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GroupHealth Claims Portlet

Notify Claims Online - Group Health Insurance Claims

Please Enter Your Details Below

Name of Insured/Corporate Required

Policy No./Cover Note No Required

Email Required

Name of Patient Required

Name of Employee Required

Employee No Required

Member Id Required

Contacts :

Mobile Number Required

Residency Phone No.

Office Phone No

Address Required

Date Of Admission into Hospital Required

Date of Discharge Required

Hospital Name Required

Hospital Place Required

Nature of Ailment Required

Estimated Claim Amount Required

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Text to Identify

Text Verification Required

With respect to my claim under Policy Number: for the hospitalization of Mr/Mrs./Ms . I hereby declare that I have not made any claims under any other health insurance policies towards the subject hospitalization and I undertake to submit all the claim documents in original within 10 days.

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