Electronic reimbursement form

Issuance/claiming of insurance reimbursement in electronic form is aimed at facilitating insurance service delivery for the customers of Insurance Company IC Group (hereinafter the Insurer).

Please read below rules and terms for electronic reimbursement:

The scheme for claiming/issuing insurance reimbursement  electronically is only applicable if the sum paid according to a single receipt makes 500 GEL and/or less.

In order to claim insurance reimbursement electronically the insurer must fill in the form developed buy the Insurer.

All mandatory information requested by the Insurer must be submitted in the form

The applicant must upload electronic versions of documents requested by the Insurer. They must be readable and the information given in them must be compliant with the reimbursement sum requested by the applicant;

Insurance reimbursement will be issued according to specific insurance terms;

The applicant is responsible for authenticity and accuracy of the data submitted;

The applicant shall be held fully liable for damage incurred to third person or the Insurer due to dishonest behavior of the applicant;

The applicant has no right to include in the application information the content of which is non compliant with current Georgian legislation or the aims of issuance/claiming of insurance reimbursement in electronic form;

In order to submit the application, the applicant must fill in all the mandatory fields, upload requested documentation and agree to terms of use of electronic application form;

By submitting the application form the applicant confirms he/she is entitled to claim insurance reimbursement and is responsible for authenticity and accuracy of the submitted information/data;

The insured is required to keep the submitted receipts for 6 months and provide them if requested to do so by the Insurer;

 

It is strictly prohibited that the application:

Is untrue or inaccurate and misleading the Insurer;

Serves fraudulence, deception or abuses trust;

Is non compliant with or violating third party’s rights and interests;

Violates current Georgian legislation in any manner;

Serves any purpose other than claiming/receiving insurance reimbursement in electronic form.

 
Special condition!

The insurer is not held responsible for the authenticity and accuracy of submitted information/accuracy;

All applications submitted non compliant with present regulations will be rejected by the Insurer;

Personal information provided by the applicant during registration in order to use the site, will be used/processed solely for the purpose of issuing insurance reimbursement and will not be used for any other purpose;

     
 

 

CONTACT US

Chose the Product :
Name, Surname:
E-mail:
Contact phone:
Employer:
Comment:
Security Code: Code
 
CONTACT US
Copyright © 2009 - 2019 IC Group. All Rights Reserved. Developed by Neomedia