HEALTH CARD
TPA ID NO :
Name	:
Address	:
Date of Birth	:		Age	:
Policy No	:
Policy Period	:
Name Of Insured	:
Relation with Policyholder :
Phone No	:		Blood Group	:

HEALTH INSURANCE CARD This card is for identification purpose only General & Claims Enquiry Helpline Cashless Enquiry Helpline         Toll Free : 1800-209-7777 Toll Free : 1800-209-7800 Uan No : 1860-233-4446 Uan No : 1860-233-4448 Fax No : 1860-233-4447 Fax No : 1860-233-4449 Email : customercare@mdindia.com Email : authorisation@mdindia.com TERMS AND CONDITIONS 1.Pre-authorisation is compulsory from tpa prior to a planned admission and within 24 hours for emergencies. 2.Admission for investigation/evaluation not covered. 3.All terms and conditions of the policy would be applicable. 4.Cashless hospitalisation in network hospitals can be obtained in conjunction with this card, an authorisation letter issued by the tpa and photo identification such as voters id, driver license, passport etc.