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Reimbursement Claim Reference Number:(34624800)

(Please quote this reference number in all future correspondence)

E-card Claims Plan hospitalzation Hospitals

Date : 28 Sep 2023 16:17

Dear Shrikant Dodamani,

Your claim bearing number 34624800 against a policy issued by ICICI Lombard General Insurance Co. Ltd. has been processed for Rs 10430 against the amount claimed
for Rs 10810 based on the soft copy documents received via our online platforms.
View full details of this claim now.

However, it is mandatory to submit a physical copy of all the documents submitted online along with the signed claim form so that we can initiate payment process. It is
important that you submit the documents within 15 days.

Please Note -

1. Documents can be submitted to the nearby Medi Assist offices by courier, post, speed post or physical visit.
Click here to locate the nearby Medi Assist office.
2. Make sure to send the signed claim form.
You may download the filled-out claim from under the claim details section in your Medi Assist login or download the reimbursement claim form here.

We assure you the best of our services, always.

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Warm Regards,
Medi Assist Insurance TPA Pvt. Ltd
(Formerly known as Medi Assist India TPA Private Limited)
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