{"id":1097,"title":"Vehicle Residual Value Insurance – Claim Form","purpose":"claim","insurer":{"slug":"sbi-general-insurance","name":"SBI General Insurance Company Limited"},"source_pdf":"https://content.sbigeneral.in/uploads/7_Claim_Form_Residual_Value_Insurance_90cbd59a8b.pdf","sha256":"a73d9d06133b1ed72edeb86935acafe3302b149235bc14eeab3ca3d66d95b0f2","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured or policyholder to claim the residual value insurance for their vehicle under the policy.","notes":[],"title":"Vehicle Residual Value Insurance – Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Policy Details","fields":[{"help":"","type":"amount","label":"Residual Value as per Policy (₹):","options":[],"required":null,"pdf_field":""},{"help":"Enter the date when the claim is being made","type":"date","label":"Date of Claim:","options":[],"required":null,"pdf_field":""},{"help":"Location where the vehicle was inspected","type":"text","label":"Place of Inspection:","options":[],"required":null,"pdf_field":""},{"help":"Enter your insurance policy number","type":"text","label":"Policy Number:","options":[],"required":null,"pdf_field":""},{"help":"Enter the certificate or cover note number if applicable","type":"text","label":"Certificate / Cover Note Number:","options":[],"required":null,"pdf_field":""},{"help":"Name of the insurance company","type":"text","label":"Insurance Company:","options":[],"required":null,"pdf_field":""},{"help":"Type of residual value coverage under the policy","type":"text","label":"Residual Value Coverage Type:","options":[],"required":null,"pdf_field":""},{"help":"Start date of the insurance policy","type":"date","label":"Policy Start Date:","options":[],"required":null,"pdf_field":""},{"help":"Expiry date of the insurance policy","type":"date","label":"Policy Expiry Date:","options":[],"required":null,"pdf_field":""}],"filled_by":"insured / policyholder"},{"title":"Insured / Customer Details","fields":[{"help":"Full name of the insured person","type":"text","label":"Name of the Insured:","options":[],"required":null,"pdf_field":""},{"help":"Full postal address","type":"text","label":"Address:","options":[],"required":null,"pdf_field":""},{"help":"City of residence","type":"text","label":"City:","options":[],"required":null,"pdf_field":""},{"help":"Postal Index Number (PIN code)","type":"number","label":"PIN:","options":[],"required":null,"pdf_field":""},{"help":"Email address of the insured","type":"email","label":"Email ID:","options":[],"required":null,"pdf_field":""},{"help":"Phone number including country/area code","type":"phone","label":"Contact Number:","options":[],"required":null,"pdf_field":""}],"filled_by":"insured / policyholder"},{"title":"Vehicle Details","fields":[{"help":"Make and model of the vehicle","type":"text","label":"Vehicle Make & Model:","options":[],"required":null,"pdf_field":""},{"help":"List any non-original equipment manufacturer accessories fitted","type":"text","label":"NON-OEM Accessory Fitment if done:","options":[],"required":false,"pdf_field":""},{"help":"Date when the vehicle was purchased","type":"date","label":"Date of Purchase:","options":[],"required":null,"pdf_field":""},{"help":"Describe the vehicle's usage purpose","type":"text","label":"Purpose for which vehicle was being used:","options":[],"required":null,"pdf_field":""},{"help":"Describe any structural modifications done to the vehicle","type":"text","label":"Modification of vehicle structure:","options":[],"required":false,"pdf_field":""},{"help":"Vehicle registration number","type":"text","label":"Registration Number:","options":[],"required":null,"pdf_field":""},{"help":"Engine number of the vehicle","type":"text","label":"Engine Number:","options":[],"required":null,"pdf_field":""},{"help":"Chassis number of the vehicle","type":"text","label":"Chassis Number:","options":[],"required":null,"pdf_field":""},{"help":"Original purchase invoice value of the vehicle","type":"amount","label":"Original Invoice Value (₹):","options":[],"required":null,"pdf_field":""},{"help":"Odometer reading at time of claim","type":"number","label":"Vehicle ODO Meter reading:","options":[],"required":null,"pdf_field":""},{"help":"IDV declared when policy started","type":"amount","label":"Insured