Get Glico Claim Form

Filling out the Glico Claim Form online can be a straightforward process when you know what to do. This guide will walk you through each section and field of the form to ensure you provide the necessary information accurately and comprehensively.

Follow the steps to complete your Glico Claim Form online:

1. Click ‘Get Form’ button to obtain the form, and open it in your editor.
2. In section 1, enter the particulars of the deceased. Provide the full name, staff number, address, and business occupation.
3. In section 2, fill out the name of the hospital and details regarding the place of death. Include the folder or OPD number, cause of death, occupation at the time of death, policy number, management unit, age, date of birth, date of death, and ward.
4. In section 3, respond to the history of the deceased’s illness. Specify when the insured first complained or showed indications of their last illness, when they first consulted a physician, and list all physicians who attended them during the last illness as well as those who treated them in the three years prior. Include their names, addresses, dates, and reasons for consultation.
5. In section 4, answer if the insured had other life insurance policies. If yes, provide the names, policy numbers, policy dates, and amounts.
6. In section 5, complete the particulars of the claimant. Provide the claimant’s name, date of birth, address, relationship with the deceased, confirmation of enclosed policy documents, and preferred mode of settlement.
7. Review the declaration statement carefully. Sign and date the form, and provide your contact number and email address.
8. Once all sections are completed and verified for accuracy, you may choose to save the changes, download the form, print it out, or share with the relevant parties.

Start filling out your Glico Claim Form online today to ensure a smooth claims process.