Our aim is not only to pay your claims but also to protect and assist you. For this purpose, it is indispensable that
you collaborate with us right now when completing this form. It is necessary that great care should be taken in supplying
the information set out below and the statements given should be strictly accurate, irrespective of whether the facts are in
your favour or otherwise.
You should not make any payment offer or promise of any payment or admit liability in any way, as by so doing
you may prejudice your position and make settlement a difficult matter.
If you have received any communications, verbal or written, please inform us forwarding all letters, etc, without
replying thereto. Please note that the issue of this form is not an admission of liability on the part of the Corporation.
Ethiopian Insurance Corporation