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  • Format For Claim Intimation

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    Siddharth
    28 views2 pages
    This document provides a format for intimating an insurance claim, including fields to fill out such as the name of the insured, vehicle details, policy number, accident details, estimated loss amount, and workshop information where the vehicle can be inspected. The format requests information on the insurance company, policyholder, driver, vehicle, accident cause and location, estimated damages, and contact details of the workshop where the damaged vehicle will be inspected.

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    Format for Claim Intimation (1)

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    This document provides a format for intimating an insurance claim, including fields to fill out such as the name of the insured, vehicle details, policy number, accident details, estimated loss amount, and workshop information where the vehicle can be inspected. The format requests information on the insurance company, policyholder, driver, vehicle, accident cause and location, estimated damages, and contact details of the workshop where the damaged vehicle will be inspected.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    28 views2 pages

    Format For Claim Intimation

    Uploaded by

    Siddharth
    This document provides a format for intimating an insurance claim, including fields to fill out such as the name of the insured, vehicle details, policy number, accident details, estimated loss amount, and workshop information where the vehicle can be inspected. The format requests information on the insurance company, policyholder, driver, vehicle, accident cause and location, estimated damages, and contact details of the workshop where the damaged vehicle will be inspected.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    CLAIM INTIMATION FORMAT- DETAILS TO BE FILLED AS PER POLICY,CLAIM FORM & ESTIMATE

    Name of Insurance Co. & Office

    Name of The Insured/Vehicle owner & Mobile No.

    DRIVER NAME & Mobile No.

    Policy Number

    Period of Insurance

    Vehicle Number

    Date and time of loss/accident

    Make & Model

    IDV( Rs)

    Cause of loss

    Place of ACCIDENT

    Police ROJNAMCHA/GD No. / FIR No. and date

    Details of Injury to Driver/Vehicle Occupant/Third Party

    Spot Surveyor Name & Mobile No.

    Estimated amount of loss

    WORKSHOP DETAILS - REQUIREMENT FOR AUTOMATION OF SURVEYOR DEPUTATION

    WORKSHOP NAME

    WORKSHOP ADDRESS

    Contact Name Workshop person

    Workshop Mobile Number

    Workshop Email id

    Other Contact No. Workshop person

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