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  #1  
Old April 20th, 2016, 05:14 PM
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Default Dedicated Health Insurance

Hello sir I am here as I want to get the application form of Request for Cashless Hospitalisation for Medical Insurance Policy of Dedicated Healthcare Services TPA (INDIA) Pvt. Ltd so will you please provide me that??
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  #2  
Old April 20th, 2016, 06:27 PM
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Join Date: Nov 2011
Default Re: Dedicated Health Insurance

Dedicated Healthcare Service TPA (India) Private Limited (DHS) is a Versatile Health Insurance Service provider servicing valued clients since April 2006


DHS is headed by a highly qualified, experienced and dedicated Management Team. Over 400 committed employees provide seamless services to our clients located across India.

The Company has a team of Executives with considerable experience in the field of general insurance.

As per your demand here I am providing you application form of Request for Cashless Hospitalisation for Medical Insurance Policy of Dedicated Healthcare Services TPA (INDIA) Pvt. Ltd

Application form of Request for Cashless Hospitalisation for Medical Insurance Policy of Dedicated Healthcare Services TPA (INDIA) Pvt. Ltd




Details need to be fill in this Form are:

Name of the Insurance Company

Name of TPA

Toll free phone number

Toll free FAX

Male Female

Age

Date of birth

Contact number of attending relative

Membership Card Number/ID Number

Name of the family physician

Name of the Patient

Gender

Mobile Number

Email ID

Employee ID

Name of Employer

In case group health insurance taken by Employer

Work address

Currently do you have any other Mediclaim/Health insurance:

Do you have a family physician

Contact number

Contact Detail:
Dedicated Healthcare Services TPA (India) Pvt. Ltd.
Second Floor, Cambata Building
(Eros Cinema Building), East Wing
42, Maharshi Karve Road
Churchgate, Mumbai - 400 020
Phone: 022 6627 5900
Fax: 022 2287 4235
Email: iba@dhs-india.com
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