Get Psu-uiic Claim Formpdf

This guide provides clear and detailed instructions on completing the PSU-UIIC Claim Form online. By following these steps, users can ensure that their claims are submitted accurately and promptly.

Follow the steps to successfully complete your claim form.

1. Click ‘Get Form’ button to access the PSU-UIIC Claim Form PDF and open it for editing.
2. Begin by entering the name of the insured person, which is the individual in whose name the policy has been issued.
3. Provide details of the insured person for whom the claim is being made, including their name, relationship to the insured, current age, occupation, and residential address.
4. Enter the policy number associated with the claim to link it to the specific coverage.
5. Describe the nature of the disease or injury for which the claim is filed.
6. Record the date the injury was sustained or the disease was first detected.
7. Fill in the details of the attending medical practitioner, including their name, address, registration number, qualification, and contact number.
8. Provide information about the hospital or nursing home where treatment was received, including name, address, registration number, date of admission, and date of discharge.
9. If the claim is for domiciliary hospitalizations, specify the start and completion dates of treatment, and details of the attending medical practitioner.
10. List all expenses incurred related to the treatment in the schedule of expenses, indicating receipt numbers, dates, nature of expenditure, amounts claimed, and amounts payable.
11. The claimant must sign and date the form, confirming that all provided information is true and that no other claims have been made under different medical schemes.
12. Complete the bank details section for electronic transfer, including account holder name, bank name, account number, IFSC code, account type, and bank address.
13. Finally, attach a copy of a cancelled cheque leaf to verify the bank details, then save changes to the form, download, print, or share it as needed.

Complete your PSU-UIIC Claim Form online now and ensure a smooth claims process.