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CENTRAL KYC REGISTRY | Instructions / Check list / Guidelines for filling Individual KYC Application Form General Instructions: 1 Fields marked with ‘*’ are mandatory fields. 2 Tick ‘ ’ wherever applicable. 3 Self-Certification of documents is mandatory. 4 Please fill the form in English and in BLOCK Letters.
CENTRAL KYC REGISTRY | Instructions / Check list / Guidelines for filling Legal Entity KYC Application Form General Instructions: 1 Fields marked with ‘*’are mandatory. 2 Tick ’ ’ wherever applicable. 3 Please fill the form in English and in BLOCK letters. 4 Please fill all dates in DD-MM-YYYY format.
Cashless Request Form: Pre-authorization Form (Cashless) Reimbursement Claim Form: www.nivabupa.com
GIPSA and GIC-Re Reimbursement Claim Documents Check List Download. RBI claim form Download. Provider Empanelment Information Form Download. Cashless Form Download. Claim Check List Download. Claim Form Download. KYC FORM Download. UIIC Central KYC FORM Download. NEFT RTGS Form Download.
Cashless Request Form : If the hospital concurs to provide cashless facility, they will provide you with the cashless request form. Please fill in the relevant details and submit it back to them. They will then sign and stamp it and send it to our Cashless counter along with KYC details, PHS ID and other mandatory documents.
View/Download ABHA Card. Aadhaar Number. I, hereby declare that I am voluntarily sharing my Aadhaar Number and demographic information issued by UIDAI, with National Health Authority (NHA) for the sole purpose of creation of ABHA number .
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Patient ID proof along with KYC details (PAN and Address proof) of Employee / Policy Proposer is mandatory at the time of cashless request. If the estimated amount is Rs.1 lakh and above, then Pan-card of the policy holder / Employee is mandatory.
