ÿþ<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd"> <html xmlns="http://www.w3.org/1999/xhtml"> <head> <title>Welcome to Universal Sompo</title> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> <style type="text/css"> <!-- @import url("css/universal.css"); --></style> <script language="javascript" type="text/javascript" src="js/jquery-1.3.2.js"></script> <script language="javascript" type="text/javascript" src="js/popup.js"></script> <script language="javascript" type="text/javascript" src="js/swf.js"></script> <script language="javascript" type="text/javascript" src="js/menu.js"></script> <script src="ajaxmail.js" language="javascript"></script> <script language="javascript" type="text/javascript"> function IsNumeric(sText) { var ValidChars = "0123456789.-"; var IsNumber=true; var Char; for (i = 0; i < sText.length && IsNumber == true; i++) { Char = sText.charAt(i); if (ValidChars.indexOf(Char) == -1) { IsNumber = false; } } return IsNumber; } function check() { var Name=document.form1.Name.value var PhoneNo=document.form1.PhoneNo.value var EmailID=document.form1.EmailID.value var Feedback=document.form1.Feedback.value var reg = new RegExp("^[A-Za-z0-9_-]{1,}[.]?[A-Za-z0-9_-]{1,}@{1}([A-Za-z0-9_-]+[.]{1})+[A-Za-z0-9_-]{1,}$"); if((Name=="") ||!isNaN(Name) || (Name=="Name")) { alert("Please enter your name."); document.form1.Name.focus(); return false; } else if(containsdigit(Name)==true) { alert("Name contains characters."); document.form1.Name.focus(); return false; } else if (Name.charAt(0)==" ") { alert("Name can not start with blank.") document.form1.Name.focus(); return false; } if(PhoneNo=="") { alert("Please enter your contact number."); document.form1.PhoneNo.focus(); return false; } else if(IsNumeric(PhoneNo)==false) { alert("Please enter a numeric value."); document.form1.PhoneNo.focus(); return false; } if(EmailID=="") { alert("Please enter your email id."); document.form1.EmailID.focus(); return false; } else if(!reg.test(EmailID)) { alert("Invalid email id. Please enter your correct email id."); document.form1.EmailID.focus(); return false; } if(Feedback=="") { alert("Please enter your enquiry/feedback/suggestion."); document.form1.Feedback.focus(); return false; } if ((document.form1.Feedback.value!="")&&(document.form1.Feedback.value.length>1000)) { alert("Feedback cannot be greater than 1000 character.") document.form1.Feedback.focus(); return false; } else { makeRequest("Name="+document.form1.Name.value+"&PhoneNo="+document.form1.PhoneNo.value+"&Products="+document.form1.Products.value+"&EmailID="+document.form1.EmailID.value+"&Feedback="+document.form1.Feedback.value); } } function containsdigit(param) { mystrLen = param.length; for(i=0;i<mystrLen;i++) { if((param.charAt(i)=="0") || (param.charAt(i)=="1") || (param.charAt(i)=="2") || (param.charAt(i)=="3") || (param.charAt(i)=="4") || (param.charAt(i)=="5") || (param.charAt(i)=="6") || (param.charAt(i)=="7") || (param.charAt(i)=="8") || (param.charAt(i)=="9") || (param.charAt(i)=="/")) { return true; } } return false; } function containsalpha(param) { mystrLen = param.length; for(i=0;i<mystrLen;i++) { if((param.charAt(i)<"0")||(param.charAt(i)>"9")) { return true; } } return false; } function containswrong(param){ strLen1 = param.length; for(i=0;i<strLen1;i++) { if((param.charAt(i)==";") || (param.charAt(i)=="=") || (param.charAt(i)=="+") || (param.charAt(i)=="*") || (param.charAt(i)=="#") || (param.charAt(i)=="$") || (param.charAt(i)=="%") || (param.charAt(i)=="^") || (param.charAt(i)=="?") || (param.charAt(i)=="@")||(param.charAt(i)=="/") || (param.charAt(i)=="<") || (param.charAt(i)==">")|| (param.charAt(i)=="-") || (param.charAt(i)=="~")) { return true; } } return false; } function MM_openBrWindow(theURL,winName,features) { //v2.0 window.open(theURL,winName,features); } //--> </script> </head> <body> <a name="t" id="t"></a> <div id="container"> <div id="main"> <div id="left_panel" style="height: 1250px"> <h1 class="logo"> <a href="index.html">Universal Sompo</a></h1> <ul id="nav"> <div style="position: relative" onmouseover="MM_showHideLayers('Layer1','','show')" onmouseout="MM_showHideLayers('Layer1','','hide')"> <div