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Claim Assistance
Garage Claim Registration
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Garage Claim Registration
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Policy details
Policy/CN/ECN/BQA Number
*
Please enter Policy No.
Registration Number
Please enter Registration number.
Model & Variant
Please enter Policy No.
Customer details
Customer Name
Email Id
Contact Number
*
Please enter Contact No
Accident Details
Third Party Property/Bodily injury
*
Yes
No
Nature of Loss
*
Select
OD - Accident External Means
OD - Earthquake - Shock Only
OD - Explosion - Non Nuclear
OD - Flood & Tidal Waves
OD - Fresh, Rain Water & Inundation
OD - Landslide/Rockslide
OD - Storm, Tempest, Hurricane, Cyclone
Self-Ignition
Theft of entire Vehicle
Theft of Accessories
Theft of Parts
Location of Accident
*
Description of Accident
*
Maximum of 1000 characters.
Was Vehicle Parked at the time of loss?
*
Yes
No
Driver License Number
*
Accident Date & Time
*
HH
*
MM
*
Damaged Parts
*
Front Bumper
Bonnet
Front Windshield
Right Head Light
Left Head Light
Right Side Fender
Left Side Fender
Right Fender Light
Left Fender Light
Right Side View Mirror
Left Side View Mirror
Right Front Door
Left Front Door
Right Front Door Glass
Left Front Door Glass
Right Rear Door
Left Rear Door
Right Rear Door Glass
Left Rear Door Glass
Right Quarter Panel
Left Quarter Panel
Rear Windshield
Right Tail Light
Left Tail Light
Rear Bumper
Dicky
Roof Top
Other
Underbody
Front Grill
Select
Front Bumper
Bonnet
Front Windshield
Right Head Light
Left Head Light
Right Side Fender
Left Side Fender
Right Fender Light
Left Fender Light
Right Side View Mirror
Left Side View Mirror
Right Front Door
Left Front Door
Right Front Door Glass
Left Front Door Glass
Right Rear Door
Left Rear Door
Right Rear Door Glass
Left Rear Door Glass
Right Quarter Panel
Left Quarter Panel
Rear Windshield
Right Tail Light
Left Tail Light
Rear Bumper
Dicky
Roof Top
Other
Underbody
Front Grill
Driver Name
*
Driver's Relationship with Insured
*
Workshop/Garage details
Workshop Search By
*
Name
Workshop Code
Workshop Alternate Number
Remarks
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