Follow the steps to successfully fill out the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the policy number and vehicle number in the designated fields. Ensure that all information is accurate to avoid delays in the claim process.
3. Select the class of vehicle that applies to your situation: Private Car, Commercial, or Two-wheeler. Mark the appropriate box clearly.
4. Fill in the insured or claimant details, including full name, address, city, pin code, mobile number, state, and email ID. It is important that these details are correct and clearly written.
5. Provide NEFT details, which includes bank name, branch, MICR code, IFSC code, payee name, and account number. This section is crucial for receiving any claim amounts.
6. In the loss details section, indicate the date and time of the accident. Provide a short description of the accident, specifying the place where it occurred.
7. Enter driver details, including the name, age, occupation, contact number, driving license number, the name of the RTO, and relationship of the driver to the insured.
8. Detail any co-passengers in the accident, including their names and any injuries or property damage involved. Note the number of occupants at the time of the accident.
9. If applicable, fill out the details regarding the permit number, validity dates, and RTO details for commercial vehicles.
10. Answer the question regarding the police report lodged. If 'Yes,' provide the FIR number and name of the police station.
11. Acknowledge receipt of any legal or court notices related to the incident and provide the name of any associated hospital if injuries were reported.
12. Review the list of documents that need to be attached with the claim form. Ensure that you have copies of all necessary documents, such as the policy copy, FIR, and driving license.
13. In the declaration section, confirm that the information provided is accurate. Sign and date the form properly as the insured.
14. Finally, save any changes you’ve made to the form, and consider downloading, printing, or sharing the form for your records or submission.

Complete your documents online for a streamlined insurance claim process.