{"id":1130,"title":"SBI General Bharat Laghu Udyam Suraksha – Claim Form","purpose":"claim","insurer":{"slug":"sbi-general-insurance","name":"SBI General Insurance Company Limited"},"source_pdf":"https://content.sbigeneral.in/uploads/78e271d2434c42fc82da0cd14d2f3b97.pdf","sha256":"d348b6a205e141157a97acbdfd13b6b1a5d0925937a8b3490fbec96c809c1614","pages":6,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured or claimant to report and claim losses under the SBI General Bharat Laghu Udyam Suraksha insurance policy.","notes":["If any detail or information is not readily available, do not delay dispatch of this form; such particulars may be sent later."],"title":"SBI General Bharat Laghu Udyam Suraksha – Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"A. DETAILS OF INSURED/CLAIMANT","fields":[{"help":"Enter your insurance policy number","type":"text","label":"Policy Number","options":[],"required":null,"pdf_field":""},{"help":"Enter start and end dates of the insurance coverage","type":"date","label":"Period of Insurance","options":[],"required":null,"pdf_field":""},{"help":"If available, enter the claim number","type":"text","label":"Claim Number","options":[],"required":null,"pdf_field":""},{"help":"Enter the name exactly as on the policy","type":"text","label":"Name as per policy","options":[],"required":null,"pdf_field":""},{"help":"Enter full address","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"Enter city name","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"Enter state name","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"Enter postal pin code","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Enter phone number","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Enter mobile number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Enter email address","type":"email","label":"Email 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":"Enter the date when the loss occurred","type":"date","label":"Date of Loss","options":[],"required":null,"pdf_field":""},{"help":"Enter time of loss and specify A.M. or P.M.","type":"text","label":"Time of Loss","options":["A.M.","P.M."],"required":null,"pdf_field":""},{"help":"Enter full address where loss occurred","type":"text","label":"Loss Location Address","options":[],"required":null,"pdf_field":""},{"help":"Enter city of loss location","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"Enter state of loss location","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"Enter pin code of loss location","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Name of contact person at loss location","type":"text","label":"Contact Details of person/s at Loss Location - Name","options":[],"required":null,"pdf_field":""},{"help":"Specify relationship to insured","type":"text","label":"Relationship with Insured","options":[],"required":null,"pdf_field":""},{"help":"Phone number of contact person","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Mobile number of contact person","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Email ID of contact person","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"Describe how the loss or damage happened","type":"text","label":"Describe Cause of Loss/Damage","options":[],"required":null,"pdf_field":""},{"help":"Estimate the monetary value of the loss","type":"amount","label":"Estimated Loss (Rs.)","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"Loss Details","fields":[{"help":"Enter estimated loss value for building","type":"amount","label":"(a) Building","options":[],"required":null,"pdf_field":""},{"help":"Enter estimated loss value for Plant & Machinery","type":"amount","label":"(b) P&M","options":[],"required":null,"pdf_field":""},{"help":"Enter estimated loss value for Furniture, Fixtures & Fittings","type":"amount","label":"(c) FFF","options":[],"required":null,"pdf_field":""},{"help":"Enter estimated loss value for stocks","type":"amount","label":"(d) Stocks","options":[],"required":null,"pdf_field":""},{"help":"Enter estimated loss value for other items 1","type":"amount","label":"(e) Others1","options":[],"required":null,"pdf_field":""},{"help":"Enter estimated loss value for other items 2","type":"amount","label":"(f) Others2","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"WITNESS DETAILS AND INFORMATION TO AUTHORITY","fields":[{"help":"Indicate if there were witnesses","type":"yes-no","label":"Were there any witnesses to the loss / accident?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Enter names of witnesses if any","type":"text","label":"Name of Person/s","options":[],"required":null,"pdf_field":""},{"help":"Enter address of witnesses","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"City of witnesses","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"State of witnesses","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"Pin code of witnesses","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Phone number of witnesses","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Mobile number of witnesses","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Indicate if loss was reported to any authority","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":null,"pdf_field":""},{"help":"Select the authority to which loss was reported","type":"choice","label":"If “Yes”, provide details (Fire / Police / Municipality / Other)","options":["Fire","Police","Municipality","Other"],"required":null,"pdf_field":""},{"help":"Name of the authority reported to","type":"text","label":"Name of Authority","options":[],"required":null,"pdf_field":""},{"help":"Enter report or reference number and date","type":"text","label":"Information Report No./Authority Reference No. and Date","options":[],"required":null,"pdf_field":""},{"help":"Name of contact person at authority","type":"text","label":"Contact Person/s","options":[],"required":null,"pdf_field":""},{"help":"Address of authority or contact person","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"City of authority","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"State of authority","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"Pin code of authority","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Phone number of authority","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Mobile number of authority","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Email ID of authority","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"C. DETAILS OF OTHER INSURANCE","fields":[{"help":"Indicate if other insurance covers the loss","type":"yes-no","label":"Is the loss/damage covered under any other Insurance","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Name of other insurance company","type":"text","label":"Name of Insurer","options":[],"required":null,"pdf_field":""},{"help":"Address of other insurer","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"City of other insurer","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"State of other insurer","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"Pin code of other insurer","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Phone number of other insurer","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Mobile number of other insurer","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Email ID of other insurer","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"Policy number of other insurance","type":"text","label":"Policy No.","options":[],"required":null,"pdf_field":""},{"help":"Start and end dates of other insurance","type":"date","label":"Period of Insurance","options":[],"required":null,"pdf_field":""},{"help":"Sum insured under other policy","type":"amount","label":"Sum Insured (Rs.)","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"D. DETAILS OF OTHER INTEREST","fields":[{"help":"Indicate if you are sole owner","type":"yes-no","label":"Is the Insured the Sole Owner of the property?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Describe nature of interest if not sole owner","type":"text","label":"Nature of Interest","options":[],"required":null,"pdf_field":""},{"help":"Name persons with interest on property","type":"text","label":"Person/s who has/have interest on property","options":[],"required":null,"pdf_field":""},{"help":"Address of persons with interest","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"City of persons with interest","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"State of persons with interest","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"Pin code of persons with interest","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Phone number of persons with interest","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Mobile number of persons with interest","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Email ID of persons with interest","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"E. 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":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"F. DETAILS OF OTHER INFORMATION","fields":[{"help":"Indicate if you want to provide additional information","type":"yes-no","label":"Do you wish to provide any other information?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide any other relevant information","type":"text","label":"If ‘Yes’, specify","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"Declaration and Signature","fields":[{"help":"Enter place of signing","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Sign the form","type":"signature","label":"Signature","options":[],"required":null,"pdf_field":""},{"help":"Enter date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Print your name","type":"text","label":"Name of Insured/Claimant","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"}],"deadlines":[],"applies_to":"claims under the SBI General Bharat Laghu Udyam Suraksha policy","attachments":["copy of other insurance policy if loss/damage is covered under any other insurance"],"declarations":["The claimant warrants the truth of the statements made in the 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."],"dropped_labels":0},"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/1130-sbi-general-bharat-laghu-udyam-suraksha-claim-form"}