Personal Insurance – HDFC ERGO

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Personal Accident

Claim

Personal Accident

How to file a Claim

In case of any event leading to a claim under the policy, please call our Toll-free Number 1-800-2700-2700
Our Claims Service Representative will guide you on the claim procedures and documents required
Complete the claim form relevant to the nature of loss as indicated below.
Attach the documents mentioned against the claim type

For Accidental Death Claims

Claim Form as per ‘Form E’
Police FIR or Police Panchnama
Post-mortem Report or Coroner’s Report
Death Certificate
For payment to beneficiary – succession certificate or notarized affidavit certifying legal heir status.
Where payment to beneficiary is through notarized affidavit, a letter of indemnity on Rs.200 stamp paper (Please contact us for the indemnity format)

For Accidental Injury Claims

Claim form as per ‘Form A’
Police FIR, if accident is reported to Police
Medical papers, pathology reports, X-ray reports, as applicable
For Permanent Disability Claims – disability certificate from reputed surgeon or Municipal Hospital
For Temporary Total Disability Claims-sick leave certificate from Employer
Attending Physician’s statement as per ‘Form D’

For Broken bones claim

Our Claims Service Representative may visit you in the Hospital or at Home to personally collect claim documents.
Documents, in addition to those mentioned above maybe called for, depending on the nature of accident and claim lodged.
You may also send the claim form with annexures to our Claims Processing Cell at the following address : Kindly send all documents to:
HDFC ERGO General Insurance Company Limited
6th Floor, Leela Business Park,
Andheri - Kurla Road, Andheri (East),
Mumbai – 400059
Please retain a copy of the documents sent for your records.

Insurance is the subject matter of the solicitation. Registration Number : 125