Sample Reimbursement Form

 Required Documents for Reimbursement Process

1. Final Bill 

2. Detailed Final Breal up Bill

3.Total Bill Payment Receipts Original (including PRE & POST Hospitalization Bills )

4. Indoor Case sheet Record Also

5. Doctor Prescriptions (including First Consultation )

6. Admission Details

6. Discharge Summary

7. All Original Diagnostic Reports (Medical Reports)

8.Proposer Aadhar & Pan card

9.Insured Aadhar

10. Proposer Cancelled Cheque 

11. Proposer & Insured Photo

Note : All Hospital Documents Need Origional 

Upload Documents For Reimbursement

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List of Annual Health Check-ups