|
|
INTENSIVE CARE / CORONARY CARE CLAIMS (policy or rider)
- Use claim form C101.
- Complete the section entitled "Claimant's Statement". Please be sure to date and sign in the blanks provided at the bottom of the form.
- Submit the hospital bill that shows the itemized charge for each day of confinement to Intensive Care or Coronary Care.
< Return to Main Claims Page
|
|