Get the free lic mediclaim form pdf

Form No: LIC/HI/DUB claim form 1(Jul 2009)Claim form for Domiciliary Treatment Benefit (Applicable for reimbursement of medical expenses as DUB under Health Insurance plan 901 and 902)TO:For Branch

How to fill out lic mediclaim form pdf

How to fill out LIC hospital treatment form:

1. Start by downloading or obtaining a physical copy of the LIC hospital treatment form.
2. Carefully read all the instructions and guidelines provided on the form to ensure proper filling.
3. Begin by providing your personal details such as name, address, contact information, and policy number.
4. Fill in the details of the hospital where you received treatment, including its name, address, and contact information.
5. Specify the dates of hospitalization, admission, and discharge.
6. Indicate the nature of the illness, injury, or treatment received during the hospital stay.
7. Provide information about any pre-existing medical conditions, if applicable.
8. Mention the name and contact details of the treating doctor or specialist who supervised your treatment.
9. Double-check all the filled information for accuracy and make any necessary corrections before submitting the form.
10. Sign and date the form to confirm that the information provided is true and complete.

Who needs LIC hospital treatment form:

1. Individuals who hold LIC (Life Insurance Corporation) policies and require reimbursement for hospital treatment expenses.
2. Policyholders who have undergone medical treatment at a hospital and wish to claim the associated costs from LIC.
3. Anyone who wants to avail of the hospitalization benefits provided by their LIC policy and needs to complete the required documentation.

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What is lic hospital treatment form?

The LIC Hospital Treatment Form is a document that policyholders need to fill out to claim reimbursement for hospitalization expenses incurred due to medical treatment covered under their LIC insurance policy.

Who is required to file lic hospital treatment form?

The policyholder or the insured person who has undergone treatment and is seeking reimbursement for hospitalization expenses is required to file the LIC Hospital Treatment Form.

How to fill out lic hospital treatment form?

To fill out the LIC Hospital Treatment Form, the policyholder must provide personal details, specific information about the hospitalization, treatment received, and attach necessary documents such as hospital bills and medical reports.

What is the purpose of lic hospital treatment form?

The purpose of the LIC Hospital Treatment Form is to collect relevant information required by LIC to process claims for hospitalization expenses and ensure that the policyholder receives the entitled reimbursement.

What information must be reported on lic hospital treatment form?

The LIC Hospital Treatment Form must report the policy number, insured's details, hospital's name and address, treatment dates, type of illness/injury, details of hospitalization, and the amount of expenses incurred, along with supporting documents.