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Raksha Health Insurance TPA Pvt. Ltd. ISO 9001:2015 & 27001:2013 Certified Company
Raksha Health Insurance TPA Pvt. Ltd. ISO 9001:2008 & 27001:2013 Certified Company . 0129-3501420. ... Claim Form(Insured) Claim Form(Hospital) Cashless Request Form;
Raksha Health Insurance TPA Pvt. Ltd. ISO 9001:2008 & 27001:2013 Certified Company . 0129-3501420. ... Claim Form(Insured) Claim Form(Hospital) Cashless Request Form;
Raksha Health Insurance TPA Pvt. Ltd. ISO 9001:2008 & 27001:2013 Certified Company . 0129-3501420. Faridabad ,Haryana. ... Claim Form(Hospital) Cashless Request Form;
CLAIM FORM - PART A' to 'CLAIM FORM FOR HEALTH INSURANCE POLICIES OTHER THAN TRAVEL AND PERSONAL ACCIDENT - PART A TO BE FILLED BY THE INSURED The issue of this Form is not to be taken as an admission of liablity DETAILS OF PRIMARY INSURED: a) Policy No.: (To be Filled in block letters) SECTION A SECTION B b) Sl. No/ Certificate no. c) Company ...
1 c Claim form duly signed 2 c Original pre authorization request 3 c Copy of pre - authorization approval letter 4 c Copy of photo ID card of patient verified by hospital 5 c Hospital discharge summary 6 c Operation theatre notes 7 c Hospital main bill 8 c Hospital break up bill SECTION D - CLAIM DOCUMENTS SUBMITTED - CHECK LIST
Raksha Health Insurance TPA Pvt. Ltd. ISO 9001:2015 & 27001:2013 Certified Company
