{"id":1119,"title":"MONEY INSURANCE POLICY Claim Form","purpose":"claim","insurer":{"slug":"sbi-general-insurance","name":"SBI General Insurance Company Limited"},"source_pdf":"https://content.sbigeneral.in/uploads/e5e8d5e721584785aad58604d03c8178.pdf","sha256":"635a4d53ad301a50cfae5acbe0b49dad64d39361902888e63c48b6a282205134","pages":4,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured or claimant to report and claim for loss of money under a money insurance policy.","notes":["Issue of this claim form is not to be taken as an admission of liability.","If any detail or information is not readily available, do not delay dispatch of this form; such particulars may be sent later."],"title":"MONEY INSURANCE POLICY Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"A. DETAILS OF INSURED/CLAIMANT","fields":[{"help":"","type":"text","label":"Name as per Policy","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Policy No.","options":[],"required":null,"pdf_field":""},{"help":"Enter start and end dates of the insurance period","type":"date","label":"Period of Insurance   From                                                       To","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Claim No.","options":[],"required":null,"pdf_field":""},{"help":"Fill full postal address","type":"text","label":"Address (Plot No/Door No., Building Name, Road, Area, City, Pincode, State)","options":[],"required":null,"pdf_field":""},{"help":"Provide contact phone numbers and email","type":"text","label":"Contact Details (Phone No., Mobile, E-mail Id)","options":[],"required":null,"pdf_field":""},{"help":"Describe your business or occupation briefly","type":"text","label":"Brief Description of Business /Office/Industry/Occupation","options":[],"required":null,"pdf_field":""},{"help":"Enter the indemnity limit as per policy","type":"amount","label":"Limits of Indemnity under the Policy (Rs.)","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"B. DETAILS OF LOSS/ACCIDENT","fields":[{"help":"Date when the loss occurred","type":"date","label":"Date of Loss","options":[],"required":null,"pdf_field":""},{"help":"Time of loss with a.m./p.m.","type":"text","label":"Time of Loss","options":[],"required":null,"pdf_field":""},{"help":"Provide contact details of witnesses or persons at loss location","type":"text","label":"Contact Details of person/s at Loss Location (Name, Relationship with Insured, Phone No., Mobile, E-mail Id)","options":[],"required":null,"pdf_field":""},{"help":"Explain how the loss or damage occurred","type":"text","label":"Describe Cause of Loss/Damage","options":[],"required":null,"pdf_field":""},{"help":"Estimate the amount lost","type":"amount","label":"Estimated Loss (Rs.)","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"WITNESS DETAILS","fields":[{"help":"","type":"yes-no","label":"Were there any witnesses to the loss/accident?","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"INFORMATION TO AUTHORITY","fields":[{"help":"","type":"yes-no","label":"Has the loss been reported to an Authority?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Explain why loss was not reported if applicable","type":"text","label":"If 'No', reason for not reporting","options":[],"required":false,"pdf_field":""},{"help":"Select authority to which loss was reported","type":"choice","label":"If 'Yes', provide details (Fire, Police, Municipality, Other)","options":["Fire","Police","Municipality","Other"],"required":false,"pdf_field":""},{"help":"Name of the authority reported to","type":"text","label":"Name of Authority","options":[],"required":false,"pdf_field":""},{"help":"Report or reference number and date from authority","type":"text","label":"Information Report No./Date / Authority Reference No.","options":[],"required":false,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"C. DETAILS OF OTHER INSURANCE","fields":[{"help":"","type":"yes-no","label":"Is the loss/damage covered under any other Insurance?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details of other insurance and attach copy","type":"text","label":"If 'Yes', specify details and attach a copy of the policy","options":[],"required":false,"pdf_field":""},{"help":"Name of other insurer","type":"text","label":"Name of Insurer","options":[],"required":false,"pdf_field":""},{"help":"Policy number of other insurance","type":"text","label":"Policy No.","options":[],"required":false,"pdf_field":""},{"help":"Period of other insurance","type":"date","label":"Period of Insurance From To","options":[],"required":false,"pdf_field":""},{"help":"Sum insured under other policy","type":"amount","label":"Sum Insured (Rs.)","options":[],"required":false,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"E. DETAILS OF MONEY IN TRANSIT","fields":[{"help":"","type":"choice","label":"Was the Money in Safe or Transit?","options":["Safe","Transit"],"required":null,"pdf_field":""},{"help":"Select who was carrying the money","type":"choice","label":"Money was being carried by","options":["Self","Employee","Other (Specify)"],"required":null,"pdf_field":""},{"help":"Name of employee carrying money if applicable","type":"text","label":"Name of Employee","options":[],"required":false,"pdf_field":""},{"help":"Date employee was employed since","type":"date","label":"Employed Since","options":[],"required":false,"pdf_field":""},{"help":"Employee's designation","type":"text","label":"Designation","options":[],"required":false,"pdf_field":""},{"help":"Employee number if any","type":"text","label":"Employee No.","options":[],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Was the employee covered under Fidelity Guarantee Policy?