{"id":1328,"title":"CATTLE INSURANCE (LIVESTOCK 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/Rural%20%26%20Social%20-%20Cattle%20%28Livestock%29%20Insurance_2.pdf","sha256":"34856bbda0a5ccdc8279644bd6a3193b7bf1426c8a6d2b25d2345849e6be5baa","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is for claiming insurance for cattle (livestock) loss or injury and is to be filled by the insured policyholder and the attending veterinary surgeon.","notes":["This form should be completed without delay and forwarded direct to the Company.","Attach original ear tag if available.","Attach post-mortem report on reverse if conducted."],"title":"CATTLE INSURANCE (LIVESTOCK INSURANCE) CLAIM FORM","submit":{"to":"United India Insurance Company Limited","how":"","address":""},"purpose":"claim","sections":[{"title":"Insured and Animal Details","fields":[{"help":"Enter your insurance policy number","type":"text","label":"Policy No.","options":[],"required":null,"pdf_field":""},{"help":"Enter claim number if known","type":"text","label":"Claim No.","options":[],"required":null,"pdf_field":""},{"help":"Enter your full name as per policy","type":"text","label":"Name of Insured (in full):","options":[],"required":true,"pdf_field":""},{"help":"Enter your full postal address","type":"text","label":"Address:","options":[],"required":true,"pdf_field":""},{"help":"Enter your occupation","type":"text","label":"Occupation:","options":[],"required":null,"pdf_field":""},{"help":"Describe the animal species","type":"text","label":"Description (State whether cow, buffalo, etc.)","options":[],"required":true,"pdf_field":""},{"help":"Enter the animal's identification tag number","type":"text","label":"Identification Tag No.","options":[],"required":true,"pdf_field":""},{"help":"Enter the animal's color","type":"text","label":"Colour","options":[],"required":null,"pdf_field":""},{"help":"Enter species and breed of the animal","type":"text","label":"Species & Breed","options":[],"required":null,"pdf_field":""},{"help":"Specify sex and reproductive status if female, plus color and marks","type":"text","label":"Sex (If female whether pregnant calf at foot, freshly calved or heifer) colour & full distinguishing marks","options":[],"required":null,"pdf_field":""},{"help":"Enter the animal's age in years","type":"number","label":"Exact age in years","options":[],"required":null,"pdf_field":""},{"help":"Enter milk yield before illness if applicable","type":"text","label":"Milk yield prior to illness","options":[],"required":null,"pdf_field":""},{"help":"Enter the animal's value in rupees before illness","type":"amount","label":"Value prior to illness Rs.","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"Details of Illness or Death","fields":[{"help":"Enter the date when animal was first noticed ill","type":"date","label":"When was the animal first seen ill?","options":[],"required":true,"pdf_field":""},{"help":"Enter the date when veterinarian was informed","type":"date","label":"When was notice sent to Veterinarian?","options":[],"required":true,"pdf_field":""},{"help":"Enter dates when veterinarian first and last attended","type":"text","label":"When first and last seen by Veterinarian?","options":[],"required":true,"pdf_field":""},{"help":"Enter date of veterinary attendance","type":"date","label":"Date of attendance:","options":[],"required":true,"pdf_field":""},{"help":"Provide full name and address of attending vet","type":"text","label":"Name and address of Veterinary Surgeon who attended?","options":[],"required":true,"pdf_field":""},{"help":"Specify place, date and time of death","type":"text","label":"Place of death, with date and hour:","options":[],"required":null,"pdf_field":""},{"help":"Describe cause of death","type":"text","label":"Cause of death:","options":[],"required":true,"pdf_field":""},{"help":"Explain cause if death was due to disease","type":"text","label":"If from disease, how do you account for it?","options":[],"required":null,"pdf_field":""},{"help":"Describe accident details and responsible person","type":"text","label":"If from accident, how did it occur and who was in-charge?","options":[],"required":null,"pdf_field":""},{"help":"Provide operation details and surgeon's name","type":"text","label":"If operated upon recently, state nature & data, also name of Surgeon:","options":[],"required":null,"pdf_field":""},{"help":"State the animal's last use or purpose","type":"text","label":"Purpose for which used or employed when last at work:","options":[],"required":null,"pdf_field":""},{"help":"Specify if animal was bred or purchased","type":"text","label":"Did you breed or buy the animal?","options":[],"required":null,"pdf_field":""},{"help":"Enter date of last calving if applicable","type":"date","label":"Date of last calving:","options":[],"required":null,"pdf_field":""},{"help":"Specify reproductive status and pregnancy stage","type":"text","label":"State whether the animal is dry or pregnant. If pregnant what is the stage of pregnancy?","options":[],"required":null,"pdf_field":""},{"help":"Enter the claim amount in rupees","type":"amount","label":"Amount of claim: Rs.","options":[],"required":true,"pdf_field":""},{"help":"Indicate if ear tag is enclosed","type":"choice","label":"Is the Ear tag of the animal enclosed? Yes / No","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Answer if animal has other insurance","type":"yes-no","label":"Is the animal insured elsewhere?","options":[],"required":null,"pdf_field":""},{"help":"Provide details of other compensation sources","type":"text","label":"Are you receiving compensation from any other source? If so from whom:","options":[],"required":null,"pdf_field":""},{"help":"Describe injury or disease