{"id":1362,"title":"PLANTATION/HORTICULTURE INSURANCE 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/commercial/plantation-insurance/claims-forms.pdf","sha256":"e5e24470cddf32d6b75461c0904e2670f0a7fd6aa47f056729c89b901843741e","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured to claim insurance for losses under Plantation-Horticulture Insurance (Commercial). The policyholder fills this form to report and detail the loss.","notes":["The issue of this form is not an admission of liability.","The form must be filled truthfully and completely to avoid cancellation of the policy.","The declaration and signature are mandatory.","The company’s stamp is for office use."],"title":"PLANTATION/HORTICULTURE INSURANCE CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Insured Details and Claim Information","fields":[{"help":"","type":"text","label":"Claim No.","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Policy No.","options":[],"required":null,"pdf_field":""},{"help":"Enter the full name of the insured person or entity","type":"text","label":"Name of the Insured","options":[],"required":null,"pdf_field":""},{"help":"Enter the full postal address","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"Enter a valid contact number","type":"phone","label":"Telephone No./Mobile No.","options":[],"required":null,"pdf_field":""},{"help":"Enter a valid email address","type":"email","label":"E-mail ID No.","options":[],"required":null,"pdf_field":""},{"help":"Fill in the project name, location, area, number of plants insured and destroyed, and costs as specified","type":"table","label":"Details of Project and Claim : Name and Location of the Project (Survey No), Total area covered, Total No. of Plants insured, No. of plants destroyed, Cost of inputs at the time of issue of policy (Rs), Cost of inputs incurred up to the time of loss (Rs)","options":[],"required":null,"pdf_field":""},{"help":"Enter the date when the loss occurred","type":"date","label":"Date of loss","options":[],"required":null,"pdf_field":""},{"help":"Describe the cause of the loss in detail","type":"text","label":"Cause of loss with full details","options":[],"required":null,"pdf_field":""},{"help":"Explain any preventive measures taken after the loss","type":"text","label":"What are the steps taken to prevent loss after the accident/disease?","options":[],"required":null,"pdf_field":""},{"help":"Provide the date when the insurer was informed","type":"date","label":"When the loss intimation was sent to the Insurance Company?","options":[],"required":null,"pdf_field":""},{"help":"Provide details if loss was caused by riot or strike","type":"text","label":"If the loss has been due to riot & strike-give details","options":[],"required":null,"pdf_field":""},{"help":"Mention if insured elsewhere or receiving compensation from other sources","type":"text","label":"Are crops insured elsewhere? Are you receiving compensation from any other source? If so, from where?","options":[],"required":null,"pdf_field":""},{"help":"Enter the total claim amount with supporting bills","type":"amount","label":"Total amount of Claim lodged supported by the bills","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Declaration","fields":[{"help":"Sign the form to confirm the declaration","type":"signature","label":"Signature of Insured","options":[],"required":true,"pdf_field":""},{"help":"Enter the date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"For company use","type":"signature","label":"Company’s stamp","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"}],"deadlines":[],"applies_to":"Plantation-Horticulture Insurance (Commercial)","attachments":["List of documents as received with this claim form"],"declarations":["The insured agrees to provide additional information if required and guarantees the truthfulness of the statements.","The company may verify identity, address, facts, and documents with third parties.","The insured 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-submission of required documents or information.","The insured declares that all persons with interest in the property are disclosed and no duplicate claims have been made.","The insured consents to verification of identity/address/bank details through Central KYC Registry, UIDAI, or other modes for KYC purposes."],"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/1362-plantation-horticulture-insurance-claim-form"}