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PLEASE ALLOW POP-UPS BEFORE YOU START
WORKING ON THE FORMS
NEW FROM OCTOBER 1,
2009 - $100,000 COVERAGE FOR 70 PLUS VISITORS and Increase in
Pre-existing coverage amounts - $8,000 with 50K policy and $10,000 with 100K
Policy (effective 1/1/2010)
1. Membership Form
- $10.00 per year - Required to take Health Insurance. Please complete
this before you proceed to insurance form.
2.
India Network Health Insurance Form-
Please use this for new insurance as well as renewal of existing
insurance.
Complete the above form in its entirety
(4 steps). The last step will produce ID card on the screen. If the php script forms give
trouble, please access the html form by replace the php at the end
of secure form link with html or contact our office for
assistance at 407-243-8760.
3.
Online Claim
Submission Form - Submit Only once for each sickness.
4.
CLAIM
STATUS QUERY FORM - To
know the status of your claim filed with Chartis Claims office.
5.
Add new
Visitors (current members only)
6.
Address Change Form (current members only)
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