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Get United India Claim Form

Surance scheme As allotted by the organization c) Company TPA ID No. Enter the TPA ID No License number as allotted by IRDA and printed in TPA documents. d) Name Enter the full name of the policyholder Surname, First name, Middle name e) Address Enter the full postal address Include Street, City and Pin Code SECTION B - DETAILS OF INSURANCE HISTORY a) Currently covered by any other Mediclaim / Health Insurance? Indicate whether currently covered by another Mediclaim / Health Insuranc.

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