details if animal alive","type":"text","label":"a) If animal has not died, describe the nature of injury/ disease and state when it occurred and its duration:","options":[],"required":null,"pdf_field":""},{"help":"Indicate if injury/disease caused permanent incapacity","type":"yes-no","label":"b) Has this injury/ disease resulted in permanent incapacity to conceive or yield milk, or breed or for purpose of use mentioned in the proposal?","options":[],"required":null,"pdf_field":""},{"help":"Describe preventive steps taken after injury/disease","type":"text","label":"c) What steps were taken by you after the injury/disease was noticed to prevent the permanent incapacity to conceive or yield milk or breed or for the purpose of use mentioned in the proposal?","options":[],"required":null,"pdf_field":""},{"help":"Enter date of last premium payment","type":"date","label":"When was premium paid?","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration and Signature","fields":[{"help":"Enter date of signing","type":"date","label":"Date :","options":[],"required":true,"pdf_field":""},{"help":"Provide witness name and signature","type":"signature","label":"Name & Signature of Witness:","options":[],"required":true,"pdf_field":""},{"help":"Sign the form","type":"signature","label":"Signature of Insured.","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"Veterinary Certificate","fields":[{"help":"Describe animal species","type":"text","label":"Description (State whether cow, buffalo etc)","options":[],"required":true,"pdf_field":""},{"help":"Enter animal's tag number","type":"text","label":"Identification / Tag No.","options":[],"required":true,"pdf_field":""},{"help":"Enter species and breed","type":"text","label":"Species & Breed","options":[],"required":true,"pdf_field":""},{"help":"Specify sex, reproductive status, color and marks","type":"text","label":"Sex (if female Whether Pregnant calf at foot, freshly calved or heifer) colour & full distinguishing marks","options":[],"required":true,"pdf_field":""},{"help":"Enter animal's age","type":"number","label":"Exact age in years","options":[],"required":true,"pdf_field":""},{"help":"Enter animal's height","type":"text","label":"Height","options":[],"required":null,"pdf_field":""},{"help":"Enter value before illness","type":"amount","label":"Value prior to illness","options":[],"required":true,"pdf_field":""},{"help":"Indicate if post-mortem was done","type":"yes-no","label":"Did you make a post-mortem? If so, give detailed report on reverse of the form","options":[],"required":null,"pdf_field":""},{"help":"State cause of death","type":"text","label":"Cause of death","options":[],"required":true,"pdf_field":""},{"help":"Explain disease cause","type":"text","label":"If from disease, how do you account to it?","options":[],"required":null,"pdf_field":""},{"help":"Describe accident location and injuries","type":"text","label":"If from accident, where did it occur and nature of injuries sustained","options":[],"required":null,"pdf_field":""},{"help":"Provide operation details","type":"text","label":"If from an operation, give date and nature of operation","options":[],"required":null,"pdf_field":""},{"help":"Confirm if animal received proper care","type":"yes-no","label":"Had the animal had every care and attention?","options":[],"required":true,"pdf_field":""},{"help":"Confirm examination and identification","type":"yes-no","label":"Did you examine for Insurance and do you identify the animal?","options":[],"required":true,"pdf_field":""},{"help":"Describe injury/disease if animal alive","type":"text","label":"a) If animal has not died, describe the nature of injury / disease and state when it occurred and its duration.","options":[],"required":null,"pdf_field":""},{"help":"Indicate permanent incapacity","type":"yes-no","label":"b) Has the injury/disease resulted in permanent incapacity to conceive or yield milk or breed or for the purpose for which it is intended?","options":[],"required":null,"pdf_field":""},{"help":"Describe treatment given","type":"text","label":"a) Did you treat the animal for the injury/disease? And if so, what was the nature of treatment given to prevent the permanent incapacity to conceive or yield milk or breed or the purpose for which it is intended?","options":[],"required":null,"pdf_field":""},{"help":"Veterinary surgeon's signature","type":"signature","label":"Signature:","options":[],"required":true,"pdf_field":""},{"help":"Veterinary surgeon's qualification","type":"text","label":"Qualification:","options":[],"required":true,"pdf_field":""},{"help":"Date of certificate signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Veterinary surgeon's name and address","type":"text","label":"Name & Address:","options":[],"required":true,"pdf_field":""}],"filled_by":"veterinary surgeon"}],"deadlines":["Please return this form duly completed within 14 days of the loss together with necessary documents"],"applies_to":"Cattle insurance claims for livestock insured under United India Insurance policies","attachments":["Necessary documents as required","Ear tag of the animal (if applicable)","Post-mortem report (if conducted)"],"declarations":["The issue of this form is not to be construed as an admission of liability.","The insured warrants the truth of the statements and affirms proper treatment and care were given to the animal.","If any false statement or concealment is made, the policy shall be void and rights to recover shall be forfeited.","The veterinary surgeon warrants the truth of answers and that no material information has been withheld."],"dropped_labels":4},"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/1328-cattle-insurance-livestock-insurance-claim-form"}