I hereby declare that the above statement is true to the best of my knowledge and belief.
1. Details of Medical Expenses should be supported by relevant documents like Hospitalisation bill, Doctors prescription, Discharge Card, Investigation Reports, Medical Receipts and Cash Memos in Original (to expedite its settlement of your claim).
2. Separate Claim Form should be submitted for each illness.
3. In case of Maternity claim certified photo copy of Birth Certificate should be attached.
4. Officers are requested to submit photo copy of Leave Sanctioned Form , current year Provident fund statement and relevant page of CDC of last Vessel signed off while filling of Claim Forms.
5. Claim Form should be submitted within 90 days after completion of treatment.
6. The officer must ensure that Claim Form should be signed either by the Officer or in his absence by his wife.
7. Verification by the Doctor giving the diagnosis and period of treatment is a MUST for audit purpose.
8. Please intimate if you are receiving medical financial benefits for self and family from any other source(s). Please give details.
9. Officer's children's up to the age of 25 years are entitled for the Medical reimbursement benefits, subject to the condition that they are unmarried, unemployed and are solely dependent on him.
10. Parents, Brothers, Sisters and Relatives of Officer will not be entitled for the Medical benefits.
11. Reimbursement of medical expenses will be made by RTGS/NEFT only. Please ensure to submit correct details of your Bank Account.
12. Additional information pertaining to your Medical Claims may be furnish in a separate sheet or to be mentioned in covering letter for sake of clarification.
13. Medical Reimbursement Forms (Hospitalisation Treatment or Domiciliary Treatment) can be obtained from the Funds office on reauest or you can download Claim Forms from Website : www.mnowf.com
14. All correspondence relating to Medical claims should be sent directly to "The Merchant Navy Officers' Welfare Fund", Udyog Bhavan, 4th Floor, 29 Walchand Hirachand Marg, Ballard Estate, Mumbai - 400 001.