Ref. No.

: 290423519670
Date: Apr 29, 2023

ARVIND SIROHI
Near Tagore
Public School,
Dayalpur 86,
Faridabad,
Faridabad
Haryana - 121004
Mobile Number: 83******99

Sub: Insurance Claim No. MOT13286073 under the Private Car Insurance Policy No.
3001/235137423/01/000 for vehicle bearing Reg No. HR26DM7784

Dear ARVIND SIROHI,

Thank you for choosing ICICI Lombard General Insurance Company Limited (ICICI Lombard) as your
preferred service provider.

Please note that the above claim remains unprocessed as the following documents required for claim
appraisal have not been received by us:

Tp vehicle detail FIR copy Fast Tag Detail Mr. Harsh statement & his DL copy Vehicle loan
1.
statement & transaction detail of paid installments Injury detail Towing Bill

The same was informed to you vide our letters dated Mar 14, 2023 and Apr 04, 2023. Please find
enclosed the same for your reference.

We are unable to process the claim for the above stated reason(s), we would be treating the claim as
closed and hence, ICICI Lombard shall not have any liability in respect of the captioned subject
matter. In case you want any further clarification, please feel free to communicate with us at the
below contact details at your convenience, quoting the above claim number and we shall be pleased to
assist you.

Sincerely,
For ICICI Lombard General Insurance Company Ltd.

Authorised Signatory

Customer Service Manager - Rajveer Singh, rajveer.singh@icicilombard.com, 8657450373