When there is any employee sustained work injury or occupational disease arising out of and in the course of employment, you should report the incident to Labour Affairs Bureau by submitting an online notification via https://www3.dsal.gov.mo/InjuryOnline/Declaration within the time limit as stated below.

Meanwhile, please complete our “Employee’ Compensation Insurance Claim Form” with full particulars, sign with company chop (if appropriate) and submit to us together with the following supporting documents immediately.

1. Copy of legal identification document of the injured victim
2. Copy of employment contract signed between the employer and the injured victim
3. Copy of salary proof for the last 3 months prior to the injury and the attendance record of the injured victim
4. Original medical report(s) and/or medical examination report(s) with diagnosis certified by registered medical practitioner(s) in Macau
5. Original medical receipt(s) issued by registered medical practitioner(s) or hospital in Macau
6. Original convalescent leave certificate(s) issued by registered medical practitioner(s) or hospital in Macau
7. Copy of salary receipt(s) of the injured victim during convalescent period
8. Copy of record of social security of the injured victim

In case of death or serious injury occurred, please inform us by call immediately.
Should the employer receive further leave certificate(s) or medical receipt(s) from injured victim after the claim submission, please send the original documents to insurance intermediary or us soonest.

In accordance with the circumstance of the incident, we may ask for further information and document when necessary.

Should you have any enquiry on your claim, you can call our Claims Services Hotline at (853) 2888 3876. Please state your claim number in all communications. Our claim handler will give you reply instantly.

If you have any query about the Employees’ Compensation Ordinance, please contact the Labour Affairs Bureau at Enquiry Service Hotline (853) 2871 7810 or http://www.dsal.gov.mo。

Employees' Compensation Claim Form

When there is an accident occurred, complete claim form with full particulars, sign with company chop (if appropriate) and submit to us together with the following supporting documents immediately.

1. Copy of driver’s Identity card and driving licence,
2. Copy of Vehicle Registration Document (with back page) and vehicle licence
3. Color photographs showing the extent of damaged vehicle(s) involved and accident scene
4. Screening breath test report
5. Copy of Police statement
6. Video recorder or memory card at the material time (if any)
7. Original of Letter of Consent duly signed by the driver

Own Damage Claim

Repair quotation should be obtained from a repairer. We will appoint a motor surveyor to inspect and assess the damaged vehicle soon.
Do not give instruction to repairer to commence repair work without our consent.
If the repairer advise the repair costs of damaged vehicle might be higher than market value, no quotation would be issued. Please notify us soon for our arrangement of inspection.
You are required to sign on a “Satisfaction Certificate” at the time to collect your vehicle from repairer when the repair work is completed satisfactorily.

Third Party Claim

If any third party bodily injury involved in the accident, you must report the accident to Police immediately. Please complete the “Third Party Bodily Injury Questionnaires”.
Do not give personal comment on the cause of incident without investigation.
Do not admit liability, make offer or accept settlement with third party without our prior consent.
Forward any communication, writ and summons to us immediately unanswered.

In accordance with the circumstance of the incident, we may ask for further information and document when necessary.

Complete claim form with full particulars from the date of accident and submit to us together with the following supporting documents immediately.

1. Police report with statement, if any
2. Copy of identity card of insured person
3. Original medical receipt(s) with diagnosis and sick leave certificate(s) and discharge slip for hospitalization
4. Original doctor’s referral letter for x-ray / lab testing / physiotherapy, etc.
5. Any claim for temporary total disablement, the employer of insured person should complete the form of “Employer’s Confirmation of Sick Leave”
6. Any claim for permanent total disablement, an assessment medical report from an attending registered medical practitioner must be submitted
7. “Certificate of Medical Attendant” must be filled by an attending registered medical practitioner
8. Copy of document for any payment made by other insurance company paid part of the relevant medical expenses, if any

Supporting documents for Death case

1. Original Policy
2. Police report and statement, if any
3. Copy of deceased’s identity card or passport
4. Copy of identity card of beneficiary or the Administrator
5. If no designated beneficiary, Letter of Administration is required
6. Documentary evidence to prove the relationship with the deceased
7. Original Death certificate (will be returned after verified the information)
8. Medical report / Post-mortem examination report / Coroner’s report for an inquest, if any

In accordance with the circumstance of the incident, we may ask for further information and document when necessary.

