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Claim Intimation
Refer to policy certificate to identify what details are mentioned:

  *  Indicates mandatory fields.
* Policy Type :
* Certificate No / Policy No. :
E.g.: For Policy No: 2008-A0000001-FGP, enter A0000001
* Name of Insured :
* Date of Loss :
* Location of Loss :
* City of Loss :
*State
* Brief Description of Loss :
* Mobile No : 91
eg: 9205677525
* Email Id :
* Covernote No. :
Policy No. :
E.g.: For Policy No: 2008-A0000001-FGP, enter A0000001
* Name of Insured :
Policy Type : Motor
* Date of Loss :
* Location of Loss :
* City of Loss :
*State
* Brief Description of Loss :
* Mobile No : 91
eg: 9205467752
* Email Id :
* Health Card No. :
Policy No. :
E.g.: For Policy No: 2008-A0000001-FGP, enter A0000001
* T.P.A.
* Name of Insured :
Policy Type : Misc(Others)
* Date of Admission :
* Hospital Name :
* Location of Hospital :
* City of Loss :
*State
* Brief Description of Illness :
* Mobile No : 91
eg: 9205677852
* Email Id :
 

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