{"id":1469,"title":"Zuno Loan Care Claim Form","purpose":"claim","insurer":{"slug":"zuno-general-insurance","name":"Zuno General Insurance Ltd"},"source_pdf":"https://cms.hizuno.com/uploads/Zuno_Loan_Care_claim_form_V_1_1_f22fc2a114.pdf?updated_at=2024-09-26T12:15:10.229Z","sha256":"83e4c414c9027b611752f426f99def560a6258f117a4071494c98797bf8a83d1","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured or claimant to file a claim under the Zuno Loan Care insurance policy.","notes":["Fill the form in capital letters and sign it.","Do not leave any column unanswered; if not applicable, mention 'not applicable'.","Use a separate sheet if space is insufficient and attach it.","Attach original documents and copies as specified.","Attach cancelled cheque leaf of bank account in the name of beneficiary/nominee."],"title":"Zuno Loan Care Claim Form","submit":{"to":"Zuno General Insurance Limited, Corporate Office","how":"post / e-mail / upload","address":"2nd Floor, Tower 3, Kohinoor City Mall, Kohinoor City, Kirol Road, Kurla (West), Mumbai – 400070; E-mail: support@hizuno.com"},"purpose":"claim","sections":[{"title":"Details of Insured and Policy","fields":[{"help":"Enter full name in capital letters","type":"text","label":"Name of the insured:","options":[],"required":true,"pdf_field":""},{"help":"Enter full postal address","type":"text","label":"Address of the insured:","options":[],"required":true,"pdf_field":""},{"help":"Use DD/MM/YYYY format","type":"date","label":"Date of birth:","options":[],"required":true,"pdf_field":""},{"help":"Tick the appropriate option","type":"choice","label":"Whether self-employed     Salaried","options":["Self-employed","Salaried"],"required":true,"pdf_field":""},{"help":"Enter loan account number","type":"text","label":"Loan A/c No:","options":[],"required":true,"pdf_field":""},{"help":"Enter full name and address","type":"text","label":"Name & address of bank / institution:","options":[],"required":true,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"If yes, please specify the details.","options":[],"required":false,"pdf_field":""},{"help":"Enter name if applicable","type":"text","label":"Name of the insurance company:","options":[],"required":false,"pdf_field":""},{"help":"Enter policy number if applicable","type":"text","label":"Policy No.:","options":[],"required":false,"pdf_field":""},{"help":"Enter sum insured amount","type":"amount","label":"Sum insured:","options":[],"required":false,"pdf_field":""},{"help":"Enter amount claimed","type":"amount","label":"Claimed amount:","options":[],"required":true,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"Claim Details","fields":[{"help":"Use DD/MM/YYYY format","type":"date","label":"Date of diagnosis of major medical illness or undergoing of surgery","options":[],"required":false,"pdf_field":""},{"help":"Describe illness or surgery","type":"text","label":"Please mention the type of major medical illness suffered or surgery undergone","options":[],"required":false,"pdf_field":""},{"help":"Enter full name","type":"text","label":"Name of the treating doctor","options":[],"required":false,"pdf_field":""},{"help":"Provide phone or address","type":"text","label":"Contact details of the treating doctor","options":[],"required":false,"pdf_field":""},{"help":"Select one applicable option","type":"choice","label":"Personal accident (please tick the appropriate box)","options":["Death due to accident","Permanent total disability due to accident","Permanent partial disability due to accident"],"required":false,"pdf_field":""},{"help":"Use DD/MM/YYYY format","type":"date","label":"Date of accident:","options":[],"required":false,"pdf_field":""},{"help":"Enter location","type":"text","label":"Place of accident:","options":[],"required":false,"pdf_field":""},{"help":"Describe cause","type":"text","label":"Cause of accident:","options":[],"required":false,"pdf_field":""},{"help":"Enter employer name","type":"text","label":"Name of organization employed:","options":[],"required":false,"pdf_field":""},{"help":"Enter employer address","type":"text","label":"Address:","options":[],"required":false,"pdf_field":""},{"help":"Enter employer contact number","type":"phone","label":"Contact number:","options":[],"required":false,"pdf_field":""},{"help":"Enter job title","type":"text","label":"Designation:","options":[],"required":false,"pdf_field":""},{"help":"Tick the appropriate option","type":"choice","label":"Nature of employment: Permanent             Probation             Casual             Temporary             Seasonal             Contractual","options":["Permanent","Probation","Casual","Temporary","Seasonal","Contractual"],"required":false,"pdf_field":""},{"help":"Enter date of applicable event","type":"date","label":"Date of: Termination            Suspension            Retrenchment","options":[],"required":false,"pdf_field":""},{"help":"Enter names of children for education benefit","type":"text","label":"Name of children:","options":[],"required":false,"pdf_field":""},{"help":"Enter