Checklist of the Claim Documents

Company Name(s): 

Check list of the claim documents for Permanent Total Disability
SL.
No.
Documents
1 Claim form duly filled
2 FIR
3 Panchanama
4 Disability Certificate from civil surgeon or from designated
govt./competent authority
5 Policy Certificate
6 Age proof of Insured: Election ID Card / PAN Card/ School Leaving
Certificate / Copy of passport
· Depending upon the merits of the case, additional information or additional documents can
be asked from the claimant
Check list of the claim documents for PA - Death
SL.
No.
Documents
1 Claim form duly filled
2 FIR
3 Panchanama/Inquest Panchanama
4 Police Final Report/Charge Sheet (Based on FIR)
5 For PM Report having remark for FSLR or CA Report, the FSLR or CA reports are must
6 Death Certificate issued by the Municipal authority
7 Cause of death certificate issued by the hospital
8 Original Policy Certificate
9 Age proof of Insured: Election ID Card / PAN Card/ School Leaving
Certificate / Copy of passport
· Depending upon the merits of the case, additional information or additional documents can be asked from the claimant
Check list of the claim documents for CI: Cancer
SL.
No.
Documents
1 Claim form duly filled
2 Hospital Discharge Card photocopy
3 Investigations Reports
4 Histopathology / Cytology / FNAC / Biopsy / Immuno-histochemistry
reports.
5 X-Ray / CT scan / MRI scan / USG / Radioisotope / Bone scan Reports.
6 Any other specific investigation done to support the diagnosis
7 Policy Certificate
8 Age proof of Insured: Election ID Card / PAN Card/ School Leaving
Certificate / Copy of passport
· Depending upon the merits of the case, additional information or additional documents can be asked from the claimant
Check list of the claim documents for CI : Myocardial Infarction
SL.
No
Documents
1 Claim form duly filled
2 Hospital Discharge Card photocopy from treating hospitals
3 Investigations Reports
4 ECG On Admission and subsequent ECG’s
5 Policy Certificate
6 Age proof of Insured: Election ID Card / PAN Card/ School Leaving
Certificate / Copy of passport
· Depending upon the merits of the case, additional information or additional documents can
be asked from the claimant
Check list of the claim documents for CI : CABG
SL.
No.
Documents
1 Claim form duly filled
2 Photocopy Hospital Discharge Card of hospital of surgery
3 Investigations Reports
4 Policy Certificate
5 Age proof of Insured: Election ID Card / PAN Card/ School Leaving
Certificate / Copy of passport
· Depending upon the merits of the case, additional information or additional documents can
be asked from the claimant
Check list of the claim documents for CI : Stroke
SL.
No
Documents
1 Claim form duly filled
2 Hospital Discharge Card photocopy
3 Investigations Reports
4 Subsequent details of the Treatment, with the Consultation papers from
the Treating Neurologist/ Physician stating the Neurological deficit.
5 MRI / CT scan/ 2D Echocardiography Reports or any other Imaging
technique Used during the diagnosis and treatment of the Stroke
6 Policy Certificate
7 Age proof of Insured: Election ID Card / PAN Card/ School Leaving
Certificate / Copy of passport
· Depending upon the merits of the case, additional information or additional documents can be asked from the claimant
Check list of the claim documents for CI: Paralysis
SL.
No
Documents
1 Claim form duly filled
2 Hospital Discharge Card photocopy
3 Investigations Reports
4 Subsequent details of the Treatment, with the Consultation papers from
the Treating Neurologist/ Physician stating the Neurological deficit and the
degree/current status and duration of the Paralysis.
5 MRI / CT scan Reports or any other Imaging technique Used during the
diagnosis and treatment of the Stroke
6 Policy Certificate
7 Age proof of Insured: Election ID Card / PAN Card/ School Leaving
Certificate / Copy of passport
· Depending upon the merits of the case, additional information or additional documents can be asked from the claimant
Check list of the claim documents for CI: End Stage Kidney failure
SL.
No.
Documents
1 Claim form duly filled
2 Hospital Discharge Card photocopy
3 Photocopy Hospital Bills
4 Investigations Reports
5 Blood Tests- Renal Function Tests specifically
6 Dialysis Papers/Receipts done in recent past.
7 Renal scan
8 Policy Certificate
9 Age proof of Insured : Election ID Card / PAN Card/ School Leaving
Certificate / Copy of passport
· Depending upon the merits of the case, additional information or additional documents can be asked from the claimant
Check list of the claim documents for CI: Major Organ Transplant
SL
No.
Documents
1 Claim form duly filled
2 Hospital Discharge Card photocopy of hospital of surgery
3 Investigations Reports
4 Scan / Histopathology / Cytology / FNAC / Biopsy report of the particular
organ.
5 Policy Certificate
6 Age proof of Insured: Election ID Card / PAN Card/ School Leaving
Certificate / Copy of passport
· Depending upon the merits of the case, additional information or additional documents can
be asked from the claimant
Check list of the claim documents for CI: Multiple Sclerosis
SL.
No
Documents
1 Claim form duly filled
2 Hospital Discharge Card photocopy
3 Investigations Reports
4 MRI / CT Scan Report/Electo-myogram report/Biopsy / Cytology Report
5 Policy Certificate
6 Age proof of Insured: Election ID Card / PAN Card/ School Leaving
Certificate / Copy of passport
· Depending upon the merits of the case, additional information or additional documents can be asked from the claimant
Check list of the claim documents for CI: Heart Valve Replacement
SL.
No
.
Documents
1 Claim form duly filled
2 Hospital Discharge Card photocopy of hospital of surgery
3 Investigations Reports
4 X-ray and 2D-Echocardiography Report.
5 Policy Certificate
6 Age proof of Insured: Election ID Card / PAN Card/ School Leaving
Certificate / Copy of passport
· Depending upon the merits of the case, additional information or additional documents can be asked from the claimant
Check list of the claim documents for Loss of Job
SL.
No.
Documents
1 Claim form duly filled
2 Appointment letter with annexures
3 Last 3 Months Salary Slip
4 Certificate from the employer confirming the termination due to Lock out,
Retrenchment, Cost Cutting and Pink Slip/Relieving letter from employer
/Any communication from employer
5 Contact details of employer-phone no. mobile no., email ID, contact
person in HR/Admin/Personnel dept.
6 Appointment letter Employer if Re employed
7 VISA proof and Passport copy in case of Insured is NRI
8 Xerox Copy of the policy certificate
9 Age proof of Insured: Election ID Card / PAN Card/ School Leaving
Certificate / Copy of passport
· Depending upon the merits of the case, additional information or additional documents can
be asked from the claimant
Check list of the claim documents for death due to medical illness
Sr.No. Documents
1 Claim form duly filled
2 Death certificate issued from hospital-Form 4A
3 Death certificate issued by Municipal authority
4 Hospital Indoor paper records of treatment and course in Hospital
5 Investigations Reports
6 Details of the Treatment received by the Customer on admission to
hospital
7 Age proof of Insured: Election ID Card / PAN Card/ School Leaving
Certificate / Copy of passport
8 Policy certificate
9 Any past medical records, treatment, investigations done
· Depending upon the merits of the case, additional information or additional documents can be asked from the claimant