The Oriental Insurance Company
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PLEASE GIVE ALL THE DETAILS ASKED FOR IN THE CLAIM FORM. CLAIM FORM TO BE FILLED IN AND SIGNED BY THE INSURED ONLY. Policy No _____Claim No _____ (For office use only) Vehicle No _____ Engine No _____ Chassis No _____ ... National Insurance Company Limited, Registered Office:- 3, Middleton street, Kolkata-700071 IRDA Registration No. 58. Created Date: 11/29/2022 12:37:58 PM ...
National Insurance Company Limited. Regd. Office 3, Middleton Street, Post Box 9229, Kolkata 700 071 CIN - U10200WB1906GOI001713 IRDA Regn. No. - 58. Version: 08/2013. d) Bank BranchEnter the bank branch name Name of the Bank Branch in full. Read declaration carefully and mention date (in dd:mm:yy format), place (open text) and sign.
GUIDANCE FOR FILLING CLAIM FORM – PART A (To be filled in by the insured) DATA ELEMENT DESCRIPTION FORMAT. SECTION A - DETAILS OF PRIMARY INSURED. a) Policy No. Enter the policy number As allotted by the insurance company. b) SI. No/ Certificate No. Enter the social insurance number or the certificate number of social health insurance scheme.
National Insurance Company Limited Regd. Office 3, Middleton Street, Post Box 9229, Kolkata 700 071 CIN - U10200WB1906GOI001713 IRDA Regn. No. - 58 b) Company/ TPA ID No: City: ... GUIDANCE FOR FILLING CLAIM FORM – PART A (To be filled in by the insured) FORMAT SECTION A - DETAILS OF PRIMARY INSURED As allotted by the insurance company SECTION B - DETAILS OF INSURANCE HISTORY Tick Yes or No
NATIONAL INSURANCE COMPANY LIMITED (Regd. Office : 3, Middleton Street, Calcutta – 700 071) MOTOR CLAIM FORM • Issue of this form is not to be taken as an admission of liability. • To avoid unnecessary delay, correspondence and trouble, this form should be returned within 7 days of its issue to the Policy Issuing
Premises No.18-0374, Plot No. CBD-81, New Town, Kolkata-700156. Telephone: 03322022100. CIN - U10200WB1906GOI001713
Claim Form. This Claim Form is in addition to the Claim Form for Private Car Package/OD Policy: Private Car Package/OD Policy Number: . 1. THE INSURED. a) Name in full : . b) Address for Correspondence : . c) Telephone Number, if any : . 2. THE INSURED VEHICLE. a) Particulars of Vehicle . Make Year of Manufacture. Engine No. Chasis No.
National Insurance Company Limited. We are pleased to inform that our customers may lodge the Motor OD Claim through SMS facility w.e.f. 26/01/2021. They have to send SMS "MOTORODCLAIM (POLICYNUMBER)" to 56767556 (e.g MOTORODCLAIM 900210312010012548) from their registered mobile number (RMN).
PERSONALACCIDENT CLAIM FORM ( If the Insured is unable to complete this form, it may be filled up on his behalf. ) The Insurers do not admit liability by issuing this form . Name of Insured : _____
CLAIM FORM. Issuance of this Form does not amount to admission of any liability under the claim on the part of the insurers. YOU ARE ADVISED TO FILL EACH AND EVERY COLUMN OF THIS CLAIM FORM and give all information correctly and completely to enable the company to process your claim promptly. 1.
