MaxCare Complaint


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Please fill up the form below to register your complaint
Complainant * :      
Complainant Type * :      
Name of Complainant :
Card Number : *
Email : * ( Communication purpose )
Emirate ID :
Mobile No :
Date of Complaint :
Name of Patient :
Policy Details : Maxcare ID : Employee ID :
Company Name :
Insurance Company Name :
Intermediary Name :
Complaint category :
Grievance Description: *
Is this a repeat complaint : Yes No
Escalated for outside deliberation or arbitration : Yes No
Complaint fully upheld : Yes No
Complaint partially upheld : Yes No
Complaints denied (prior to any external escalation) : Yes No
Upload File :  
      
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