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+252 (63) 7155555

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info@tacawun.com

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Omar Hashi Building, Road 1, Hargeisa

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Form Download

Providing the best insurance policy to customers.

Download below Service Guide and Endorsement  forms

Service Guide Forms

Claim Settlement

This letter is to inform your staff of our reimbursement procedures
Claim Settlement

Reimbursement Procedures (2023)

This letter is to inform your staff of our reimbursement procedures
Reimbursement Procedures (2023)

Endorsement and Reimbursement Claim Forms

Addition Form

Addition Form

This Form use only Dependant's ADDITION of the Existing Member with Tacawun Insurance
Pre-Authorization and Claim Form

Pre-Authorization and Claim Form

For Inpatient, Dental and Optical Preauthorization is COMPULSORY Other than taking Preauthorization TIA is not liable for payment of any Bill
Deletion Form

Deletion Form

This Form is used for DELETION of the Existing Member and/or his/her Dependants from Tacawun Ins.
Lost Card Form

Lost Card Form

To be completed by Employee (For Himself and on behalf of the Dependants)
Member Detection /Dependent Drop Form

Member Detection /Dependent Drop Form

This Form use for DELETION of the Existing Member and/or his/her Dependants from Tacawun Ins
New Member Application

New Member Application

This Form use only ENROLLED the New Member with Tacawun
Reimbursement Claim Form (Medicare)

Reimbursement Claim Form (Medicare)

This Form uses Reimbursement which both the doctor and tacawun Member need to complete
Tacawun