Theft Claim Report
Theft Claim Report
Theft Claim Report
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;
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.
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:
OPINION:
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
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