{"id":1196,"title":"Shri Shopkeeper Package Insurance Policy: Retail 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_Policy_(Retail)Claim_Form.pdf","sha256":"b5497f7fb7cc0b63c67a5e5fe95c4ad810e06c15026d6cc7edb5a5d3637ee087","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured policyholder to file a claim under the Shri Shopkeeper Package Insurance Policy: Retail.","notes":["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":"Shri Shopkeeper Package Insurance Policy: Retail Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"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":"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":["1. Shri Bharat Sookshma Udyam Suraksha Policy","2. Burglary Insurance","3. Personal Accident Insurance","4. Employee’s Compensation Insurance","5. Plate Glass and / or Sanitary Fittings Insurance Policy","6. All Risk Insurance","7. Machinery Breakdown Insurance Policy","8. Electronic Equipment Insurance Policy","9. Baggage Insurance","10. Public Liability (Non-Industrial) Insurance Policy","11. Money Insurance Policy","12. Fire loss of Profit Policy","13. Fidelity Guarantee Policy","14. 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":"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":"Estimate of Loss","fields":[{"help":"Description of contents lost or damaged","type":"text","label":"Contents","options":[],"required":null,"pdf_field":""},{"help":"Description of other items lost or damaged","type":"text","label":"Others (furniture/fixture/fittings if owned by insured)","options":[],"required":null,"pdf_field":""},{"help":"Total estimated loss amount","type":"amount","label":"Total","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration and Signature","fields":[{"help":"Date of signing the form","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Place of signing the form","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Signature of the insured person","type":"signature","label":"Signature of the Insured","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"claims under Shri Shopkeeper Package Insurance Policy: Retail","attachments":["Relevant claim form for each section"],"declarations":["The issue of this form is not to be taken as an admission of liability.","The undersigned confirms that the above given details 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/1196-shri-shopkeeper-package-insurance-policy-retail-claim-form"}