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  • E-claim for vitrified tiles damage

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    sarathlal
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    This document provides details of an insurance claim for broken vitrified tiles. It includes information about the insured company, policy details, loss details such as the date and location of loss, a brief description of the loss, and the approximate loss amount of 15,000 rupees. Contact details are provided for surveying the loss location and coordinating the claim. Additional details pertain to transportation of the tiles from Morbi to Kannur, including invoice, LR, and dispatch date information.

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    BHARTI_INTIMATATION.docx

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    This document provides details of an insurance claim for broken vitrified tiles. It includes information about the insured company, policy details, loss details such as the date and location of loss, a brief description of the loss, and the approximate loss amount of 15,000 rupees. Contact details are provided for surveying the loss location and coordinating the claim. Additional details pertain to transportation of the tiles from Morbi to Kannur, including invoice, LR, and dispatch date information.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    20 views2 pages

    E-claim for vitrified tiles damage

    Uploaded by

    sarathlal
    This document provides details of an insurance claim for broken vitrified tiles. It includes information about the insured company, policy details, loss details such as the date and location of loss, a brief description of the loss, and the approximate loss amount of 15,000 rupees. Contact details are provided for surveying the loss location and coordinating the claim. Additional details pertain to transportation of the tiles from Morbi to Kannur, including invoice, LR, and dispatch date information.

    Copyright:

    © All Rights Reserved
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    of 2

    E- CLAIM INTIMATION

    GENERAL INFORMATION COMMON TO ALL LINES OF BUSINESS


    Nature of Loss □ VITRIFIED TILES
    Insured’s Details
    Name SARJU VITRIFIED PVT.LTD.
    Address
    Contact Details -

    Policy Details
    Policy No MCO/ I2449518/71/11/003127
    Loss Details
    Date & Time of loss 3/7/18
    Place of loss /Accident ABC MERCENTILE GROUP (INDIA) PVT LTD
    CORPORATE HOUSE, PP XII/130-A/130-B
    KUPPAM, (PO). TALIPARAMBA. PIN- 670 502
    KUNNUR (DIST)
    TALIPARAMBA
    Short Description of loss DUE TO BREKAGE
    Approximate Loss Amount 15,000/-
    Survey Details
    Place of survey ABC MERCENTILE GROUP (INDIA) PVT LTD
    CORPORATE HOUSE, PP XII/130-A/130-B
    KUPPAM, (PO). TALIPARAMBA. PIN- 670 502
    KUNNUR (DIST)
    TALIPARAMBA

    Contact details of person to be 9526084141


    contacted for survey
    ADDITIONAL DETAILS IN CASE OF MARINE & MOTOR
    Voyage / Transit Details (For MORBI TO KANNUR
    Marine claims only)
    Marine Certificate No. -
    Invoice No & date 507 & Dt:07/06/2018

    LR/RR /AWB/BL No & date 8021 Dt.07/06/2018


    Date of dispatch 07/06/2018
    Drivers Details ( For Motor -
    claims only)
    Name of Driver -
    Driving License No. -
    --
    FIR / Injury Details -
    FIR Lodged -
    If Yes FIR No. & Name of -
    Police station
    Injuries sustained by any -
    Occupant/Employee/Third Party
    If Yes, Furnish Details -
    Any other information -
    relevant to loss / accident

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