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Motor Vehicle Insurance Claim Form (Pakistan)

Motor Vehicle Insurance Claim Form (Pakistan)

MOTOR VEHICLE INSURANCE CLAIM FORM

Insurance Ordinance 2000 | Motor Vehicles Act 1939 | SECP Insurance Division Regulations

Insurer: [Insurer Name]

Policy Number: [Policy Number]

Policy Type: [Policy Type]

Policy Period: [Policy Period]

Date of Claim: [Claim Date]

SECTION 1: POLICYHOLDER DETAILS

Name: [Policyholder Name]

CNIC No.: [Policyholder CNIC]

Address: [Policyholder Address]

Contact: [Policyholder Phone]

SECTION 2: INSURED VEHICLE DETAILS

Registration Number: [Vehicle Registration]

Make and Model: [Vehicle Make Model]

Year of Manufacture: [Vehicle Year]

Engine Number: [Engine Number]

Chassis Number: [Chassis Number]

SECTION 3: INCIDENT DETAILS

Date of Incident: [Incident Date]

Time of Incident: [Incident Time]

Location: [Incident Location]

Type of Claim: [Claim Type]

Description of Incident:

[Incident Description]

FIR Number (if filed): [FIR Number]

SECTION 4: DAMAGE AND DRIVER DETAILS

Damage Description:

[Damage Description]

Driver at Time of Incident: [Driver Name] — CNIC: [Driver CNIC]

Driver's Licence: [Driver Licence]

Third Party Details: [Third Party Details]

Witness Details: [Witness Details]

SECTION 5: DECLARATION

I, [Policyholder Name] (CNIC: [Policyholder CNIC]), hereby declare that the information provided in this Motor Vehicle Insurance Claim Form is true and correct to the best of my knowledge and belief, and that I have not concealed any material fact. I understand that submitting a false or fraudulent insurance claim constitutes an offence under Section 340 of the Pakistan Penal Code 1860 and may result in criminal prosecution, forfeiture of the claim, and cancellation of my insurance policy.

I further acknowledge my obligation to notify the insurer of all material facts within the period specified in the policy under the doctrine of utmost good faith (uberrimae fidei) as required by the Insurance Ordinance 2000. Any complaints regarding claim settlement delays or wrongful repudiation may be submitted to the Insurance Ombudsman under Section 120 of the Insurance Ordinance 2000 or to the SECP Insurance Division.

Policyholder: [Policyholder Name] — CNIC: [Policyholder CNIC]

Signature: _________________________ Date: [Claim Date]

FOR INSURER USE ONLY

Claim Reference No.: _____________

Surveyor Appointed: _____________

Date of Survey: _____________

Assessment Amount: PKR _____________

Policyholder

________________

Signature

Maintained by Vladislav Sergienko, Founder·Template last modified: ·Report an error

What Is a Motor Vehicle Insurance Claim Form (Pakistan)?

A Motor Vehicle Insurance Claim Form in Pakistan sets out the particulars the recipient needs to deal with the request, in a structured and reviewable form.

The Insurance Ordinance 2000 replaced the Insurance Act 1938 and established the Securities and Exchange Commission of Pakistan (SECP) as the regulatory authority for the insurance sector through the Insurance Division of SECP. Section 99 of the Insurance Ordinance 2000 requires that every claim under a motor insurance policy be notified to the insurer within the time period specified in the policy terms and conditions — most Pakistani motor insurance policies require notification within 24 to 72 hours of the incident. Failure to notify within the stipulated time may prejudice or forfeit the claim under the condition of timely notification, though the insurer must demonstrate actual prejudice from late notification under the principle established by Pakistani courts.

Motor Vehicles Act 1939 (Act IV of 1939) — currently under review for replacement by a modern Motor Vehicles Ordinance — requires all motor vehicles registered and operated on public roads in Pakistan to carry at minimum a Third Party Liability (TPL) motor insurance policy. TPL insurance covers the vehicle owner's legal liability to third parties (other road users, pedestrians, and their property) injured or killed by the vehicle. The Motor Vehicles Act 1939 requires every vehicle to display valid insurance documents alongside the vehicle registration certificate issued by the provincial motor vehicle licensing authorities.