Declared Value (IDV) at Policy Inception (₹):","options":[],"required":null,"pdf_field":""},{"help":"Variant of the vehicle model","type":"text","label":"Variant:","options":[],"required":false,"pdf_field":""}],"filled_by":"insured / policyholder"},{"title":"Bank Details for Claim Payment","fields":[{"help":"Name of the bank account holder","type":"text","label":"Account Holder Name:","options":[],"required":null,"pdf_field":""},{"help":"Name of the bank","type":"text","label":"Bank Name:","options":[],"required":null,"pdf_field":""},{"help":"Bank branch name","type":"text","label":"Branch:","options":[],"required":null,"pdf_field":""},{"help":"Bank account number for claim payment","type":"text","label":"Account Number:","options":[],"required":null,"pdf_field":""},{"help":"IFSC code of the bank branch","type":"text","label":"IFSC Code:","options":[],"required":null,"pdf_field":""},{"help":"Type of bank account (Savings/Current)","type":"text","label":"Type of Account:","options":[],"required":null,"pdf_field":""}],"filled_by":"insured / policyholder"},{"title":"Documents Submitted","fields":[{"help":"Tick if you have attached the signed claim form","type":"checkbox","label":"Claim Form (Signed)","options":["Tick if submitted"],"required":null,"pdf_field":""},{"help":"Tick if you have attached the vehicle purchase invoice","type":"checkbox","label":"Vehicle Purchase Invoice","options":["Tick if submitted"],"required":null,"pdf_field":""},{"help":"Tick if you have attached the vehicle registration certificate copy","type":"checkbox","label":"Vehicle RC Copy","options":["Tick if submitted"],"required":null,"pdf_field":""},{"help":"Tick if you have attached the policy schedule","type":"checkbox","label":"Policy Schedule (Residual Insurance)","options":["Tick if submitted"],"required":null,"pdf_field":""},{"help":"Tick if you have attached the survey or valuator report","type":"checkbox","label":"Survey / Valuator Report","options":["Tick if submitted"],"required":null,"pdf_field":""},{"help":"Tick if you have attached vehicle photographs","type":"checkbox","label":"Vehicle Photographs","options":["Tick if submitted"],"required":null,"pdf_field":""},{"help":"Tick if you have attached vehicle service records","type":"checkbox","label":"Vehicle Service Records.","options":["Tick if submitted"],"required":null,"pdf_field":""},{"help":"Tick if you have attached accident history and repair records","type":"checkbox","label":"Vehicle Accident History & repair Records.","options":["Tick if submitted"],"required":null,"pdf_field":""},{"help":"Tick if you have attached telematics records","type":"checkbox","label":"Vehicle Telematics Records. (If applicable)","options":["Tick if submitted"],"required":false,"pdf_field":""},{"help":"Specify any other documents attached","type":"text","label":"Any Other Document:","options":[],"required":false,"pdf_field":""}],"filled_by":"insured / policyholder"},{"title":"Declaration","fields":[{"help":"Print your name","type":"text","label":"Name:","options":[],"required":true,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of Insured:","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date:","options":[],"required":true,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place:","options":[],"required":true,"pdf_field":""}],"filled_by":"insured / policyholder"},{"title":"Discharge Voucher","fields":[{"help":"Vehicle registration number","type":"text","label":"Registration No.:","options":[],"required":null,"pdf_field":""},{"help":"Claim number assigned by insurer","type":"text","label":"Claim No.:","options":[],"required":null,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place:","options":[],"required":null,"pdf_field":""},{"help":"Signature to acknowledge receipt and discharge","type":"signature","label":"Signature of Insured/Claimant:","options":[],"required":null,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date:","options":[],"required":null,"pdf_field":""},{"help":"Print name of insured or claimant","type":"text","label":"Name of Insured/Claimant:","options":[],"required":null,"pdf_field":""}],"filled_by":"insured / claimant"}],"deadlines":[],"applies_to":"Residual Value Insurance claims","attachments":["Claim Form (Signed)","Vehicle Purchase