{"id":1259,"title":"MULTI LINE PACKAGE CLAIM FORM","purpose":"claim","insurer":{"slug":"tata-aig-general-insurance","name":"Tata AIG General Insurance Company Limited"},"source_pdf":"https://www.tataaig.com/s3/Claims_Forms_industrial_package.pdf_d906c97e23.pdf","sha256":"51ce0bc5db4a05154416e427ad88d55ca1ca6121b6e9607f4a36927e241e4a45","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured to claim for loss or damage under a multi line package insurance policy. The policyholder fills it to notify the insurer about the loss and provide details.","notes":["Issuance of this form does not constitute admission of liability.","If any detail or information is not readily available, do not delay dispatch of this form; such particulars may be sent later."],"title":"MULTI LINE PACKAGE CLAIM FORM","submit":{"to":"Tata AIG General Insurance Company Ltd.","how":"","address":"Corporate Office : A-501, 5th Floor, Building No. 4, Infinity Park, Gen. A. K. Vaidya Marg, Dindoshi, Malad (East), Mumbai - 400 097."},"purpose":"claim","sections":[{"title":"INSURED","fields":[{"help":"","type":"text","label":"Name","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Telephone Number","options":[],"required":null,"pdf_field":""},{"help":"Start date of the insurance coverage","type":"date","label":"Period of Insurance From","options":[],"required":null,"pdf_field":""},{"help":"Occupation of the insured","type":"text","label":"Occupation","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"DETAILS OF THE PREMISES WHERE LOSS HAS OCCURRED","fields":[{"help":"Address of the premises where loss occurred","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"Postal code of the premises","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Purpose of the premises","type":"text","label":"What was the premises used for?","options":[],"required":null,"pdf_field":""},{"help":"Describe how entry or exit was made","type":"text","label":"How was the entry to/exit from the premises effected?","options":[],"required":null,"pdf_field":""},{"help":"Specify affected area","type":"text","label":"Which portion of the premises was affected by the entry or exit?","options":[],"required":null,"pdf_field":""},{"help":"State occupancy status and last occupied date/time if unoccupied","type":"text","label":"Whether the premises was occupied at the time of loss. If not, at what date and time was it last occupied?","options":[],"required":null,"pdf_field":""},{"help":"Answer ownership status for property and premises","type":"text","label":"Are you the sole owner of: a. The property lost or damaged? b. The premises?","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Are you responsible for repair of the premises?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Total value of property at loss time","type":"amount","label":"State the total value of property upon the premises at the time of loss.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"DETAILS OF THE LOSS","fields":[{"help":"When the loss happened","type":"date","label":"Date & Time of Loss.","options":[],"required":null,"pdf_field":""},{"help":"Date/time and person who discovered the loss","type":"text","label":"When discovered & by whom?","options":[],"required":null,"pdf_field":""},{"help":"Describe the loss incident and list damaged or stolen items on the back","type":"text","label":"Give brief details of how exactly the loss occurred. (Specify overleaf the property damaged/articles stolen ).","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Is anybody suspected in this incident?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Details of suspected persons if any","type":"text","label":"If Yes, state full details.","options":[],"required":null,"pdf_field":""},{"help":"Attach fire report if applicable","type":"yes-no","label":"Was information given to the Fire Brigade? If so when and by whom.(Attach Copy of the Fire Report)","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Has a complaint been lodged with the Police station?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Police complaint details and attach report if available","type":"text","label":"If Yes, by whom, when & at which Police station? (Attach a copy of the police report). If not, this may be done immediately.","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Has the police apprehended any person?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Details of apprehended persons if any","type":"text","label":"If yes, give details.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"DETAIL OF OTHER INSURANCES","fields":[{"help":"List other insurance policies covering this loss","type":"text","label":"Give details of other Insurance's, if any, covering the present loss.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"DETAILS OF PREVIOUS LOSSES","fields":[{"help":"List any prior losses on this property","type":"text","label":"Give details of Previous losses, if any, on the affected property.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"}],"deadlines":["duly completed form together with relevant vouchers, etc., must be returned within fourteen days of the loss"],"applies_to":"multi line package insurance claims","attachments":["relevant vouchers","copy of the Fire Report (if applicable)","copy of the police report (if applicable)"],"declarations":["The particulars given are true and correct in every respect.","The articles or properties described belong to the person(s) named with no other person having any interest."],"dropped_labels":1},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"address","value":"TATA AIG General Insurance Company Limited, 5th and 6th Floor, Imperial Towers, H.No 7-1-6-617/A, GHMC No - 615,616, Ameerpet, Hyderabad – 500016, Telangana","label":"Claims Submission Address","level":null,"hours":null,"applies_to":"health","source_url":"https://www.tataaig.com/s3/medicare_select_cis_e7df7ce2ec.pdf","quote":"tion or procedure. Submit claim documents within 15 days of occurrence of incident. Kindly send the claim documents to: TATA AIG General Insurance Company Limited, 5th and 6th Floor, Imperial Towers, H.No 7-1- 6-617/A, GHMC No - 615,616, Ameerpet, Hyderabad – 500016, Telangana, Phone-040-66864900 Assistance: 1. Website www.tataaig.com or Call 24*7 Customer Support No.: 022 6489 8282/1800 267 1","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"healthclaimsupport@tataaig.com","label":"Health Claims Support Email","level":null,"hours":null,"applies_to":"health","source_url":"https://www.tataaig.com/s3/medicare_select_prospectus_efd23b0ad6.pdf","quote":"al Towers, H.No 7-1-6-617/A, GHMC No - 615,616, Ameerpet, Hyderabad – 500016, Telangana, Phone: 040-66864900\nEmail ID | healthclaimsupport@tataaig.com\nCustomer Support Number: | 022 6489 8282 / 1800 267 1955 (nly for senior citizen policy holders)\nWebsite | www.tataaig.","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"040-66864900","label":"Claims Administrator Phone","level":null,"hours":null,"applies_to":"health","source_url":"https://www.tataaig.com/s3/medicare_select_prospectus_efd23b0ad6.pdf","quote":"th and 6th Floor, Imperial Towers, H.No 7-1-6-617/A, GHMC No - 615,616, Ameerpet, Hyderabad – 500016, Telangana, Phone: 040-66864900\nEmail ID | healthclaimsupport@tataaig.com\nCustomer Support Number: | 022 6489 8282 / 1800 267 1955 (nly for senior citi","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/tata-aig-general-insurance/1259-multi-line-package-claim-form"}