{"id":1356,"title":"EXCESS AVIATION LIABILITY 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/excess-aviation-liability-policy/claim-form.pdf","sha256":"98c91319900972adff1537c9f8a9e5874814a1745ab456119bec4abac3bb265a","pages":6,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured or operator to file a claim under the Excess Aviation Liability Policy for an aviation-related incident or accident.","notes":["The issue of this form is not an admission of liability.","The form must be filled by the insured or operator.","Attach photocopies of all listed documents for claim processing."],"title":"EXCESS AVIATION LIABILITY POLICY CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Ownership Details","fields":[{"help":"","type":"text","label":"Registered Owners’ Name and Address","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Operators Name & address","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Leasing or Finance Company’s’ Name & Address","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/operator"},{"title":"Airframe Data","fields":[{"help":"","type":"text","label":"Certificate of Airworthiness Category","options":[],"required":null,"pdf_field":""},{"help":"Enter the date the certificate was issued","type":"date","label":"Date of issue of Certificate","options":[],"required":null,"pdf_field":""},{"help":"Enter the expiry date of the certificate","type":"date","label":"Date of Expiry","options":[],"required":null,"pdf_field":""},{"help":"Specify the aircraft frame and model","type":"text","label":"Aircraft Frame & Model","options":[],"required":null,"pdf_field":""},{"help":"Enter the manufacturer’s serial number","type":"text","label":"Manufacturers’ Serial No.","options":[],"required":null,"pdf_field":""},{"help":"Enter the year the aircraft was manufactured","type":"number","label":"Year of Manufacturing","options":[],"required":null,"pdf_field":""},{"help":"Enter the aircraft’s registered mark or number","type":"text","label":"Registered Mark/Number","options":[],"required":null,"pdf_field":""},{"help":"Total hours the aircraft has been used","type":"number","label":"Aircraft Used total Hours","options":[],"required":null,"pdf_field":""},{"help":"Provide last check time, date, and airframe hour for each check type","type":"table","label":"Maintenance Schedule: Last check Time, Date, At Airframe Hour for Check A, Check B, Check C, Special Check, Any Other Check","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/operator"},{"title":"Engine Data","fields":[{"help":"Provide serial number and year of manufacturing for each engine","type":"table","label":"Manufacturers’ Serial No and Year of Manufacturing","options":[],"required":null,"pdf_field":""},{"help":"Provide used time and cycles since new for each engine","type":"table","label":"Used time and Cycle since new","options":[],"required":null,"pdf_field":""},{"help":"Provide used time since last overhaul for each engine","type":"table","label":"Used since Overhaul","options":[],"required":null,"pdf_field":""},{"help":"Provide overhaul times and dates for each engine","type":"table","label":"Overhaul Time & dates","options":[],"required":null,"pdf_field":""},{"help":"Provide date and place of last shop visit for each engine","type":"table","label":"Date and place of last shop visit","options":[],"required":null,"pdf_field":""},{"help":"State purpose of last shop visit for each engine","type":"table","label":"Purpose of shop visit","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/operator"},{"title":"Propeller Data","fields":[{"help":"Provide serial number for each propeller","type":"table","label":"Manufacturers’ Serial No.","options":[],"required":null,"pdf_field":""},{"help":"Provide usage time since new for each propeller","type":"table","label":"Used Since New","options":[],"required":null,"pdf_field":""},{"help":"Provide date of overhaul for each propeller","type":"table","label":"Date of Overhaul","options":[],"required":null,"pdf_field":""},{"help":"Provide usage time since last overhaul for each propeller","type":"table","label":"Used since overhaul","options":[],"required":null,"pdf_field":""},{"help":"Provide time interval between overhauls for each propeller","type":"table","label":"Time between the overhauls","options":[],"required":null,"pdf_field":""},{"help":"Provide date and place of last shop visit for each propeller","type":"table","label":"Date and place of last shop visit","options":[],"required":null,"pdf_field":""},{"help":"State purpose of last shop visit for each propeller","type":"table","label":"Purpose of visit","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/operator"},{"title":"Avionics Data","fields":[{"help":"Provide serial number, make, and model for each instrument listed","type":"table","label":"Instruments: Serial No of manufacturer, Make, Model for VHF, HF, VOR/ILS/G/S, ADF, Transponders, Altimeter, Radar, FDR, Any other