Motor insurance policies in Pakistan are classified into two categories: Third Party Liability (TPL) only — the minimum mandatory cover — and Thorough Motor Insurance, which covers own damage (OD) in addition to third-party liability. Major motor insurance providers in Pakistan include Adamjee Insurance, EFU General Insurance, Jubilee General Insurance, New Jubilee Insurance, United Insurance Company, and Askari General Insurance. These companies are regulated by the SECP Insurance Division, which enforces the Takaful Rules 2012 for Islamic window insurance operators.

The Pakistan Motor Accidents Claims Tribunal — established under the Motor Vehicles Act 1939 — adjudicates third-party compensation claims where the insurer or vehicle owner refuses to pay or disputes the claim amount. Claimants (injured third parties or their heirs in fatal accident cases) file a claim petition before the Motor Accidents Claims Tribunal in the district where the accident occurred, and the tribunal assesses compensation based on the Motor Accident Claims Assessment Guidelines issued by the High Court of the relevant province.

The SECP's Insurance Division handles consumer complaints against insurance companies through the SECP complaint portal ([email protected]) and through the Insurance Ombudsman established under Section 120 of the Insurance Ordinance 2000. The Insurance Ombudsman has jurisdiction to investigate complaints relating to unreasonable delay in settlement, repudiation of claims without valid reasons, and misrepresentation of policy terms by insurance companies and their agents.

When Do You Need a Motor Vehicle Insurance Claim Form (Pakistan)?

A Motor Vehicle Insurance Claim Form in Pakistan is required whenever a policyholder suffers a loss covered by their motor insurance policy and wishes to seek indemnification from their insurer under the Insurance Ordinance 2000.

A Motor Vehicle Insurance Claim Form is needed immediately after a road accident in which the insured vehicle is damaged — whether in a collision with another vehicle, a single-vehicle accident, or contact with a fixed object such as a wall, barrier, or pole. The claim must be notified to the insurer within the period specified in the policy (typically 24 to 72 hours) to avoid potential forfeiture of the claim.

A Motor Vehicle Insurance Claim Form is required when the insured vehicle is stolen — a common claim type in major Pakistani cities including Karachi, Lahore, and Rawalpindi. For theft claims, an FIR (First Information Report) filed at the local police station under the Police Order 2002 is mandatory documentation. The insurer typically requires 90 days to pass without vehicle recovery before settling a theft claim, in case the vehicle is traced by police.

A Motor Vehicle Insurance Claim Form is needed when the insured vehicle suffers fire damage — whether from an electrical fault, fuel system failure, arson, or civil unrest. Thorough motor insurance policies cover fire damage; TPL-only policies do not cover own damage from fire.

A Motor Vehicle Insurance Claim Form is required when a third party — a pedestrian, cyclist, occupant of another vehicle, or owner of damaged property — is injured or killed by the insured vehicle and makes a claim against the vehicle owner. The vehicle owner must notify their TPL or thorough insurer immediately so the insurer can take over conduct of the third-party claim and defend proceedings before the Motor Accidents Claims Tribunal if necessary.

A Motor Vehicle Insurance Claim Form is needed when the insured vehicle suffers damage from natural disasters — floods, landslides, hailstorms, or earthquakes — which are covered under most thorough policies as Act of God or natural perils. Pakistan's geographic exposure to monsoon flooding and earthquake activity makes this a regular claim category, particularly for vehicles registered in Sindh (flood-prone) and KPK and Balochistan (earthquake-prone areas).

A Motor Vehicle Insurance Claim Form is required when windscreen, glass, or individual components (tyres, batteries, accessories) are damaged and covered under the policy's extensions or riders. Glass claims are often covered without affecting the no-claims discount under Pakistani thorough motor policies.

What to Include in Your Motor Vehicle Insurance Claim Form (Pakistan)

A valid Motor Vehicle Insurance Claim Form in Pakistan under the Insurance Ordinance 2000 must contain the following essential information for the insurer to assess, process, and settle the claim.

Policyholder and Policy Details: Full name, NADRA CNIC number (13-digit), address, and contact number of the policyholder. The insurance policy number, insurer's name (regulated by SECP), policy commencement and expiry date, and coverage type (TPL only or Thorough) must be stated. The premium payment status must be confirmed — claims under policies with unpaid premiums may be disputed by the insurer.

