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11th February 2016, 05:57 PM
Super Moderator
 
Join Date: Apr 2013
Re: ICICI Lombard Two Wheeler Insurance Claim

As per your demand here I am providing you Claim Form for Motor Vehicle of ICICI Lombard
Claim Form for Motor Vehicle of ICICI Lombard






Details to be filled in the Form are the following:

Name

Address

Tel No.

District

Fax No

Mobile

Email Id

PAN No.

Aadhar Card No

Average Income

Occupation

No of member in family

Average kms run in Year

Information about Insured Vehicle

Registration no

Make

Date of Registration

Mileage

Engine No

Chassis No


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