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Estimation Details
Policy Details :
Insurance
Customer Name Mr. OKA RAM NIA
Company
Policy Expiry
Policy No 98000031240915144984 02-Aug-2027
Date
Vehicle Sub ERTIGA VXI CNG 1.5L 5MT
Registration No. --
Model ERRCEV100 BS6
Engine No 9563849 Chassis No 842660
Dealer Work LMJ SERVICES LTD-6502 PALI G-14Jhakha Mata
Dealer Name LMJ SERVICES LTD-6502
Shop Address Opp- Dasharaha Ground Sumerpur,,,
64Vb Status Verified Claim Count 2
NCB 0%
Claim Deatils
Estimation Date 16/04/2025 Estimation No E21163564
Service Adviser
SHARWAN SINGH Claim No 98000031250391018771
Name
Service Adviser
9660640985
Mobile No
Accident Details :
Date Of
13-Apr-2025 Accident City PALI
Accident
Cause Of
AS PER CLAIM
Accident
Part Estimation Detail Total Cost : 40467
*Depreciation Claimed Service
S.No. Part No. Part Desc. MRP Quantity Total Approved Amount Replace Repair Allow
% Value Type
1 35321M72R21 UNIT HEADLAMP LH 6600 0 1 6600 6600 Replace
2 17100M72R00 FAN ASSY, COOLING 6450 0 1 6450 6450 Replace
3 57300M72R00 PANEL, FRONT HOOD 5835 0 1 5835 5835 Replace
71740M50UB0-
4 GRILLE,RADIATOR UPPER 5590 0 1 5590 5590 Replace
DB8
5 17700M72R00 RADIATOR ASSY 5240 0 1 5240 5240 Replace
6 95310M72R00 CONDENSER ASSY 3960 0 1 3960 3960 Replace
71711M72R00-
7 BUMPER,FRONT 2750 0 1 2750 2750 Replace
5PK
8 57711M73R10 PANEL,FRONT FENDER,L 1840 0 1 1840 1840 Replace
9 72340M72R01 LINING COMPFRONT FENDER 725 0 1 725 725 Replace
71721M73R00-
10 GRILLE,RADIATOR LOWER 265 0 1 265 265 Replace
5PK
11 57410M72R00 HINGE COMP,FRONT HOOD,R 260 0 1 260 260 Replace
12 57420M72R00 HINGE COMP,FRONT HOOD,L 260 0 1 260 260 Replace
71761M73R00-
13 BEZEL,FRONT FOG LAMP,L 110 0 1 110 110 Replace
5PK
71751M73R00-
14 BEZEL,FRONT FOG LAMP,R 110 0 1 110 110 Replace
5PK
15 71734M72R00 HOLDER,FR BUMPER FRONT,L 100 0 1 100 100 Replace
16 71733M72R00 HOLDER,FR BUMPER 100 0 1 100 100 Replace
FRONT,R
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71762M73R00- COVER,FRONT FOG LAMP
17 71 0 1 71 71 Replace
5PK BEZEL,L
71752M73R00- COVER,FRONT FOG LAMP
18 71 0 1 71 71 Replace
5PK BEZEL,R
19 71732M73R00 HOLDER,FR BUMPER SIDE,L 65 0 1 65 65 Replace
20 71731M73R00 HOLDER,FR BUMPER SIDE,R 65 0 1 65 65 Replace
Labour Estimation Detail Total Cost : 0
Labour Deatil does not exist for this Estimation
Paint Estimation Detail Total Cost : 0
Paint Deatil does not exist for this Estimation
Other Paint Deatil does not exist for this Estimation
Miscellaneous Estimation Detail Total Cost : 27500
S.No. Description Cost Approved Amount Allow
1 DENTING CHARGES 4000
2 PAINTING CHARGES 18500
3 VEHICLE REPLACMENT 5000
Total Insurer Liability : 67967
Remarks
㠞
㠟
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Documents Details :
Driving License RC Scan Copy
Copy of FIR -if any Copy of affidavit -if any
Claim Form
Vehicle Images :
Vehicle Photo 1 Vehicle Photo 2
Vehicle Photo 3 Vehicle Photo 4
Vehicle Photo 5 Vehicle Photo 6
Vehicle Photo 7 Vehicle Photo 8
Vehicle Photo 9 Vehicle Photo 10
Vehicle Photo 11 Vehicle Photo 12
Vehicle Photo 13 Vehicle Photo 14
Vehicle Photo 15
__________________________ __________________________
Service Adviser Signature Surveyor Signature
Date : 25/04/2025 Date : 25/04/2025
*Taxes extra as applicable
*Not Payable by customer as this policy has zero dep cover
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