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MOTOR INSURANCE CLAIM FORM. THE ISSUE OF THIS FORM IS NOT TO BE TAKEN AS AN ADMISSION OF LIABILITY. If any detail or information is not readily available please do not delay dispatch of this form and such particulars may be sent later. Claim No. _____________ Policy no. ____________________________ Estimated Loss : Rs.
If your vehicle Description of Accident/Incidence ed in c ollision, please dra w diagram of the incident and enclose the same with the claim form
Oct 23, 2023 · Universal Sompo Motor Insurance Claim Form. This is a Motor Insurance Claim form issued by the Universal Sompo General Insurance Co. and this form can be obtained from the nearest branch of Universal Sompo Co. or it can be downloaded directly from the link given below.
The issue of this form is not to be taken as admission of liability
Claim form is to be filled in capital letter & signed by the insured/beneficiary.
We hereby declare that the information furnished in this Claim Form is true & correct to the best of our my knowledge and belief. If we have made any false or untrue statement, suppression or concealment of any material fact, our right to claim under this claim shall be forfeited.
I/We have received a list of documents with this claim Form and have understood the entire requirement to be fulfilled for administration of this claim and the Company shall not be held responsible for any delay in settlement of claim due to non-fulfillment of requirements including the documents as mentioned in the claim form.
Personal Accident Claim Form. (A joint venture between Indian Bank, Sompo Japan Insurance Inc., Indian Overseas Bank, Karnataka Bank and Dabur Investments.) Regd. Office: Office No 103, First Floor, Ackruti Star, MIDC Central Road, Andheri (East), Mumbai - 400093.
Guidance information for completing and processing the NCPDP manual claim forms, which include • The Universal Claim Form that aligns with NCPDP Telecommunication Standard Version D.Ø and above • The Workers’ Compensation/Property and Casualty Universal Claim Form that aligns with NCPDP Telecommunication Standard Version D.Ø and above ...
Universal Sompo General Insurance Co. Ltd. Products. Health Insurance. Complete Healthcare Insurance. Super Healthcare Insurance. Arogya Sanjeevani Insurance. Corona Rakshak Policy. Corona Kavach Policy. Saral Suraksha Bima.
