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Covid claim

Covid Claims Portlet

Notify Claims Online - Covid Secure Insurance Claims

Please Enter Your Details Below

Insured Details :

Name Of Insured Required

Policy No. Required

Mobile Number Required

Alternate Mobile No

Email Required

Date Of Birth Required

Address Required

Whether Hospitalized or Home Quarantined Required

Claim Details :

Date of testing positive for covid Required

Date of providing sample for covid test Required

Date Of Admission into Hospital Required

Date Of Discharge Required

Hospital Name Required

Hospital Address Required

Download Medical Certificate Form

Upload Cancelled Cheque Required

Upload Medical Certificate

COVID Test Report Required

Discharge Summary of Hospitalization

Doctor's Provisional Diagnosis Prescription

Additional Document

Other Document

Bank Details :

PAN Number Required

Account No Required

IFSC Code Required

Text to Identify

Text Verification Required

I hereby declare that the information furnished in this claim form is true & correct to the best of my knowledge and belief. If I have made any false or untrue statement, suppression or concealment of any material fact with respect to questions asked in relation to this claim, my right to claim reimbursement shall be forfeited. I also consent & authorize the insurance company, to seek necessary medical information / documents from any hospital / Medical Practitioner who has attended on the person against whom this claim is made.

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