Get Nationaltrustniramaya Form

Completing the Nationaltrustniramaya Form is an important step in processing your claim under the Niramaya Health Insurance Scheme. This guide will provide you with clear, step-by-step instructions to ensure you fill out the form accurately and effectively.

Follow the steps to accurately complete the form.

1. Press the ‘Get Form’ button to retrieve the form and open it in your document editor.
2. In the first section, enter the claimant's details. This includes full name, present age, relationship with the patient, telephone number, and residential address.
3. In the second section, provide details about the patient, including their full name, age, disability, relationship of the patient to the claimant, BPL card number, and residential address.
4. Fill out the information regarding your permanent business or occupation. If you have more than one occupation, list them all.
5. In this section, input the name and address of the hospital where the treatment occurred, as well as the name, address, and qualifications of the doctor who performed the treatment.
6. Specify the nature of the claim as either OPD or IPD. Additionally, provide the relevant dates and details related to the disease, including dates of admission and discharge.
7. Indicate the total amount you are claiming.
8. If the claim is for domiciliary hospitalization, fill in the details of treatment commencement and completion, as well as the name and qualifications of the attending medical practitioner.
9. Answer whether you are insured elsewhere by providing details of the other insurance company and the sum insured.
10. Attach supportive documents as indicated in the box. Ensure that you mark each document that you are submitting.
11. Complete the declaration section by confirming that the particulars provided are true to the best of your knowledge.
12. Finally, add the date, place, and signature of the insured before submitting the form.

Complete your documents online to facilitate a smooth claim process.