Get Orient Insurance Head Office

This guide provides a comprehensive overview of how to accurately complete the Orient Insurance Head Office personal accident claim form online. By following these instructions, you can ensure that all necessary information is provided clearly and succinctly, facilitating a smoother claim process.

Follow the steps to successfully complete your claim form.

1. Press the ‘Get Form’ button to access the claim form and open it in the editor.
2. Fill out your personal details in section one, including your name (in block letters), address, city, state, PIN, occupation, and age.
3. In the second section, provide the details of the accident including the time, date, and full address of where the incident occurred, as well as a description of the cause.
4. Describe the nature of your injuries in the third section, specifying which parts of the body are injured. Indicate if there is any total disablement and provide the percentage of disablement if applicable.
5. Complete section four by listing witnesses to the accident. Include their names, addresses, and phone numbers.
6. In the fifth section, provide details about the treatment received. Include information for your casualty doctor, family doctor, and any hospitals visited, along with their respective names, addresses, phone numbers, and registration numbers.
7. Enter your contact details in the sixth section. Specify where you can be available, including your phone number.
8. Complete the confinement details in section seven by indicating the duration of total and partial confinement, including the specific dates.
9. In section eight, fill out the amount of your claim by providing separate amounts for total temporary disablement, permanent disablement, medical expenses, and death if applicable.
10. Provide your past claim history in section nine. Indicate if you have made any previous claims and, if so, provide details including accident and insurance information.
11. In section ten, indicate if you are insured under any other policy and provide details if applicable.
12. Confirm whether police authorities have been informed of the accident in section eleven. If so, provide the case number and police station.
13. Finally, review the declaration statement at the end of the form. Confirm that all details are accurate and true before signing with the date and place.
14. Once you complete filling out the form, you have options to save changes, download the document, print it, or share it as necessary.

Complete your claims online today for a more efficient process.