{"id":1265,"title":"MARINE 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_marine_open_policy.pdf_5e552b9c3d.pdf","sha256":"fd3f43596d43e506fd4fe04f937dd144c201313009ac0985bf289b9fc489fd6d","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured policyholder to claim for loss or damage of marine cargo covered under the insurance policy.","notes":["The issue of this form is not to be taken as an admission of liability","Notify the company without delay as soon as loss or damage is known","If any detail is not readily available, do not delay dispatch of this form; send particulars later"],"title":"MARINE CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"A. 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":"Enter the postal PIN code","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Include area code if applicable","type":"phone","label":"Telephone Number","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"B. DETAILS OF THE AFFECTED ITEM","fields":[{"help":"","type":"text","label":"Name of the Consignor","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":"Enter the postal PIN code","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Include full address","type":"text","label":"Name & Address of the Consignee","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":"Enter the postal PIN code","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Describe the goods","type":"text","label":"Nature of the Goods","options":[],"required":null,"pdf_field":""},{"help":"Include any identifying marks","type":"number","label":"Total number of Packages and/or cases dispatched with marks if any","options":[],"required":null,"pdf_field":""},{"help":"Provide all relevant transport document numbers and dates","type":"text","label":"Bill of Lading No./Air Way Bill No./Lorry Receipt No./Railway Receipt No. & Date (if multiple modes are involved, specify the details of all)","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Place of Dispatch","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Place of Destination","options":[],"required":null,"pdf_field":""},{"help":"Date when goods landed at final port","type":"date","label":"If by Steamer/Air - Date of Landing at Final Port","options":[],"required":null,"pdf_field":""},{"help":"Date customs clearance was obtained","type":"date","label":"Date of Clearance","options":[],"required":null,"pdf_field":""},{"help":"Date goods were dispatched to final destination","type":"date","label":"Date of dispatch to Final Destination, if any","options":[],"required":null,"pdf_field":""},{"help":"Explain any delay in customs clearance","type":"text","label":"Reasons for delay in clearance, if any","options":[],"required":false,"pdf_field":""},{"help":"Date goods were received at final destination","type":"date","label":"Date of receipt at Final Destination","options":[],"required":null,"pdf_field":""},{"help":"Explain any delay in taking delivery","type":"text","label":"Reasons for delay in taking delivery at Final Destination, if any","options":[],"required":false,"pdf_field":""},{"help":"Date goods received at final rail station","type":"date","label":"If by Rail: Date of Receipt at Final Station","options":[],"required":null,"pdf_field":""},{"help":"Date goods delivered from final station","type":"date","label":"Date of delivery from Final Station","options":[],"required":null,"pdf_field":""},{"help":"Explain any delay in delivery","type":"text","label":"Reasons for delay in taking delivery, if any","options":[],"required":false,"pdf_field":""},{"help":"Date goods dispatched to interior destination","type":"date","label":"Date of dispatch to Interior Destination","options":[],"required":false,"pdf_field":""},{"help":"Date goods received at interior destination","type":"date","label":"Date of receipt at Interior Destination","options":[],"required":false,"pdf_field":""},{"help":"Explain any delay in delivery at interior destination","type":"text","label":"Reasons for delay in taking delivery at Interior Destination","options":[],"required":false,"pdf_field":""},{"help":"Date loss or damage was first observed","type":"date","label":"Date when loss or damage noted","options":[],"required":null,"pdf_field":""},{"help":"Number of packages received","type":"number","label":"Number of Packages and/or cases, delivery taken of","options":[],"required":null,"pdf_field":""},{"help":"Number of packages not delivered","type":"number","label":"Number of Packages and/or cases not delivered by the Carriers (Steamer agents/Airport Authorities or Land Carriers)","options":[],"required":null,"pdf_field":""},{"help":"Describe the condition of received packages","type":"text","label":"Details of the Condition of the cases and/or packages taken delivery of","options":[],"required":null,"pdf_field":""},{"help":"Indicate if survey or open delivery was done and attach certificates","type":"yes-no","label":"State whether Steamer Survey held or Open delivery taken? If so, attach Certificates from the Carriers","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Indicate if claim was made against carrier","type":"yes-no","label":"Has Claim been made against the Carrier? (Note: The Claim has to be lodged within the stipulated timeframe)","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Explain why claim was not lodged if applicable","type":"text","label":"If Claim has not been lodged, state reasons for the same","options":[],"required":false,"pdf_field":""},{"help":"Provide details of customs examination and claims if damages noticed before clearance","type":"text","label":"If damages are noticed before Clearance for Home Consumption is issued, state details of Examination carried out by Customs and the claim made on them (Remission/Abatement)","options":[],"required":false,"pdf_field":""},{"help":"Enter the market value of undamaged goods","type":"amount","label":"Sound market value of the goods at the final Port of Discharge","options":[],"required":null,"pdf_field":""},{"help":"Enter customs duty payable on sound goods","type":"amount","label":"Duty Payable on Sound Goods","options":[],"required":null,"pdf_field":""},{"help":"Provide any additional relevant information","type":"text","label":"Any other information that may be relevant","options":[],"required":false,"pdf_field":""},{"help":"List other insurance policies covering the goods","type":"text","label":"Give details of other Insurances, if any, covering the affected property","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"}],"deadlines":["The Claim has to be lodged within the stipulated timeframe"],"applies_to":"","attachments":["Original Insurance Policy and/or Certificate duly endorsed","Complete Invoices together with Supplementary, if any and packing list","Original Bill Of Lading (for consignments by Sea/Air where damages noticed prior to removal to interior destination)","Original Lorry receipt/Rail receipt","Third copy of Bill of Entry","Open Delivery Certificate if it has been arranged","Landing Remarks Certificate","Steamer survey report, if it has been arranged","Copies of correspondence exchanged with the Carriers/Port Trust Authorities together with their replies in Original","Carriers' Certificate (Rail, Lorry, Post, Ship, Air) in original"],"declarations":["The insured declares that the answers given are conscientious and faithful","The insured is liable for the correctness and completeness of the statement"],"dropped_labels":0},"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/1265-marine-claim-form"}