Hospitalized AFPMBAI Members may now claim FREE Daily Hospital Income Benefit

Complete Medical Record, consisting of the following:

• Admission Notes or Admission Record
• Vital Signs Chart
• Daily Progress Notes or Course in the Wards
• Nurses’ Notes
• Laboratory and/or Imaging Reports (as applicable)
• Operative and Anesthesia Records (as applicable)
• Discharge Summary showing date and time of admission and discharge, final diagnosis, and brief hospital course, if the patient has already been discharged

If the Complete Medical Records are unavailable, the applicant may submit a Narrative Summary / Clinical Summary / Clinical Abstract / Medical Abstract or equivalent documents containing the following information:

• Physician’s signature, license number, and contact information
• Dates of admission and discharge, or an indication that the in-patient management is still ongoing
• Date of issuance of the document

• Police/NBI Report, Final Spot Report, or Accident Report from immediate Commanding Officer;
• Driver’s license if the member-claimant was the driver

• Authorization Letter signed by the affected regular member. If necessary, a thumbprint may be affixed in place of the signature, preferably with a witness attesting to its authenticity.
• Photocopy of the authorized representative’s valid ID with 3 specimen signatures