{"id":1145,"title":"CYBER DEFENSE INSURANCE CLAIM FORM","purpose":"claim","insurer":{"slug":"sbi-general-insurance","name":"SBI General Insurance Company Limited"},"source_pdf":"https://content.sbigeneral.in/uploads/d7efe2b4dafb4de48849b5271e36c7d3.pdf","sha256":"de85e77c7aa56abba60570c4103c5374247314a8ef01443d7d4c79e2c593e1c4","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured policyholder to file a claim under the Cyber Defense Insurance policy for losses due to cyber events.","notes":["Please read the claim form fully before answering all questions.","Use additional sheets if necessary.","Attach copies of relevant documentation.","Send the completed claim form as soon as possible.","Do not appoint legal representatives without prior consent of the insurer."],"title":"CYBER DEFENSE INSURANCE CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Policy Details","fields":[{"help":"","type":"text","label":"Policy Number","options":[],"required":null,"pdf_field":""},{"help":"Enter start and end dates of the policy period","type":"text","label":"Period of Insurance","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Claim Number","options":[],"required":null,"pdf_field":""},{"help":"Enter the retroactive date if applicable","type":"date","label":"Retroactive date, if any","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Policy","fields":[{"help":"","type":"text","label":"Name of the Insured","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Policy Number","options":[],"required":null,"pdf_field":""},{"help":"Enter the policy start and end dates","type":"text","label":"Policy Period","options":[],"required":null,"pdf_field":""},{"help":"Select one cover type under which the claim is being made","type":"choice","label":"Please select the COVER under which you want to register a Claim. (Any One)","options":["Privacy Breach","System Damage","Business Interruption","Computer Virus Transmission and Hacking","Multimedia Liability","Breach of Statutory Duties Relating to E-Commerce","Cyber Extortion Cover"],"required":true,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Claim Details","fields":[{"help":"Provide the date and details of how the cyber event loss was discovered","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":"Indicate if the event was reported to police and attach FIR 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":"Indicate if any third party has claimed legal liability and provide details if yes","type":"yes-no","label":"Has any Affected Person or Third Party lodged a claim against you for legal liability directly resulting from Cyber Event If Yes, please provide details","options":["YES","No"],"required":true,"pdf_field":""},{"help":"Indicate if court summons received and attach copy 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":"Indicate if a lawyer was appointed and provide 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":"Indicate attendance at court hearings and 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":"Indicate if photocopying expenses were incurred and provide 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":"Indicate if a criminal case was lodged and provide details and lawyer name 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":"Provide the estimated amount being claimed","type":"amount","label":"What is the estimated claim amount?","options":[],"required":true,"pdf_field":""},{"help":"Describe the details and circumstances of the cyber event","type":"text","label":"Please explain the circumstances of the Cyber Event:","options":[],"required":true,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Details of Other Insurance/Interest","fields":[{"help":"Indicate if other insurance covers the loss and provide details if yes","type":"choice","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":"Provide name of other insurer if applicable","type":"text","label":"Name of Insurer","options":[],"required":false,"pdf_field":""},{"help":"Provide address of other insurer if applicable","type":"text","label":"Address","options":[],"required":false,"pdf_field":""},{"help":"Provide policy number of other insurance if applicable","type":"text","label":"Policy No.","options":[],"required":false,"pdf_field":""},{"help":"Provide period of other insurance if applicable","type":"text","label":"Period of Insurance","options":[],"required":false,"pdf_field":""},{"help":"Provide sum insured under other insurance if applicable","type":"amount","label":"Sum Insured (Rs.)","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Declaration and Signature","fields":[{"help":"Enter place of signing","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 date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""}],"filled_by":"policyholder"}],"deadlines":[],"applies_to":"Claims under Cyber Defense Insurance covers","attachments":["Copy of FIR if reported to Police Authority/Cyber Cell","Copy of court summons if received","Details of lawyer appointed for defense if any","Details of court hearings and transport expenses if attended","Details of photocopying expenses if incurred","Details of criminal case and lawyer appointed if lodged","Copy of other insurance policy if loss covered under other insurance"],"declarations":["The insured warrants the truth of all statements and understands that false or fraudulent statements will forfeit the claim and policy.","The insured acknowledges receipt of the list of required documents and understands that non-fulfillment may delay claim settlement."],"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/1145-cyber-defense-insurance-claim-form"}