Claim Intimation
IRDAI License No: 006
ISO 9001:2015
ISMS - ISO/IEC 27001:2013
Cashless Everywhere
About
Overview
Vision & Mission
Management Team
Partners
Gallery
Group of Companies
Customer Testimonial
Annual Reports
Annual Report
ROC-Annual Return (Form MGT-7)
FY 2020-21
FY 2021-22
FY 2022-23
Public Disclosure
Corporate Social Responsibility (CSR)
Corporate Social Responsibility
CSR Annual Action Plan
FY 2022-23
Login
Insurer Login
Agent Login
Broker Login
Member Login
Corporate Login
Provider Login
Approval Module
Quick Help
E-Cards
Intimate a claim
View claim status
Claim Procedures
Cashless Claims Procedure
Reimbursement Claims Procedure
List of Non Payables by IRDAI
IRDAI Non Payable List Before 01-10-2020
IRDAI Optional Cover List w.e.f. 01-10-2020
Downloads
Forms
CKYC Form
Other Information
Common Deficiencies
Claim Document Checklist
AML Guidelines
Network Hospital
Hospital Network
Enroll In Network
Cautious / Excluded Hospital
Information Guide
Accrediation Standards
ROHINI Registration Guide
IRDAI Protocols for Hospitals
Dated 28.3.2016
Dated 18.3.2013
Hospital Guide & FAQ
Hospital Downloads
Policy Declaration Form
IRDAI - Modification Guidelines on
Standardization in Health lnsurance
GIPSA PPN Network - Declaration Form
(National, United, New India and Oriental)
Discount circular - IRDAI & NIAC
(For Cashless-Reimbursement)
Circular for Signing Authority on
Laboratory & Diagnostic Reports
Standard Discharge Card
Summary Bill Format
Detailed Bill Format
Mobile App
Download Link
iOS Users
Android Users
Manual
FAQ's
Health Corner
Health Tip
Covid - JN 1
Magazine
Health Guide
Policy Information
Standard Guide Book
Help Line
Toll Free Number - 1800226655
General Helpline - 022-66620808
Senior Citizen - 022-66629813
Contact Us
Contact Us
Grievance
FAQ
Home
Download Forms
Cashless Request Form
Filled Sample Claim Form
Public Sector Insurance Companies
United India Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form
Super Top-up Claim Form
Top-up Claim Form
GIPSA PPN Network Declaration Form
www.uiic.co.in
New India Assurance Co. Ltd
Cashless Request Form
Reimbursement Claim Form
GIPSA PPN Network Declaration Form
Declaration Form for Network Hospital (Other than PPN)
www.newindia.co.in
National Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form
Request for Cashless Hospitalisation
GIPSA PPN Network Declaration Form
www.nationalinsurance.nic.co.in
The Oriental Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form A
Reimbursement Claim Form B
Request for Cashless Hospitalisation
GIPSA PPN Network Declaration Form
www.orientalinsurance.org.in
Private Sector Insurance Companies
Aditya Birla Health Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form A
Reimbursement Claim Form B
CKYC form
www.adityabirlacapital.com
Bajaj Allianz Life Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form
NEFT Mandate Form
www.bajajallianz.com
Cholamandalam General Insurance Co. Ltd
Cashless Request Form
Reimbursement Claim Form
www.cholainsurance.com
HDFC Ergo General Insurance Co. Ltd.
Cashless Request Form
Group Mediclaim Claim Form
Reimbursement Claim Form
www.hdfcergo.com
ICICI Lombard
Cashless Request Form
Reimbursement Claim Form
www.icicilombard.com
IFFCO Tokio General Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form
Medishield Claim Form
www.iffcotokio.co.in
Liberty General Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form
www.libertyinsurance.in
Niva Bupa Health Insurance Co. Ltd.
Cashless Request Form
Pre-authorization Form (Cashless)
Reimbursement Claim Form
www.nivabupa.com
Reliance General Insurance Co. Ltd
Cashless Request Form A
Reimbursement Claim Form A
Reimbursement Claim Form B
Cashless Request form
www.reliancegeneral.co.in
Care Health Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form
www.careinsurance.com
Royal Sundaram General Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form
Reimbursement Claim Form Guidelines
NEFT Mandate Form
www.royalsundaram.in
SBI General Insurance Co. Ltd.
Cashless Request Form
Group Health Claim Form
CKYC form
Retail Health Claim Form
www.sbigeneral.in
Tata AIG General Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form
CKYC - For Employee NEFT more than 1 Lac
CKYC - Legal Entity-For Corporate NEFT more than 1 Lac
www.tataaig.com
Universal Sompo General Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form
NEFT Mandate Form
www.universalsompo.com
Navi General Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form
www.navi.com
ManipalCigna Health Insurance Co. Ltd.
Cashless Request Form
Request for Cashless Hospitalisation
Reimbursement Claim Form A
Reimbursement Claim Form B
www.manipalcigna.com
Zuno General Insurance Co. Ltd.
Cashless Request Form
Request for Cashless Hospitalisation
Reimbursement Claim Form A
Reimbursement Claim Form B
Group Health Claim Form A
Group Health Claim Form B
www.hizuno.com
Magma HDI General Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form A
Reimbursement Claim Form Part B
www.magmahdi.com
Kotak Mahindra General Insurance Co. Ltd.
Cashless Request Form
Request for Cashless Hospitalisation
Reimbursement Claim Form A
Reimbursement Claim Form B
www.kotakgeneral.com
Go Digit General Insurance Ltd.
Cashless Request Form
Reimbursement Summary Format
www.godigit.com
Raheja QBE General Insurance Co. Ltd.
Reimbursement Claim Form
Cashless Form Part-c
Cashless Form Part-d
www.rahejaqbe.com
Private Sector Life Insurance Companies
Aegon Life Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form
www.aegonlife.com
HDFC Life Insurance Co. Ltd.
Cashless Request Form
Reimbursement Claim Form A
Reimbursement Claim Form B
www.hdfclife.com
Max Life Insurance Co.
Cashless Request Form
Reimbursement Claim Form
www.maxlifeinsurance.com
Today's Health Tip