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Gambar Hati Gambar Box Kesehatan

Health Insurance Claim Form

Please fill out the form along with the required documents for claim review

Select an option
  • Indonesia
  • English

Disclaimer: if submiting a claim for more than IDR 5.000.000, please submit it using a hard copy document to the respective Third-party administrator (TPA). How To Submit A Claim Over IDR 5.000.000

  • - Select claim type -
  • Rawat Inap
  • Rawat Jalan
  • Dental
  • Maternity
  • Kacamata
  • Option
  • YES
  • NO
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