{"id":1344,"title":"MARINE CARGO OPEN TRANSIT (INLAND & IMPORT/EXPORT) POLICY CLAIM FORM","purpose":"claim","insurer":{"slug":"universal-sompo-general-insurance","name":"Universal Sompo General Insurance Company Limited"},"source_pdf":"https://www.universalsompo.com/assets/file/marine-cargo-open-transit-policy/claim-form.pdf","sha256":"44a8bbc10b8f32b469be643bf88d2a7d8e3159a90b1c9f42de4dbd0810ce67b8","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured to claim for loss or damage under the Marine Cargo Open Transit Policy covering inland and import/export shipments.","notes":["All questions must be answered fully; incomplete forms will be returned.","Use separate sheet if space is insufficient and attach it.","Issue or acceptance of this form is not admission of liability by insurer."],"title":"MARINE CARGO OPEN TRANSIT (INLAND & IMPORT/EXPORT) POLICY CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"A. The Insured","fields":[{"help":"","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"Full postal address","type":"text","label":"Address","options":[],"required":true,"pdf_field":""},{"help":"","type":"phone","label":"Tel No. Office","options":[],"required":false,"pdf_field":""},{"help":"","type":"phone","label":"Mobile","options":[],"required":false,"pdf_field":""},{"help":"","type":"email","label":"Email","options":[],"required":false,"pdf_field":""},{"help":"Name of contact person for claim","type":"text","label":"Contact name","options":[],"required":false,"pdf_field":""},{"help":"Contact person's mobile number","type":"phone","label":"Mobile","options":[],"required":false,"pdf_field":""},{"help":"Contact person's email","type":"email","label":"Email","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"B. Policy Details","fields":[{"help":"Policy number as per insurance documents","type":"text","label":"Policy No.","options":[],"required":true,"pdf_field":""},{"help":"Certificate number if applicable","type":"text","label":"Certificate No.","options":[],"required":false,"pdf_field":""},{"help":"Sum insured amount","type":"amount","label":"Sum Insured","options":[],"required":true,"pdf_field":""},{"help":"Excess amount applicable","type":"amount","label":"Excess","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"C. Invoice Details","fields":[{"help":"Invoice number for the goods","type":"text","label":"Invoice No.","options":[],"required":true,"pdf_field":""},{"help":"Invoice date","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Invoice amount","type":"amount","label":"Amount","options":[],"required":true,"pdf_field":""},{"help":"Name of consignor","type":"text","label":"Consignor","options":[],"required":true,"pdf_field":""},{"help":"Name of consignee","type":"text","label":"Consignee","options":[],"required":true,"pdf_field":""},{"help":"Select applicable terms of sale","type":"choice","label":"Terms of Sale CIF   C&F/CFR   Ex-works  FOB  Others","options":["CIF","C&F/CFR","Ex-works","FOB","Others"],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"D. Goods Details","fields":[{"help":"Describe the goods insured","type":"text","label":"Description of Goods","options":[],"required":true,"pdf_field":""},{"help":"Total weight of goods","type":"number","label":"Total weight","options":[],"required":true,"pdf_field":""},{"help":"Number of packages","type":"number","label":"No. of packages","options":[],"required":true,"pdf_field":""},{"help":"Packing method used","type":"text","label":"Mode of packing","options":[],"required":true,"pdf_field":""},{"help":"Select if packing is standard","type":"yes-no","label":"Is this standard & customary packing for similar goods? Yes  No ","options":["Yes","No"],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"E. Carriage Details","fields":[{"help":"Starting point of transit","type":"text","label":"Voyage/journey From","options":[],"required":true,"pdf_field":""},{"help":"Destination point of transit","type":"text","label":"to","options":[],"required":true,"pdf_field":""},{"help":"Port where goods were loaded","type":"text","label":"Port of Loading","options":[],"required":true,"pdf_field":""},{"help":"Port where goods were to be delivered","type":"text","label":"Port of destination","options":[],"required":true,"pdf_field":""},{"help":"Name of the carrier transporting the goods","type":"text","label":"Name of Carrier","options":[],"required":true,"pdf_field":""},{"help":"Bill of Lading or Air Waybill or other transport document number","type":"text","label":"B/L/AWB/LR/RR No.","options":[],"required":true,"pdf_field":""},{"help":"Date of the transport document","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Select if open truck was used","type":"yes-no","label":"Was the consignment carried by an Open truck? Yes  No ","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Specify container load type","type":"text","label":"Was the consignment Full Container Load or Partial Container Load","options":[],"required":false,"pdf_field":""},{"help":"Specify if goods were carried at owner or carrier risk","type":"text","label":"Goods Carried at owner risk/carrier’s risk","options":[],"required":false,"pdf_field":""},{"help":"Carrier's remarks on condition at loading","type":"text","label":"Carrier’s endorsement, if any, as regards condition of goods/packing at the time of loading","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"F. Loss details","fields":[{"help":"Date when loss occurred","type":"date","label":"Date of Loss","options":[],"required":true,"pdf_field":""},{"help":"Location where loss happened","type":"text","label":"Place of Loss","options":[],"required":true,"pdf_field":""},{"help":"Describe the loss or damage","type":"text","label":"Description of Loss","options":[],"required":true,"pdf_field":""},{"help":"Cause or reason for loss","type":"text","label":"Cause of Loss","options":[],"required":true,"pdf_field":""},{"help":"Number of missing packages or items","type":"number","label":"In case of shortage, No. of short packages/Items","options":[],"required":false,"pdf_field":""},{"help":"Select if damaged goods can be repaired","type":"yes-no","label":"Are the damaged goods/items in repairable condition? Yes  No ","options":["Yes","No"],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"G. Delivery Details","fields":[{"help":"Date goods arrived at destination","type":"date","label":"Date of arrival of goods at destination(Port/transporter’s