equipment","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/operator"},{"title":"Flight Data","fields":[{"help":"Enter the flight number","type":"text","label":"Flight No","options":[],"required":null,"pdf_field":""},{"help":"Provide the flight schedule details","type":"text","label":"Flight Schedule","options":[],"required":null,"pdf_field":""},{"help":"State the purpose of the flight","type":"text","label":"Purpose of Flight","options":[],"required":null,"pdf_field":""},{"help":"Enter the departure airport or place","type":"text","label":"Place/Airport of departure","options":[],"required":null,"pdf_field":""},{"help":"Enter the intended arrival airport","type":"text","label":"Airport of intended arrival","options":[],"required":null,"pdf_field":""},{"help":"Attach or provide passenger manifest/checklist","type":"text","label":"Passenger manifesto/check list","options":[],"required":null,"pdf_field":""},{"help":"Attach or provide baggage manifest/checklist","type":"text","label":"Baggage manifesto/check list","options":[],"required":null,"pdf_field":""},{"help":"Attach or provide cargo manifest/checklist","type":"text","label":"Cargo manifesto/check list","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/operator"},{"title":"Accident Details","fields":[{"help":"Enter the location of the accident","type":"text","label":"Place of accident","options":[],"required":null,"pdf_field":""},{"help":"Provide latitude and longitude coordinates","type":"text","label":"Latitude and longitude of the place of accident","options":[],"required":null,"pdf_field":""},{"help":"Enter date and time when the accident occurred","type":"date","label":"Date and time of Accident","options":[],"required":null,"pdf_field":""},{"help":"Describe the cause of the accident","type":"text","label":"Cause of accident","options":[],"required":null,"pdf_field":""},{"help":"Name the pilot flying at the time","type":"text","label":"Who was flying the aircraft at the time of accident","options":[],"required":null,"pdf_field":""},{"help":"Indicate if the pilot had a valid license","type":"yes-no","label":"Whether at the time of accident pilot had valid licence","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Indicate if the pilot was authorized for the flight","type":"yes-no","label":"Whether the pilot is authorized to carry out the flight","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Indicate if the aircraft was airworthy at the time","type":"yes-no","label":"Whether the aircraft was airworthy","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Describe the nature and estimate of losses","type":"text","label":"Nature of losses/estimated loss","options":[],"required":null,"pdf_field":""},{"help":"Provide numbers of persons died or injured in each category","type":"table","label":"Number of persons died/injured: 1. Pilots 2. Other crew members 3. Passengers","options":[],"required":null,"pdf_field":""},{"help":"Provide number of persons uninjured","type":"number","label":"Number of persons uninjured","options":[],"required":null,"pdf_field":""},{"help":"Describe any baggage or cargo loss","type":"text","label":"Baggage/cargo loss details","options":[],"required":null,"pdf_field":""},{"help":"Describe any third party injuries","type":"text","label":"Third party injury","options":[],"required":null,"pdf_field":""},{"help":"Describe any third party property damages","type":"text","label":"Third party property Damages","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/operator"}],"deadlines":[],"applies_to":"Excess Aviation Liability Policy claims","attachments":["Certificate of Airworthiness","Certificate of Registration","Passengers manifesto/check list","Cargo Manifesto/check list","Baggage Manifesto/check list","Load sheet/ weight and balance sheet","Weather forecast (en-route and at arrival)","Last entry form/Technical Log","All flight Crew Licence and Medical Certificates","Pilots’ Report and/or Operators accident/Incident report","Airport approach/Departure Schedule","Loss estimate"],"declarations":["The insured agrees to provide additional information if required and guarantees the truthfulness of the statements.","The company reserves the right to verify identity, address, facts, and documents with third parties.","The insured has read and agrees to the company's privacy policy as amended from time to time.","The insured understands the company is not responsible for delays caused by non-fulfillment of requirements or non-submission of documents.","The insured declares that details of all persons having interest in the property are provided and no other claim for the same loss has been made elsewhere.","The insured consents to verification of identity/address/bank details through Central KYC Registry, UIDAI, or other modes for KYC purposes."],"dropped_labels":3},"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/1356-excess-aviation-liability-policy-claim-form"}