MCIS Life MCIS Life
Application Forms & Other Documents

A quick re-cap of the document we require for your application to MCIS Life Group EB Program.

Group Master Application Form Latest Employee Census / Listing
  • Authorized Person with copy of NRIC/Passport of Authorized Personnel
  • Certified True Copy of Registration of Business (Registrar of Company) - Form 9, 13 (if any), 24 and 49
  • Ultimate Beneficiary Owner (UBO) Information* with copy of NRIC/Passport of the Beneficial Owners

For takeover cases, we would require the following (in addition to the above): -

  • Previous Insurer's Schedule, Policy and Endorsements
  • Updated previous Insurer's Employee Census / Listing (in excel)
  • Evidence of Acceptance (if any)
  • Claims Listing (in excel) (if any)
*As per regulatory requirements effective 1 April 2024, set by Bank Negara Malaysia under the Anti-Money Laundering, Anti-Terrorism Financing and Proceeds of Unlawful Activities Act 2001 (Sections 13 and 16) and the Financial Services Act 2013 (Sections 47 and 123), we are required to collect information on the Ultimate Beneficial Owners (UBOs) when you apply for employee benefits insurance.
Welcome to a world convinience in managing your Employee Benefits with MCIS Life EB Portal
Simplify Your Policy Administration
Access Essential Resources Anytime
Download our Manual
EB Portal User Manual HR EB Portal User Manual Member

Not signed on? Please complete the below form, contact your Benefits Advisor or submit to groupebportal@mcis.my

Authorization Form (PDPA) Appointment / Removal of Authorized Personnel
Movement Declaration Form

Please use our Movement Declaration Form to submit information about staff additions, deletions, and changes. This ensures accurate records, prevents processing delays, and avoids any missing information.

Movement Declaration Form
Claims Forms and Medical Questionaire
Claim Form – Death Claim Form – Total Permanent or Partial Permanent Claim Form – Personal Accident Claim Form – Critical Illness MCIS GIRO Form
GHS and GOP Claims

Download our form for your onward submission

Group Hospital and Surgical Claim Epayment

For GOP Claims – please refer to the TPA User Guide

Third Party Administrators (TPA)

MCIS Life partners with Third-Party Administrators (TPAs) that specialize in managing healthcare operations. By working with TPAs, we enhance service efficiency, control costs through specialized expertise, and provide our members with a smoother, more responsive healthcare experience. 

In MCIS Life partnered with the following TPAs. Download the TPA USer Guide assigned to you below: -

Micare PMCare
Product Disclosure Sheet
Group Term Life Group Hospitalisation and Surgical Rider Group Outpatient Clinical Rider Group Personal Accident Rider Group Accelerated Dread Disease Rider Group Standalone Dread Disease Rider
Help your Employees to Top-up their Cover with MCIS Life's MediGap Care
Brochure
Contact your Broker / Corporate Agent / Financial Advisor for more information
Where can you get more help?

Your Group EB arrangement with us is unique to your business, so sometimes issues might arise that you need more help with from Us.

In the first instance, your Benefits Expert will be able to help but should you need to speak with us, here are the contact details:

Tel: +603 7652 3388

Email: customerservice@mcis.my, groupeb@mcis.my

Telephone lines are open Monday - Friday, 9am - 5pm.

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