Complete claim form with full particulars from the date of accident and submit to us together with the following supporting documents soonest. In case of serious event, please inform us by call immediately for our arrangement of investigation.

1. Police report with statement / Property Management incident report
2. Photographs showing the scene of accident especially the point of entry into and exit from the premises for burglary and the extent of damage items
3. A detailed list of loss / damaged items
4. Original purchase invoice / receipt / warranty cards of lost property
5. Repair / replacement quotation
6. Any correspondence in relation to the accident from any authorities

Important Notes

Do not proceed repair of damaged item without our consent.
Do not discard the damaged items and retain it for inspection if needed.
Provide us a copy of insurance policy issued by other insurance company covering the same property.

In accordance with the circumstance of the incident, we may ask for further information and document when necessary.

Complete claim form with full particulars from the date of accident and submit to us together with the following supporting documents immediately.

1. Police report / accident report / Property Management incident report
2. Photographs showing the scene of accident and the extent of damage to third party property and/or bodily injury
3. Completed the form of “Third Party Bodily Injury Questionnaires” (if applicable)
4. Any correspondence in relation to the accident from third party or authorities

Important Notes

Do not give personal comment on the cause of incident without investigation.
Do not admit liability, make offer or compromise settlement with third party without our prior consent.
Forward any communication, writ and summons to us immediately unanswered.

In accordance with the circumstance of the incident, we may ask for further information and document when necessary.

When there is an accident or any event occurred, complete claim form with full particulars and submit to us together with the following supporting documents within 30 days.

Basic documents for any nature of benefit claim

1. Boarding Pass showing all the incurred flights
2. Air-ticket / e-ticket
3. Scheduled itinerary

Original supporting documents for different nature of benefit claim

Medical Expenses
Medical receipt(s) with patient name, diagnosis, date, signature and stamp of attending physician
Referral letter (if any)
Medical report and/or discharge slip for hospitalization

Loss or Damage of Personal Baggage
Purchase receipt(s) of lost item
Photographs showing the extent of damage
Police report / written report from airline / public common carrier and/or hotel
Repair quotation or written confirmation from repairer if damaged item cannot be repaired

Loss of Money / Travel Document
Police report with statement
Official receipt(s) for extra accommodation fee or travel expenses
Official receipt(s) for replacement of travel document
Document showing the value of cash lost (e.g. currency exchange slip / withdrawal record)

Travel / Baggage Delay / Trip Re-arrangement
Written report from airline or public common carrier specifying the reason and number of hours of delay
Official receipt(s) for emergency purchase of essential items for baggage delay
Official receipt(s) for extra accommodation fee for travel delay
Official receipt(s) for re-routing costs

Trip Cancellation or Trip Interruption
Medical report or death certificate
Document to prove the relationship with insured person (e.g. birth certificate, marriage certificate)
Official receipt(s) for the paid travel fare / accommodation / travel tour
Refund receipt(s) for the paid amount issued by airline / public common carrier / travel agent

Personal Liability
Police report or incident report issued by relevant authorities
Any correspondence from third party or their representative / authorities concerned, please do not answer and forward the document to us immediately

Rental Vehicle Excess

Copy of comprehensive insurance policy for rental vehicle
Excess payment receipt; rental receipt and vehicle rental agreement
Police report / incident report and damage report and photographs showing extent of damage

Worldwide Travel Assistance

You are advised to bring along your Emergency Assistance Card with the Policy number while travelling. In case of following situation, you can call 24-hour Min Xin Worldwide Assistance Service Hotline at (852) 2862 0191 for instant help.

Emergency medical evacuation or repatriation of remains, compassionate visit, child escort arrangements
Deposit guarantee for hospital admission, emergency re-routing
Legal assistance, travel information or other emergency assistance services

In accordance with the circumstance of the incident, we may ask for further information and document when necessary.