id="Layer1"> <table width="100%" border="0" cellspacing="0" cellpadding="5"> <tr> <td bgcolor="#ffffff" class="text"> <a href="about-us.html">About Us </a> </td> </tr> <tr> <td bgcolor="#ffffff" class="text"> <a href="our-vision.html">Our Vision </a> </td> </tr> <tr> <td bgcolor="#ffffff" class="text"> <a href="why-universal-sompo.html">Why Universal Sompo </a> </td> </tr> <tr> <td bgcolor="#ffffff" class="text"> <a href="message-from-chairman.html">Message from Our Chairman </a> </td> </tr> </table> </div> </div> <div style="position: relative" onmouseover="MM_showHideLayers('Layer2','','show')" onmouseout="MM_showHideLayers('Layer2','','hide')"> <div id="Layer2"> <table width="100%" border="0" cellspacing="0" cellpadding="5"> <tr> <td bgcolor="#ffffff" class="text"> <a href="retail.html">Retail</a></td> </tr> <tr> <td bgcolor="#ffffff" class="text"> <a href="commercial.html">Commercial</a></td> </tr> <tr> <td bgcolor="#FFFFFF" class="text" style="border-bottom:1px solid #CCCCCC"><a href="microinsurance.html">Micro Insurance</a></td> </tr> </table> </div> </div> <li onmouseover="MM_showHideLayers('Layer1','','show')" onmouseout="MM_showHideLayers('Layer1','','hide')"> <a href="#">About Us </a> <li onmouseover="MM_showHideLayers('Layer2','','show')" onmouseout="MM_showHideLayers('Layer2','','hide')"> <a href="#">Our Products</a> <li><a href="branchlocations.aspx">Contact Us</a> </li> <li><a href="Claim.html">Claims</a><li><a href="careers.html">Careers</a></li> </ul> <div> <h3 class="leftpanelpink" style="width: 210px" align="center"> Quick Links</h3> <a onclick="callfastcontact()"><h3 class="leftpanel" style="width: 208px"><blink>Fast Claim Notification</blink></h3></a> <a href="Downloadpage.html"><h3 class="leftpanel" style="width: 208px">Download Section</h3></a> <a href="garageSearch.aspx"><h3 class="leftpanel" style="width: 208px">Search Garage near to you </h3></a> <a href="HospitalList.aspx"><h3 class="leftpanel" style="width: 208px">Search Hospital near to you</h3></a> </div> </div> <div id="right_panel"> <div id="top_header"> <div id="divinquiry"> <a> <img src="image/topband.gif" width="461" height="59" align="right" style="padding-right: 10px; padding-top: 4px;" vspace="10" /></a> </div></div> <div id="band"> <img src="image/contact.jpg" width="728" height="173"></div> <div id="content"> <h2 class="heading"> Workmen's Compensation Claim Process</h2> <div id="content_text"> <b>IMMEDIATE ACTION AFTER ACCIDENT:</b> <ul> <li>Give immediate written notice to the insurance company about the death or disablement of the employer.</li> <li>Intimation of Accident to Factory Inspector.</li> <li>Furnish all information and documentary evidence as the insurance company may require.</li> <li>Deposit the compensation payable to the employee with Workmen Compensation Commissioner. Obtain their receipt and submit the same to Insurance Company. </li> <li>If any notice is received from W.C. Commissioner, send the same to Insurance Company.</li> <li>To collect the relevant data with the objective to quantify reasonable and just compensation, a trained investigator is appointed by the insurance company.</li> <li>At the same time you should be submit claim form along with relevant documents.</li> </ul> <h3>CLAIMS PROCEDURE </h3> <b>Basic Documents:</b> <ul> <li>General for all type of claims <ul> <li>Claim Form duly filled in & signed.</li> <li>Claim Bill.</li> </ul> </li> <li>1.Temporary Disablement Claims: <ul> <li> Medical Certificate regarding Cause & Duration of Disablement.</li> <li>Medical Bills.</li> </ul> </li> <li>Permanent Disablement Claims: <ul> <li>Medical Certificate regarding Disablement.</li> <li>Memorandum of Agreement as per W.C Act between Insured and the injured workman.</li> </ul> </li> <li>Fatal Claims: <ul> <li> Death certificate.</li> <li>Copy of post Mortem report.</li> <li>F.I.R / Final Investigation report</li> <li>Form A of W.C Act duly completed by the Insured.