Claim Form

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Claim Form (Health Insurance)

A Claim Form is a mandatory document you submit to your insurance company or TPA (Third Party Administrator) to initiate a claim for hospitalization, either for cashless or reimbursement.

It is used to:

  • Declare your hospitalization or treatment details

  • Request payment or reimbursement

  • Provide personal and policy information to the insurer

PART A – To Be Filled by the Insured / Policyholder

  1. Policyholder Details

    • Name:

    • Policy No.:

    • Company Name (if corporate group policy):

    • Contact No.:

    • Email ID:

  2. Patient Details

    • Name:

    • Relationship with Policyholder:

    • Gender:

    • Age:

    • Date of Birth:

    • Occupation:

  3. Hospitalization Details

    • Name of Hospital:

    • Date of Admission:

    • Date of Discharge:

    • Reason for Hospitalization (Diagnosis):

    • Treatment Given:

  4. Claim Type

    • ☐ Cashless

    • ☐ Reimbursement

  5. Bank Details (for Reimbursement)

    • Account Holder Name:

    • Bank Name:

    • Account No.:

    • IFSC Code:

    • Cancelled Cheque Attached: ☐ Yes ☐ No

  6. Declaration & Signature

    • I hereby declare that the information provided is true and correct.

    • Signature of Policyholder:

    • Date:


PART B – To Be Filled by the Hospital

  1. Hospital Name & Address

  2. Hospital Registration No.

  3. Nature of Admission (Planned / Emergency)

  4. Diagnosis (Final)

  5. Treatment Given

  6. Doctor’s Details and Signature


Documents to Attach with Claim Form

  • Discharge Summary

  • Bills & Receipts

  • Diagnostic Reports

  • Prescriptions

  • Health Card Copy

  • ID Proof

  • Cancelled Cheque (for reimbursement)

Important Instructions for Filling the Claim Form

Please read the claim form carefully before you begin. This ensures smooth processing and helps avoid unnecessary delays or rejections.


Before You Start:

  • Write your Employee ID, Contact Number, and Intimation ID clearly at the top right corner of the form.


Mandatory Fields to Fill:

  1. Policy Number

  2. Insurance Card ID Number

    • (Unique ID given by the TPA — found on your health card)

  3. Name of the Insured

    • Include address and contact details

  4. Corporate/Employer Name and Employee Code

    • (For group/corporate insurance policies)

  5. Patient Details

    • Name

    • Date of Birth

    • Relationship with the employee

  6. Claim Type

    • Tick the appropriate option (Cashless / Reimbursement)

    • Mention:

      • Date of Admission

      • Date of Discharge

      • Hospital Name, Address, and Contact Details

  7. Details of Illness / Injury / Diagnosis

    • Reason for hospitalization/treatment

  8. Claim Amount Details

    • Mention the total amount claimed

    • Add a bill-wise breakup with bill numbers

  9. Attach All Original Documents

    • As mentioned in the claim form (discharge summary, bills, reports, etc.)

  10. Signature of the Claimant

    • Include Place and Date


After Filling the Form:

Submit the completed and signed claim form along with all mandatory original documents to the TPA or insurer.


Note: Incomplete forms or missing information may lead to claim delays or rejections. If you need help at any step, feel free to reach out to your HR SPOC or insurance support team.

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