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United India Motor Claim Satisfaction Voucher

The document is a Satisfaction/Discharge Voucher for a motor vehicle insurance claim. The insured/claimant confirms receipt of their repaired vehicle and certifies satisfaction with the repairs. It also states that the payment received from United India Insurance Co. Ltd. is in full and final discharge of the claim, with no further amounts owed.

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868 views1 page

United India Motor Claim Satisfaction Voucher

The document is a Satisfaction/Discharge Voucher for a motor vehicle insurance claim. The insured/claimant confirms receipt of their repaired vehicle and certifies satisfaction with the repairs. It also states that the payment received from United India Insurance Co. Ltd. is in full and final discharge of the claim, with no further amounts owed.

Uploaded by

WM Country wheels
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

SATISFACTION/DISCHARGE VOUCHER

POLICY NO.___________________________
CLAIM NO.____________________________
DATE OF LOSS_________________________

I/We_____________________________________________________(Insured/
Claimant Name) hereby declare that we have taken delivery of my/our Motor
Vehicle bearing Registration No.___________________________________
From ________________________________________________(Workshop
Name) bearing
Address__________________________________________________________
__________________________________________________________.

I/We hereby certify that Workshop has repaired the Motor Vehicle bearing
Registration No. _____________________________________ to my/our
satisfaction.

I/We confirm that payment/reimbursement of Rs. __________________


towards repair of the vehicle by United India Insurance Co. Ltd. Is in full and
final discharge of the above loss and claim number and no further amounts are
due to me from the company.

Place:__________________

Date: __________________ Signature of Insured/Claimant

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