Raksha PPN
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Claim Intimation
As per the policy terms and conditions intimation of claim is compulsory for all hospitalisation, this can be done by sumbitting the following details. After sucessful completion of this form the system will generate claim number, which can be used for while submitting your claim.

Please fill-up the below form- All fields are compulsory
Enter Member id
Select Policy Number
Patient Name
Phone No
Claim Type
Admission Date:
Requested Amount::
State Name
City Name
Enter Hospital Name
Enter Hospital Address
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