{"id":665,"title":"मोटार विमा दावा प्रपत्र खाजगी कार / दुचाकी","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(Marathi).PDF","sha256":"85cd3897fc67a318d3de16f1122dbfbf4565829f8395dfa79dc01bc4124d9948","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is for filing a motor insurance claim for private cars or two-wheelers by the policyholder or claimant.","notes":["The claim form must be signed by the policyholder.","The damaged vehicle should be kept in a safe place to prevent further damage or theft.","Attach all documents listed at the back of the form.","Do not leave any column blank; write 'N/A' if not applicable.","Submit the form promptly even if some information is not immediately available; remaining details can be sent later.","Use original documents for verification where specified.","For queries, contact toll free 1800 266 5844 or email care@libertyinsurance.in."],"title":"मोटार विमा दावा प्रपत्र खाजगी कार / दुचाकी","submit":{"to":"care@libertyinsurance.in","how":"e-mail","address":""},"purpose":"claim","sections":[],"deadlines":[],"applies_to":"Private car and two wheeler motor insurance claims","attachments":["1. विम्याचा पुरावा - पॉलिसी / कव्हर नोट कॉपी","2. नोंदणी पुस्तिकेची कॉपी, टॅक्सची पावती [कृपया पडताळणीसाठी मूळ प्रत द्यावी]","3. अपघाताच्या वेळी गाडी चालविणाऱ्या माणसाच्या चालक परवान्याची कॉपी (कृपया पडताळणीसाठी मूळ प्रत द्यावी)","4. पोलीस पंचनामा / एफआयआर","5. चोरी आणि \"वापरात नाही\" हे सांगणारे आरटीओला संबोधित लिहिलेल्या आणि पोच मिळालेल्या पत्राची प्रत","6. विमाधारकाने सही केलेले 28, 29 आणि 30 क्रमांकाचे अर्ज आणि भांडवलदाराने सही केलेला अर्ज क्रमांक","7. जिथून वाहन दुरुस्ती होणार असेल तिथल्या दुरुस्ती करणार्याकडून दुरुस्तीचा (खर्चाचा) अंदाज","8. दुरुस्ती देयक / इन्व्हॉइस आणि काम पूर्ण झाल्यावरच्या पैसे दिल्याच्या पावत्या","9. डिस्चार्ज व्हाउचर","10. प्रस्थापनासह विशेष मुखत्यारपत्र","11. दाव्याच्या ठरलेल्या भरपाईच्या किमतीविषयी तुमची आणि भांडवलदाराची संमती","12. जर दावा तुमच्या बाजूने लावायचा असेल तर भांडवलदाराचे ना हरकत प्रमाणपत्र","13. नुकसान भरपाई करारनामा आणि डिस्चार्ज व्हाउचर"],"declarations":["All information provided in this claim form is true and accurate to the best of my knowledge.","If any false or misleading information is given or facts are concealed, the claim and policy will be cancelled.","I have attached the required documents and understand that incomplete documents may delay claim processing.","I agree to provide any additional information or documents as required by the company.","I authorize Liberty General Insurance Limited to process and share my personal data with related entities for claim and policy purposes."],"dropped_labels":77},"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/665-x"}