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CRITICAL ILLNESS CLAIM FORM
INSTRUCTIONS
Critical illness Claim
Please complete the Policyholder/Claimants Information section and attach a copy of the claimants birth certificate. If additional space
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How to fill out critical illness claim form
How to fill out critical illness claim form
01
To fill out a critical illness claim form, follow these steps:
02
Start by reading the instructions carefully that are provided with the form.
03
Begin filling out the personal details section. This includes your full name, address, contact information, and policy number.
04
Next, provide information about the illness that you are claiming for. Specify the date of diagnosis and the name of the treating physician.
05
Provide a detailed description of the illness and its impact on your daily life. Mention any medical treatments or surgeries you have undergone.
06
If required, attach all relevant medical documents such as test reports, hospital bills, and prescriptions to support your claim.
07
Review the completed form to ensure accuracy and completeness.
08
Sign and date the form before submission.
09
Follow the submission instructions mentioned in the form, either by mailing it or submitting it online.
10
Keep a copy of the filled form and supporting documents for your records.
11
Please note that these steps may vary depending on the specific critical illness claim form. It is always advisable to refer to the instructions provided with the form.
Who needs critical illness claim form?
01
Anyone who is diagnosed with a critical illness and holds an insurance policy covering critical illness benefits needs to fill out a critical illness claim form.
02
This form is required to initiate the claim process and receive the financial benefits provided by the insurance policy.
03
Individuals who have suffered from serious illnesses such as cancer, heart attack, stroke, organ failure, or other major medical conditions should fill out a critical illness claim form to avail the benefits they are entitled to.
04
It is important to review the policy terms and conditions to determine if the critical illness claim form is necessary for the specific insurance coverage.
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What is critical illness claim form?
A critical illness claim form is a document that policyholders submit to their insurance company to request benefits after being diagnosed with a specific critical illness covered by their policy.
Who is required to file critical illness claim form?
The policyholder or the beneficiary of the insurance policy is required to file the critical illness claim form following a diagnosis of a covered critical illness.
How to fill out critical illness claim form?
To fill out the critical illness claim form, the applicant must provide personal information, details about the diagnosis, medical treatment received, policy number, and signature to authorize the claim.
What is the purpose of critical illness claim form?
The purpose of the critical illness claim form is to initiate a claim for benefits from an insurance policy when the policyholder has been diagnosed with a critical illness, facilitating the claims process.
What information must be reported on critical illness claim form?
The information that must be reported on the critical illness claim form includes the policyholder’s personal details, the date and type of diagnosis, treatment received, and any relevant medical history.
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