Get Sail Sampark Mediclaim

Filling out the Sail Sampark Mediclaim online is a crucial step for members looking to avail of the mediclaim benefits. This guide will walk you through the process of completing the application form accurately and efficiently.

Follow the steps to complete your Sail Sampark Mediclaim form.

1. Click ‘Get Form’ button to obtain the Sail Sampark Mediclaim application form and open it for editing.
2. Begin by filling out the employee details section. Enter the name of the employee, personnel number, unit from where you retired, place of last posting, and date of separation. Include the designation last held.
3. Next, select the claim center from the available options such as Kolkata, Chennai, Delhi, Bhilai, Rourkela, Bokaro, Salem, Asansol, and Durgapur.
4. Fill in member details for both the employee and spouse, including name, date of birth, and gender. Affix recent photographs of both the member and the spouse in the designated areas.
5. In the address section, provide the new address only if there has been a change since the last policy period, including pin code, phone number, cell number, and email ID.
6. Specify the premium amounts for both the employee and spouse. Also, list the nominees for both, including their relationship with the employee and spouse.
7. Complete the ECS details by providing the name of the account holder for both employee and spouse, along with the name of the bank, branch address, and account numbers.
8. Fill out the payment details section, including challan or DD number and IFSC codes for both member and spouse accounts. Indicate the amount paid.
9. Finally, sign the application form in the respective signature fields for both the member and the spouse.
10. Once all sections are complete, review the form for accuracy. Save any changes, download a copy, print the form, or share it as needed.

Start completing your Sail Sampark Mediclaim application online today to ensure you are covered.