Green Delta Insurance Co. Ltd.

Head Office, Dhaka.

Check List for Fire Claims
Insured: Nature of Loss:

Claim No.: Date of Loss:

SL No. Required Papers/Documents Status/ Remarks

1 Loss Intimation Letter from the insured

2 Copy of Policy (along with endorsements if any)

3 Fire Brigade Report in their official format (In case of Fire)

4 Copy of GD/FIR with original seal

5 Stock Position/Register since inception of the policy

6 Purchase Documents (L/C, Invoice, Local Bill e.t.c)

7 Money Receipt, Bank Deposit Slip and Bank Statement

8 Meteorological Report (In case of Flood/Cyclone)

9 Valid Documents of Electric Connection/Line

10 Permission Letter for Own Power Generation

11 Periodical Test Report of Electric Pannel/ Equipments

12 Copy of Fire License

13 Claim Form dully filled-in by the insured & Bank jointly if any

14 Statement of Factory Manager regarding the incidnet

15 Statement of Security Guard/In-Charge regarding the incidnet

16 Statement of the person who first noticed the incident

17 Chairman/ Ward Commissioner Certificate regarding incident

18 Claim Bill with supporting documents

19 Quotation of Bill of Servicing Charge/Estimates of Reparing

20 Final Survey Report with their bill

21 Premium Deposit Confirmation Slip/Certificate

22 Expert Report/ Engineer's Evaluation about affected property

23 Stock Position for the day before incident attested by Bank

24 Papers Cutting of Local/ National Newspapers on the loss

25 Copy of Trade License

26 Letter of Subrogation/Letter of Indemnity (if necessary)

27 Documents of Premium Rate (Approval of IDRA)

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 Green Delta Insurance Co. Ltd.
Head Office, Dhaka.
Client wise Claims Paid Statement (Fire & Engineering)

2018 2019 2020 2021 2022

Year/ Group
Premium Premium Premium Premium Premium
Claims Paid Claims Paid Claims Paid Claims Paid Claims Paid
Earned Earned Earned Earned Earned

BRAC Bank Ltd.

Abul Khair

Youngone

Ispahani

Premier

A.K. Khan

BSRM

Kenpark-Regency

Geebee

Confidence

AL-Hamedi

Fahim Ahmed

Bengal Fisheries
 2018 2019 2020 2021 2022
Year/ Group
Premium Premium Premium Premium Premium
Claims Paid Claims Paid Claims Paid Claims Paid Claims Paid
Earned Earned Earned Earned Earned

Baraoora

PHP

T.K.

BSM

Pacific

Four H

Ritzy

Others

Total
 Green Delta Insurance Co. Ltd.
Head Office, Dhaka.
Client wise Claims Paid Statement (Fire & Engineering)

BRAC Bank Ltd. Abul Khair Group BSRM Group Others Tolal Claims Paid
Year/
Particulars Premium Premium Premium Premium Premium
Claims Paid Claims Paid Claims Paid Claims Paid
Earned Earned Earned Earned Earned

2017 45,336,197.00

2018 35,551,239.00

2019 25,821,908.00

2020 11,665,866.00

2021

2022

Total
een Delta Insurance Co. Ltd.
Head Office, Dhaka.
ise Claims Paid Statement (Fire & Engineering)

Tolal Claims Paid

Claims Paid
 Green Delta Insurance Co. Ltd.
Head Office, Dhaka.
Claims Statement (Fire & Engineering)

Previous Outstanding Claims Intimated Claims Total Claims Total Claims Settled Outstanding Claims
Year/
Particulars Nos. of Nos. of Nos. of Nos. of
Nos. of Claims Amount Amount Paid Amount Amount
Claims Claims Claims Claims

2017 274

2018 253

2019 190

2020 132

2021 142

2022

Total
 Green Delta Insurance Co. Ltd.
Head Office, Dhaka.
Claims Statement (Fire & Engineering)

Claims Intimated Claims Settled

Year/ Fire Engineering In the considered year In the previous year Total
Particulars
Nos. of Nos. of Nos. of Nos. of Nos. of
Paid Amount Paid Amount Paid Amount
Claims Claims Claims Claims Claims

2018 253 7 152 869,429,827

2019 190 9 59 237,800,844

2020 132 2 43 126,580,069

2021 142 7

2022 141 2

Total 858 27
 Green Delta Insurance Co. Ltd.
Head Office, Dhaka.
Claims Statement (Fire & Engineering)

