{"id":1179,"title":"Annexure-II Business Protector Claim Form","purpose":"claim","insurer":{"slug":"shriram-general-insurance","name":"Shriram General Insurance Company Limited"},"source_pdf":"https://cdn.shriramgi.com/webassets/download/claim/Business-Protector-Claim-Form.pdf","sha256":"966eee85d4b0e80d17bcf972d0af794ada133b2dd556019a911490842d2618da","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is for the insured to claim losses under the Business Protector Policy by providing details of the loss and previous insurances.","notes":["The issue of this form is not to be taken as an admission of liability.","Please ensure that all columns of the claim forms are filled in by the insured and no column remains unanswered.","Attach separate sheet if the space is not sufficient."],"title":"Annexure-II Business Protector Claim Form","submit":{"to":"Shriram General Insurance Company Ltd. Head Office– E-8, EPIP, RIICO Industrial Area, Jaipur-302022","how":"","address":""},"purpose":"claim","sections":[{"title":"INSURED DETAILS","fields":[{"help":"","type":"text","label":"Policy Number","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Claim Number","options":[],"required":false,"pdf_field":""},{"help":"Enter the insurance coverage period","type":"text","label":"Period of Insurance","options":[],"required":true,"pdf_field":""},{"help":"Name of the insured","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"Full postal address of the insured","type":"text","label":"Address","options":[],"required":true,"pdf_field":""},{"help":"Landline number if available","type":"phone","label":"Contact Number Landline","options":[],"required":false,"pdf_field":""},{"help":"Email address of the insured","type":"email","label":"E-mail","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"CLAIM LODGED UNDER WHICH SECTION OF THE POLICY","fields":[{"help":"Select the section under which the claim is lodged","type":"choice","label":"Section","options":["1. Fire & Allied Perils","2. Burglary","3. Glass & Sanitary Fittings","4. Neon Sign/ Glow Sign/ Hoardings","5. Machinery Breakdown","6. Electronic Equipment Insurance","7. Portable Electronic Equipment","8. Money Insurance","9. Baggage Insurance","10. Fidelity Guarantee","11. Public Liability","12. Personal Accident"],"required":true,"pdf_field":""},{"help":"Enter the amount of loss for the selected section","type":"amount","label":"Amount of Loss","options":[],"required":true,"pdf_field":""},{"help":"Brief description of the loss","type":"text","label":"Description of Loss","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"DETAILS OF PREVIOUS LOSS","fields":[{"help":"Date when the previous loss occurred","type":"date","label":"Date of Loss","options":[],"required":false,"pdf_field":""},{"help":"Amount of previous loss","type":"amount","label":"Amount of Loss","options":[],"required":false,"pdf_field":""},{"help":"Insurance company for previous loss","type":"text","label":"Name of Insurance Company","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"DETAILS OF OTHER INSURANCES AND CO-INSURANCES, IF ANY","fields":[{"help":"Name of other insurer or co-insurer","type":"text","label":"Name of the Company","options":[],"required":false,"pdf_field":""},{"help":"Policy number of other insurance","type":"text","label":"Policy Number","options":[],"required":false,"pdf_field":""},{"help":"Sum insured under other policies","type":"amount","label":"Sum Insured","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"ESTIMATE OF LOSS","fields":[{"help":"Provide estimated loss values for contents and other items owned by insured","type":"table","label":"Contents, Others (furniture/fixture/fittings if owned by insured), Total","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Business Protector Policy claims","attachments":["Relevant claim form for each section"],"declarations":["The undersigned confirms that the details provided are true and correct to the best of their knowledge."],"dropped_labels":1},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"chd@shriramgi.com","label":"Help Desk Email ID for claim intimation","level":null,"hours":null,"applies_to":"all","source_url":"https://www.shriramgi.com/claims","quote":"ase download the CLAIM INTIMATION SHEET, fill it and send it to our Help\n                            Desk via Email ID (chd@shriramgi.com)\nNote:\nPlease ensure that the following information is ready with you at the time of\n                            claim","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800-300-30000","label":"Customer Help Desk Toll Free","level":null,"hours":"7 Days in week 4:00 AM to Midnight 12:00","applies_to":"all","source_url":"https://www.shriramgi.com/claims","quote":"Option 1:\nIntimate a claim online on Shriram General Insurance website or over the\n                            phone at 1800-300-30000/1800-103-3009 or through the MYSGI App\nOption 2:\nPlease download the CLAIM INTIMATION SHEET, fill it and send it to our","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800-103-3009","label":"Customer Help Desk Toll Free","level":null,"hours":"7 Days in week 9:30 am to 5:30 pm","applies_to":"all","source_url":"https://www.shriramgi.com/claims","quote":"ate a claim online on Shriram General Insurance website or over the\n                            phone at 1800-300-30000/1800-103-3009 or through the MYSGI App\nOption 2:\nPlease download the CLAIM INTIMATION SHEET, fill it and send it to our Help","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/shriram-general-insurance/1179-annexure-ii-business-protector-claim-form"}