INDIA NETWORK HEALTH INSURANCE
                      

 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. 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 407-2588346.

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)

(c) India Network Services

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