Get Dengue Shield Claim Form

Completing the Dengue Shield Claim Form online is a straightforward process that allows you to submit your claim efficiently. Follow this guide to understand each section of the form and ensure that all required information is accurately provided.

Follow the steps to complete the form correctly.

1. Press the ‘Get Form’ button to access the Dengue Shield Claim Form and open it in your chosen editor.
2. Begin by entering the name of the life insured in block letters in the designated field.
3. Provide the address of the life insured, ensuring it is complete and accurate.
4. Fill in the phone number and the email address of the life insured for communication purposes.
5. Input the policy number as listed on your documentation to enable proper identification of your claim.
6. Enter the date of diagnosis or illness, ensuring the date format is correct for clarity.
7. Provide details of the diagnosis accurately, including any pertinent medical information.
8. Fill out the name, address, telephone number, and Medical Council of India (MCI) registration number of the treating doctor.
9. List the name and address of the hospital where treatment was received.
10. Indicate the number of beds available in the hospital where treatment was provided.
11. Record the date of the first consultation with the doctor.
12. Specify whether the treatment was inpatient or outpatient, along with the name and address of the doctor or hospital.
13. Confirm if there was a consecutive hospitalization of 48 hours, noting the admission and discharge dates and times.
14. Complete details about the nominee in case of the policyholder's death, including their name, date of birth, relationship, address, contact number, and email.
15. Provide bank account details for the policyholder or nominee. Note that a cancelled cheque leaf must be attached for direct transfers.
16. Review the declaration section, indicate your acceptance of responsibility for the provided bank details, and sign as the policyholder or nominee.
17. Attach all required supporting documents, ensuring they are self-attested, including medical reports, hospital certificates, and identification proof.
18. Save changes to the completed form, then download or print it as needed for submission.
19. Submit the form along with the required documents through the available channels.

Start completing your Dengue Shield Claim Form online today to ensure a smooth and efficient claims process.