Downloads

• Pre Authorization Form :-

  • PreAuthorization Form [For Cashless Request]
    
    
    

• Claim Form :-

  • Reimbursement Claim Form [For Insured]
  • Cashless Claim Form [For Hospital]
    
    
    

• PPN Declaration Forms :-

  • PPN Declaration Form [For PPN Hospital]
  • Form 60 [For PPN Hospital]
    
    
    

• IRDAI Schedules :-

  • Provider Service-Cashless Facility Admission Procedure [Schedule-A]
  • Process Note for de-empanelment of providers [Schedule-B]
  • Standard discharge summary [Schedule-C]
  • Standard format for provider bills [Schedule-D]
    
    
    

• CKYC for United Insurance

• Template/Application Form For Individual Customer
• Template/Application Form For Related Person i.e Annexure A1