{"id":1144,"title":"CLAIM FORM — TRADE CREDIT INSURANCE","purpose":"claim","insurer":{"slug":"sbi-general-insurance","name":"SBI General Insurance Company Limited"},"source_pdf":"https://content.sbigeneral.in/uploads/3d1b9652a5624faba57ffd20f7d2f103.pdf","sha256":"d92eadf50d976a4f18cd473ee8ebbd5738a3abaf80d3d169b66ec249df9d74f6","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured policyholder to notify and claim for overdue payments under their trade credit insurance policy.","notes":["Issue of this claim form is not to be taken as an admission of liability.","Submit the specified documents together with the notification of overdue account form.","Intervention fee is payable."],"title":"CLAIM FORM — TRADE CREDIT INSURANCE","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Details of Insured/Claimant","fields":[{"help":"Enter the date when the claim is being made","type":"date","label":"Date claim made","options":[],"required":null,"pdf_field":""},{"help":"Enter the full name of the insured party","type":"text","label":"Name of the Insured","options":[],"required":null,"pdf_field":""},{"help":"Enter the insured's address","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"Enter the city of the insured","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"Enter the state of the insured","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"Enter the postal pin code","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Enter the phone number","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Enter the mobile number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Enter the email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"Describe the trade or business of the insured","type":"text","label":"Trade or Business","options":[],"required":null,"pdf_field":""},{"help":"Enter the date when the last premium was paid","type":"date","label":"Date of Last Premium Paid","options":[],"required":null,"pdf_field":""},{"help":"Enter the insurance policy number","type":"text","label":"Policy Number","options":[],"required":null,"pdf_field":""},{"help":"Enter the insurance coverage period","type":"text","label":"Period of Insurance","options":[],"required":null,"pdf_field":""},{"help":"Enter the claim number if already assigned","type":"text","label":"Claim Number","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"Details of Loss","fields":[{"help":"Enter invoice reference number","type":"text","label":"Invoice Ref","options":[],"required":null,"pdf_field":""},{"help":"Enter invoice date","type":"date","label":"Inv. date","options":[],"required":null,"pdf_field":""},{"help":"Enter payment due date","type":"date","label":"Due Date","options":[],"required":null,"pdf_field":""},{"help":"Enter currency code","type":"text","label":"Cur","options":[],"required":null,"pdf_field":""},{"help":"Enter invoice amount","type":"amount","label":"Amount","options":[],"required":null,"pdf_field":""},{"help":"Enter any remarks related to the invoice or payment","type":"text","label":"Remarks","options":[],"required":false,"pdf_field":""},{"help":"Enter the net outstanding amount excluding tax or VAT","type":"amount","label":"Net Outstanding Amount (As per the Statement Of Account) (Excluding tax/VAT if any)","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Reasons for Non Payment and Other Details","fields":[{"help":"Select the reason(s) for non-payment; specify if 'Others'","type":"choice","label":"Reasons for Non Payment","options":["Cash Flow problem","Insolvency","Bank transfer delay","Trade Dispute","Others (specify)"],"required":null,"pdf_field":""},{"help":"Provide any additional relevant details","type":"text","label":"Other details","options":[],"required":false,"pdf_field":""},{"help":"Describe actions taken to recover the debt","type":"text","label":"Measures taken so far to effect recovery","options":[],"required":false,"pdf_field":""},{"help":"List any securities held as collateral","type":"text","label":"Securities held against the debtor","options":[],"required":false,"pdf_field":""},{"help":"Enter the usual payment terms in days","type":"number","label":"What is the usual terms of payment given to the buyer? days","options":[],"required":null,"pdf_field":""},{"help":"Indicate if an extension of terms was previously requested","type":"yes-no","label":"Have you applied for an extension of terms with this buyer previously?","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration and Signature","fields":[{"help":"Enter the place where the form is signed","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Sign and affix company seal","type":"signature","label":"Insured's Signature with Company Seal","options":[],"required":true,"pdf_field":""},{"help":"Enter the date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Trade credit insurance claims for overdue payments","attachments":["Invoices","Sales contract/purchase order","Statement of account","Bill of Lading / Delivery Receipt"],"declarations":["The insured must declare the full debt exposure on the buyer even for invoices not yet due.","If any false or fraudulent statement or concealment is made, the claim will be forfeited and the policy null and void."],"dropped_labels":2},"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/1144-claim-form-trade-credit-insurance"}