Common use of Documents to be submitted Clause in Contracts

Documents to be submitted. The claim is to be supported with the following documents and submitted within the prescribed time limit. 1. Covid Hospitalization Cover ▇. ▇▇▇▇ filed and signed claim form II. Copy of Insured Person’s passport, if available (All Pages) III. Photo Identity proof of the patient (if Insured does not own a passport) IV. Medical practitioner's prescription advising admission V. Original bills with itemized break-up VI. Payment receipts VII. Discharge summary including complete medical history of the patient along with other details. VIII. Investigation reports including Insured person’s test reports from Authorized diagnostic centre for COVID. IX. OT notes or Surgeon's certificate giving details of the operation performed, wherever applicable X. Sticker/ Invoice of the Implants, wherever applicable. XI. NEFT Details (to enable direct credit of claim amount in bank account) and cancelled cheque XII. KYC (Identity proof with Address) of the proposer, where claim liability is above Rs.1 Lakh as per AML Guidelines. XIII. Legal heir/succession certificate, wherever applicable. XIV. Any other relevant document required by Company/ TPA for assessment of the claim. 2. Home Care Treatment expenses ▇. ▇▇▇▇ filed and signed claim form II. Copy of Insured Person’s passport, if available (All Pages) III. Photo Identity proof of the patient (if Insured does not own a passport) IV. Medical practitioner's prescription advising hospitalization V. A certificate from medical practitioner advising treatment at home or consent from the Insured person on availing home care benefit. VI. Discharge Certificate from medical practitioner specifying date of start and completion of home care treatment.

Documents to be submitted. The claim is to be supported with the following documents and submitted within the prescribed time limit. 1. Covid Hospitalization Cover ▇. I. ▇▇▇▇ filed and signed claim form II. Copy of Insured Person’s passport, if available (All Pages) III. Photo Identity proof of the patient (if Insured does not own a passport) IV. Medical practitioner's prescription advising admission V. Original bills with itemized break-up VI. Payment receipts VII. Discharge summary including complete medical history of the patient along with other details. VIII. Investigation reports including Insured person’s test reports from Authorized diagnostic centre for COVID. IX. OT notes or Surgeon's certificate giving details of the operation performed, wherever applicable X. Sticker/ Invoice of the Implants, wherever applicable. XI. NEFT Details (to enable direct credit of claim amount in bank account) and cancelled cheque XII. KYC (Identity proof with Address) of the proposer, where claim liability is above Rs.1 Lakh as per AML Guidelines. XIII. Legal heir/succession certificate, wherever applicable. XIV. Any other relevant document required by Company/ TPA for assessment of the claim. 2. Home Care Treatment expenses ▇. I. ▇▇▇▇ filed and signed claim form II. Copy of Insured Person’s passport, if available (All Pages) III. Photo Identity proof of the patient (if Insured does not own a passport) IV. Medical practitioner's prescription advising hospitalization V. A certificate from medical practitioner advising treatment at home or consent from the Insured person on availing home care benefit. VI. Discharge Certificate from medical practitioner specifying date of start and completion of home care treatment.