{"id":1300,"title":"MONEY INSURANCE CLAIM FORM","purpose":"claim","insurer":{"slug":"united-india-insurance","name":"United India Insurance Company Limited"},"source_pdf":"https://uiic.co.in/web/sites/default/files/Policy-Document/Money%20InsuranceClaim%20Form.pdf","sha256":"c7a37112cccb921a81404ccc335977ffa2f9cae1cdc3bea1d47d81080847b443","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is for the insured person to claim loss of money under a money insurance policy.","notes":[],"title":"MONEY INSURANCE CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Insured Details","fields":[{"help":"","type":"text","label":"Policy No.","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Claim No.","options":[],"required":null,"pdf_field":""},{"help":"Write your full name as insured on the policy","type":"text","label":"Name of Insured (in full)","options":[],"required":null,"pdf_field":""},{"help":"Write your full address","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"Write your occupation","type":"text","label":"Occupation","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Details of Loss","fields":[{"help":"Provide exact time and date when loss was discovered","type":"text","label":"a. When was the loss discovered? (Give time & date).","options":[],"required":null,"pdf_field":""},{"help":"Mention origin and destination places of money transit","type":"text","label":"b. What were the places between which money was in transit?","options":[],"required":null,"pdf_field":""},{"help":"Describe the circumstances and location of the loss","type":"text","label":"c. How and where did the loss occur?","options":[],"required":null,"pdf_field":""},{"help":"State the total amount of money carried","type":"amount","label":"d. What was the amount being carried?","options":[],"required":null,"pdf_field":""},{"help":"Name the person responsible for the money at loss time","type":"text","label":"In whose custody was the money at the time of loss?","options":[],"required":null,"pdf_field":""},{"help":"Explain security arrangements during transit","type":"text","label":"Were the persons conveying the money accompanied by an armed guard? If not, state what protection if any, was provided?","options":[],"required":null,"pdf_field":""},{"help":"Describe the containers and quantity used to carry money","type":"text","label":"How was the money being carried? (i.e. whether in bags trunks, etc, and in how many of them)","options":[],"required":null,"pdf_field":""},{"help":"Specify the mode of transport used","type":"text","label":"What means of transport was being used by the persons conveying the money?","options":[],"required":null,"pdf_field":""},{"help":"Provide detailed description of the loss event","type":"text","label":"Give the circumstances of the loss or damage (full particulars must be given).","options":[],"required":null,"pdf_field":""},{"help":"State the amount lost","type":"amount","label":"What is the amount of loss?","options":[],"required":null,"pdf_field":""},{"help":"Mention if and when the insurer was informed","type":"text","label":"Have you informed the policy authorities? If so when and where?","options":[],"required":null,"pdf_field":""},{"help":"Describe any recovery efforts made","type":"text","label":"What steps have been taken to recover the lost money?","options":[],"required":null,"pdf_field":""},{"help":"Provide details of any fidelity guarantee coverage","type":"text","label":"Were the persons conveying the money covered under Fidelity Guarantee Policy / Policies? If so, for what sums and with which office/s?","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Additional Information","fields":[{"help":"Mention any other insurance policies covering the same money","type":"text","label":"Are there any other insurance upon the same money? If so, give full particulars.","options":[],"required":null,"pdf_field":""},{"help":"Provide details of any previous similar losses","type":"text","label":"Have you ever before sustained loss of the same nature? If so give particulars.