Get Psu-uiic Claim Form - Nitjacin

Filing a claim can be a straightforward process when you understand how to accurately complete the PSU-UIIC Claim Form - Nitjacin. This guide will walk you through each section of the form, ensuring that you provide all necessary information to facilitate prompt processing of your claim.

Follow the steps to complete the claim form efficiently.

1. Click the ‘Get Form’ button to access the PSU-UIIC Claim Form - Nitjacin for online completion.
2. Begin by filling in the name of the insured person, which is the individual whom the policy has been issued for.
3. Provide the details of the insured person for whom the claim is submitted, including their name, relationship to the insured, present age, occupation, and residential address.
4. Enter the policy number associated with the claim. This helps the insurer identify your coverage.
5. Describe the nature of the disease or injury by providing a clear explanation of the condition that necessitated the claim.
6. Indicate the date when the injury was sustained or the disease was first detected.
7. Supply information about the attending medical practitioner, including their name, address, registration number, qualifications, and telephone number.
8. If applicable, provide the name and address of the hospital or nursing home, alongside its registration number, as well as the dates of admission and discharge.
9. For domiciliary hospitalization claims, specify the dates of commencement and completion of treatment, along with the name and address of the attending medical practitioner and their contact information.
10. You will need to outline the expenses incurred during treatment in the schedule of expenses section, detailing receipt numbers, dates, nature of expenditure, claimed amounts, and amounts payable.
11. Affirm the truthfulness of the information provided, and acknowledge that any false statements may result in forfeiture of the claim.
12. Complete the electronic transfer details required for reimbursement, including bank account information, IFSC code, and contact details.
13. Finally, review all information for accuracy, then save your changes and proceed to download or print the completed form for submission.

Begin filling out your PSU-UIIC Claim Form - Nitjacin online today to ensure prompt processing of your claim.