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Theft Claim Report

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From:- At: Subasini Shradha Bhawam

SUBASH CHANDRA BEHERA Angaragadia, PO: Ishannagar


ADVOCATE-CUM-INVESTIGATOR Dist: Balasore, Odisha, PIN-756001
BALASORE. MOB NO. 0861586472, 09337214687
Report Submitted on
E Mail Id. [email protected]
26.05.2017

REF: Policy No " P0017400007/4102/101837 (THEFT)

Case Title Vehicle No. Policy No.


Dhurjati Dandapat OD-11G-0387 P0017400007/4102/101837
VS Magma HDI (Motorcycle)

To
Mr Prakash Samal (OD Claims)
MAGMA HDI GENERAL INSURANCE Co. Ltd.

BHUBANESWAR

Dear Sir,
As per your instruction I am submitting the investigation report of the above case as follows;

INSURED VEHICLE DETAILS

Vehicle No. OD-11G-0387 (Honda Unicorn Motorcycle)


Engine No. KC20E80153052
Chassis No. ME4KC201KF8138539
Name of the owner Dhurjati Dandapat
Father’s /Husband’s name S/O Surendra Nath Dandapat
At:Kathuabeda, PO: Dugudha, PS: Udala,
Permanent address
Dist: Mayurbhanj
Insurance Policy /Cover
P0017400007/4102/101837
Note No:
Validity 31.03.2017 to 30.03.2018
IDV of vehicle Rs 65720/-
Date and time of occurrence 14.04.2017 at about 5:00 PM
Whether the policy covers
YES
the occurrence
HDFC Bank Ltd. Baripada Branch, Mayurbhanj
Date of Purchase 03.03.2016
Hypothecated with
No. of EMI-36, Amount of each EMI-Rs.2199/-
No. of EMI paid-12, outstanding EMI-24
From:- At: Subasini Shradha Bhawam
SUBASH CHANDRA BEHERA Angaragadia, PO: Ishannagar
ADVOCATE-CUM-INVESTIGATOR Dist: Balasore, Odisha, PIN-756001
BALASORE. MOB NO. 0861586472, 09337214687

BRIEF FACT OF THE CASE

That, Dhurjati Dandapat is the registered owner of on Motorcycle bearing


Regd. No.OD-11G-0387. On 14.04.2017 at about 5:00 PM his son Manas
Ranjan Dandapat had parked the said vehicle near Udala Kacheri Field with
handle lock and went to the electrical shop. After some time when he came
back to the place of parking, the said motorcycle was not there. He
searched the vehicle and did not find. The matter of theft was reported by
Manas Ranjan Dandapat at Udala PS on 17.04.2017 (after four days) and
police registered PS Case No.53/2017 of dated 17.04.2017 and started
inquiry. The matter of theft has been duly reported at RTO, Baripada.

ENQUIRED FROM POLICE STATION:

During my inquiry I met the Investigating Officer of Udala PS namely B. Singh


(A.S.I) and asked about the initiation of PS Case No.53/2017 and he verbally
stated that the case is under investigation.

ENQUIRED FROM THE OWNER/DRIVER:

During my inquiry I met the owner and driver of the insured vehicle at their
residence and being asked about the occurrence they stated the matter of
occurrence and shown me the spot of occurrence. The owner submitted the
copies of his vehicular documents with me along with his statement in written,
Form 29 & 30, Affidavit which are enclosed herewith. The owner also stated
that during report of theft at RTO, Baripada the official called him to surrender
the original RC in the office and he submitted the same in the office.
From:- At: Subasini Shradha Bhawam
SUBASH CHANDRA BEHERA Angaragadia, PO: Ishannagar
ADVOCATE-CUM-INVESTIGATOR Dist: Balasore, Odisha, PIN-756001
BALASORE. MOB NO. 0861586472, 09337214687

DRIVER DETAILS

D/L No. & name of driver Manas Ranjan Dandapat, S/O Dhurjati Dandapat
At:Kathuabeda, PO: Dugudha, PS: Udala,
Dist: Mayurbhanj
D/L No. & validity OD-1120130088690, valid till 05.12.2033
Authorized to drive MCWG

DRIVER’S STATEMENT

The driver is the son of the owner and he stated that he had parked the
vehicle bearing Regd. No.OD-11G-0387 near Udala Kacheri Field with
handle lock and went to the electrical shop. After some time when he
came back to the place of parking, the said motorcycle was not there. He
searched the vehicle and did not find and reported the matter at Udala PS.

INQUIRY FROM RTO

During my inquiry I met the office of the RTA, Baripada and availed the
certified copy of the RC of the insured vehicle in which the theft report has
been duly effected with respect to Udala PS case No. 53 of dated
17.04.2017 and being asked the officials admitted that the original RC of
the theft vehicle bearing Regd. No.OD-11G-0387 has been surrendered by
the owner.

FINDINGS:

 Vehicular documents of the insured vehicle are valid.


 Police has not submitted the Final Report of the case.
From:- At: Subasini Shradha Bhawam
SUBASH CHANDRA BEHERA Angaragadia, PO: Ishannagar
ADVOCATE-CUM-INVESTIGATOR Dist: Balasore, Odisha, PIN-756001
BALASORE. MOB NO. 0861586472, 09337214687

OPINION:

Keeping in view of the above mentioned facts and on my


investigation and after going through the related documents I opined
that the vehicle bearing Regd. No.OD-11G-0387 has been theft.

Enclousures:
Sl Description of documents Nature of No. of
No. Document pages
1. Bill 1
2. Investigation report 4
3. FIR Xerox copy 5
4. RC Certified copy 1
5. Vehicular documents of insured vehicle Xerox copy 6
6. D/L of driver Original 1
Scanned copy
7. Statement of owner Original 1
8. Photo of spot of occurrence Original 1
9. Form 29 & 30 duly signed Original 3
10. Affidavit Original 1

This report is submitted without prejudice

Thanking you, Your’s faithfully,

Date: 26.05.2017
Place: Balasore (S.C. Behera)
Advocate-cum- Investigator
From:- At: Subasini Shradha Bhawam
SUBASH CHANDRA BEHERA Angaragadia, PO: Ishannagar
ADVOCATE-CUM-INVESTIGATOR Dist: Balasore, Odisha, PIN-756001
BALASORE. MOB NO. 0861586472, 09337214687

BILL Date: 26.05.2017

Case Title Vehicle No. Policy No.


Dhurjati Dandapat OD-11G-0387 P0017400007/4102/101837
VS Magma HDI (Motorcycle)

1. Professional Fee Rs. 3000.00


2. CC of RC Rs. 600.00
3. Xerox & Courier charges Rs. 100.00
4. Travelling & conveyance Rs. 800.00
5. Miscellaneous Expenses Rs. 100.00
In total Rs. 4,600.00
(Rupees four thousand six hundred ) only

Bank A/C No. 30045189172


State Bank of India
SME Branch, Balasore, Odisha Subash Ch. Behera
IFSC Code: SBIN0007020 Investigator
PAN-AOGPB0099C
Spot of occurrence

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