Get Formulir Klaim Rawat Inap Claim Form For Hospitalization - Zurich Co

This guide provides you with clear and supportive instructions on how to accurately complete the Formulir Klaim Rawat Inap Claim Form For Hospitalization from Zurich Co online. By following the steps outlined, you will be able to submit your claim smoothly and efficiently.

Follow the steps to successfully complete your claim form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the 'Data Polis' section, enter your policy number and personal information, including your full name and date of birth in the specified formats.
3. Proceed to the 'Identitas Tertanggung' section where you will again provide the insured's full name, date of birth, gender, and reason for hospitalization.
4. Fill in the hospitalization dates, the date of outpatient treatment, and enter any diagnosis or symptoms experienced during hospitalization.
5. Include any previous medical history by detailing past illnesses or conditions.
6. List any additional insurance policies you may have, specifying insurance company names and policy numbers.
7. Input the bank account information for the policyholder to facilitate payment upon claim approval.
8. Lastly, confirm all the information provided is accurate, sign the form, and ensure to include your name clearly along with the contact information.
9. Attach all necessary supporting documents as specified, including medical certificates and hospital receipts.
10. Upon completion, save your changes, download the file, and prepare it for submission.

Complete your claim form online today to ensure a swift processing of your hospitalization claim.