sample clai… · annexure - declaration ay the insured: i hereby declare that the information...

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Page 1: Sample clai… · Annexure - DECLARATION ay THE INSURED: I hereby declare that the information furnished ih this claim form is true & correct to the best of my knowledge and belief]
Page 2: Sample clai… · Annexure - DECLARATION ay THE INSURED: I hereby declare that the information furnished ih this claim form is true & correct to the best of my knowledge and belief]
Page 3: Sample clai… · Annexure - DECLARATION ay THE INSURED: I hereby declare that the information furnished ih this claim form is true & correct to the best of my knowledge and belief]
Page 4: Sample clai… · Annexure - DECLARATION ay THE INSURED: I hereby declare that the information furnished ih this claim form is true & correct to the best of my knowledge and belief]