institution names","type":"text","label":"Name of educational institution:","options":[],"required":false,"pdf_field":""},{"help":"Enter class or standard","type":"text","label":"Standard:","options":[],"required":false,"pdf_field":""},{"help":"Enter annual fees","type":"amount","label":"Fees payable (Rs):","options":[],"required":false,"pdf_field":""},{"help":"Enter amount claimed for education benefit","type":"amount","label":"Claimed amount (Rs):","options":[],"required":false,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"Bank Details","fields":[{"help":"Enter PAN number","type":"text","label":"PAN:","options":[],"required":true,"pdf_field":""},{"help":"Enter name as per bank records","type":"text","label":"Payee name (as bank records):","options":[],"required":true,"pdf_field":""},{"help":"Enter account type (e.g. Savings, Current)","type":"text","label":"Type of account:","options":[],"required":true,"pdf_field":""},{"help":"Enter bank account number","type":"text","label":"Account No:","options":[],"required":true,"pdf_field":""},{"help":"Enter bank name and branch","type":"text","label":"Bank name & branch:","options":[],"required":true,"pdf_field":""},{"help":"Enter IFSC code","type":"text","label":"IFSC:","options":[],"required":true,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"Declaration","fields":[{"help":"Enter date of signing","type":"date","label":"Date:","options":[],"required":true,"pdf_field":""},{"help":"Enter place of signing","type":"text","label":"Place:","options":[],"required":true,"pdf_field":""},{"help":"Sign the form","type":"signature","label":"Signature of Insured","options":[],"required":true,"pdf_field":""}],"filled_by":"insured/claimant"}],"deadlines":[],"applies_to":"claims under Zuno Loan Care insurance policy","attachments":["Cancelled cheque leaf of bank account in the name of beneficiary/nominee","Certificate from the attending medical practitioner confirming insured event details","Certificate from bank/financial institution stating amortization schedule, EMI amounts, principal outstanding, outstanding loan statement","Original discharge certificate/card from hospital/medical practitioner","Original investigation test reports, indoor case papers","Copy of PAN card","Disability certificate or medical report (for permanent total/partial disablement)","FIR, police panchnama (in case of accident outside residence)","Medical practitioner’s report (for accidental death)","First information report and final police report (wherever necessary)","Death certificate (wherever applicable)","Investigation reports like laboratory test, x-rays and reports confirming injury","Post mortem report (if conducted)","Newspaper cutting (if accident reported by press)","Proof to establish relationship for child education benefit (passport/education certificate/birth certificate/adoption papers)","Photo identity proof of child","Age proof of child","Certificate from educational institution describing course details","Certificate from employer confirming termination, dismissal, suspension or retrenchment (for involuntary loss of job)"],"declarations":["The details given are true and correct to the best of my belief and knowledge.","If any information is found incorrect, all rights under the policy will be forfeited.","I agree to provide additional information if required.","I authorize Zuno General Insurance / Zuno authorized TPA to collect relevant medical documents from the treatment provider."],"dropped_labels":1},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"support@hizuno.com","label":"Health claims support email","level":null,"hours":null,"applies_to":"health","source_url":"https://www.hizuno.com/health-insurance/health-claim","quote":"ls, you will need to submit a reimbursement claim. For cashless services at a common network hospital, you can write to\nsupport@hizuno.com\n, call us at 1800 12000, or connect with your TPA as mentioned on your card.\nWhen you’re covered by a health insurance","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 12000","label":"Health claims toll free number","level":null,"hours":null,"applies_to":"health","source_url":"https://www.hizuno.com/health-insurance/health-claim","quote":"imbursement claim. For cashless services at a common network hospital, you can write to\nsupport@hizuno.com\n, call us at 1800 12000, or connect with your TPA as mentioned on your card.\nWhen you’re covered by a health insurance policy and need to be ho","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022 423 12000","label":"Paid Landline","level":null,"hours":null,"applies_to":"all","source_url":"https://www.hizuno.com/contact-us","quote":"uote\nHome\nContact us\nReach out to us for any Query/ Request or Grievance\nCall us\nToll free - 1800 12000\nPaid Landline -\n022 423 12000\nSenior citizen -\n022 423 12001\nEmail address\nsupport@hizuno.com\nsenior.citizen@hizuno.com\nGrievance Redressal Officer\nM","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/zuno-general-insurance/1469-zuno-loan-care-claim-form"}