{"id":1385,"title":"CLAIM FORM FOR CONTRACTOR’S PLANT & MACHINERY INSURANCE POLICY","purpose":"claim","insurer":{"slug":"universal-sompo-general-insurance","name":"Universal Sompo General Insurance Company Limited"},"source_pdf":"https://www.universalsompo.com/assets/file/contractor-plant-machinery-insurance-policy/claim-form.pdf","sha256":"cf27462eda7da1e9cb053a971a4b1eb31c3f54466a5a06afc340335ec21e4ec6","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured to claim for loss or damage under the Contractor’s Plant & Machinery Insurance Policy.","notes":["If any detail is not readily available, do not delay dispatch of the form; such particulars may be sent later.","The issue of this form is not an admission of liability.","Use original documents as required by the company.","Contact toll free 1-800-22-4030 or helpline 022-26748600 for assistance."],"title":"CLAIM FORM FOR CONTRACTOR’S PLANT & MACHINERY INSURANCE POLICY","submit":{"to":"Universal Sompo General Insurance Co. Ltd.","how":"","address":"8th & 9th Floor (South Side), Commerz International Business Park, Oberoi Garden City Off Western Express Highway, Goregaon East, Mumbai 400063\nEmail: contactclaims@universalsompo.com"},"purpose":"claim","sections":[{"title":"A. INSURED","fields":[{"help":"","type":"text","label":"Policy No.","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Claim No.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"B. DETAILS OF LOSS","fields":[{"help":"Enter date in DD/MM/YYYY format","type":"date","label":"Date of Loss","options":[],"required":null,"pdf_field":""},{"help":"Specify time and select AM or PM","type":"text","label":"Time","options":["AM","PM"],"required":null,"pdf_field":""},{"help":"","type":"text","label":"LOSS LOCATION Address line 1","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Address line 2","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"Enter 6 digit postal code","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Enter landline number with STD code","type":"phone","label":"Phone No.","options":[],"required":null,"pdf_field":""},{"help":"Enter 10 digit mobile number","type":"phone","label":"Mobile No.","options":[],"required":null,"pdf_field":""},{"help":"Enter valid email address","type":"email","label":"Email","options":[],"required":null,"pdf_field":""},{"help":"Briefly describe how the loss or damage occurred","type":"text","label":"Describe cause of Loss/Damage","options":[],"required":null,"pdf_field":""},{"help":"Enter estimated loss amount in Indian Rupees","type":"amount","label":"Estimated Loss (Rs.)","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"WITNESS DETAILS","fields":[{"help":"Select Yes or No","type":"yes-no","label":"Is any witness available for accident / loss?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide witness name if available","type":"text","label":"If \"Yes\", specify Name of the witness","options":[],"required":null,"pdf_field":""},{"help":"Witness address","type":"text","label":"Address line 1","options":[],"required":null,"pdf_field":""},{"help":"Witness address","type":"text","label":"Address line 2","options":[],"required":null,"pdf_field":""},{"help":"Witness city","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"Witness state","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"Witness postal code","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Witness phone number","type":"phone","label":"Phone No.","options":[],"required":null,"pdf_field":""},{"help":"Witness mobile number","type":"phone","label":"Mobile No.","options":[],"required":null,"pdf_field":""},{"help":"Witness email address","type":"email","label":"Email","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"INFORMATION TO AUTHORITY","fields":[{"help":"Name of authority informed","type":"text","label":"If \"Yes\", specify Name of the Authority","options":[],"required":null,"pdf_field":""},{"help":"Contact person at authority","type":"text","label":"Contact Person","options":[],"required":null,"pdf_field":""},{"help":"Reference number given by authority","type":"text","label":"Authority reference no.","options":[],"required":null,"pdf_field":""},{"help":"Authority address","type":"text","label":"Address line 1","options":[],"required":null,"pdf_field":""},{"help":"Authority address","type":"text","label":"Address line 2","options":[],"required":null,"pdf_field":""},{"help":"Authority city","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"Authority state","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"Authority postal code","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Authority phone number","type":"phone","label":"Phone No.","options":[],"required":null,"pdf_field":""},{"help":"Authority mobile number","type":"phone","label":"Mobile No.","options":[],"required":null,"pdf_field":""},{"help":"Authority email address","type":"email","label":"Email","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"C. DETAILS OF OTHER INSURANCE","fields":[{"help":"Select Yes or No","type":"yes-no","label":"Is the Loss/damage covered under any other Insurance?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide other insurer details and attach policy copy","type":"text","label":"If \"Yes\", specify details and attach copy of policy","options":[],"required":null,"pdf_field":""},{"help":"Name of other insurance company","type":"text","label":"Name of the Insurer","options":[],"required":null,"pdf_field":""},{"help":"Policy number of other insurance","type":"text","label":"Policy No.","options":[],"required":null,"pdf_field":""},{"help":"Specify indemnity limits","type":"text","label":"Limits of Indemnity under the Policy","options":[],"required":null,"pdf_field":""},{"help":"Start date of other insurance","type":"date","label":"Period of Insurance From","options":[],"required":null,"pdf_field":""},{"help":"End date of other insurance","type":"date","label":"To","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Claims lodged during the preceding 3 years","fields":[{"help":"Year of previous claim","type":"number","label":"Claim Year","options":[],"required":null,"pdf_field":""},{"help":"Brief description of previous claim","type":"text","label":"Claim Description","options":[],"required":null,"pdf_field":""},{"help":"Amount claimed previously","type":"amount","label":"Amount Rs.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"D. DETAILS OF OTHER INTEREST","fields":[{"help":"Name of other interested party","type":"text","label":"Name","options":[],"required":null,"pdf_field":""},{"help":"Address of other interested party","type":"text","label":"Address line 1","options":[],"required":null,"pdf_field":""},{"help":"Address of other interested party","type":"text","label":"Address line 2","options":[],"required":null,"pdf_field":""},{"help":"City of other interested party","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"State of other interested party","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"Postal code of other interested party","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Phone number of other interested party","type":"phone","label":"Phone No.","options":[],"required":null,"pdf_field":""},{"help":"Mobile number of other interested party","type":"phone","label":"Mobile No.","options":[],"required":null,"pdf_field":""},{"help":"Email of other interested party","type":"email","label":"Email","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"E. DETAILS OF DAMAGED PROPERTY","fields":[{"help":"Select Yes or No","type":"yes-no","label":"Is the insured sole owner of the property?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details of other owners if not sole owner","type":"text","label":"If \"No\", specify details","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"G. DETAILS OF OTHER INFORMATION","fields":[{"help":"Select Yes or No","type":"yes-no","label":"Do you wish to provide any other information?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide any additional information","type":"text","label":"If \"Yes\", specify","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration and Signature","fields":[{"help":"Location where form is signed","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of Insured","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Contractor’s Plant & Machinery Insurance Policy claims","attachments":["Copy of other insurance policy if loss/damage is covered under any other insurance","List of documents received with this claim form (as per company requirements)"],"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 agrees to the company's privacy policy as amended from time to time.","The insured acknowledges receipt of the list of required documents and understands that non-submission may delay claim processing.","The insured declares all persons having 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 or UIDAI or other modes."],"dropped_labels":1},"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/1385-claim-form-for-contractors-plant-and-machinery-insurance-policy"}