Documente Academic
Documente Profesional
Documente Cultură
Company Name Employee Name Contact Number Vehicle Make / Model Date of Accident Time of Accident Place of Accident Present Kms ALD Contract No Date of Registration Door to Door Service Registration No Speed of Vehicle (at the time of accident)
FIR Details (if necessary) Date of FIR FIR No. / Diary No. Address of Police Station Valid Upto
Copy of Registration Certificate & Driving License must accompany this report form. Brief description of the accident justifying the damage on the vehicle including third party damage. If any
(specify in detail and use additional sheet, if necessary)
Date : ATTENTION
* Damage to the vehicle that is not justified because of the above accident will not be covered in the claim * Fill separate forms for individual incidence of damage. Sign & send to ALD within 48 hrs of occurance of the event. E-Mail version of this form will not be accepted. * Wherever FIR is mandatory, repairs will not commence unless FIR details are provided. FIR details are mandatory
ALD Toll Free No : 1800 - 209 - 5253 [Mon to Fri Time 0900 - 1730 hrs]
Fax : Mumbai - 022 61933213 Delhi - 011 4661 3222 Bangalore - 080 4061 3248 Hyderabad - 040 2335 5990
Note: Damaged vehicle when driven could result into additional damage to the vehicle which is not covered under insurance and hence will be rebilled. While handing over the vehicle for repairs check it thoroughly and take out all personal belongings, stereo panel.
The ALD Service Guide contains all of it and will be of assistance to you and should you have any questions on it, we will be happy to discuss and clarify the same.
We at ALD would like to wish you safe driving and a happy motoring experience