Ā ਀਀฀ᔂЀᜀ̀᠀฀଀฀਀̀ Ѐ Ă ؀ሀጀ᐀ᔀᘀᜀĀᜀఀЀ਀ༀ฀ࠀ ᤀက฀ԀఀЀᨀ܀ఀᄀ̀଀ᬀ ᐀ࠀကԀᔒЀᨀ܀ఀᄀ̀଀ᬀ ᰀഀ؀܀଀̀ༀᬀ ăက̀᠀Ȁࠀഀ̀ Ѐᨀ܀ఀᄀ̀଀ᬀ ᴀ ฀ഀༀကԀഀ̀ἀ

 

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Toll Free Number 1800-209-5846 1800-209-LTIN www. ltinsurance. com is the brand of L T General Insurance Company Limited Registered Office: L T House, N. M. Marg, Ballard.

 

10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002 Easy Health ClaimForm1PART A TO BE FILLED IN BY THE INSURED The issue of this.

 

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IFFCO-TOKIO GENERAL INSURANCE COMPANY LIMITED REGISTERED OFFICE: 34, NEHRU PLACE, NEW DELHI – 110019 Claim No. : _____________ Date of Issue: __________.

 

IFFCO-TOKIO GENERAL INSURANCE COMPANY LIMITED REGISTERED OFFICE: 34, NEHRU PLACE, NEW DELHI – 110019 Claim No. : _____________ Date of Issue: __________.

 

IFFCO-TOKIO GENERAL INSURANCE COMPANY LIMITED REGISTERED OFFICE: 34, NEHRU PLACE, NEW DELHI – 110019 Claim No. : _____________ Date of Issue: __________.

 

As soon as Loss or Damage has become known the Company must be notified without delay. If any detail or information is not readily available please do not delay.

 

,x “Ьh Ааc JД A ю„т Kз Й ў JГЗ ’я9эК.

 

THE FOLLOWING ITEMS MUST BE INCLUDED WITH THIS CLAIM 1. The Original if a refund is not obtainable. 2. Doctor Õ s/Hospital Certificate specifying exact nature.

 

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10. OTHER INSURANCE DETAILS :Date :Signature of the Insured with Date Driver / Friend / Relative / Employee / Passenger / Others7. INJURY / DEATH.

 

Name and address of Injured person s. Damage to. Repairers, name and. Telephone. Damage to Third Party. Name of third Party Insure. Full.

 

The Oriental Insurance Company Limited Incorporated in India, subsidiary of General Insurance Corp oration of India Regd. Office: Oriental House,.

 

Claim No. : Date Time of Initmation Policy No. / Cover Note No. Period of insurance FIR No. DateCharges u/s:Police Station: Policy details of that Vehicle.

 

a. The claim form is to be duly filled and signed by the insured. b. All facts and statements must be factual not influenced or biased in any favor. c. The damaged vehicle must.

 

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Claim No. : Date Time of Initmation Policy No. / Cover Note No. Period of insurance FIR No. DateCharges u/s:Police Station: Policy details of that Vehicle.

 

MOTOR INSURANCE - CLAIM FORM Insurer PolicyNo. THE P OLICY OLDER Name in full Date of birth ID No. Occupation Place of work Address.

 

Registered Office: Cnr. Long Temple Streets, P. O. Box 1609, St JohnÕs, Antigua MOTOR CLAIMFORM Agency DearSir, Claim No. With reference to your.

 

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Downloaded from www. insureatclick. com - Broker : Loyal Insurance Brokers Ltd.

 

CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED Registered and Head Office:” Dare House” 2nd Floor, No. 2, N. S. C. Bose Road, Chennai 600 001. MOTOR INSURANCE.

 

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a. The claim form is to be duly filled and signed by the insured. b. All facts and statements must be factual not influenced or biased in any favor. c. The damaged vehicle must.

 

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Downloaded from www. insureatclick. com - Broker : Loyal Insurance Brokers Ltd.

 

CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED Registered and Head Office:” Dare House” 2nd Floor, No. 2, N. S. C. Bose Road, Chennai 600 001. MOTOR INSURANCE.

 

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Downloaded from www. insureatclick. com - IMD Code : 10000006.

 

CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED Registered and Head Office:” Dare House” 2nd Floor, No. 2, N. S. C. Bose Road, Chennai 600 001. MOTOR INSURANCE.