{"id":1444,"title":"MARINE CARGO INSURANCE (COMMERCIAL) 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-insurance-commercial/claim-form.pdf","sha256":"afb4da263c19dbb1ed9258cf1ffe70b04ab0a570f99f966272d2008bb510ac4b","pages":4,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured to claim for loss or damage under a marine cargo insurance policy.","notes":["The issue of this form is not an admission of liability.","If any detail or information is not readily available, dispatch the form without delay and send particulars later.","Attach all required original documents as listed for claim processing."],"title":"MARINE CARGO INSURANCE (COMMERCIAL) CLAIM FORM","submit":{"to":"Universal Sompo General Insurance Co. Ltd.","how":"","address":"8th Floor & 9th Floor (South Side), Commerz International Business Park, Oberoi Garden City, Off Western Express Highway, Goregaon East, Mumbai 400063, Maharashtra."},"purpose":"claim","sections":[{"title":"Insured Details","fields":[{"help":"","type":"text","label":"Policy Number:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Certificate Number:","options":[],"required":null,"pdf_field":""},{"help":"Name of the insured","type":"text","label":"Name:","options":[],"required":null,"pdf_field":""},{"help":"Full address of the insured","type":"text","label":"Address:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"City:","options":[],"required":null,"pdf_field":""},{"help":"Postal code","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Landline number","type":"phone","label":"Telephone Number:","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":""}],"filled_by":"insured"},{"title":"Details of the Affected Item","fields":[{"help":"Name of the sender of goods","type":"text","label":"Name of the Consignor:","options":[],"required":null,"pdf_field":""},{"help":"Consignor's address","type":"text","label":"Address:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"City:","options":[],"required":null,"pdf_field":""},{"help":"","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Name and address of the receiver of goods","type":"text","label":"Name & Address of the Consignee:","options":[],"required":null,"pdf_field":""},{"help":"Consignee's address","type":"text","label":"Address:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"City:","options":[],"required":null,"pdf_field":""},{"help":"","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Description of the goods insured","type":"text","label":"Nature of the Goods:","options":[],"required":null,"pdf_field":""},{"help":"Count of packages or cases dispatched","type":"number","label":"Total number of Packages and/or cases Dispatched with marks if any","options":[],"required":null,"pdf_field":""},{"help":"Provide all relevant transport document numbers and dates","type":"text","label":"Bill of Lading No. /Air Way Bill No. / Lorry Receipt No. /Railway Receipt No. & Date (if multiple modes are involved, specify the details of all )","options":[],"required":null,"pdf_field":""},{"help":"Location from where goods were dispatched","type":"text","label":"Place of Dispatch:","options":[],"required":null,"pdf_field":""},{"help":"Final destination of the goods","type":"text","label":"Place of Destination:","options":[],"required":null,"pdf_field":""},{"help":"Provide details below about steamer or air transport","type":"text","label":"If by Steamer/Air:","options":[],"required":null,"pdf_field":""},{"help":"Date goods landed at final port","type":"date","label":"Date of Landing at Final Port","options":[],"required":null,"pdf_field":""},{"help":"Date customs clearance was obtained","type":"date","label":"Date of Clearance","options":[],"required":null,"pdf_field":""},{"help":"Date goods dispatched to final destination after clearance","type":"date","label":"Date of dispatch to Final Destination, if any","options":[],"required":null,"pdf_field":""},{"help":"Explain any delay in customs clearance","type":"text","label":"Reasons for delay in clearance, if any","options":[],"required":false,"pdf_field":""},{"help":"Date goods received at final destination","type":"date","label":"Date of receipt at Final Destination","options":[],"required":null,"pdf_field":""},{"help":"Explain any delay in taking delivery","type":"text","label":"Reasons for delay in taking delivery at Final Destination, if any","options":[],"required":false,"pdf_field":""},{"help":"Provide details below about rail transport","type":"text","label":"If by Rail:","options":[],"required":null,"pdf_field":""},{"help":"Date goods received at final rail station","type":"date","label":"Date of Receipt at Final Station","options":[],"required":null,"pdf_field":""},{"help":"Date