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DETAILS OF PRIMARY INSURED

WebCLAIM FORM - PART A TO BE FILLED IN BY THE INSURED The issue of this Form is not to be taken as an admission of liability DETAILS OF PRIMARY INSURED: (To be filled in …

Actived: 1 days ago

URL: https://enrol.uhcpindia.com/enrollment/DownloadPDF/Claim_Form_partA.pdf

CHECKLIST FOR CLAIM SUBMISSION

WebPoints to remember 1) Do not forget to attach this checklist with the Claim file. 2) Arrange the documents in the same order as in the checklist.

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SAMPLE CLAIM FORM PART A REIMBURSEMENT (Please fill in …

Weba) Details of Treatment Expenses. Enter the amount claimed as treatment expenses. In rupees (Do not enter paise values) b) Claim for Domiciliary Hospitalization. Indicate …

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Important notice:

WebAs we have migrated to a new portal, this page shall no longer be accessible. To access the new platform please click here.. Please ensure that you reset your

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