{"id":1181,"title":"Annexure - II Shri Shopkeeper Package Insurance Co. Ltd. Claim Form","purpose":"claim","insurer":{"slug":"shriram-general-insurance","name":"Shriram General Insurance Company Limited"},"source_pdf":"https://cdn.shriramgi.com/webassets/download/claim/Shri-Shopkeeper-Package-Insurance-Policy-Claim-Form.pdf","sha256":"cc531d09da7019e573b957cb81c2cff88052be08d9ceb570479130bb459a52b8","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured to file a claim under the Shri Shopkeeper Package Insurance Policy with Shriram General Insurance Co. Ltd.","notes":["The issue of this form is not to be taken as an admission of liability.","Ensure all columns of the claim form are filled and no column remains unanswered.","Attach separate sheet if space is insufficient."],"title":"Annexure - II Shri Shopkeeper Package Insurance Co. Ltd. Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"1. INSURED DETAILS","fields":[{"help":"","type":"text","label":"Policy Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Claim Number","options":[],"required":null,"pdf_field":""},{"help":"Enter the insurance coverage period","type":"text","label":"Period of Insurance","options":[],"required":null,"pdf_field":""},{"help":"Name of the insured","type":"text","label":"Name","options":[],"required":null,"pdf_field":""},{"help":"Full postal address of the insured","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"Landline phone number","type":"phone","label":"Contact Number Landline","options":[],"required":null,"pdf_field":""},{"help":"Email address of the insured","type":"email","label":"E-mail","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"2. CLAIM LODGED UNDER WHICH SECTION OF THE POLICY","fields":[{"help":"Select the policy section under which the claim is made","type":"choice","label":"Section","options":["Standard Fire & Special Perils Policy","Burglary Insurance","Personal Accident Insurance","Employee’s Compensation Insurance","Plate Glass and / or Sanitary Fittings Insurance Policy","All Risk Insurance","Machinery Breakdown Insurance Policy","Electronic Equipment Insurance Policy","Baggage Insurance","Public Liability (Non-Industrial) Insurance Policy","Money Insurance Policy","Fire loss of Profit Policy","Fidelity Guarantee Policy","Neon Sign/Glow Sign/Hoarding Insurance Policy"],"required":null,"pdf_field":""},{"help":"Enter the amount of loss for the selected section","type":"amount","label":"Amount of Loss","options":[],"required":null,"pdf_field":""},{"help":"Brief description of the loss","type":"text","label":"Description of Loss","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"3. DETAILS OF PREVIOUS LOSS","fields":[{"help":"Date of any previous loss","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":"4. ESTIMATE OF LOSS","fields":[{"help":"Estimated loss value of contents","type":"amount","label":"Contents","options":[],"required":null,"pdf_field":""},{"help":"Estimated loss value of furniture, fixtures, fittings","type":"amount","label":"Others (furniture/fixture/fittings if owned by insured)","options":[],"required":null,"pdf_field":""},{"help":"Total estimated loss","type":"amount","label":"Total","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"claims under Shri Shopkeeper Package Insurance Policy","attachments":["Please attach relevant claim form for each section"],"declarations":["The undersigned confirms that the details given 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/1181-annexure-ii-shri-shopkeeper-package-insurance-co-ltd-claim-form"}