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Get Claim Form - Chola MS General Insurance

The issue of this form is not to be taken as an admission of liability. The completion and return of this from to the Company should not be delayed. If any of the particulars required cannot be immediately given, they may be forwarded to the Company afterwards as soon as possible. 1 a) Name of Insured: . b) Address: c) Address for communication a) Policy number: b) Period of the Policy: c) Limits of Indemnity under the Policy: 2 Particulars of accident: . a) Date of occurrence: b) Place of accid.

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