STAR HEALTH AND ALLIED INSURANCE CO. LTD.

No.15, SRI BALAJI COMPLEX,1st FLOOR, WHITES LANE,ROYAPETTAH,

CHENNAI-600014.Toll Free No: 1800 425 2255 / Toll Free Fax: 1800 425 5522, www.
starhealth.in

Date : 14-06-2019
To,
MR.ASHOK KUMAR VAID
# 5 HARNAM SINGH NAGAR
THREEKAY ROAD
LUDHIANA
BADDOWAL , Pincode : 142021
LUDHIANA, PUNJAB
Telephone : 9417089845

Dear Customer,

Sub: Requirement of additional documents/information.

This has reference to the claim preferred on us as per details given below-

Policy No P/211200/01/2019/003661 Claim Intimation No CLI/2020/211200/0108926

Product Name Senior Citizens Red Carpet Name of the patient MR.ASHOK KUMAR VAID

Policy Period 31-10-2018 to 30-10-2019 DOA - DOD 19-05-2019 19-05-2019

FORTIS HOSPITAL LUDHIANA -

Policy Issuing Office Area Office - Ludhiana Hospital Name & City
LUDHIANA (M CORP.)

MS.JASMINE WADHWA -
SM Name / Code
TA0000002295
Diagnosis CAD,
Intermediary Name / MS.MONA NARULA -
Code BA0000332829

We require the following additional documents/information to enable us to process your claim further. Kindly send us the
documents/information within 15 Days on receipt of this communication.These are mandatorily required.

S.No. Description of documents required

A letter from treating doctor with seal and sign, clarifying the past history of heart diseases, if so; kindly submit its
1
records.
Serial ECG, ECHO, Cardiac markers, CAG report, if done; submit all relevant investigation report supporting the
2
diagnosis.

3 Comorbids with duration and treatment records.

Thanking you,
Yours faithfully,

Authorised Signatory.

IRDA Regn.No.129
Corporate Identity Number U66010TN2005PLC056649
Email ID : info@starhealth.in
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