Vehicle Details: Registration number of the insured vehicle as shown on the certificate of registration issued by the provincial motor vehicle registering authority (in Pakistan, vehicles are registered by district Motor Vehicle Registrars under the Motor Vehicles Act 1939); make, model, and year of manufacture; engine number; chassis number; and the seating capacity. The vehicle's colour and any identifying features are important for theft claims.

Incident Details: Date, time, and precise location (road name, area, city, province) of the incident — whether accident, theft, fire, or natural disaster. A clear factual narrative of how the incident occurred, without admitting liability (which could prejudice third-party claims). For accidents involving other vehicles, the other vehicle's registration number, make, model, and insurer should be recorded.

Damage Description: A detailed description of the damage suffered by the insured vehicle — parts damaged, estimated repair cost, and whether the vehicle is a total loss (write-off) or repairable. Photographs of the damage, taken immediately after the incident, should be attached. The insurer will depute a Loss Assessor or Surveyor to inspect the vehicle — under SECP regulations, the surveyor must be licensed under the Insurance Ordinance 2000.

Police Report (where applicable): For accidents involving third parties, theft, or fire of suspicious origin, the FIR number and date, name of the police station, and the Station House Officer (SHO) designation must be recorded. Under the Insurance Ordinance 2000, insurers are entitled to require police documentation before settling claims involving criminal activity.

Driver Details: Name, NADRA CNIC number, and driving licence number (issued by the relevant provincial motor vehicle licencing authority under the Motor Vehicles Act 1939) of the driver at the time of the incident. Whether the driver was the policyholder or an authorised driver under the policy must be confirmed — unlicensed or excluded drivers may invalidate the claim.

Witness Information: Names, CNIC numbers, and contact details of any witnesses to the accident — their statements may be required by the insurer or the Motor Accidents Claims Tribunal in disputed third-party liability claims.

Third-Party Details (if applicable): Names, CNIC numbers, addresses, vehicle details, and injury or property damage particulars of any third parties involved in the incident. Copies of third-party medical reports (for personal injury claims) from recognised hospitals should be attached.

Repair Authorisation: Whether the policyholder has obtained prior approval from the insurer before proceeding with repairs — many thorough policies require pre-authorisation for non-emergency repairs to designated panel repairers. Repairs carried out without insurer approval may not be reimbursed.

Declaration: The policyholder's declaration that all information is true and correct, and that no material facts have been concealed, under the doctrine of utmost good faith (uberrimae fidei) which governs all insurance contracts under the Insurance Ordinance 2000. False claims constitute insurance fraud and attract criminal liability under Section 340 of the Pakistan Penal Code 1860.

Forms-legal.com provides this Motor Vehicle Insurance Claim Form (Pakistan) template as a practical resource for vehicle owners. The template reflects the Insurance Ordinance 2000, Motor Vehicles Act 1939, and SECP Insurance Division regulations. Policyholders whose claims are wrongly repudiated should file a complaint with the Insurance Ombudsman under Section 120 of the Insurance Ordinance 2000.

Cite this page

Reference this free template in an article, syllabus, or research note:

APA

Forms Legal. (2026). Motor Vehicle Insurance Claim Form (Pakistan) (Pakistan) [Legal document template]. Forms Legal. https://forms-legal.com/pakistan/personal/insurance/motor-vehicle-insurance-claim-pakistan

MLA

"Motor Vehicle Insurance Claim Form (Pakistan) (Pakistan)." Forms Legal, 2026, https://forms-legal.com/pakistan/personal/insurance/motor-vehicle-insurance-claim-pakistan.

BibTeX
@misc{formslegal-motor-vehicle-insurance-claim-pakistan,
  author       = {{Forms Legal}},
  title        = {Motor Vehicle Insurance Claim Form (Pakistan) (Pakistan)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/pakistan/personal/insurance/motor-vehicle-insurance-claim-pakistan}},
  note         = {Free legal document template}
}

Frequently Asked Questions

Statute-referenced template — Template last modified June 2026

This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer

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