內地合作保險服務機構 ─ 中國太平洋財產保險股份有限公司全國統一24小時服務熱線：+86-95500（中國大陸地區） / +86-20-95500（非中國大陸地區）。

車輛出險後，48小時內撥打全國統一24小時服務熱線 +86-95500（中國大陸地區） / +86-20-95500（非中國大陸地區）報案電話，以及致電110報交警處理。案件需由內地合作保險服務機構的 理賠人員現場查勘，或經理賠人員指引後進行交警處理或事故雙方自行協商處理。

在車輛維修前，需撥打全國統一24小時服務熱線 +86-95500（中國大陸地區） / +86-20-95500（非中國大陸地區）報案電話，通知內地合作保險服務機構的定損人員進行損失核定。

車輛如在廣東省內發生保險事故時，被保險人需保護現場並迅速撥打 +86-95500（中國大陸地區） / +86-20-95500（非中國大陸地區）：

1. 閩信保險的內地合作保險服務機構報案、申報，提供：車牌號碼、事故時間、地點、事故簡要經過等資料。接線員在了解事故情況後會即時對出險人作出處理指引；
2. 110 報警電話；
3. 如出現人傷，視傷者情況撥打120求助。

如被保車輛投保了《澳車北上車險》及在內地發生交通意外事故，撥打內地合作保險服務機構電話報案後，接線員會及時根據事故情況作出指引，並調度事故地查勘定損人員，查勘定損員將會聯絡被保險人指示後續的處理流程。

內地和澳門的車險理賠慣常處理流程是有分別的。內地的處理流程：

1. 出險後，當事人在確保安全前提下需保護現場環境以免發生二次碰撞，並即時撥打內地保險服務機構電話報案及撥打110報警進行意外現場的定責調查。
2. 車輛查勘、定損。
   (1) 報案人按保險服務機構電話接線員的指引配合完成事故處理。在確保安全的情況下，可用手機拍攝現場環境，以備證據。待查勘員、交警、或救護車等到達現場後，配合完成事故責任認定、現場查勘等工作。
   (2) 現場查勘完成後，查勘員將根據現場損失情況與當事人協商物損定損程序及是否現場調解。輕微人傷案件，可適用人傷快賠案件處理流程，現場簽署調解協議書，免除提供醫療機構單證。對於損失較大的事故車輛、物損、人傷，無法現場核定損失的，查勘員做好後續定損指引與承接。
3. 單證收集與賠款支付。
   (1) 車輛修復完畢後，內地保險服務機構將根據定損核定的維修金額，待被保險人支付維修款後，內地保險服務機構將賠款支付至被保險人賬戶；對於符合直賠的案件，被保險人可無需墊付維修費用，授權內地保險服務機構委託由修理廠代收賠款，內地保險服務機構或保險人直接將賠款支付至修理廠賬戶。
   (2) 對於人傷損失案件，根據內地《道路交通事故受傷人員臨床診療指南》對傷者損失確定後，被保險人可根據核定的損失金額支付賠償款給傷者，再由內地保險服務機構或保險人將對應賠款支付至被保險人賬戶；也可進行三方協商，授權內地保險服務機構或保險人將應承擔的賠償款直接支付至第三者賬戶。

被保險人向保險公司通知及提交要求文件後，保險公司根據提供材料進行審核，審核過程中如還需補充材料的，保險公司會及時通知被保險人進行補充，後續被保險人跟進賠款到賬情況。

內地車險快速理賠又稱快處快賠。機動車與機動車發生僅造成車輛損失的道路交通事故，各方均投保機動車交通事故責任強制保險，且當事人能夠自行移動車輛的，適用快處快賠。
一般情況下，被保險人在撥打內地保險服務機構報案及撥打110報警後，警方會給予相關指導。可以用手機在網上辦理，或者交警現場開具快賠協議書，或者指引到道路交通事故快處快賠服務中心辦理。

一般情況下，車輛如在內地出險必需即時通知內地合作保險公司，並因應各保險公司的理賠指引進行後續必要的賠償程序，詳情請諮詢所投保的公司。

保險事故發生後，保險公司或其內地合作的保險服務機構按照內地有關法律法規規定的賠償範圍、項目和標準以及港珠澳大橋香港跨境車輛內地交強險等效保險合同的約定，並根據中華人民共和國國務院衛生主管部門組織制定的交通事故人員創傷臨床診療指南和國家基本醫療保險標準，在港珠澳大橋香港跨境車輛內地交強險等效保險的責任限額內核定人身傷亡的賠償金額。

保險事故發生後涉及到第三者物損的，被保險人或第三者應當在維修前會同保險公司或其內地合作的保險服務機構進行檢驗，協商確定修理或者更換項目、維修方式和費用。無法協商確定的，雙方委託共同認可的有資質的第三方進行評估。

一般情況下，責任認定由交警部門調查後認定，責任認定後交警發出交通事故責任認定書。駕駛人和車主需根據具體的事故責任比例，對超出保險責任範圍外或超出賠償限額外的需要承擔賠償責任。

