As you have asked for the health policy claim form of United India Insurance Company Limited (UIIC), I am giving you information about it, check below for the details

CLAIM FORM - PART A
TO BE FILLED IN BY THE INSURED
The issue of theis form is not to be taken as admission of liability

DETAILS OF PRIMARY INSURED

a) Policy no:
b) Sl. No/ Certificate No:
c) Company/ TPA ID No: SECTION A
d) Name:
SECTION A
e) Address:
City:
State:
Pin Code
Phone No:
Email ID:

UIIC Health Policy claim form