{"id":1091,"title":"Personal Accident Death Claim Form","purpose":"claim","insurer":{"slug":"royal-sundaram-general-insurance","name":"Royal Sundaram General Insurance Company Limited"},"source_pdf":"https://www.royalsundaram.in/assets/claim-forms/personal-accident-insurance/personal-accident-deathclaim.pdf","sha256":"abf17e5bf04b5ee0179c704c5b8ed42672a813ac62487455244c9c58107bdc66","pages":4,"collected":"2026-10-20","instructions":{"about":"This form is used to claim the death benefit under a personal accident insurance policy. It is filled by the nominee or claimant of the deceased policyholder.","notes":["Use block letters to fill the form.","Attach original or attested copies of all required documents.","Incomplete forms or missing documents may delay the claim process."],"title":"Personal Accident Death Claim Form","submit":{"to":"The Insurance Company or its TPA as mentioned in the policy documents","how":"By post or as per insurer's instructions","address":""},"purpose":"claim","sections":[],"deadlines":["Submit the claim form and documents within the time limit specified in the policy (usually within 30 days of the accident or death)"],"applies_to":"Personal Accident Death Claims","attachments":["Death Certificate of the Deceased","Policy Document Copy","Accident Report or FIR Copy","Medical Certificate or Hospital Records","Proof of Identity and Address of Claimant","Any other documents as required by the insurer"],"declarations":["I hereby declare that the information provided is true and correct to the best of my knowledge.","I authorize the insurer to verify the information and obtain necessary documents.","I agree to provide any additional information or documents if required."],"dropped_labels":17},"pdf_fields":null,"fillable_pdf":false,"send_to":[],"how_to_use":"Ask the user for each field in order, in plain words; never invent an answer. Labels are as printed. If fillable_pdf is true, pdf_fields gives the PDF's own field names so the file can be filled directly. The printed form decides if anything differs.","url":"https://indiainsurances.com/forms/royal-sundaram-general-insurance/1091-personal-accident-death-claim-form"}