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PERSONAL ACCIDENT CLAIM FORM Policy No: Claim No: Date of Accident: This form is issued without admission of Liability, and must be completed and returned within seven days after its receipt. No claim.

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How to fill out the PERSONAL ACCIDENT CLAIM FORM - Trident Insurance online

Filing a personal accident claim can be a straightforward process when guided properly. This guide will assist you in completing the PERSONAL ACCIDENT CLAIM FORM from Trident Insurance online, ensuring you provide all necessary information accurately and efficiently.

Follow the steps to complete the form successfully.

  1. Press ‘Get Form’ button to access the form and open it for editing.
  2. In the 'Policyholder' section, fill in your full name, present age, height, weight, residence address, business address, and current occupation. If applicable, list multiple occupations.
  3. In the 'Accident' section, provide the date, time, and location of the accident. Additionally, describe the causes of the accident and the injuries sustained. Be sure to include names and addresses of any witnesses.
  4. For the 'Injury and General Information' section, provide the names and addresses of the doctors who attended to you, as well as your regular medical practitioner. Include details about when a medical officer from the company can visit you if needed.
  5. State the duration of total disability caused by the accident and if you are still totally disabled. If you have resumed any work duties, specify the date this occurred.
  6. If you have previously claimed compensation under any accident or sickness policy, provide details here. Also, indicate if you are eligible for compensation from other sources.
  7. In the declaration section, ensure you carefully read the statement regarding false claims. Sign and date the form to confirm truthfulness.
  8. Lastly, save your changes to the completed form, and consider downloading, printing, or sharing the form as needed.

Complete your PERSONAL ACCIDENT CLAIM FORM online today for efficient processing.

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It will ensure that you are taken care of financially if an accident occurs. The Personal Accident policy provides you financial coverage in the event of physical injuries, burns, death, and permanent partial or total disability due to an accident, and this cover can extend to your spouse or children as well.

Personal accident cover isn't mandatory, and it does often cost a little extra – but you can't put a price on peace of mind. If you get in a serious accident, you might need expensive rehab, or you could even lose your work – but personal accident cover can help you recoup those costs.

A general list of exclusions, however, is mentioned below: Intentional injury: If the burns, broken bones, permanent partial disability, permanent total disability, dismemberment, temporary partial disability, temporary total disability, death, etc.

It covers hospitalisation, treatment, surgery (if required) and associated medical costs. Furthermore, it covers expenses towards permanent or partial disabilities suffered because of the accident. In case of accidental death, the nominee gets compensation up to the sum insured.

Personal Accident Insurance Claim Process After the accident, immediately inform the customer care of the insurance company through the website or the customer care number. Provide the policy documents. Provide the duly filled in claim form.

Documents Required for Death Claims Original Death Certificate. Post Mortem Report. Inquest report. Accident report. FIR/MLC copy. Hospital records. News Paper cuttings if any and any other relevant records Chemical Analysis Report if available English Translation of vernacular documents.

A personal accident policy does not cover third-party liability or injury. Therefore, if an accident occurs in a vehicle and the vehicle damages a third-party property, the insured will not get a claim through personal accident insurance.

A personal accident insurance policy gives you coverage against medical treatment, accidental death, or disability. It is part of a health insurance policy and provides coverage for all medical-related expenses caused due to an accident.

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© Copyright 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232