Documents Which Are Requested With Respect to the Involuntary Unemployment Indemnity Claims
- Indemnity application form which is filled in completely and signed or the petition with regard to the indemnity claim
- Statement of the Employer
- “Statement Regarding the Termination of Employment” which is issued by the Employer or the SSI
- Stamped – signed payroll with respect to the last 6 months
- Document regarding that registration to the Turkish Employment Agency (İş-Kur) has been completed
- Turkish Employment Agency indemnity payment document
- Identification card of the insured
- Other documents which may be required
Prior to each monthly payment
- SSI 4A Service scheme which is obtained from turkiye.gov.tr or SSI
- Other documents which may be required
Documents Which Are Requested With Respect to the Indemnity Claims Due to Temporary Incapacity to Work In Consequence of Accidents and Diseases
- A fully filled and signed compensation application form or a petition regarding the claim for compensation
- Documents indicating the income status
- Medical report indicating the non-working period (approved by the SSI)
- Authentication of the social security indemnities which are provided by the social security institutions
- Other documents which are required for the approval of the payment request and the insurance indemnity amount (for instance, additional medical documents)
- Reasons of the accident (Accident report, police report, court report)
- Photocopy of the identification card of the insured
- Other documents which may be required
Prior to each monthly payment
- Document with regard to the payment of the temporary disability insurance amount which is provided by the Social Security Institution
Documents Which Are Requested With Respect to the Hospital Daily Indemnity Claims In Consequence of Accidents and Diseases
- Indemnity application form which is filled in completely and signed or the petition with regard to the indemnity claim
- Medical report
- Documents indicating the income status
- Photocopy of the identification card of the insured
- Reasons of the accident (Accident report, police report, court report)
- Information regarding the fact that the insured has been hospitalized and his/her hospitalization period (in terms of days)
- Photocopy of the identification card of the insured
- Other required documents (for instance, additional medical documents)
Prior to each monthly payment
- The hospitalization period of the insured (in terms of days) and the fact that he/she has been hospitalized must be documented.
Documents Which Are Requested With Respect to the Life Insurance Death Indemnity Claims
- Filling in of the “Life Insurance Death Statement Form” and “Life Insurance Death Indemnity Payment Request Form” in a complete manner and signing of this form
- In the case where the death has occurred in consequence of a disease; the detailed medical/epicrisis report indicating the first diagnosis date with respect to the disease which caused the death, results of all analyses and examinations, if available the surgical operation and pathology report and the SSI medula records
- In the case where the death has occurred in consequence of an accident; the official accident report or the event scene investigation report
- If the death event has been notified to the prosecution office; the indictment of the Public Prosecution Office or the Decision of Non-Prosecution
- Turkish Statistical Institute Death Certificate
- Certificate of Inheritance
- Photocopies of the identification cards of the legal heirs/beneficiaries
- Account numbers of the legal heirs/beneficiaries
- Inheritance and transfer tax enclosed letter
*** In necessary cases, the original copies of the documents or the document copies which are certified by the institution issuing the document may be requested.
Annex : Life Insurance Death Statement Form and the Payment Information Form
For information: Customer Support Center (444 11 11)
Note : AgeSA Hayat ve Emeklilik A.Ş. may request additional documents when necessary.
Life Insurance Death Statement Form
Documents Which Are Requested With Respect to the Life/Personal Accident Insurance Disability Indemnity Claims
- Filling in of the “Life/Accident Insurance Disability Indemnity Claim Form” in a complete manner and signing of this form
- The original copy or the certified copy of the disability committee report which states the final condition and degree of the disability that constitutes the subject matter of the indemnity which will be obtained from a state hospital or a full-fledged university hospital
- The detailed medical/epicrisis report indicating the first diagnosis date with respect to the disease which caused the disability, results of all analyses and examinations, if available the surgical operation and pathology report and the SSI medula records
- In the case where the disease has arisen consequence of an accident; the original copy or certified copy of the official accident report or the event scene investigation report
- In the case where the disability of the driver arises in consequence of the traffic accident; the original copy or certified copy of the alcohol report
- Photocopy of the identification card
- Account number
*** In order for your request to be put into operation, please send the signed original copy of the below stated form along with the above mentioned documents to the address of our General Directorate by mail.
Annex : Life/Accident Insurance Disability Indemnity Request Form
For information: Customer Support Center (444 11 11)
Note : AgeSA Hayat ve Emeklilik A.Ş. may request additional documents when necessary.
Life/Accident Insurance Disability Indemnity Request Form
Documents Which Are Requested With Respect to the Life Insurance Hazardous Disease Indemnity Claims
- Filling in of the below stated “Critical Health Risks/Hazardous Diseases Indemnity Claim Form” in a complete manner and signing of this form
- The detailed medical/epicrisis report indicating the first diagnosis date with respect to the disease which caused the indemnity claim, results of all analyses and examinations, if available the original copies of the pathology and surgical operation report and the SSI medula records
- Original copy of the medical information form which will be separately communicated by our company
- Photocopy of the identification card
*** In order for your request to be put into operation, please send the signed original copy of the below stated form along with the above mentioned documents to the address of our General Directorate by mail.
