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I, aged (DOB:) years, enrolled under the Group Mediclaim policy / Retail Health Insurance policy of Reliance general Insurance Co limited bearing Policy / Health card ID hereby accept the following 1. I / we herewith understand that Reliance General Insurance Co limited ( RGICL ) reserves the right to process the claim as per policy terms and conditions of the policy. 2. RGICL reserves its right to settle the claim on soft copies and reserves it right to call for original documents if deemed necessary at any given point of time. 3. I/we hereby declare that the information furnished is true and correct to the best of my knowledge and belief, In Addition to the above I/we also consent RGICL, to seek necessary medical information / documents from the hospital / Medical Practitioner who has attended on the person against whom this claim is made 4. . I/we will not be making any claim with any other insurance company for any undue benefit. In addition to the above the I also declare that RGICL will reserve the rights to seek all the original documents in physical form for a period of one year from the date of claim submission and also will be refunding the entire claim amount to RGICL if any misrepresentation/concealment of facts are been noted in my respective hospitalization related to claim/ hospitalisationation. RGICL may take legal action, as deemed fit, if any discrepancy found in the claim.
This is an initiative from Reliance General Insurance Co. Ltd (RGICL) for its customers during or in post-treatment/surgical care. This is not an advertisement, and there is no compulsion on anyone reading this document to opt for the services mentioned herein. RGICL is a facilitator alone in this arrangement. The customers are of their free will to decide on opting or opting out of these services. RGICL in no way is making any representation or warranty regarding any of these products or services, nor will RGICL be liable to you or regarding quality, standard & timely services delivery provided by the service provider for any disputes arising from or in connection with their products and services. RGICL will not be liable for any claim, damages, demands, or actions, and any liabilities, losses, damages, or expenses incurred due to the use, misuse, or failure of any of the equipment or services procured through this service and the policyholder/ claimant at this moment acknowledges that they are availing these services at their own risk. The service provider or the manufacturer will be solely responsible in cases where it fails to provide opted services on a timely basis or where an unforeseen incident occurs due to failure to provide convenient services. However, RGICL will nowhere be liable in case the above incident occurs due to negligence on the part of the service provider to deliver the defined/opted services in the agreement/policy. RGICL shall not be liable to reimburse/release any payments for services provided by the Service Provider that are not in compliance with the Policy.
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