當被保車輛只投保了港珠澳大橋跨境車輛內地交強險等效保險時，被保車輛車上人員受傷，如事故屬雙方的事故，先由對方的交強險依法賠償，超出對方交強險責任部分按雙方責任比例由被保險人自行承擔。如被保車輛同時投保了港珠澳大橋跨境車輛商業保險中的車上人員責任險，對於超出對方交强險責任部分，由保險公司在車上人員保險責任範圍內承擔賠償責任；

當被保車輛只投保了港珠澳大橋跨境車輛內地交強險等效保險時，被保車輛車上人員受傷，如事故屬單方碰撞(屬被保險人責任)的事故，賠償由被保險人自行承擔。如被保車輛同時投保了港珠澳大橋跨境車輛商業保險中的車上人員責任險，保險公司在車上人員保險責任範圍內承擔賠償責任。

如被保車輛投保了《港珠澳大橋跨境車輛商業保險》中的車上人員責任險，當發生交通事故造成被保險人及/或被保險人車上的人員受傷，保險公司在車上人員保險責任範圍內承擔賠償責任，具體程序根據各公司的理賠指引而定。原則上，被保險人/被保險人車上的人員受傷，可以回澳門治療，醫療費用賠償標準根據“澳車北上”保險條款，按照內地《道路交通事故受傷人員臨床診療指南》以內地治療標準核定賠償。

索賠時需要提供事故認定書有備注受傷人員的信息；索賠醫葯費需要提供在澳門就醫所取得的病歷及醫療報告等資料及相應的病例發票清單，醫葯費賠償參照內地的醫保標準，超過醫保標準部分需要自費。醫葯費賠償還需要考慮事故責任比例的影響。

如事故屬於投保人責任，投保人應及時向保險公司的內地合作保險服務機構報案，根據指引進行查勘、定損等；倘投保人返回香港並需要保險公司協助處理賠償，須向所投保的公司申報，保險公司將會因應相關交通意外事故的情節提供適切的理賠服務。

如事故非屬投保人責任，投保人需自行聯絡引致交通意外駕駛人/車主的內地保險服務機構處理賠償。倘投保人已回澳門，如需所投保的公司協助賠償事宜，應通知保險公司，保險公司將提供諮詢服務指導投保人自行向事故責任當事人的保險公司進行後續的理賠程序。

客戶投保了港珠澳大橋跨境車輛內地交強險等效保險，被保車輛在內地出險且因賠償有關事項產生訴訟時，如第三者提起訴訟的，一般情況會將保險人和被保險人視為共同被告，被保險人應在接獲訴訟通知後盡快聯絡內地保險服務機構申報，並按照中華人民共和國民事訴訟法等相關規定正常及時答辯、舉證、應訴、參加庭審等，內地合作保險服務機構會提供協助。

發生交通事故後，對方駕駛人為責任方而要求與被保險人自行協商解決賠償，被保險人是有權選擇同意或拒絕接受自行協商的。

倘肇事各方當事人按照雙方意願選擇自行協商賠償方案，務必注意需要對意外事故的性質清晰及責任認同，並取得有關執法部門出具的事故認定書，且應為沒有造成人身傷亡的輕微交通事故。對於涉及人傷事故的交通意外不適宜自行協商，需由交警認定事故起因，確認受傷人員。
倘當事人對意外事故採取了自行協商處理賠償，原則上日後較難再通過保險進行理賠索償；然而，後續倘出現要求向保險公司申索賠償，保險公司將根據合同約定對雙方自行協商的賠償方案重新進行核定，可能會發生核定金額與雙方協商金額不一致的情況。同時，在協商過程中，如當事人對損害賠償無法達成協議的，可以請求公安機關交通管理部門進行調解，也可以就爭議到人民法院提起民事訴訟。

雙方當事人選擇私下解決 (俗稱“私了”) 賠償事宜，日後保險公司將不會接受對雙方私了的損失按照合同約定進行保險核定賠付（此處所指私了為未經事故的處理部門認定事故責任，雙方對包括事故成因、責任比例、具體損失金額等均私了的情形）。
然而，各保險公司對於 “車險賠償自行協商” 或 “當事人私下解決” 的賠償處理持不同的見解和認可，被保險人在決定採用何種理賠方案前必須審慎了解不同處理的利弊之處，以免招致損失。