Claims Intimated Claims Settled

Claims Settled in the Claims Settled in the
Total Nos & Amount Paid
Year/ considered year previous year
Fire Engineering Fire
Particulars
Nos. of Nos. of Nos. of Nos. of Nos. of Nos. of
Paid Amount GDIC's Share Paid Amount Paid Amount Paid Amount
Claims Claims Claims Claims Claims Claims

2017 274 6 465 456,950,912 460,031,508 85,651,431 375,310,014 460,961,445 With Survey fees

2018 253 7 152 876,450,224 876,138,739

2019 190 9 4 1,387,552,404 1,387,487,507

2020 132 2 205 191,290,016 190,922,353

2021 142 7 305 1,195,037,281 1,194,607,380

2022 141 2 208 124,704,029 70,088,322

Total 1132 33 1339 4,231,984,866 4,179,275,809

With Survey fees
 Green Delta Insurance Co. Ltd.
Head Office, Dhaka.
Claims Statement (Fire & Engineering)

Claims Intimated Claims Settled Claims Settled in the previo

Fire Engineering Fire ENG Fire

Nos. of Nos. of Paid Nos. of Paid Nos. of
Nos. of Claims Paid Amount
Claims Claims Amount Claims Amount Claims

148 2 27 7,927,106 1 79,900 46 118,692,475

Claims Settled in the previous year

ENG

Paid Amount
Nos. of Claims
2 9,190,806
 Green Delta Insurance Co. Ltd.
Head Office, Dhaka.
Claims Statement (Fire & Engineering)

Claims Intimated Claims Settled

Claims Settled in the Claims Settled in the
Total Nos & Amount Paid
Year/ considered year previous year
Fire Engineering Fire
Particulars
Nos. of Nos. of Nos. of Nos. of Nos. of Nos. of
Paid Amount GDIC's Share Paid Amount Paid Amount Paid Amount
Claims Claims Claims Claims Claims Claims

2017 274 6 465 456,950,912 460,031,508 80,571,211 360,212,458 440,783,669

2018 253 7 404 876,450,224 876,138,739

2019 190 9 442 1,387,552,404 1,387,487,507

2020 132 2 205 191,290,016 190,922,353

2021 142 7 305 1,195,037,281 1,194,607,380

2022 141 2 208 124,704,029 70,088,322

Total 1132 33 2029 4,231,984,866 4,179,275,809

 Green Delta Insurance Co. Ltd.
Head Office, Dhaka.
Claims Statement (Fire & Engineering)

Claims Intimated Claims Settled

Year/ Fire Engineering Fire Engineering
Particulars
Nos. of Nos. of Nos. of Nos. of
Amount Amount Paid Amount GDIC's Share Paid Amount GDIC's Share
Claims Claims Claims Claims

2017 274 6 465 456,950,912 460,031,508 5 965,129 965,129

2018 253 7 404 876,450,224 876,138,739 10 5,823,041 5,823,041

2019 190 9 442 1,387,552,404 1,387,487,507 4 3,188,142 3,188,142

2020 132 2 205 191,290,016 190,922,353 2 1,444,053 1,444,053

2021 142 7 305 1,195,037,281 1,194,607,380 7 506,237 481,697

2022 141 2 208 124,704,029 70,088,322 7 9,418,595 9,418,595

Total 1132 33 2029 4,231,984,866 4,179,275,809 35 21,345,197 21,320,657

 Green Delta Insurance Co. Ltd.
Head Office, Dhaka.
Analysis Sheet for Fire Claims
Insured: Claim No.:

SL No. Particulars Status/Remarks

1 Loss/Incident occurred on

2 Intimation to us about loss on

3 Name of the Surveyors

4 Premium Deposited on

5 Intimation to Re-Insurers on

6 Certificate/Cover Note/Policy Period

7 Cause of Loss

8 Perils/Risks Covered

9 Construction as per Policy

10 Construction as per Survey Report

11 Interest Insured in Details

12 Damaged Items in Details

13 Purchase Documents of affected items

14 Quotations for Repair/Replacement

15 Any other Cost/Expenditure

16 is Claim Bill supported by documents ?

17 Insured Claim Amount (Tk.)

18 Preliminery Loss Amount (Tk.)

19 Final Net Assesment (Tk.)

20 Surveyors' Observations

Ensure documents (Claim Form & Stock

21 Report etc.) sealed & singned by the
concerened Bank
Previous Claims Status (Date, Nos,
22
Amount etc.)

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