2 0 obj Overall rating: 5 out of 5 based on 1 reviews. �xPO{:��/٥sO:VZC. <> All bills and payment receipts towards transportation and lodging(incurred overseas) if applicable. NEFT form and Cancelled cheque stating insured’s / Claimant Indian Bank account details. CLAIM FORM- PART B TO BE FILLED IN BY THE HOSPITAL The issue of this form is not to be taken as admission of liability Please include the original preauthorization request form in lieu of PART-A DETAILS OF HOSPITAL Bajaj Allianz General Insurance Company Limited. wtJ9 �ۇ��A�a�4,|T�\�͢1�v�t$�]��P��"�) ��+�՝��/�S�!��B4u��3���`���8(�38��w��4f�P�w���2�m��5[ Duly Completed Personal Accident Claim Form signed by Nominee. stream It offers you an all-encompassing life cover with multiple variants and benefits. The claim form, along with bills, complete hospitalization documents should be sent to Bajaj Allianz for reimbursement purpose. endobj Bajaj Allianz Star Package Claim forms and Neft form. Passport and Visa copy with Entry Stamp Overseas and exit Stamp from India. Attested copy of Death Certificate. Bajaj Allianz Star Package Health Insurance Plan Premium calculator. To ... • I / We undertake to revoke the instruction for NEFT in the event of the business relationship ... • After Bajaj Allianz General Insurance Company Limited issuing the Payment instruction Original Paid receipts (hardcopy) in case of reimbursement claim. Invoices / Bills towards medical expenses. Fax no: 020-30512246. 3 0 obj All prescriptions, investigation reports & medicine bills are to be kept handy. Bajaj Travel insurance extension/renewal while outside India Indian overseas travelers who are stranded outside India due to coronavirus and are unable to travel back want to extend or renew Bajaj Allianz travel insurance online.These travelers can complete the Bajaj Allianz international travel insurance renewal request form online and we will try to get an approval for you. Court order or any judicial order received against the compensation. NEFT Form (available at branch) Original Pre-printed cancelled cheque; Bank Statement (If cancelled cheque is non personalized) Standard ID proof of Proposer; 2 Once the required changes are done, the insurer will provide a confirmation . NEFT Form; Copy of address proof (Ration card or electricity bill copy). Letter from the airlines stating reason for cancellation. Bajaj Allianz General Insurance Co. Ltd, GE Plaza, Airport Road, Yerawada, Pune, 411006. Post receiving of all required info, the claim will be processed within 30 days. Bajaj Allianz Life Insurance Death Claim Form ... Cancelled cheque with printed name and account details of Claimant Attested passbook copyof bank NEFT form attested bybank Additional documents in case of Suicide / Accident - (FIR and Post Mortem Report is mandatory) fa�^G��!��R0Zi�� �f�m��W�={�y4氛 Regd. ]?c��&���A�0� ��}�T�:l�^Z.�E��BD��ӐL^��$|�m[$P��H~�GЛ��o��4������N�`qZ���np�L<8td2���GG �0[��K�Ec��D Copy of Receipt towards the advance payment of tuition fee, Letter regarding the inability of the student to continue semester duly acknowledged by the school, All bills and payment receipts towards transportation. NEFT Form and Cancelled cheque stating insured’s / Claimant Indian Bank account details (for reimbursement claim). Bajaj Allianz Life Smart Protect Goal is a complete term plan with new-age features in line with your evolving needs. 5.0 rating based on 12,345 ratings. If the claim is approved, amount will be transferred within 30 days. Duly completed claim form and NEFT form, signed by the Claimant. Search for the best hospital for cashless facility across India from the health insurance hospital list of Bajaj Allianz. The treatment is to be intimated with respective service providers within prescribed timelines. Regd. For senior citizens: seniorcitizen@bajajallianz.co.in. Original bill of purchase for the laptop. CLAIM FORM- PART B TO BE FILLED IN BY THE HOSPITAL The issue of this form is not to be taken as admission of liability Please include the original preauthorization request form in lieu of PART-A DETAILS OF HOSPITAL Bajaj Allianz General Insurance Company Limited. Claim Form – (to be filled and signed by insured). 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GLOSSARY - PULL SMS TABLE; No Service Type Keyword Send To ; 1: For Callback for service related queries : SUPPORTPOLICY NO : 8108222251: 2: For Callback for renewal premiu CLAIM FORM FOR HEALTH INSURANCE POLICIES OTHER THAN TRAVEL AND PERSONAL ACCIDENT – PART A TO BE FILLED IN BY THE INSURED The issue of this form is not to be taken as an admission of liability Email id:-customercare@bajajallianz.co.in Toll free no:1800-209-5858 020-30305858 (To be filled in block letters) DETAILS OF PRIMARY INSURED Bajaj Allianz General Insurance Company. Invoices / Bills supporting the claim amount, Original Paid receipts if paid (hardcopy) in case of reimbursement claim. Claim Form (to be filled and signed by insured) Hospitalization discharge summary/consultation papers of insured if applicable. OPD Claims & claims other then In-Patient will be reimbursed upon return to India. 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