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration and Signature","fields":[{"help":"Signature of the insured person","type":"signature","label":"Insured's Signature","options":[],"required":null,"pdf_field":""},{"help":"Name of the witness","type":"text","label":"Name","options":[],"required":null,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"money insurance policy claims","attachments":[],"declarations":["The insured warrants the truth of the statements to the best of their knowledge and belief.","Any false or fraudulent statement or concealment will forfeit the claim and void the policy."],"dropped_labels":1},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"mayfair.claims@mayfairwecare.com","label":"Overseas Mediclaim Claims Email","level":null,"hours":null,"applies_to":"travel","source_url":"https://uiic.co.in/web/product/overseas-travel-insurance/OMP-for-Business-and-Holiday","quote":"/\nContact Details\nMedical Emergency\nGeneral Queries\nGrievances and Escalations\nEmail ID\nmayfairassist@mayfairwecare.com\nmayfair.claims@mayfairwecare.com\ninfo@mayfairwecare.com[AJ1]\nPolicy pays through below plans:\n1. OMP - Policy : B - Worldwide - Excluding USA & Canada -","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"mayfairassist@mayfairwecare.com","label":"Overseas Mediclaim Medical Emergency Email","level":null,"hours":null,"applies_to":"travel","source_url":"https://uiic.co.in/web/product/overseas-travel-insurance/OMP-for-Business-and-Holiday","quote":"://www.mayfairwecare.com/contact/\nContact Details\nMedical Emergency\nGeneral Queries\nGrievances and Escalations\nEmail ID\nmayfairassist@mayfairwecare.com\nmayfair.claims@mayfairwecare.com\ninfo@mayfairwecare.com[AJ1]\nPolicy pays through below plans:\n1. OMP - Policy : B - Wor","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"18004190133","label":"Overseas Mediclaim Policy Toll-Free Number (India)","level":null,"hours":null,"applies_to":"travel","source_url":"https://uiic.co.in/web/product/overseas-travel-insurance/OMP-for-Business-and-Holiday","quote":"l - Free Number\nUnited States: 18888811701 United Kingdom: 08083045211 Canada: 18885192693 Singapore: 8003211710 India: 18004190133 For Other Country Specific Local Contact Numbers, please visit https://www.mayfairwecare.com/contact/\nWebsite\nhttps://w","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"18888811701","label":"Overseas Mediclaim Policy Toll-Free Number (United States)","level":null,"hours":null,"applies_to":"travel","source_url":"https://uiic.co.in/web/product/overseas-travel-insurance/OMP-for-Business-and-Holiday","quote":"ss\nTower D, 4th Floor, IBC Knowledge Park, 4/1 Bannerghatta Road, Bangalore - 560 029\nToll - Free Number\nUnited States: 18888811701 United Kingdom: 08083045211 Canada: 18885192693 Singapore: 8003211710 India: 18004190133 For Other Country Specific Loc","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"08083045211","label":"Overseas Mediclaim Policy Toll-Free Number (United Kingdom)","level":null,"hours":null,"applies_to":"travel","source_url":"https://uiic.co.in/web/product/overseas-travel-insurance/OMP-for-Business-and-Holiday","quote":"nowledge Park, 4/1 Bannerghatta Road, Bangalore - 560 029\nToll - Free Number\nUnited States: 18888811701 United Kingdom: 08083045211 Canada: 18885192693 Singapore: 8003211710 India: 18004190133 For Other Country Specific Local Contact Numbers, please v","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"18885192693","label":"Overseas Mediclaim Policy Toll-Free Number (Canada)","level":null,"hours":null,"applies_to":"travel","source_url":"https://uiic.co.in/web/product/overseas-travel-insurance/OMP-for-Business-and-Holiday","quote":"annerghatta Road, Bangalore - 560 029\nToll - Free Number\nUnited States: 18888811701 United Kingdom: 08083045211 Canada: 18885192693 Singapore: 8003211710 India: 18004190133 For Other Country Specific Local Contact Numbers, please visit https://www.may","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"8003211710","label":"Overseas Mediclaim Policy Toll-Free Number (Singapore)","level":null,"hours":null,"applies_to":"travel","source_url":"https://uiic.co.in/web/product/overseas-travel-insurance/OMP-for-Business-and-Holiday","quote":"lore - 560 029\nToll - Free Number\nUnited States: 18888811701 United Kingdom: 08083045211 Canada: 18885192693 Singapore: 8003211710 India: 18004190133 For Other Country Specific Local Contact Numbers, please visit https://www.mayfairwecare.com/contact","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"18001236889","label":"General Contact Number","level":null,"hours":null,"applies_to":"all","source_url":"https://uiic.co.in/web/","quote":"Links\nCustomer Portal\nKYC Process\nFacebook\nInstagram\nYoutube\nTwitter\nOffice Locator\nIntermediary Portal\nDigi Locker\ntel:18001236889","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/united-india-insurance/1300-money-insurance-claim-form"}