ACCIDENT CLAIMS HELPLINE -
Comprehensive Insurance policy holders (MUMBAI Only)
Get help with your Insurance Claim procedures
Asset Details ( Accident Car )
Car Make
:
Manufacturer
Imported
Daewoo
General Motors
Hindustan Motors
Honda
Hyundai
FIAT
Ford
Mahindra
Maruti
Mitsubishi
Maruti
Mercedes
Premier Auto
Tata
*
Model
:
* RTO Reg.No
:
*
Year of Manufacture
:
*
Market Value (Rs) :
*
Other Features :
A/C
Power Steering
Auto Transmission
Metallic Color
Is the Car under a Finance Contract
No
Hypothecation
H/P
Lease
*
If a Finance Contract exists - Name of Bank / Finance Co
INSURANCE & ACCIDENT DETAILS
Name of Policy Holder :
*
Choose your Insurance Company :
Select Insurance company
The New India Assurance Co. Ltd.
The Oriental Insurance Co. Ltd.
The National Insurance Co. Ltd.
The United India Insurance Co. Ltd.
*
Have you intimated the Insurance Company about the accident :
Yes
No
Has the Accident Car been taken to a workshop :
Yes
No
Accident Details
Place of Accident
Time of Accident
Briefly describe the damage incurred to the car
Contact Person
:
Contact Tel.No
:
Your E-Mail i.d.
*
Addition info and your remarks :
Fields marked
*
are required fields