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personal accident

   Personal Accident Insurance Claims
How to file a Claim
   In case of any event leading to a claim under the policy, please call our Toll-free Number 1800-2-700-700
   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 following documents :
 For Accidental Injury Claims
1. Claim form as per 'Form A'
2. Police FIR, if accident is reported to Police
3. Medical papers, pathology reports, X-ray reports, as applicable
4. For Permanent Disability Claims - disability certificate from reputed surgeon or Municipal Hospital
5. For Temporary Total Disability Claims-sick leave certificate from Employer
6. Attending Physician's statement as per 'Form D'
 For Emergency Medical Expenses
1. Claim form as per 'Form B'
2. Police FIR, if accident is reported to Police
3. Medical papers, pathology reports, X-ray reports, as applicable
4. Doctor's prescription and line of treatment suggested
5. Bills and cash memos
6. Attending Physician's statement as per 'Form D'
 For Hospital Cash- Sickness Claim
1. Hospital Cash Claim Form as per 'Form C'
2. Hospital Discharge Card
3. Doctor's certificate and line of treatment suggested
4. Attending Physician's statement as per 'Form D'
 For Hospital Cash - Accident Claim
1. Hospital Cash Claim Form as per 'Form C'
2. Hospital Discharge Card
3. Doctor's certificate and line of treatment suggested
4. Attending Physician's statement as per 'Form D'
 For Accidental Death Claims
1. Claim Form as per 'Form E'
2. Police FIR or Police Panchnama
3. Post-mortem Report or Coroner's Report
4. Death Certificate
5. For payment to beneficiary - succession certificate or notarized affidavit certifying legal heir status.
6. Where payment to beneficiary is through notarized affidavit, a letter of indemnity on Rs.200 stamp paper ( please contact us for the indemnity format)
   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 :
 
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.
If you have any claim related queries please call 1800-2-700-700 or email care@hdfcergo.com
Download claim form   (PDF 357 KB)


For more information, please write to us at care@hdfcergo.com. You can also contact us on our Toll Free No. 1800-2-700-700.
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