godown/city/Railway siding)","options":[],"required":true,"pdf_field":""},{"help":"Date goods arrived at consignee","type":"date","label":"Date of arrival at consignee’s place","options":[],"required":true,"pdf_field":""},{"help":"Condition of packages on delivery","type":"text","label":"Outward condition of packages/consignment","options":[],"required":true,"pdf_field":""},{"help":"Select if open delivery was obtained","type":"yes-no","label":"In case of outwardly damaged consignment: Was an open delivery obtained Yes  No ","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Select if joint survey was held","type":"yes-no","label":"Joint Survey held Yes  No ","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Select if delivery note had qualifications","type":"yes-no","label":"Was the Delivery Note qualified Yes  No ","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Select if transporter signed on qualifications","type":"yes-no","label":"Signatures of transporter’s representative obtained on above Qualification Yes  No ","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Date when packages were opened at final destination","type":"date","label":"Date of opening of packages after arrival at final destination","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"H. Claim on Carrier","fields":[{"help":"Select if claim on carrier has been lodged","type":"yes-no","label":"Has the monetary claim on Carrier as per provisions of the Carriage of Goods Act been lodged to protect Rights of Recovery? Yes  No ","options":["Yes","No"],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"I. General","fields":[{"help":"Select if police informed","type":"yes-no","label":"Have the Police been informed of any theft or non-delivery? Yes  No ","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide FIR number and date if police informed","type":"text","label":"If yes, kindly provide FIR No. and date","options":[],"required":false,"pdf_field":""},{"help":"Select if salvage is to be retained","type":"yes-no","label":"Are you interested in retaining the salvage? Yes  No ","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Estimated value of salvage if retained","type":"amount","label":"If so, estimated salvage value of damaged goods","options":[],"required":false,"pdf_field":""},{"help":"Describe actions taken to reduce loss","type":"text","label":"Steps taken to minimize the loss","options":[],"required":false,"pdf_field":""},{"help":"Additional relevant information","type":"text","label":"Any other information that may be relevant to the claim","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration","fields":[{"help":"Sign the form","type":"signature","label":"Signature of Insured","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Marine Cargo Open Transit (Inland & Import/Export) Policy claims","attachments":["Attach separate sheet if insufficient space","Attach list of documents as received with claim form"],"declarations":["Agree to provide additional information if required and guarantee truthfulness of statements.","Understand company may verify identity, address, facts and documents with third parties.","Agree to the company's privacy policy as amended from time to time.","Acknowledge responsibility for timely submission of required documents to avoid claim delays.","Declare all persons having interest in the property are disclosed and no duplicate claims exist.","Consent to verification of identity/address/bank details through official registries for KYC."],"dropped_labels":0},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"contactclaims@universalsompo.com","label":"Claims Email","level":null,"hours":null,"applies_to":"all","source_url":"https://www.universalsompo.com/resourse-grievance-redressal/","quote":"e Claim Details\nTPA’s Servicing Group Health Insurance\nDownload Pulz App\nConnect with Us\ncontactus@universalsompo.com\ncontactclaims@universalsompo.com\nHealth Insurance :\nComplete Healthcare Insurance\nA Plus Health Insurance\nSaral Suraksha Bima\nGroup Mashak Rakshak Polic","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"contactus@universalsompo.com","label":"Theft Claim Email","level":null,"hours":null,"applies_to":"motor","source_url":"https://www.universalsompo.com/claimintimation/","quote":"ntimate claim.\nFor\nTheft Claim\n, please connect with us on below details.\nPhone:\n1800-22-4030\n,\n1800-200-4030\nor\nEmail:\ncontactus@universalsompo.com\nOk\nView All Policies\nHealth Insurance\nComplete Healthcare Insurance\nSuper Healthcare Insurance\nArogya SanjeevaniInsuran","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800-22-4030","label":"Claims Toll Free Number (MTNL/BSNL Lines)","level":null,"hours":null,"applies_to":"all","source_url":"https://www.universalsompo.com/claims/","quote":null,"fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022-41582900 - 41582999","label":"Claims Helpline Number","level":null,"hours":null,"applies_to":"all","source_url":"https://www.universalsompo.com/claims/","quote":"tactclaims@universalsompo.com 2. Call on our Toll Free number 1-800-22-4030 (from MTNL & BSNL Lines) 3. Helpline number 022-41582900 - 41582999\nIn case of telephonic contact, our call centre executive shall note down the basic requirements and pass on the informa","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800-200-4030","label":"Motor Claim Intimation Toll Free","level":null,"hours":"24/7","applies_to":"motor","source_url":"https://www.universalsompo.com/claimintimation/","quote":"Motor Claim Intimation for Coverage | Universal Sompo\n24/7, Customer Care\n1800-22-4030\n,\n1800-200-4030\nCrop Helpline No.\n1800-200-5142\nSenior Citizen\n1800-267-4030\nAbout\r\n                                us\nContact Us\nLogin","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800-200-5142","label":"Crop Helpline Number","level":null,"hours":null,"applies_to":"crop","source_url":"https://www.universalsompo.com/claimintimation/","quote":"otor Claim Intimation for Coverage | Universal Sompo\n24/7, Customer Care\n1800-22-4030\n,\n1800-200-4030\nCrop Helpline No.\n1800-200-5142\nSenior Citizen\n1800-267-4030\nAbout\r\n                                us\nContact Us\nLogin\nI am a Customer\nI am an Agent\nP","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/universal-sompo-general-insurance/1344-marine-cargo-open-transit-inland-and-import-export-policy-claim-form"}