Invoice","Vehicle RC Copy","Policy Schedule (Residual Insurance)","Survey / Valuator Report","Vehicle Photographs","Vehicle Service Records","Vehicle Accident History & repair Records","Vehicle Telematics Records (If applicable)","Any Other Document"],"declarations":["I hereby declare that the information provided above is true and correct to the best of my knowledge.","I understand that any false or misleading information may result in rejection of the claim.","I acknowledge receipt of the settlement amount and discharge the insurer from all liabilities related to this claim."],"dropped_labels":3},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"customer.care@sbigeneral.in","label":"Motor Claims Email","level":null,"hours":null,"applies_to":"motor","source_url":"https://www.sbigeneral.in/claim/motor","quote":"m\nRegister or Track Claim Status with one simple click\nIntimate Claim\nCheck Claim Status\n1800 102 1111\n(Available 24/7)\ncustomer.care@sbigeneral.in\nMail ID\nSmooth rides, smoother claims\nBecause you deserve worry-free journeys, always\nDownload SBIG App\nRegister or Tra","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"sbig.health@sbigeneral.in","label":"Health Claims Email","level":null,"hours":null,"applies_to":"health","source_url":"https://www.sbigeneral.in/claim/health","quote":"ailable 24/7\n1800 210 3366\n/\n1800 210 6366\nSMS Us:\n“HEALTHCLAIM”\nto\n561612\nEmail Us:\nseniorcitizen.health@sbigeneral.in\nsbig.health@sbigeneral.in\n18,000+\nNetwork Hospitals\nHealth Vertical Office:\nSBI General Insurance Company Limited,\n9th Floor, Westport, Pan Card","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"seniorcitizen.health@sbigeneral.in","label":"Senior Citizen Health Claims Email","level":null,"hours":null,"applies_to":"health","source_url":"https://www.sbigeneral.in/claim/health","quote":"Feel Free to Reach Out\nCall Us:\nAvailable 24/7\n1800 210 3366\n/\n1800 210 6366\nSMS Us:\n“HEALTHCLAIM”\nto\n561612\nEmail Us:\nseniorcitizen.health@sbigeneral.in\nsbig.health@sbigeneral.in\n18,000+\nNetwork Hospitals\nHealth Vertical Office:\nSBI General Insurance Company Limited,\n9th","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 102 1111","label":"Motor Claims Toll-free Number","level":null,"hours":"Available 24/7","applies_to":"motor","source_url":"https://www.sbigeneral.in/claim/motor","quote":"e Claim\nFAQs\nDownload Claim Form\nRegister or Track Claim Status with one simple click\nIntimate Claim\nCheck Claim Status\n1800 102 1111\n(Available 24/7)\ncustomer.care@sbigeneral.in\nMail ID\nSmooth rides, smoother claims\nBecause you deserve worry-free journ","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 210 3366","label":"Health Claims Toll-free Number","level":null,"hours":"Available 24/7","applies_to":"health","source_url":"https://www.sbigeneral.in/claim/health","quote":"e simple click\nCheck Claim Status\nIntimate Claim\nFor any Queries, Please Feel Free to Reach Out\nCall Us:\nAvailable 24/7\n1800 210 3366\n/\n1800 210 6366\nSMS Us:\n“HEALTHCLAIM”\nto\n561612\nEmail Us:\nseniorcitizen.health@sbigeneral.in\nsbig.health@sbigeneral.in","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 210 6366","label":"Health Claims Toll-free Number","level":null,"hours":"Available 24/7","applies_to":"health","source_url":"https://www.sbigeneral.in/claim/health","quote":"heck Claim Status\nIntimate Claim\nFor any Queries, Please Feel Free to Reach Out\nCall Us:\nAvailable 24/7\n1800 210 3366\n/\n1800 210 6366\nSMS Us:\n“HEALTHCLAIM”\nto\n561612\nEmail Us:\nseniorcitizen.health@sbigeneral.in\nsbig.health@sbigeneral.in\n18,000+\nNetwork","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"sms","value":"561612","label":"Health Claims SMS 'HEALTHCLAIM'","level":null,"hours":null,"applies_to":"health","source_url":"https://www.sbigeneral.in/claim/health","quote":"y Queries, Please Feel Free to Reach Out\nCall Us:\nAvailable 24/7\n1800 210 3366\n/\n1800 210 6366\nSMS Us:\n“HEALTHCLAIM”\nto\n561612\nEmail Us:\nseniorcitizen.health@sbigeneral.in\nsbig.health@sbigeneral.in\n18,000+\nNetwork Hospitals\nHealth Vertical Office","fetched_at":"2026-10-20"}],"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/sbi-general-insurance/1097-vehicle-residual-value-insurance-claim-form"}