A claim under a motor insurance policy for damage to the insured vehicle.
Date: 1 April 2026, at Ludhiana
TO:
The Claims Manager
ABC General Insurance Company Limited
Regional Office, SCO 25, Sector 17-E, Chandigarh 160017
FROM:
Harjinder Singh Gill
House No. 412, Sector 38-A, Chandigarh 160036
Phone: 98765 43210
Email: harjinder.gill@example.com
SUBJECT: Own-damage claim under policy no. P/141234/01/2026/003318 for vehicle PB 10 AB 1234
Sir / Madam,
1.1 I am the insured owner of Maruti Suzuki Swift VXi, white, registration no. PB 10 AB 1234, insured with you under motor policy no. P/141234/01/2026/003318.
2.1 On 2 April 2026 the vehicle was damaged at Zirakpur-Ambala highway near the Baltana flyover. The car was moving slowly in traffic when a truck from behind hit its rear. The rear bumper, boot lid and tail lamps were damaged.
2.2 The vehicle was being driven by Harjinder Singh Gill, driving licence no. PB10 20190012345.
2.3 I reported the accident to the police. The reference is FIR No. 214 of 2026, Police Station Zirakpur.
2.4 I first told you of the accident on 3 April 2026. The claim number is MC/2026/118842.
3.1 Please register this claim, give me the claim number in writing, and appoint a surveyor to inspect the vehicle. The vehicle is at Authorised service centre, Industrial Area Phase 1, Chandigarh.
3.2 I ask you to arrange cashless repair at one of your network garages. The repairer's estimate is ₹48,500 (Rupees Forty Eight Thousand Five Hundred only).
3.3 I will not have the vehicle repaired before your surveyor has seen it, except for the steps needed to stop further loss.
3.4 Please tell me in one list every paper you still need, and the name and number of the officer handling the claim.
3.5 If you reduce or reject any part of the claim, please give me each deduction or reason in writing, with the clause of the policy you rely on.
3.6 The truck was PB 65 CD 7788; its driver gave his name as Gurdev Singh.
4.1 Please pay any amount due by transfer to the account held by Harjinder Singh Gill with HDFC Bank, Sector 40, Chandigarh, account ending 3391. I will give the full account number on your own form, not in this letter.
5.1 What I have written is true to the best of my knowledge. I will give you the papers listed below and let your surveyor inspect the vehicle.
- 1. Claim form. 2. Policy copy. 3. Registration certificate. 4. Driving licence. 5. Repair estimate. 6. Photographs of the damage. 7. FIR. 8. Cancelled cheque.
Yours faithfully,
_________________________
Harjinder Singh Gill
Insured owner
House No. 412, Sector 38-A, Chandigarh 160036
Date: 1 April 2026