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  • Claim ID Submission Ref No Card Holder Name Card Number Policy No

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    Fathelbab
    26 views4 pages
    This document contains a claims submission report with 4 claims. It includes details of the claimants such as name, relationship to the employee, claimed and approved amounts. The majority of the claims are still under process with no payment reference or update date provided yet. One claim of $250 was partially approved for $160.

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    ClaimSubmissionList - 20-02-2018

    Original Title

    ClaimSubmissionList - 20-02-2018

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    This document contains a claims submission report with 4 claims. It includes details of the claimants such as name, relationship to the employee, claimed and approved amounts. The majority of the claims are still under process with no payment reference or update date provided yet. One claim of $250 was partially approved for $160.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    26 views4 pages

    Claim ID Submission Ref No Card Holder Name Card Number Policy No

    Uploaded by

    Fathelbab
    This document contains a claims submission report with 4 claims. It includes details of the claimants such as name, relationship to the employee, claimed and approved amounts. The majority of the claims are still under process with no payment reference or update date provided yet. One claim of $250 was partially approved for $160.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    of 4

    Claim ID Submission Ref No Card Holder Name Card Number Policy No

    NA 0218047960 ROVAN HAMED FATHELBABOIG/ME-34834/C/6987059 34834


    26986059 0218047206 ROVAN HAMED FATHELBAB6987059 34834
    26936912 0218047085 ROVAN HAMED FATHELBAB6987059 34834
    26962139 0218047208 NEVIEN AHMED KHEIR 6987058 34834
    Claimant Type Relationship Last Updated Date Submission Date Claimed Amount Approved Amount
    Dependent Daughter 2/20/2018 20/02/2018 09:35 0.00 0.00
    Dependent Child 2/7/2018 01/02/2018 00:00 250.00 160.00
    Dependent Child 2/7/2018 01/02/2018 00:00 250.00 0.00
    Dependent Spouse 2/6/2018 05/02/2018 00:00 1074.00 1000.00
    Claim Status Payment Status Mode Of Payment Payment Reference No. Payment Update Date
    Submitted NA
    Processed Under Process NA NA NA
    Reversed NA NA NA NA
    Processed Under Process NA NA NA
    Employee Id
    52489
    52489
    52489
    52489

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