Follow the steps to correctly fill out the claim form.

1. Press the ‘Get Form’ button to access the form and open it in the editing tool.
2. In Part I, fill out your details as the insured employee or for your dependent, including your name, date of birth, civil status, and the name of your employer.
3. Continue to provide your employment details, including your business address and occupation. Specify if the claim is for yourself or a dependent by checking the appropriate box.
4. If relevant, answer if your dependent is employed and fill out any additional information requested, including maternity case details if applicable.
5. If the injury is due to an accident, provide details regarding the time and location of the accident, what the injured person was doing, and how the accident occurred.
6. Certify that the provided information is true by printing your name and signature at the bottom of Part I.
7. Forward the completed form to your employer, who will need to fill out Part II with additional employment information.
8. In Part II, the employer must confirm details regarding the employee’s disability, if applicable, and certify the information before submitting it to Generali.
9. Have the hospital complete Parts III and IV, including the hospital charges and the attending physician’s details. Ensure all bills and receipts are attached.
10. Review the form for accuracy, save your changes, and prepare to download or print the completed form for submission.

Complete your Group In-Patient Claim Form online today to ensure a seamless claims process.