{"id":1108,"title":"CLAIM FORM CYBER VAULTEDGE","purpose":"claim","insurer":{"slug":"sbi-general-insurance","name":"SBI General Insurance Company Limited"},"source_pdf":"https://content.sbigeneral.in/uploads/52501f35327e443b963fb31047467038.pdf","sha256":"1ad33ba794bb484dd664a44643684090cc589be96aa4424ba21be1daf6bdbe69","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is for the insured policyholder to file a claim under the Cyber VaultEdge insurance policy for losses due to cyber events.","notes":["Fill the form in block letters.","Use additional sheets if necessary.","Attach copies of relevant documentation.","Do not appoint legal representatives without prior consent of the insurer."],"title":"CLAIM FORM CYBER VAULTEDGE","submit":{"to":"SBI General Insurance Company Limited","how":"send the completed claim form as soon as possible","address":"Corporate & Registered Office: Fulcrum Building, 9th Floor, A & B Wing, Sahar Road, Andheri (East), Mumbai - 400099"},"purpose":"claim","sections":[{"title":"Policy Details","fields":[{"help":"","type":"text","label":"Name of the Insured","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Policy Number","options":[],"required":true,"pdf_field":""},{"help":"Enter start and end dates of the policy period","type":"date","label":"Policy Period","options":[],"required":true,"pdf_field":""},{"help":"Select one cover option applicable to your claim","type":"choice","label":"Please select the COVER under which you want to register a Claim.","options":["Theft of Funds","Identity Theft","Data Restoration / Malware Decontamination","Cyber Bullying, Stalking, and loss of Reputation","Cyber Extortion","Online Shopping","Online Sales","Social Media and Media Liability","Network Security Liability","Privacy Breach and Data Breach liability","Privacy Breach and Data Breach by third party","Smart Home Cover","Liability for intentional mis-behavior of underage persons"],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"Details of Cyber Event","fields":[{"help":"Provide exact date and description of how you discovered the loss","type":"text","label":"Please mention the date and circumstances under said loss due to Cyber Event was discovered by you.","options":[],"required":true,"pdf_field":""},{"help":"Attach FIR copy if Yes","type":"yes-no","label":"Have you reported the Cyber Event to the Police Authority/Cyber Cell? If Yes, please provide a copy of FIR","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Attach court summons if Yes","type":"yes-no","label":"Have you received any court summons? If Yes, please provide copy of court summons","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide lawyer details if Yes","type":"yes-no","label":"Have you appointed any lawyer for your defense? If Yes, please provide details","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide dates and transport expenses if Yes","type":"yes-no","label":"Have you attended any court hearings in response to the court summons? If Yes, please provide the dates of court hearings and expenses incurred on transportation for attending court hearings","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide photocopying expense details if Yes","type":"yes-no","label":"Have you incurred any expenses on photocopying of documents for submission to the court? If Yes, please provide details","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide case and lawyer details if Yes","type":"yes-no","label":"Have you lodged a criminal case against Third Party for Cyber Event? If Yes, please provide details of the case including the name of the lawyer appointed by you for prosecuting the criminal case","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Enter estimated amount in INR","type":"amount","label":"What is the estimated claim amount?","options":[],"required":true,"pdf_field":""},{"help":"Describe the event in detail","type":"text","label":"Please explain the circumstances of the Cyber Event:","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"Details of Other Insurance / Interest","fields":[{"help":"Attach other insurance policy copy if Yes","type":"yes-no","label":"Is the loss/damage covered under any other Insurance (Yes) (No), If ‘Yes’, specify details and attach a copy of the policy","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Name of Insurer:","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Address :","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Policy No.:","options":[],"required":false,"pdf_field":""},{"help":"Enter start and end dates","type":"date","label":"Period of Insurance : to","options":[],"required":false,"pdf_field":""},{"help":"Enter sum insured amount in INR","type":"amount","label":"Sum Insured (Rs.):","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration and Signature","fields":[{"help":"Date of signing the form","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Place of signing the form","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of the Insured","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Claims under Cyber VaultEdge policy covers including theft of funds, identity theft, data restoration, cyber bullying, cyber extortion, online shopping and sales, social media liability, network security liability, privacy breach, smart home cover, and liability for underage persons' misbehavior.","attachments":["Copy of FIR if reported to Police/Cyber Cell","Copy of court summons if received","Details and documents of lawyer appointed if any","Copy of other insurance policy if applicable"],"declarations":["The insured warrants the truth of all statements made in this form to the best of their knowledge and belief.","If any false or fraudulent statement or concealment is made, the claim shall be forfeited and the policy null and void.","The insured has received and understood the list of documents required for claim administration.","The company is not responsible for delays due to non-fulfillment of requirements including documents."],"dropped_labels":1},"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/1108-claim-form-cyber-vaultedge"}