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  • All Risks Claim Form

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    Nayan Singh
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    The document is an "All Risks" claim form from The Oriental Insurance Company Limited requesting information from a claimant about a loss or damage. It requests details such as the claimant's name and address, policy number, date of loss/accident, description of loss/damage, cause of loss/damage, details if theft was involved, whether police were notified, results of any police investigation, and whether the claimant is insured under any other policies for the loss. The claimant must sign declaring the information provided is true.

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    Risk form

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    The document is an "All Risks" claim form from The Oriental Insurance Company Limited requesting information from a claimant about a loss or damage. It requests details such as the claimant's name and address, policy number, date of loss/accident, description of loss/damage, cause of loss/damage, details if theft was involved, whether police were notified, results of any police investigation, and whether the claimant is insured under any other policies for the loss. The claimant must sign declaring the information provided is true.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    7 views1 page

    All Risks Claim Form

    Uploaded by

    Nayan Singh
    The document is an "All Risks" claim form from The Oriental Insurance Company Limited requesting information from a claimant about a loss or damage. It requests details such as the claimant's name and address, policy number, date of loss/accident, description of loss/damage, cause of loss/damage, details if theft was involved, whether police were notified, results of any police investigation, and whether the claimant is insured under any other policies for the loss. The claimant must sign declaring the information provided is true.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
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    The Oriental Insurance Company Limited

    Head Office: A 25/27, Asaf Ali Road, New Delhi -110002

    “ALL RISKS” CLAIM FORM


    THE ISSUE OF THIS FORM IS NOT TO BE TAKEN AS AN ADMISSION OF LIABILITY
    QUESTIONS TO BE ANSWERED BY THE CLAIMANT
    “THIS FORM SHOULD BE COMPLETED AND RETURNED TO THE COMPANY IMMEDIATELY”

    POLICY NO.
    CLAIM NO.

    1. Name & Address:

    2. Policy No:

    3. Date of Loss/Accident:

    4. Description of Loss or damage:

    5. Cause Of Loss or Damage:

    6. If by theft

    (a) Time & Day

    (b) How committed

    (c) By whom discovered and when

    (d) Have Police been notified, if so, when

    (e) State result of Police Investigation, if any

    7. Are you Insured against the present loss


    under any other Policy?
    I declare that foregoing statement are true
    to the best of my knowledge and belief; that the articles and property described on the other side
    hereof were lost/stolen or damaged under the circumstance above described, and that such
    articles and property belong to the persons named, no other person having any interest therein
    whether as owner, Mortgage, Trustee or otherwise.

    Place:
    Date: Insured’s Signature

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