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MEDICAL CLAIM NON WALAA
Customer Info
SME/Domestic Health Workers/Premium Residency
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Policy No (CCHI No)
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Card number or National id or Resident id
*
Treatment From
*
select
Select Country
Afghanistan
Algeria
All / Rem
Angola
Australia
Austria
Azerbaigan
Bahrain
Bangladesh
Belgium
Belize
Benin
Bhutan
Bosnia
Botswana
Brazil
Brunei
Bulgaria
Burkina
Burundi
Cambodia
Cameroon
Canada
Cape Verde Islands
Chad
China
Colombia
Congo
Cyprus
Czech Republic
Danish
Djibouti
Egypt
Eritrea
Ethiopia
France
Gabon
Gambia
Germany
Ghana
Greece
Guinea
Haiti
Hong Kong
India
Indonesia
Iran
Iraq
Iriland
Italy
Ivory Coast
Japan
Jordan
Kazakhstan
Kenya
Korean
Kuwait
Laos
Lebanon
Liberia
Libya
Madagascar
Malawi
Malaysia
Maldives
Mali
Mauritania
Mauritius
Mexico
Moldova
Mongolia
Morocco
Mozambiq
Myanmar
Namibia
Nepal
Netherlands / Holland
New Zealand
Niger
Nigeria
Norway
Oman
Pakistan
Palestine
Papua New Guinea
Peru
Philippines
Poland
Qatar
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Seychelles
Singapore
Slovakia
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan
Sweden
Switzerland
Syria
Taiwan
Tanzania
Thailand
Togo
Tunisia
Turkey
Uganda
Ukrania
United Arab Emirates
United Kingdom
United States
Venezuela
Vietnam
Yemen
Zair
Zambia
Zimbabwe
Email
*
Mobile No
*
Admission Date
*
RadDatePicker
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Open the calendar popup.
Calendar
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Discharge Date
*
RadDatePicker
RadDatePicker
Open the calendar popup.
Calendar
Title and navigation
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Choose OTP
*
Email OTP
Mobile OTP
Remarks
FOC/FOB
*
Select Service
Dental
Optical
Maternity
Repatriation
IP and OP
Send OTP
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OTP will be sent your mobile and Email
تم إرسال رقم التحقق إلى رقم جوالك وبريدك الإلكتروني
CLAIM OTP WALAA
OTP Info
OTP
OTP has been sent your mobile and Email
تم إرسال رقم التحقق إلى رقم جوالك وبريدك الإلكتروني
Next
Resend OTP
Medical Service & Attachment Info
FORM & IBAN
Support format for all Upload pdf,png, jpeg, jpg, tif, tiff
Reimbursement Form [Globemed]
Reimbursement Form [NextCare]
Reimbursement Form [ Domestic Worker Health]
Related Medical Plan
*
select
Select Service
Reimbrusement Form
Hospital Report
Insurance Card Copy
Iqama Copy
IBAN Sponsor
ID Copy Sponsor
NOC for Transfer to Insured IBAN
Death Certificate (Death Claim)
Email attachement
Attach Related Docs
*
Description
*
Add
Clear
S.No
Medical Plan
Description
File
No Record Found
Medical Plan
*
select
Select Service
Hospital Paid Bills
Mummification Paid Bill (Death Claim)
Air Transport Paid Bill
Invoice No
*
Invoice Date
*
RadDatePicker
RadDatePicker
Open the calendar popup.
Calendar
Title and navigation
Title and navigation
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June 2025
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June 2025
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Gross.Amt
*
VAT Amt
Net Amt
*
Documents
*
Description
*
Add
Clear
S.No
Medical Plan
Invoice No
Invoice Date
Cost
Vat
TotalAmt
Description
File
No Record Found
Save