Scribd Logo
Upload

Welcome to Scribd!

  • Annexure VI - Final Consent For TL

    Uploaded by

    Ashirwad Banerjee
    23 views2 pages
    This document is a letter from an insured vehicle owner to an insurance company agreeing to a "total loss" settlement of an own damage claim. The key details are: 1) The insured agrees to accept Rs.___________ in full and final settlement of the claim for the loss that occurred on __/__/20__. 2) The insured authorizes the insurer/surveyors to facilitate identifying the best wreck value through available resources, and agrees that the wreck will either be retained by the insured or handed over to an identified buyer. 3) The insured agrees to surrender the insurance certificate and policy for cancellation without refund of any unexpired premium.

    Original Description:

    Original Title

    Annexure VI - Final Consent for TL

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document is a letter from an insured vehicle owner to an insurance company agreeing to a "total loss" settlement of an own damage claim. The key details are: 1) The insured agrees to accept Rs.___________ in full and final settlement of the claim for the loss that occurred on __/__/20__. 2) The insured authorizes the insurer/surveyors to facilitate identifying the best wreck value through available resources, and agrees that the wreck will either be retained by the insured or handed over to an identified buyer. 3) The insured agrees to surrender the insurance certificate and policy for cancellation without refund of any unexpired premium.

    Copyright:

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

    Annexure VI - Final Consent For TL

    Uploaded by

    Ashirwad Banerjee
    This document is a letter from an insured vehicle owner to an insurance company agreeing to a "total loss" settlement of an own damage claim. The key details are: 1) The insured agrees to accept Rs.___________ in full and final settlement of the claim for the loss that occurred on __/__/20__. 2) The insured authorizes the insurer/surveyors to facilitate identifying the best wreck value through available resources, and agrees that the wreck will either be retained by the insured or handed over to an identified buyer. 3) The insured agrees to surrender the insurance certificate and policy for cancellation without refund of any unexpired premium.

    Copyright:

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

    TO PRINT ON RS.

    100/- STAMP PAPER

    Date:

    To,
    HDFC Ergo General Insurance Co. Ltd.
    th
    6 Floor, Leela Business Park,
    Andheri-Kurla Road,
    Andheri [East]
    Mumbai- 400 059.

    Sir,

    Ref: My Vehicle ___________________ bearing Regd. No.______________, Policy No.


    ______________________& Claim No.____________________

    I the undersigned owner of (vehicle make)___________________________bearing registration number


    __________________ do hereby agree to and accept treatment of the claim on “TOTAL LOSS” basis for
    consideration of Rs._______________ (Rupees_______________________________________________
    _____________________________only) in full and final settlement of own damage claim for the loss which
    occurred on / /20 .
    I authorize the Insurers/Surveyors to facilitate me to identify the best wreck value through the resources
    available. The wreck shall be either retained by me or handed over to the wreck buyer at my own behest. It
    is hereby understood that this aforesaid transaction between myself and the wreck buyer is only being
    facilitated by yourself to identify its value without any charges.

    I hereby agree to surrender insurance certificate and policy for necessary cancellation without consideration
    of any refund of premium for the unexpired period.
    In event of hand over of the wreck to the identified buyer, I accept to release the wreck with registration
    cancelation order / certificate and will clear all outstanding dues of the workshop including but not limited to
    estimation/garaging charges, parking charges etc.

    I undertake and agree to clear all outstanding loans including any top up loans where the subject vehicle
    has been held as security prior to settlement of this claim.

    I understand and agree that the complete transaction including vehicle registration cancelation shall be
    concluded by myself.

    It is understood that above settlement is subject to the terms and condition of the policy in force at the time
    of mishap and also subject to your accepting liability there to.

    Sign *

    Name of Insured:
    Address:

    Witness Signature:
    Witness Name:

    You might also like