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

    • Claim form as per ‘Form A’
    • Police FIR, if accident is reported to Police
    • Medical papers, X-ray report and X ray plate
    • Doctor’s prescription and line of treatment suggested
    • Bills and cash memos
    • Attending Physician’s statement as per ‘Form D’
  • 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.

" All claims are subject to approval by Surveyor appointed by HDFC ERGO GIC LTD "

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