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Details of fidelity guarantee policy if applicable","type":"text","label":"If 'Yes' specify","options":[],"required":false,"pdf_field":""},{"help":"Insurer of fidelity guarantee policy","type":"text","label":"Name of Insurer","options":[],"required":false,"pdf_field":""},{"help":"Policy number of fidelity guarantee","type":"text","label":"Policy No.","options":[],"required":false,"pdf_field":""},{"help":"Period of fidelity guarantee insurance","type":"date","label":"Period of Insurance From To","options":[],"required":false,"pdf_field":""},{"help":"Sum insured under fidelity guarantee policy","type":"amount","label":"Sum Insured (Rs.)","options":[],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Was the money in conveyance accompanied with armed guard/s?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Describe protection if no armed guard","type":"text","label":"If 'No' state what protection, if any, was provided","options":[],"required":false,"pdf_field":""},{"help":"Describe the containers and quantity used to carry money","type":"text","label":"How was the money being carried (in bags, trunks, chests etc… and in how many such (bags, trunks, chests, etc.)?","options":[],"required":false,"pdf_field":""},{"help":"Select mode of transport used","type":"choice","label":"State Mode of Conveyance","options":["Own Transport","Private Transport","Public Transport (specify)"],"required":false,"pdf_field":""},{"help":"Provide number of persons and vehicle registration number","type":"text","label":"If Own Transport and Private Transport, No. of persons travelling at the time of incidence and registration no. of the vehicle","options":[],"required":false,"pdf_field":""},{"help":"Specify start and end points of transit","type":"text","label":"Places between which money was in transit? From To","options":[],"required":false,"pdf_field":""},{"help":"Explain how the loss happened","type":"text","label":"Give circumstances leading to loss","options":[],"required":false,"pdf_field":""},{"help":"State the origin of the money","type":"text","label":"Specify the source of money being conveyed","options":[],"required":false,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"D. DETAILS OF OTHER INTEREST","fields":[{"help":"","type":"yes-no","label":"Is the Insured the Sole Owner of the property?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Specify other interested parties if not sole owner","type":"text","label":"If 'No', specify","options":[],"required":false,"pdf_field":""},{"help":"Describe nature of interest of other parties","type":"text","label":"Nature of Interest","options":[],"required":false,"pdf_field":""},{"help":"Names of persons with interest","type":"text","label":"Person/s who has/have interest on property","options":[],"required":false,"pdf_field":""},{"help":"Address of interested persons","type":"text","label":"Address (Plot No/Door No., Building Name, Road, Area, City, Pincode, State)","options":[],"required":false,"pdf_field":""},{"help":"Contact details of interested persons","type":"text","label":"Contact Details (Phone No., Mobile, E-mail Id)","options":[],"required":false,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"F. DETAILS OF PREVIOUS LOSSES","fields":[{"help":"List previous losses with date, description, value and insurer","type":"table","label":"Losses during the 3 preceding years (Date of Loss, Claim Description and Cause of Loss, Value of Loss (Rs.), Insurer)","options":[],"required":false,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"G. DETAILS OF OTHER INFORMATION","fields":[{"help":"","type":"yes-no","label":"Do you wish to provide any other information?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Additional information if any","type":"text","label":"If 'Yes', specify","options":[],"required":false,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"Declaration and Signature","fields":[{"help":"Place where form is signed","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Print name of signer","type":"text","label":"Name of Insured/Claimant","options":[],"required":true,"pdf_field":""}],"filled_by":"insured/claimant"}],"deadlines":[],"applies_to":"Money insurance claims","attachments":["Copy of other insurance policy if loss is covered under any other insurance"],"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, suppression or concealment is made, the claim shall be forfeited and the policy null and void."],"dropped_labels":14},"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/1119-money-insurance-policy-claim-form"}