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HDFC ERGO General Insurance Company Limited Motor Insurance (Private Vehicles) - PROPOSAL FORM (Please fill in CAPITALS only) CUSTOMER INFORMATION For Individual Customers only Name of Insured Date.

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Fill in your name, relation with the insured person (in case of primary dependents like children etc.) Write your address and other relevant details (the details should match the information given in original policy documents). Enter the amount/tax ID etc. and other details that are listed.

Policy No. / Cover Note No. Name of the Insured & Address, e-mail ID & Mobile No. For what purpose was the vehicle being used at the material time? FIR: Specify the reasons for delayed FIR or not lodging an FIR.

HDFC ERGO General Insurance Company Limited. ... SIMPLIFYING THE CLAIMS PROCESS FOR YOU. 1 Register the claim with us through. Customer care - 0120 6234 6234 / 022 6234 6234. ... 2 Submit all documents along with duly signed claim. form within 30 days. ... 3 Documents which you need to submit are:

Documents Required for Filing Reimbursement Claim Health Card Copy. Duly Filled Claim Form. Original Hospital Discharge Summary. Investigation Reports like scans, X-rays, blood reports, etc. Cash Receipts from Hospitals. If an accident happens, then FIR or medico-legal certificate(MLC)

Claims procedure. In the event of any claim, call HDFC ERGO's toll free helpline no. 022 6234 6234 / 0120 6234 6234 and register your claim at the earliest.

¡ For other claim send the form along with the annexures to our claim department: HDFC ERGO General Insurance Company Limited, 6th Floor, Leela Business Park, Andheri kurla Road, Andheri (East), Mumbai – 400 059.

What are the Steps Involved in a Mediclaim Reimbursement? Step 1:Notify the Insurance Company. ... Step 2: Obtain the Documents. ... Step 3: Fill Out the Claim Form and Submit it. ... Step 4: Verification of Documents. ... Step 5: Reimburse the claim amount.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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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
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232