{"id":144,"title":"MOTOR PROTECT COMMERCIAL VEHICLE (LIABILITY ONLY) CLAIM FORM","purpose":"claim","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited"},"source_pdf":"https://www.generalicentralinsurance.com/downloads/motor-insurance/motor-protect-commercial-vehicle-liability-only/claim-forms/motor-protect-commercial-vehicle-liability-only-claim-form.pdf","sha256":"8da1edc6c7eb88baf1035cd78b13506c1a5394aa3eed48d483b6daa2272bdce4","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is for insured persons to claim for liability-only commercial vehicle insurance. The insured fills it to report accident and loss details.","notes":["Issue of this claim form is not an admission of liability.","The damaged vehicle shall not be left unattended without proper precaution to prevent further damage.","Use factual and unbiased statements.","The list of documents is indicative; additional documents may be requested.","For claims above one lakh rupees, AML documents are mandatory.","Sign and date the declaration section."],"title":"MOTOR PROTECT COMMERCIAL VEHICLE (LIABILITY ONLY) CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Insured and Policy Details","fields":[{"help":"","type":"text","label":"Policy Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Vehicle No","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Claim No.","options":[],"required":null,"pdf_field":""},{"help":"Start date of insurance coverage","type":"date","label":"Period Of Insurance From","options":[],"required":null,"pdf_field":""},{"help":"Full name of the insured or claimant","type":"text","label":"Name Of Insured/Claimant","options":[],"required":null,"pdf_field":""},{"help":"Full postal address","type":"text","label":"*Address","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"Postal PIN code","type":"number","label":"Pin code","options":[],"required":null,"pdf_field":""},{"help":"Landline phone number","type":"phone","label":"Phone No.","options":[],"required":null,"pdf_field":""},{"help":"Mobile phone number","type":"phone","label":"Mobile No.","options":[],"required":null,"pdf_field":""},{"help":"Email address","type":"email","label":"Email Id:","options":[],"required":null,"pdf_field":""},{"help":"Name exactly as in bank account","type":"text","label":"Name (As per Bank Account)","options":[],"required":null,"pdf_field":""},{"help":"Name of bank","type":"text","label":"Bank Details - Bank Name","options":[],"required":null,"pdf_field":""},{"help":"Bank branch name","type":"text","label":"Branch","options":[],"required":null,"pdf_field":""},{"help":"Savings, Current, etc.","type":"text","label":"Type of Account","options":[],"required":null,"pdf_field":""},{"help":"Bank account number","type":"text","label":"A/c No.","options":[],"required":null,"pdf_field":""},{"help":"Bank IFSC code","type":"text","label":"IFSC Code","options":[],"required":null,"pdf_field":""},{"help":"Permanent Account Number","type":"text","label":"PAN No.","options":[],"required":null,"pdf_field":""},{"help":"MICR code of bank branch","type":"text","label":"MICR","options":[],"required":null,"pdf_field":""},{"help":"Aadhar number","type":"text","label":"Aadhar No.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Loss Details","fields":[{"help":"Date when accident occurred","type":"date","label":"Date of Accident","options":[],"required":null,"pdf_field":""},{"help":"Time of accident with am or pm","type":"text","label":"Time of Accident: am/pm","options":[],"required":null,"pdf_field":""},{"help":"Location of accident","type":"text","label":"Place of Accident","options":[],"required":null,"pdf_field":""},{"help":"Select applicable loss type","type":"choice","label":"Type of Loss Own Damage Theft Third Party","options":["Own Damage","Theft","Third Party"],"required":null,"pdf_field":""},{"help":"Details of any add-on claims","type":"text","label":"In case, the claim has triggered in any of the add-on. Please provide the details.","options":[],"required":null,"pdf_field":""},{"help":"Brief description of accident","type":"text","label":"Short Description of Accident","options":[],"required":null,"pdf_field":""},{"help":"Details of police report if filed","type":"text","label":"Police Report Details, if any","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Driver Details at the Time of Accident","fields":[{"help":"Driver's full name","type":"text","label":"Name","options":[],"required":null,"pdf_field":""},{"help":"Driver's age","type":"number","label":"Age","options":[],"required":null,"pdf_field":""},{"help":"Driver's license number","type":"text","label":"Driver License No.","options":[],"required":null,"pdf_field":""},{"help":"Name of Regional Transport Office","type":"text","label":"Name of RTO","options":[],"required":null,"pdf_field":""},{"help":"Whether driver had learner's license","type":"yes-no","label":"Learner’s License Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Details of any co-passengers","type":"text","label":"Co-passenger details","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Commercial Vehicle Specific Details","fields":[{"help":"Number of passengers in vehicle","type":"number","label":"No. of passengers carried at the time of Accident","options":[],"required":null,"pdf_field":""},{"help":"Goods Receipt number and date if applicable","type":"text","label":"G R Number & Date","options":[],"required":null,"pdf_field":""},{"help":"Permit number of vehicle","type":"text","label":"Permit No.","options":[],"required":null,"pdf_field":""},{"help":"Authority that issued permit","type":"text","label":"Permit Issuing Authority","options":[],"required":null,"pdf_field":""},{"help":"Permit expiry date","type":"date","label":"Permit Valid Up to","options":[],"required":null,"pdf_field":""},{"help":"Area for which permit is valid","type":"text","label":"Permit Valid for (Area)","options":[],"required":null,"pdf_field":""},{"help":"Authority