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Docket No
:
*
No.of Pkgs Delivered
:
*
No.of Pkgs Booked
:
Actual Weight Delivered
:
*
Actual Weight Booked
:
Invoice Number
:
*
Booking date
:
Invoice Date
:
*
Booking Stn.
:
Contents as per Invoice
:
*
Delivery Stn.
:
Remarks given on POD
:
*
Select
Yes
No
Actl. Delivery Date
:
Nature of loss
:
*
Select
DAMAGE
PILFERAGE
SHORT
Decl. cargo value
:
Claim Registered by
:
Risk Coverage
:
Email ID
:
*
Mobile Number
:
*
Insurance Policy No
:
Insurance policy expiry date
:
Insurer Name
:
Select
Bajaj Allianz General Insurance Co. Ltd.
Icici Lombard General Insurance Co. Ltd.
Iffco Tokio General Insurance Co. Ltd.
National Insurance Co. Ltd.
The New India Assurance Co. Ltd.
The Oriental Insurance Co. Ltd.
United India Insurance Co. Ltd.
Reliance General Insurance Co. Ltd.
Royal Sundaram Alliance Insurance Co. Ltd
Tata Aig General Insurance Co. Ltd.
Cholamandalam Ms General Insurance Co. Ltd.
Hdfc Ergo General Insurance Co. Ltd.
Export Credit Guarantee Corporation Of India Ltd.
Agriculture Insurance Co. Of India Ltd.
Star Health And Allied Insurance Company Limited
Apollo Munich Health Insurance Company Limited
Future Generali India Insurance Company Limited
Universal Sompo General Insurance Co. Ltd.
Shriram General Insurance Company Limited,
Bharti Axa General Insurance Company Limited
Raheja Qbe General Insurance Company Limited,
Sbi General Insurance Company Limited
Max Bupa Health Insurance Company Ltd.
L&T General Insurance Company Limited
Religare Health Insurance Company Limited
Magma Hdi General Insurance Company Limited
Liberty Videocon General Insurance Company Limited,
Survey Requirement
:
*
Select
Yes
No
Assessed Loss Amount (INR)
:
*
Salvage Amount (INR)
:
*
Net Loss Amt(INR)
:
*
Loss description
:
*
Observation Note (OBN) in favor of
:
*
Select
Shipper
Receiver
Address
:
*
Remarks if any
:
Upload File(pdf)
:
*
* We reserve the right to call for any further documentation as may be required on a case to case basis
Note:Need to Submit Hard Copy Documents for Final Claim Settlement
Documentation Required (As Applicable)
Claim Letter
Download
Invoice of Material
Material - Declaration
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Bank Details - Match to Dockets
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