{"id":663,"title":"Claim Form - Private Car and Two Wheeler (Gujarati)","purpose":"claim","insurer":{"slug":"liberty-general-insurance","name":"Liberty General Insurance Limited"},"source_pdf":"https://www.libertyinsurance.in/Docx/Claim%20Form%20-%20Private%20Car%20and%20Two%20Wheeler%20(Gujarati).PDF","sha256":"1eea1ed6503c496d765a75c8a133ae4269f7b7f312cf9b541ecdc2923ec65330","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is used by policyholders to claim insurance for damages or losses related to private car and two wheeler vehicles.","notes":["Attach original or true copies of all required documents.","Use block letters to fill the form.","Submit the form with all attachments to the insurer's care email or address.","Photos of the accident site and vehicle condition are required.","FIR or police report must be attached if available."],"title":"Claim Form - Private Car and Two Wheeler (Gujarati)","submit":{"to":"Liberty General Insurance","how":"post / e-mail","address":"care@libertyinsurance.in"},"purpose":"claim","sections":[{"title":"B. Details of Loss / Damage / Accident","fields":[{"help":"Speed of the vehicle at the time of accident in kmph","type":"number","label":"ખડસ્માત સમયે ગતિ kmph","options":[],"required":null,"pdf_field":""},{"help":"Attach copy of FIR / DDR / GDR if available","type":"attachment","label":"FIR / DDR / GDR & sts sled","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"}],"deadlines":[],"applies_to":"Private Car and Two Wheeler insurance policies","attachments":["FIR / DDR / GDR copy","Driving license copy","Vehicle registration certificate","Repair estimate or bills","Photos of accident site and vehicle condition"],"declarations":["I declare that the information given is true and correct to the best of my knowledge.","I authorize the company to verify the information and investigate the claim.","I understand that any false information may lead to rejection of the claim.","I agree to submit all required documents and cooperate with the insurer."],"dropped_labels":36},"pdf_fields":null,"fillable_pdf":false,"send_to":[],"how_to_use":"Ask the user for each field in order, in plain words; never invent an answer. Labels are as printed. If fillable_pdf is true, pdf_fields gives the PDF's own field names so the file can be filled directly. The printed form decides if anything differs.","url":"https://indiainsurances.com/forms/liberty-general-insurance/663-claim-form-private-car-and-two-wheeler-gujarati"}