Get Icici Lombard Claim Form

Filing a claim can be a straightforward process when you have a clear guide to follow. This document outlines step-by-step instructions on how to accurately complete the Icici Lombard Claim Form online, ensuring that you provide all necessary information for your claim.

Follow the steps to fill out the Icici Lombard Claim Form with ease.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin with section one where you will provide the personal details of the insured. Fill in the name, address for correspondence, and contact number.
3. In the second section, enter details regarding the injured or deceased person. This includes their name, address, age, designation, date and time of injury or death, place of injury or death, a description of the accident, and whether it was reported to the police along with the police station details if applicable.
4. Next, indicate if the injured or deceased person was moved to a hospital immediately after the accident. If yes, provide the name and address of the hospital.
5. Address whether you have any other personal accident policy. If yes, fill in the issuing office address, policy number, and policy period.
6. Complete the declaration section affirming that all statements made in the form are true and complete. This section also includes a notice regarding the implications of submitting false information.
7. If the injured person was absent from work, the employer or insured must confirm this and provide details of such absence.
8. For the hospital section, input the name and address of the hospital, dates of admission and discharge, nature of injury, and particulars of treatment provided.
9. If applicable, include information related to permanent disability as a result of the accident. Provide pertinent details as required.
10. In the event of the insured's death, section three must be filled out by the nominee detailing their full name, address, age, and relationship with the deceased. Required documents such as the death certificate and original policy document should also be attached.
11. Finally, review all completed sections for accuracy. You can then save changes, download your form, print it, or share it as needed.

Start filling out your Icici Lombard Claim Form online today to ensure your claim is processed smoothly.