Best TPA For Health Insurance In India

MDIndia Health Insurance TPA Pvt. Ltd.
IRDAI Licence No. 005 | Valid till 20/03/2026

1800 209 77 77 / 1800 209 78 00 | customercare@mdindia.com

CCN

MDID (MDI5-XXXXXXXXXX)

Policy Number

AND

Policy Holder / Employee

Insurance Company Name

Policy No *

MDID No. / Emp No. *

Claim Number *

Policy Holder Name *

Mobile No. *

Email ID *

Name of Account Holder *

Account Number *

IFSC Code *

Name of Bank *

Branch Name *

MICR Code *

Branch Address *

Type of Account *

Submitted By *

Upload Cancelled Cheque with duly filled and signed ECS Form * Only Pdf,Tif,Jpg,Png files allowed.

ECS Form

I accept all the below terms and conditions

Terms and Conditions

I hereby declare that the information furnished in this ECS Form is true & correct to the best of my knowledge & belief. If I have Made any false or untrue statement, suppression or concealment of any material fact, my right to claim reimbursement shall be Forfeited.
I agree that I shall not hold TPA/Insurance Company responsible for delay or non-receipt of the payment for any reason whatsoever after issue of the instructions for payment by Insurer/TPA based on the above.
As per the revised RBI guidelines, Canceled cheque should have pre-printed name of account holder.

Note: your banker should be a participant of NEFT/RTGS Facility.