Change Language

Commercial Insurance Claim Registration

As your trusted insurance partner, we'll make your claim process quick and easy

1 Insured Details
2 Claim Details
3 Loss Details

Policyholder name is and policy number is .

Insured's mobile number +91 Please enter valid mobile number

Insured's email ID Please enter valid email id

Date of loss/accident Please enter date of loss

Time of loss

00:30

Please enter correct time

Explain how loss occurred Please enter circumstances

Place/address of loss Please enter Place/address of loss

Landmark Please enter landmark

Estimated loss amount ₹ Please enter loss amount

Pincode Please enter pincode

State

GOA

Please Select

City

Please Select

Area

Please Select

Reason for delay in intimation Please enter circumstances

Name Please enter name

Mobile Number +91 Please enter mobile number

Email ID Please enter emailId

Same as insured's details

Disclamier

I have understood the claim process and all the information being provided with the claim intimation is true / correct. I shall comply to claim process as stipulated by the company and submit all required documents in support of the claim.

Please select

Disclaimer

I hereby authorize Bajaj Allianz General Insurance Co. Ltd. to call me on the contact number made available by me on the website with a specific request to call back at a convenient time. I further declare that, irrespective of my contact number being registered on National Customer Preference Register (NCPR) under either Fully or Partially Blocked category, any call made or SMS sent in response to my request shall not be construed as an Unsolicited Commercial Communication even though the content of the call may be for the purposes of explaining various insurance products and services or solicitation and procurement of insurance business. Furthermore, I understand that these calls will be recorded & monitored for quality & training purposes, and may be made available to me if required.

Please enter valid quote reference ID

Would you recommend Bajaj and its services to a friend who is looking to buy insurance?

Select

Please select
Any comments you have about our service/product/website? Please write your comment

Submit

Getting In Touch With Us Is Easy

Customer Login
Go
Partner Login
Go
Employee Login
Go