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Motor Claims
Ticket No. :
Registration No.
*
:
Claim Number
*
:
Claim Number
*
:
IMS Claim Number. :
Cover Note No.:
Policy No. *:
RT No. :
Nature of Loss
*
:
Make
*
:
Year of Make
*
:
Name of intimating Person
*
:
Insured / Company Name:
Email:
PTCL No:
Cell No
*
:
Date of Loss
*
:
Estimated Loss (Rs.):
Approved Amount:
Accident Occured At:
Current Location of Vehicle:
Cheque In Favour Of:
Fire Claims
Ticket No. :
Cover Note No.:
Policy No. *:
RT No. :
Nature of Loss
*
:
Name of intimating Person
*
:
Insured / Company Name:
Email:
PTCL No :
Cell No
*
:
Date of Loss
*
:
Description of Loss:
Estimated Loss (Rs.):
Current Location of Loss:
Marine Claims
Ticket No. :
Cover Note No.:
Policy No. *:
RT No. :
Nature of Loss
*
:
Name of intimating Person
*
:
Insured / Company Name:
Email:
PTCL No :
Cell No
*
:
Sailing Date
*
:
Estimated Loss (Rs.):
Current Loc. of Consignment:
Engineering Claims
Ticket No. :
Cover Note No.:
Policy No. *:
RT No. :
Nature of Loss
*
:
Name of intimating Person
*
:
Insured / Company Name:
Email:
PTCL No :
Cell No
*
:
Date of Loss
*
:
Descripiton of Loss:
Estimated Loss (Rs.):
Site of Loss:
Crop Insurance Claims
Ticket No. :
Cover Note No.:
Policy No. *:
RT No. :
Nature of Loss
*
:
Name of intimating Person
*
:
Insured / Company Name:
Email:
PTCL No :
Cell No
*
:
Date of Loss
*
:
Descripiton of Loss:
Estimated Loss (Rs.):
Live Stock Claims
Ticket No. :
Cover Note No.:
Policy No. *:
RT No. :
Nature of Loss
*
:
Name of intimating Person
*
:
Insured / Company Name:
Email:
PTCL No :
Cell No
*
:
Date of Loss
*
:
Descripiton of Loss:
Estimated Loss (Rs.):
Travel Insurance Plan Claims
Ticket No. :
Cover Note No.:
Policy No. *:
RT No. :
Nature of Loss
*
:
Name of intimating Person
*
:
Insured / Company Name:
Email:
PTCL No :
Cell No
*
:
Date of Loss
*
:
Descripiton of Loss:
Estimated Loss (Rs.):
Health Insurance Plan Claims
Ticket No. :
Cover Note No.:
Policy No. *:
RT No. :
Employee ID.:
Nature of Loss / Cover Type
*
:
Description:
Name of intimating Person
*
:
CNIC No.:
Insured / Company Name:
Hospital Name
*
:
Email:
PTCL No :
Cell No
*
:
Date of Loss
*
:
Description of Loss:
Education Secure Plan Claims
Ticket No. :
Cover Note No.:
Policy No. *:
RT No. :
Nature of Loss
*
:
Name of intimating Person
*
:
Insured / Company Name:
Email:
PTCL No :
Cell No
*
:
Date of Loss
*
:
Site of Loss:
Home Secure Plan Claims
Ticket No. :
Cover Note No.:
Policy No. *:
RT No. :
Nature of Loss
*
:
Name of intimating Person
*
:
Insured / Company Name:
Email:
PTCL No :
Cell No
*
:
Date of Loss
*
:
Description of Loss:
Estimated Loss (Rs.):
Self Secure Plan Claims
Ticket No. :
Cover Note No.:
Policy No. *:
RT No. :
Nature of Loss
*
:
Name of intimating Person
*
:
Insured / Company Name:
Email:
PTCL No :
Cell No
*
:
Date of Loss
*
:
Description of Loss:
Estimated Loss (Rs.):
Shop Secure Plan Claims
Ticket No. :
Cover Note No.:
Policy No. *:
RT No. :
Nature of Loss
*
:
Name of intimating Person
*
:
Shop Name:
Insured / Company Name:
Email:
PTCL No :
Cell No
*
:
Date of Loss
*
:
Description of Loss:
Estimated Loss (Rs.):
Personal Accident Claims
Ticket No. :
Cover Note No.:
Policy No. *:
RT No. :
Nature of Loss
*
:
Name of intimating Person
*
:
Insured / Company Name:
Email:
PTCL No :
Cell No
*
:
Date of Loss
*
:
Description of Loss:
Site of Loss:
Miscellaneous Claims
Ticket No. :
Cover Note No.:
Policy No. *:
Sub Policy Type
*
:
RT No. :
Name of intimating Person
*
:
Insured / Company Name:
Email:
PTCL No :
Cell No
*
:
Date of Loss
*
:
Estimated Loss (Rs.):
Site of Loss:
Name of Surveyor:
Date of Appointment:
PLR. Loss Report/Received On:
Final Report Received On:
Claim Approved On:
Final App. Sent to Mr. yaseen On:
Report Sent to Accts. Dept. for Payment:
Cheque Disp. to Branch/Client On:
To Client
To Branch
Status :
Set from the list
Open
Closed
Inprocess
Settled
Pending
Branch Follow-up:
Comments:
Family Health Secure Plan Claims
Ticket No. :
Cover Note No.:
Policy No. *:
RT No. :
Employee ID.:
Nature of Loss / Cover Type
*
:
Description:
Name of intimating Person
*
:
CNIC No.:
Insured / Company Name:
Hospital Name
*
:
Email:
PTCL No :
Cell No
*
:
Date of Loss
*
:
Description of Loss:
*
: Required field
*: Atleast one field required