Md india domiciliary claim form canara bank 2026

1. Click ‘Get Form’ to open the md india domiciliary claim form in the editor.
2. Begin by filling in the details of the primary insured. Use block letters for clarity. Include your Policy number, IOB Employee ID, and personal information such as name, address, and contact details.
3. Next, provide information about the insured person who was hospitalized. Fill in their name, gender, age, date of birth, and relationship to the primary insured.
4. In the claims section, enter the name of the treating doctor and specify the commencement and end dates of treatment. Clearly indicate what domiciliary treatment is being claimed.
5. Review the checklist for claim documents required. Ensure you have included all necessary documents like illness certificates and pharmacy bills.
6. Finally, complete the declaration section at the end of the form. Sign and date it to confirm that all information provided is accurate.

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