To

LIC OF INDIA

Kalyan Bhawan,

R 2, Transport Nagar,

Jaipur, Rajasthan 302003

Subject: Application for Late Insurance Claim Due to Shifting of Floor and Document Loss

Dear Sir/Madam,

I am writing to submit a late insurance claim for an incident that occurred in my property.
I apologize for the delay in reporting the claim, as unforeseen circumstances hindered my
ability to file it within the specified timeframe. I have encountered significant difficulties
due to the shifting of the floor, and as a result, certain documents necessary for the
claim were lost. I recently found my documents few days back.

I kindly request your understanding and consideration regarding the late submission of
this claim.

Thank you for your attention to this matter. I look forward to a favorable response at the
earliest convenience.

Yours sincerely,

Policyholder Information:

Name: ANIL AGARWAL

Policy Number: 190746140

Mobile: 9352382856