IRDA REGISTERED ALL TPA CLAIM FORM
Medvantage Insurance TPA Private Limited
- Cashless Request Form
- Reimbursement Claim Form
- Super Top-up Claim Form
- Top-up Claim Form
- GIPSA PPN Network Declaration Form
1800 209 8884
www.medvantage.in
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Medi Assist Insurance TPA Private Ltd.
- Cashless Request Form
- Request for Cashless Hospitalisationform
- GIPSA PPN Network Declaration Form
1800 572 9792
www.mediassisttpa.in
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MDIndia Health Insurance TPA Private Ltd.
- Cashless Request Form
- Reimbursement Claim Form
- GIPSA PPN Network Declaration Form
- Declaration Form for Network Hospital (Other than PPN)
1 800 233 45 05
www.mdindiaonline.com
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Paramount Health Services & Insurance TPA Private Ltd.
- Cashless Request Form
- Reimbursement Claim Form
- Request for Cashless Hospitalization
- GIPSA PPN Network Declaration Form
1800226655
www.paramounttpa.com
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Private Sector Insurance Companies
Heritage Health Insurance TPA Private Ltd.
1800 345 3477
www.heritagehealthtpa.in
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Raksha Health Insurance TPA Private Ltd.
1800 208 5544
www.rakshatpa.com
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Vidal Health Insurance TPA Private Ltd.
1800-425-7878
www.vidalhealthtpa.com
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Medsave Health Insurance TPA Limited
- Medishield Claim Form
1800111142
www.medsave.in
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Genins India Insurance TPA Services PVT. Ltd.
0120- 4144100
www.geninsindia.com
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Health India Insurance TPA Services PVT. Ltd.
- Cashless Request Form
- Pre-authorization Form (Cashless)
1800 2201 02
www.healthindiatpa.com
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Good Health Insurance TPA Limited
1860-425-3232
www.goodhealthtpa.com
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Park Mediclaim Insurance TPA PVT. Ltd.
1800-11-55-33
www.parkmediclaim.co.in
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Safeway Insurance TPA Private Limited
- Cashless Request Form
- Reimbursement Claim Form A
- Reimbursement Claim Form B
- Guidelines
- NEFT Mandate Form
1800 102 5671
www.safewaytpa.in
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Anmol Medicare Insurance TPA Limited
- Cashless Request Form
- Group Health Claim Form
- CKYC form
- Retail Health Claim Form
1800 233 1999
www.anmolmedicare.co.in
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Ericson Insurance TPA Private Limited
- CKYC - For Employee NEFT more than 1 Lac
- CKYC - Legal Entity-For Corporate NEFT more than 1 Lac
1800 22 2034
www.eric.co.in
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Health Insurance TPA of India Limited
- Cashless Request Form
- Reimbursement Claim Form
- NEFT Mandate Form
1800 102 3600
www.hitpa.co.in
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Akna Health Insurance TPA Pvt. Ltd.
- Cashless Request Form
- Reimbursement Claim Form
1800 569 4455
www.aknatpa.com
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