{"id":1272,"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_sales_turnover_policy.pdf_acced87f1b.pdf","sha256":"53879176d22d0efe5123ec4b8c7d10fe2a78da9838f0e0535cc9371bdfb1b48d","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is for the insured policyholder to report and claim for loss or damage to marine cargo under their insurance policy.","notes":["The issue of this form is not an admission of liability","If any detail or information is not readily available, do not delay dispatch of this form; particulars may be sent later"],"title":"MARINE 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":"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":"6-digit postal 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":"6-digit postal 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":"6-digit postal 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":"Total count of packages or cases","type":"number","label":"Total number of Packages and/or cases dispatched with marks if any","options":[],"required":null,"pdf_field":""},{"help":"Include numbers and dates for all transport modes","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":"Location where goods were dispatched","type":"text","label":"Place of Dispatch","options":[],"required":null,"pdf_field":""},{"help":"Final destination location","type":"text","label":"Place of Destination","options":[],"required":null,"pdf_field":""},{"help":"Date 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 from port to final destination","type":"date","label":"Date of dispatch to Final Destination, if any","options":[],"required":null,"pdf_field":""},{"help":"Explain any clearance delays","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 delivery delays","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":false,"pdf_field":""},{"help":"Date goods delivered from final rail station","type":"date","label":"Date of delivery from Final Station","options":[],"required":false,"pdf_field":""},{"help":"Explain any delivery delays","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 delivery delays","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":"Count of packages received","type":"number","label":"Number of Packages and/or cases, delivery taken of","options":[],"required":null,"pdf_field":""},{"help":"Count 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 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","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","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","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":"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":"Customs duty amount","type":"amount","label":"Duty Payable on Sound Goods","options":[],"required":null,"pdf_field":""},{"help":"Additional relevant details","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"},{"title":"Declaration and Signature","fields":[{"help":"Date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Sign the form","type":"signature","label":"Signature of the Insured","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":["Notify the Company without delay as soon as loss or damage has become known","Claim against the Carrier has to be lodged within the stipulated timeframe"],"applies_to":"marine cargo claims","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/1272-marine-claim-form"}