granting vehicle fitness","type":"text","label":"Fitness Granting Authority","options":[],"required":null,"pdf_field":""},{"help":"Fitness certificate expiry date","type":"date","label":"Fitness Valid up to","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Third Party Property Damage or Injury Details","fields":[{"help":"Name of third party or occupants involved","type":"text","label":"Name of Third party / occupants/driver/property","options":[],"required":null,"pdf_field":""},{"help":"Contact number of third party","type":"phone","label":"Contact No","options":[],"required":null,"pdf_field":""},{"help":"Describe injury or property damage","type":"text","label":"Type of Injury/property damage","options":[],"required":null,"pdf_field":""},{"help":"Hospital name if admitted","type":"text","label":"Name of the hospital where admitted","options":[],"required":null,"pdf_field":""},{"help":"Details of any legal or court notices","type":"text","label":"Any Legal / Court Notice Received","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Documents Submitted","fields":[{"help":"Tick all documents submitted","type":"checkbox","label":"I HEREBY DECLARE HAVING SUBMITTED THE FOLLOWING DOCUMENTS","options":["Copy of Policy/Cover Note","Copy of RC Book","Copy of Driving License","Estimate of repairs","Copy of Fitness Certificate","Copy of Permit","Copy of FIR","G.R Form"],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration and Signature","fields":[{"help":"Sign and date the form","type":"signature","label":"I/We here by declare that the details given above are true and correct to the best of my belief and knowledge. In event above information or any part thereof is found incorrect, I/We agree that all rights under the policy will be fortified. I/We also agree to provide additional information to the company, if required.","options":[],"required":true,"pdf_field":""},{"help":"Signature of insured","type":"signature","label":"Insured Signature","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date:","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Motor Protect Commercial Vehicle (Liability Only) insurance claims","attachments":["Claim Intimation","Policy Copy","Claim form","Copy of RC book","Copy of Driving License","Estimate","Photos","Survey Report","Survey Fees Bills","Supplementary Report / Re-inspection report","Final repair invoice and receipt / Satisfaction voucher for cashless payment","Fitness Certificate","Copy of FIR","Permit","Original Policy","Original Registration certificate","FIR","Original Set of Keys","Original Sales Invoice & Tax Receipt","Intimation to RTO (to inform RTO that the vehicle is stolen and not to transfer)","Final Report","Transfer papers","Indemnity Bond","Subrogation Letter","Cancelled Cheque for NEFT Payment","Photo Identity Proof","Passport size photo – (Individual) – Mandatory","Pan card - Mandatory","Passport / Driving License / voters ID Card","Proof of Address – (last six month)","Telephone Bill / Electricity Bill / Bank Statement / Ration Card Memorandum of understanding / Registration of Company – (Regd. Company / firm / establishment)"],"declarations":["The details given are true and correct to the best of my knowledge.","If any information is incorrect, all rights under the policy will be forfeited.","I agree to provide additional information if required."],"dropped_labels":1},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"GCIcare@generalicentral.com","label":"Claim Intimation Email","level":null,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/motor-insurance/motor-claim-process","quote":"ses.\nCLAIM FORM\nYou can\nclick here\nand check our claim form\nCALL ON\n1800 220233\n1860 500 3333\n022 6783 7800\nEMAIL US AT\nGCIcare@generalicentral.com\nVISIT OUR BRANCH\nYou can check for your nearest branch\nhere\nClaim Process Simplified\nSimple steps to help you file a cl","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"GCIClaims@generalicentral.com","label":"Other Claim Intimation Email","level":null,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/other-claim-process","quote":"NLINE CLAIM INTIMATION\nYou can\nclick here\nto intimate claim\nCALL ON\n1800 220233\n1860 500 3333\n022 6783 7800\nEMAIL US AT\nGCIClaims@generalicentral.com\nVISIT OUR BRANCH\nYou can check for your nearest branch\nhere\nInitiate Quick Claim\nExtended Warranty\nMarine & Others\nProd","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 220 233","label":"Claim Intimation Phone","level":null,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/motor-insurance/motor-claim-process","quote":"aim under your insurance policy.\nCashless Claim Process\nReimbursement Claim Process\n1\nIntimate us online or  Call us on 1800 220 233\n2\nSurveyor will inspect the vehicle.\n3\nProvide requested documents to surveyor\n4\nApproved claim amount will be communic","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1860 500 3333","label":"Claim Intimation Phone","level":null,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/motor-insurance/motor-claim-process","quote":"Motor Claim Process | Generali Central\nGrievance Redressal\nQuick Pay\nNeed Analysis\n1860 500 3333\n|\n022 6783 7800\n1860 500 3333\n022 6783 7800\nProducts\nRenew\nClaim\nHelp & Support\nAbout Us\nTrending Searches\nHealth Insur","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022 6783 7800","label":"Claim Intimation Phone","level":null,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/motor-insurance/motor-claim-process","quote":"Motor Claim Process | Generali Central\nGrievance Redressal\nQuick Pay\nNeed Analysis\n1860 500 3333\n|\n022 6783 7800\n1860 500 3333\n022 6783 7800\nProducts\nRenew\nClaim\nHelp & Support\nAbout Us\nTrending Searches\nHealth Insurance\nDog Insuran","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/generali-central-insurance/144-motor-protect-commercial-vehicle-liability-only-claim-form"}