Mon Aug 21 15:18:27 PKT 2017
 
  Online Claim Intimation
Vehicle insurance online claim intimation form                       
 
CLAIM SERVICE
COMMERCIAL / INFOMERCIAL
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Registration No. *
Engine No. *
Chassis No. *
Vehicle Make/Model 
Policy Number  
EFU Branch
Insured Name 
Customer/Keeper Cell  {00000000000}
Insurance Officer Email 
Keeper Email 
Contact Person 
City 


Type of Claim  3rd Party Partial Theft  
Prefered Survey Date   Pick a date {dd-month-yyy}
Remarks/Damages 
   
 
   
 
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