Annex : Critical Health Risks/Hazardous Diseases Indemnity Claim Form
For information: Customer Support Center (444 11 11)
Note : AgeSA Hayat ve Emeklilik A.Ş. may request additional documents when necessary.
CSR Hazardous Diseases Indemnity Claim Form
MS Medical Information Form
Cancer Information Form
Heart Attack Medical Information Form
Coronary Artery Bypass Information Form
Renal Impairment Medical Information Form
Documents Which Are Requested With Respect to the Treatment Expenses Indemnity Claims
- Filling in of the “Personal Accident Insurance Treatment Expenses In Consequence of Accidents Indemnity Claim Form” in a complete manner and signing of this form
- Original copies of the invoice, scraps of the medicines and prescriptions with respect to the expenses made with regard to the treatment
- Detailed medical report u
- The original copy or certified copy of the official accident report or the event scene investigation report
- In the case where the treatment expenses of the driver arise in consequence of the traffic accident; the original copy or certified copy of the alcohol report
- Account number
*** In order for your request to be put into operation, please send the signed original copy of the below stated form along with the above mentioned documents to the address of our General Directorate by mail.
Annex : Personal Accident Insurance Treatment Expenses In Consequence of Accidents Indemnity Claim Form
For information: Customer Support Center (444 11 11)
Note : AgeSA Hayat ve Emeklilik A.Ş. may request additional documents when necessary.
Personal Accident Treatment Expenses Indemnity Claim Form
Documents Which Are Requested With Respect to the Personal Accident Insurance Death Indemnity Claims
- Filling of the below stated “Personal Accident Insurance Death Statement Form” in a complete manner and signing of this form
- In the case where the death has occurred in consequence of an accident; the official accident report or the event scene investigation report
- If the death event has been notified to the prosecution office; the indictment of the Public Prosecution Office or the Decision of Non-Prosecution
- In the case where the death of the driver occurs in consequence of the accident; the alcohol report
- Turkish Statistical Institute Death Certificate
- Certificate of Inheritance
- Photocopies of the identification cards of the legal heirs/beneficiaries
- Account numbers of the legal heirs/beneficiaries
*** In necessary cases, the original copies of the documents or the document copies which are certified by the institution issuing the document may be requested.
Annex : Personal Accident Insurance Death Statement Form
For information: Customer Support Center (444 11 11)
Note : AgeSA Hayat ve Emeklilik A.Ş. may request additional documents when necessary.
Personal Accident Insurance Death Statement Form
Documents Which Are Requested With Respect to Exit From the Private Pension System Due to Death
- Filling in of the below stated “Form Regarding the Request of the Payment of the Savings of the Participant Due to His/Her Death” in a complete manner and signing of this form
- Certificate of Inheritance
- Photocopies of the identification cards of the legal heirs/beneficiaries
- Account numbers of the legal heirs/beneficiaries
- Inheritance and transfer tax enclosed letter
*** In necessary cases, the original copies of the documents or the document copies which are certified by the institution issuing the document may be requested.
Annex : Form Regarding the Request of the Payment of the Savings of the Participant Due to His/Her Death
For information: Customer Support Center (444 11 11)
Note : AgeSA Hayat ve Emeklilik A.Ş. may request additional documents when necessary.
Form Regarding the Request of the Payment of the Savings of the Participant Due to His/Her Death
Documents Which Are Requested With Respect to Exit From the Private Pension System Due to Disability
- Filling in of the below stated “Request Form With Respect to Exit From the Private Pension System by the Pension Plan Participants Due to Becoming Disabled Permanently/Disability” in a complete manner and signing of this form
- The disability committee report which states the final condition and degree of the disability that constitutes the subject matter of the indemnity which will be obtained from a state hospital or a full-fledged university hospital/The document which will be obtained from the Social Security Institution regarding that the insured has qualified for the disability income
- The detailed medical/epicrisis report with respect to the disease which caused the disability, results of all analyses and examinations, if available the surgical operation and pathology report
- In the case where the event has occurred in consequence of an accident; the official accident report or the event scene investigation report
- Photocopy of the identification card
- Account number
*** In necessary cases, the original copies of the documents or the document copies which are certified by the institution issuing the document may be requested.
Annex : Request Form With Respect to Exit From the Private Pension System by the Pension Plan Participants Due to Becoming Disabled Permanently/Disability
For information: Customer Support Center (444 11 11)
Note : AgeSA Hayat ve Emeklilik A.Ş. may request additional documents when necessary.
Request Form With Respect to Exit From the Private Pension System Due to Disability
