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The Motor Claim Form is a crucial document in the Indonesian insurance landscape, designed to facilitate the claims process for vehicle-related incidents. It is used when policyholders need to make a claim following a motor vehicle accident, theft, or damage. The form must comply with Indonesian insurance regulations, particularly Law No. 40 of 2014 on Insurance and OJK regulations. It captures essential information including policyholder details, vehicle information, incident circumstances, third-party involvement, and damage assessment. This standardized format ensures consistent claims processing across the Indonesian insurance industry while meeting all regulatory requirements for documentation and information collection.

1. Policy Details: Essential information about the insurance policy including policy number, period of insurance, and type of coverage

2. Insured's Details: Complete information about the policyholder including name, address, contact information, and occupation

3. Vehicle Details: Specific information about the insured vehicle including registration number, make, model, year, and modifications

4. Driver Details: Information about who was driving at the time of incident, including license details and relationship to policyholder

5. Incident Details: Comprehensive information about when, where, and how the incident occurred

6. Damage Description: Detailed description of damage to the insured vehicle and any other property involved

7. Third Party Details: Information about other parties involved in the incident, including their vehicle and insurance details

8. Police Report Details: Information about police involvement, report numbers, and attending officers

9. Declaration: Statement of truth and authorization for the insurance company to handle the claim