Get New India Assurance Claim Form

Filing a claim can be a daunting process, but completing the New India Assurance Claim Form online can simplify your experience. This guide will walk you through each section of the form, providing clear instructions to ensure you submit all necessary information accurately.

Follow the steps to successfully complete your claim form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling in the ‘Claim No.’ field. This number is usually provided by your insurer and is essential for processing your claim.
3. Complete the employer section with details including the ‘Name of Policyholder’, ‘Business’, and ‘Address (and nearest Railway Station)’. Make sure these details are accurate and current.
4. Enter the ‘Policy No.’ and ‘Policy Period’ to link your claim to the correct insurance policy.
5. Provide the injured person’s details, including their ‘Name’, ‘Religion or Caste’, and local address. Be thorough to avoid delays.
6. State the occupation of the injured person and whether they were engaged in this role at the time of the accident. If not, describe the work they were performing.
7. Indicate if the injured person is in your direct employ. If not, include the name and address of the contractor.
8. Fill out the date when the injured person began employment with your organization.
9. Document details related to the medical treatment received post-accident, such as ‘Name of Hospital’, whether they were an in-patient or out-patient, and their discharge status.
10. Provide information regarding the accident itself, including the ‘DATE’, ‘TIME’, and a detailed description of how the accident occurred.
11. Describe the nature of the injury and the regions affected, noting if the injury was to the right or left side of the body.
12. Confirm if the injured person has been medically examined and if a report was submitted. If not, note if a free medical examination was offered.
13. Address the specifics about the injured person's capability to return to work and any potential periods of disablement.
14. Complete the ‘Statement of Wages’ section by entering the average monthly earnings of the injured person, paying close attention to the specified instructions.
15. After filling out all required fields, review the information for accuracy. Make any necessary corrections before proceeding.
16. Finally, save changes to your document. You can download, print, or share the completed form as needed.

Complete your New India Assurance Claim Form online today for a seamless claims process.