RESTRICTED 11605001

ROZAHAN BIN OSMAN

3A-18-3A RESIDENSI SETIAWANGSA
JALAN 1/56
TAMAN SETIAWANGSA
54200 KUALA LUMPUR

Our Ref : Claim/23268827

Date : 31/07/2023

Dear Sir/Madam,

Policy Number : 33720033, 33720042, 34763894, 34776817, 35254940

Assured : ROZAHAN BIN OSMAN
Life Assured : ELLYSSA ASHLEY BINTI ROZAHAN,EMRAN DANIEL BIN ROZAHAN,ERIN
SOPHIE BINTI ROZAHAN
NRIC No : 040322010866/BH36232,060911011427/BS08249,170111140092
Crisis Cover : 20/06/2023

Outstanding Requirement Letter

We thank you for submitting the above claim which is currently receiving our attention.

To enable us to proceed with the assessment of the claim, please furnish us the following documents:

1. Copy of kidney dialysis appointment book/card which state the date of first regular dialysis initiated.

2. Alternatively, if unable to provide item (1), kindly submit copy of confirmation letter from dialysis
center to state the first dialysis date and the frequency of dialysis per week.

Please send to us the above requirement(s) within 30 days from the date of this letter. We shall review the
claim as soon as we receive complete documentation.

Should you require any assistance, please do not hesitate to contact our Customer Care Line at
03 – 2116 0228.

Thank you for allowing us to be of service.

PRUDENTIAL ASSURANCE MALAYSIA BERHAD (107655-U)

Note:(No signature is required on this computer generated document.)

Prudential Assurance Malaysia Berhad (107655-U) Level 20, Menara Prudential, Persiaran TRX Barat, 55188 Tun Razak Exchange, Kuala Lumpur, Malaysia
P.O. Box 10025, 50700 Kuala Lumpur. Tel (603) 2778 3888 www.prudential.com.my
Customer Service Tel (603) 2116 0228 Email: customer.mys@prudential.com.my
Part of Prudential plc (United Kingdom)
CC:
SOR SIEW YIN (MK700003)
17TH FLR, DAMANSARA INTAN

IMPORTANT NOTE: PLEASE RETURN THIS LETTER AS THE COVER NOTE

WHEN SUBMITTING THE ABOVE REQUIREMENTS

Prudential Assurance Malaysia Berhad (107655-U) Level 20, Menara Prudential, Persiaran TRX Barat, 55188 Tun Razak Exchange, Kuala Lumpur, Malaysia
P.O. Box 10025, 50700 Kuala Lumpur. Tel (603) 2778 3888 www.prudential.com.my
Customer Service Tel (603) 2116 0228 Email: customer.mys@prudential.com.my
Part of Prudential plc (United Kingdom)