</li> <li>Statement of Witnesses ,if any</li> </ul> </li> </ul> </div> </div> </div> <div id="foooter"> <div id="address_bar" class="address"> <b>Regd & Corp Office :</b> Universal Sompo General Insurance Co Ltd. Unit No 401, 4th Floor,Sangam Complex, 127, <br />Andheri Kurla Road,Andheri (E), Mumbai- 400059. Tel : 022-29211800, Fax : 022-29211844 <br/> <b>Insurance is the subject matter of solicitation. IRDA Registration Number - 134 Control Number -ENG/WBHP/056/25Nov2010</b> <br/> <a href="Privacy Policyindex.html">Privacy Policy</a>| <a href="DisclaimerIndex.html">Disclaimer</a> </div> <script type="text/javascript"> var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); </script> <script type="text/javascript"> try { var pageTracker = _gat._getTracker("UA-12348426-1"); pageTracker._trackPageview(); } catch(err) {}</script> </div> </div> </div> <!--- pop up window--> <form id="formcontact" name="formcontact"> <div id="popupContactus" style="left: 0px; width: 274px; top: 0px; height: 387px"> <a id="popupContactCloseus" style="font-weight: bold">x</a> <strong> Quick Contact </strong> <hr /> <div id="divcontacttable"> <table style="width:350px;"> <tr> <td class="texttable" style="width:88px"> Contact type</td> <td style="width: 193px"> <select name="ctype" class="formhome" id="ctype" onchange='OnChange(this.form.ctype);'> <option value="Inquiry">Inquiry</option> <option value="Claim">Claim</option> <option value="other">other</option> </select> </td> </tr> <tr> <td class="texttable" style="width:88px"> Name*</td> <td style="width: 193px"><input name="cname" type="text" class="formhome" id="cname" maxlength="50" style="width: 150px" /></td> </tr> <tr> <td class="texttable" style="width:88px"> Emailid*</td> <td style="width: 193px"> <input name="cemailid" type="text" class="formhome" id="cemailid" maxlength="50" style="width: 150px" /></td> </tr> <tr> <td class="texttable" style="width:88px"> Phone Number*</td> <td style="width: 193px" > <input name="cphone" type="text" class="formhome" id="cphone" maxlength="50" style="width: 150px" /></td> </tr> <tr> <td class="texttable" style="width:88px"> </td> <td style="width: 193px"> <span style="font-size: 0.8em; font-family: Tahoma"><em>please enter phone number with your STD code</em></span></td> </tr> <tr> <td class="texttable" style="width: 88px"> </td> <td style="width: 193px"> </td> </tr> <tr> <td class="texttable" style="width: 88px"> Comments*</td> <td style="width: 193px"> &nbsp;<textarea name="ccomment" rows="3" class="formhome" id="ccomment" style="width: 150px"></textarea></td> </tr> <tr ><td colspan="2"> <div id="policynum" style="display:none;"> <table> <tr > <td class="texttable" style="width: 99px"> Policy Number*</td> <td style="width: 196px"> <input name="cpolicyno" type="text" class="formhome" id="cpolicyno" maxlength="50" style="width: 150px" /></td> </tr> </table> </div> </td><td></td></tr> <tr> <td colspan="2"> <div id="productrow"> <table> <tr > <td class="texttable" style="width:78px"> Product</td> <td style="width: 130px"> &nbsp;<select name="Productslist" class="formhome" id="Productslist" style="width: 187px"> <option value="Motor Pvt. Car">Motor Pvt. Car</option> <option value="Individual Health">Individual Health</option> <option value="Fire &amp; Allied Perils">Fire &amp; Allied Perils</option> <option value="Aapat Suraksha">Aapat Suraksha</option> <option value="Householders">Householders</option> <option value="Office Package Policies">Office Package Policies</option> <option value="Farmers&rsquo; Package">Farmers&rsquo; Package</option> <option value="Cattle Policy">Cattle Policy</option> <option value="Others">Others</option> </select></td> </tr></table> </div> </td> <td></td> </tr> <tr> <td class="texttable" style="width: 88px"> </td> <td style="width: 193px"> </td> </tr> <tr> <td class="texttable" style="width: 88px"> </td> <td style="width: 193px"> *<em> required fields</em></td> </tr> </table> <hr /> <div style="float:right;padding-bottom:0px;padding-right:44px;"><input id="Button1" title="Submit" type="button" value="Submit" class="button" onclick="checkNewpop()"; /></div> <table width="100%" border="0" cellpadding="0" cellspacing="0" id="Table1" style="display: none;"> <tr> <td class="formtext"> <span class="style1">We will get in touch with you shortly.</span></td> </tr> </table> </div> </div> </form> <!--- pop up window--> </body> </html>