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MDINDIA HEALTHCARE SERVICES (TPA) PVT. LTD.

An ISO 9001:2000 Company

Toll Free Customer Care No.: 1 800 233 11 66

Toll Free Cashless No.: 1 800 233 45 05

UAN Fax No.: 1 860 233 44 49

Download Forms

Download Claim Form

*Please select city and Click 'Download' button
to download claim form for Particular city.

Select City

Claim Intimation Format

Other Forms

Provider Empanelment Kit

Future Generali India Insurance Company Ltd. Forms

The New India Assurance Company Limited Forms

Saint Gobain Claim Form

ECS Form

Request For Authorisation Letter
	Request For Authorisation Letter
	Check List
Discharge Voucher
	Discharge Voucher
You could down load and fill the forms mentioned below for empanelment of your Hospitals / Nursing Homes with us.
Provider Empanelment Kit
	Covering Letter
	Agreement
	Provider Information
	Schedule Of Charges

Future Generali India Insurance Company Ltd.
	Claim Form
	Request For Authorisation Letter

The New India Assurance Company Limited
	Family Floater
	Group Mediclaim
	Janata Mediclaim
	New Mediclaim
	Senior Citizen

Steel Authority of India Limited
	SAIL - GuideBook

SBI General Insurance Company Limited
	Claim Form


Birla Sun Life Insurance
	Claim Form
	Preauthorization Request Form
	Reimbursement Claim - Claimant's Statement
	Reimbursement Claim - Hospital Treatment Certificate
L&T General Insurance Company Ltd
	Claim Form

HDFC ERGO General Insurance Co.
	Claim Form
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