Get Formulir Rawat Jalan

Filling out the Formulir Rawat Jalan online can seem challenging, but with clear guidance, you can complete it with ease. This guide will help you navigate through each section, ensuring a smooth experience.

Follow the steps to fill out the Formulir Rawat Jalan correctly.

1. Press the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin with the personal information section by entering your policy number, name, and contact details, including your address and phone numbers.
3. In section I, outline any changes to policyholder or insured data. Specify the name, date of birth, identity card number, marital status, and occupation of the person. Ensure to include supporting documents such as a valid identification copy.
4. Proceed to section II to update beneficiary details. Enter the full name, age, date of birth, and family relationship of the beneficiary along with their percentage of benefits. Attach relevant identification documentation.
5. In section III, indicate the new premium payment method. Choose either annual, semi-annual, quarterly, or monthly payment options and ensure to provide supporting documents for changes.
6. For section IV, choose the new premium payment method, providing details of the bank account or credit card information associated with the payment.
7. Section V allows for changes to additional insurance. Specify the details of the rider changes and ensure to include any necessary health declaration forms.
8. In section VI, indicate the desired change in the amount covered by the insurance policy, ensuring compliance with the insurance company’s requirements.
9. Section VII involves updating the basic premium amount. Fill in the necessary changes and provide relevant information.
10. For section VIII, specify any changes to the premium payment period. This includes specifying the term in years.
11. In section IX, select the new plan type and provide any additional information needed as per insurance company requirements.
12. Section X is for miscellaneous changes. Clearly state any other modifications required.
13. Review the declarations section at the end of the form. Confirm your understanding and acceptance of the terms. Sign and date the document.
14. Finally, save the changes you've made, and select an option to download, print, or share the completed form.

Complete your Formulir Rawat Jalan online today for a hassle-free experience!