the following documents or evidence at their own expense to the company within 30 days of getting the results of a medical diagnosis.

  • The company’s completed claim form
  • Medical reports that identify symptoms, the results of diagnosis and medical treatment
  • Certified true copy of the insured’s ID card or passport
  • Laboratory biopsy results
  • Other documents requested by the company as necessary (if any)
Death benefits from cancer

If the insured person, or representative of such person, depending on circumstances didn't claim for compensation benefits and then the insured died from cancer, the beneficiary, or representative of such person, depending on circumstances, must submit the following documents or evidence at their own expense to the company within 30 days from the date.

  • The company’s completed claim form
  • Certified true copy of the insured’s death certificate
  • Certified true copy of autopsy &dissection report
  • Certified true copy of daily police report, investigation report, judgment in case of lawsuit (certified true copy by the police officer handling the case)
  • Certified true copy of the insured person’s ID card or passport and house registration stamped “deceased”
  • Certified true copy of the beneficiary’s ID card or passport and house registration
  • Medical report with the main symptoms, diagnosis results, and the medical history before decease.
  • Other documents requested by the company as necessary (if any)

*Please remember to read the full policy terms and conditions.

Compensation benefits from any skin cancer

Skin cancer means any skin cancers, except malignant melanoma at stage II or above classified by the American Joint Committee on Cancer.

The cancer insurance policy has extended the coverage of skin cancer, during the period in which this policy becomes effective and after the waiting period of 90 days from the policy start. If the insured person gets a medical diagnosis of having skin cancer as defined in the insurance coverage document for the first time, the company shall pay compensation as per the sum insured stated in the schedule and/or the renewal insurance certificate. The insured must submit the following evidence at their own expense to the company within 30 days of getting the results of a medical diagnosis.

  • The company’s completed claim form
  • Medical reports that identify symptoms, the results of Diagnosis and medical treatment
  • Certified true copy of the insured’s ID card or passport
  • Laboratory biopsy results
  • Other documents requested by the company as necessary (if any)
Terminal illness benefits caused by Covid-19

If the insured person gets a medical diagnosis from a physician or specialist with coronavirus disease 2019 (COVID-19) for the first time and later suffers a coma due to COVID-19, the company will pay compensation according to the sum insured stated in the insurance policy. Terminal illness in this event, as diagnosed by a physician, is a serious incurable illness that causes coma, severe chronic obstructive pulmonary disease or end-stage lung disease. The insured must submit the following evidence at their own expense to the company within 30 days of getting the results of a medical diagnosis.

  • The company’s completed claim form
  • Medical reports that state the symptoms, the results of diagnosis and medical treatment
  • Certified true copy of the insured’s ID card or passport
  • Other documents requested by the company as necessary (if any)
Death benefits from Covid-19

If the insured person dies after a coma caused by COVID-19 and no compensation has been claimed, the company will pay compensation to the named beneficiary according to the sum insured stated in the policy. The following documents must be submitted to Roojai within 30 days from the date of the insured person’s death:

  • The company’s completed claim form
  • Certified true copy of the insured person’s death certificate
  • Certified true copy of autopsy &dissection report
  • Certified true copy of daily police report, investigation report, judgment in case of lawsuit (certified true copy by the police officer handling the case)
  • Certified true copy of the insured person’s ID card or passport and house registration stamped “deceased”
  • Certified true copy of the beneficiary’s ID card or passport and house registration
  • Other documents requested by the company as necessary (if any)

If the insured suffers from terminal illness caused by COVID-19 and at least one other condition, the company will pay benefits for only one condition.

Medical expenses caused by Covid-19

If the insured person gets a medical diagnosis of having coronavirus disease 2019 (COVID-19) for the first time and needs to be treated either as an in-patient or out-patient in a hospital or medical facility, the company will pay compensation based on the actual amount the insured person paid, not exceeding the sum insured stated in the insurance policy. The following reimbursement documents must be submitted to Roojai within 30 days from the date of leaving the hospital or medical facility:

  • The company’s completed claim form
  • Medical reports that state the symptoms, the results of diagnosis and medical treatment
  • Certified true copy of the insured ID card or passport
  • Original receipt showing medical expenses or summary statement with the receipt
  • Other documents requested by the company as necessary (if any)

The receipt listing the medical expenses must be the original receipt. If the company does not reimburse the full expense, the company will return the original receipt, certifying the amount paid, so that the insured person can claim the remaining amount from other insurers (if any). However, if the insured has received partial reimbursement from the government, other welfare/benefit schemes or other insurers, the insured must submit a copy of the receipt with a certified amount paid by the government or other authorities to claim the remaining amount from the company.

Automatic termination of the insurance contract
  • The company will return all premiums already charged to the insured person if symptoms of the coronavirus disease 2019 (COVID-19) appear within the 14 day waiting period from the policy effective date.
  • Each coverage under the insurance policy will be terminated if the company pays the full sum insured as stated in the policy for the coverage. The company will continue to cover the insured person until the end of the policy period for the remaining sum insured (if any).

Insurance claim tips

  • download the Roojai Mobile App to expedite your insurance claim process
  • if claiming for car, make sure to save and back up your dash cam footage (if any), take notes and contact details of other parties involved, any witnesses and any other vehicle details.
  • if claiming for health, save all your medical diagnosis and expense documents and ask the hospital for copies of any medical exams
  • after an accident, stay calm, do not try to establish who is at fault, pay or ask someone to pay compensation, accept any money or move your vehicle without police being present.
  • if you feel that you have received an incorrect medical diagnosis or unsatisfactory medical service, be sure to get a second opinion on your medical diagnosis at another hospital before submitting your health insurance claim.
  • if any party involved in your accident admits fault, make sure to get video, audio or written evidence of the other person admitting fault.
  • be patient, sometimes insurance claim checks can take longer than expected. If you have not heard back in more than 3 days, call the relevant insurance claim hotline and ask for an update.

Most frequently asked questions

How to check insurance claim status?

You can check the status of your claim by using the Roojai Mobile App or you can contact our claim specialists at the following:

  • Car insurance claim 24/7 hotline - 02 582 8866
  • Car insurance claim email - claim@roojai.com
  • Health insurance claim hotline - 02 582 8855 - ext. 2
  • Health insurance claim email - medicalclaim@roojai.com
How will the claim settlement be paid?

This will depend largely on your personal choice of payment methods once the claim compensation agreement has been finalized. Most common payment methods are bank transfers while cash payments are excluded.

Can I make an insurance claim if I had a personal accident abroad?

If the medical expenses are in a foreign currency, the company will reimburse the expenses in Thai baht using the exchange rate as at the specified date on the receipt.

What if the claim compensation payment has been delayed?

In most cases this does not happen but if there were any issues with your documents or the company requires to expand its investigation, the claim settlement date may be extended to 90 days from the date the company has received all the necessary documents. If claim compensation is not paid within the time specified in your insurance policy, the company is liable to pay an additional 15% interest per annum for the amount that is due.

How can I file a complaint or raise questions about the handling of my insurance claim?

You can call one of our claim hotlines and request to have your claim processed by a claim team manager, you can likewise send the details of your complaint through our online feedback form.

*Please note that, claim complaint follow up and resolution may take between 1 - 3 days.

For any additional questions please check our frequently asked questions page or contact us.