goods delivered from final rail station","type":"date","label":"Date of delivery from Final Station","options":[],"required":null,"pdf_field":""},{"help":"Explain any delay in delivery from final station","type":"text","label":"Reasons for delay in taking delivery, if any","options":[],"required":false,"pdf_field":""},{"help":"Date goods dispatched to interior destination","type":"date","label":"Date of dispatch to Interior Destination","options":[],"required":null,"pdf_field":""},{"help":"Date goods received at interior destination","type":"date","label":"Date of receipt at Interior Destination","options":[],"required":null,"pdf_field":""},{"help":"Explain any delay in delivery at interior destination","type":"text","label":"Reasons for delay in taking delivery at Interior Destination","options":[],"required":false,"pdf_field":""},{"help":"Date loss or damage was first observed","type":"date","label":"Date when loss or damage noted:","options":[],"required":null,"pdf_field":""},{"help":"Count of packages or cases received","type":"number","label":"Number of Packages and/or cases, delivery taken of","options":[],"required":null,"pdf_field":""},{"help":"Count of packages or cases not delivered by carriers","type":"number","label":"Number of Packages and/or cases not delivered by the Carriers (Steamer agents/Airport Authorities or Land Carriers)","options":[],"required":null,"pdf_field":""},{"help":"Describe condition of packages received","type":"text","label":"Details of the Condition of the cases and/or packages taken delivery of","options":[],"required":null,"pdf_field":""},{"help":"Indicate if survey or open delivery was done and attach certificates","type":"text","label":"State whether Steamer Survey held or Open delivery taken? If so, attach Certificates from the Carriers","options":[],"required":false,"pdf_field":""},{"help":"Select if claim was made against carrier","type":"choice","label":"Has Claim been made against the Carrier? (Note: The Claim has to be lodged within the stipulated timeframe)","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Explain why claim was not lodged against carrier","type":"text","label":"If Claim has not been lodged, state reasons for the same","options":[],"required":false,"pdf_field":""},{"help":"Provide details of customs examination and claims if damages noticed before clearance","type":"text","label":"If damages are noticed before Clearance for Home Consumption is issued, state details of Examination Carried out by Customs and the claim made on them(Remission/Abatement)","options":[],"required":false,"pdf_field":""},{"help":"Market value of goods at final port","type":"amount","label":"Sound market value of the goods at the final Port of Discharge","options":[],"required":null,"pdf_field":""},{"help":"Customs duty payable on undamaged goods","type":"amount","label":"Duty Payable on Sound Goods:","options":[],"required":null,"pdf_field":""},{"help":"Additional relevant information","type":"text","label":"Any other information that may be relevant:","options":[],"required":false,"pdf_field":""},{"help":"List other insurance policies covering the goods","type":"text","label":"Give details of other Insurances, if any, covering the affected property","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"}],"deadlines":["Notify the Company without delay as soon as loss or damage has become known.","Claim against the Carrier has to be lodged within the stipulated timeframe."],"applies_to":"Marine Cargo Insurance (Commercial)","attachments":["Original Insurance Policy and/or Certificate duly endorsed.","Complete Invoices together with Supplementary, if any and packing list.","Original Bill Of Lading (for sea/air consignments where damages noticed prior to removal to interior destination).","Original Lorry receipt/Rail receipt (for rail/road consignments).","Third copy of Bill of Entry.","Open Delivery Certificate if it has been arranged.","Landing Remarks Certificate.","Steamer survey report, if it has been arranged.","Copies of correspondence exchanged with the Carriers/Port Trust Authorities together with their replies in Original.","Carriers’ Certificate (Rail, Lorry, Post, Ship, Air) in original."],"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 or service providers.","The insured agrees to the Company's privacy policy as amended from time to time.","The insured understands the requirements for claim processing and that delays due to non-submission of documents are not the Company's responsibility.","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, 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/1444-marine-cargo-insurance-commercial-claim-form"}