{"id":1481,"title":"Mega Risk Insurance claim form","purpose":"claim","insurer":{"slug":"zuno-general-insurance","name":"Zuno General Insurance Ltd"},"source_pdf":"https://cms.hizuno.com/uploads/Mega_insurance_claim_form_V_1_1_b51b069e2a.pdf?updated_at=2025-08-13T11:55:51.888Z","sha256":"82e9c4e725fcbfef8e26f744ad2ddb6f065b6e690a5c16a658c1b1a81a514f85","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured or claimant to file a claim under the Mega Risk Insurance policy with Zuno General Insurance Limited.","notes":["All questions must be answered fully.","If there is insufficient space, use a separate sheet attached to this form.","Do not dispose of or destroy damaged property without consent of surveyor/Zuno General Insurance Limited.","The issue or acceptance of this form is not an admission of liability by Zuno General Insurance Limited."],"title":"Mega Risk Insurance claim form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Details of insured/claimant and loss","fields":[{"help":"","type":"text","label":"Name of the Insured:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Address for correspondence:","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Tel No. - Office:","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Mobile:","options":[],"required":null,"pdf_field":""},{"help":"","type":"email","label":"Email:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Name and contact of person available at loss site:","options":[],"required":null,"pdf_field":""},{"help":"Enter your policy number","type":"text","label":"Policy details - policy No.:","options":[],"required":null,"pdf_field":""},{"help":"Enter start and end date of insurance period","type":"date","label":"Period of insurance: to:","options":[],"required":null,"pdf_field":""},{"help":"Date when loss occurred","type":"date","label":"Loss details- Date:","options":[],"required":null,"pdf_field":""},{"help":"Time of loss with am or pm","type":"text","label":"Time: am/pm:","options":[],"required":null,"pdf_field":""},{"help":"Date and time when loss was discovered","type":"text","label":"Date/time discovered:","options":[],"required":null,"pdf_field":""},{"help":"Person who discovered the loss","type":"text","label":"By whom:","options":[],"required":null,"pdf_field":""},{"help":"Address where loss occurred","type":"text","label":"Location/address of Loss:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"City:","options":[],"required":null,"pdf_field":""},{"help":"Postal code of loss location","type":"number","label":"Pin code:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"State:","options":[],"required":null,"pdf_field":""},{"help":"Describe the incident briefly","type":"text","label":"Brief of fire / loss","options":[],"required":null,"pdf_field":""},{"help":"Approximate value of loss","type":"amount","label":"Estimated loss amount","options":[],"required":null,"pdf_field":""},{"help":"Describe the damaged property","type":"text","label":"Details of damaged property","options":[],"required":null,"pdf_field":""},{"help":"Explain any steps taken to reduce loss","type":"text","label":"Did you take any measures to minimize the loss? If yes, please provide details of the same","options":[],"required":null,"pdf_field":""},{"help":"Provide witness details if any","type":"text","label":"Was there any witness (es) to the incident? (Yes/No) If yes, please provide name, address, and phone no. and enclose statement from the witness","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"State if fire brigade was informed or reasons if not","type":"text","label":"Whether the fire / loss been reported to fire brigade? (If not, give reasons)","options":[],"required":null,"pdf_field":""},{"help":"State if police was informed or reasons if not","type":"text","label":"Whether the fire / loss been reported to police? (If not, give reasons)","options":[],"required":null,"pdf_field":""},{"help":"Any other relevant details","type":"text","label":"Any additional information relevant to claim.","options":[],"required":false,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"Claim history and other insurance","fields":[{"help":"Indicate if you have made previous claims","type":"choice","label":"Have you made any claim in the past Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details of past claims if any","type":"text","label":"If Yes, please give the details of cause of accident/occurrence, nature of injury, policy details and claim amount.","options":[],"required":false,"pdf_field":""},{"help":"Indicate if you have other insurance policies","type":"choice","label":"Are you insured under any other policy Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details of other insurance policies","type":"text","label":"If yes, please give full particulars of Name of the insurance company, Policy number, period of insurance and claim details","options":[],"required":false,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"Declaration","fields":[{"help":"Sign to declare the truthfulness of information","type":"signature","label":"Signature of insured:","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date:","options":[],"required":true,"pdf_field":""}],"filled_by":"insured/claimant"}],"deadlines":[],"applies_to":"","attachments":["Separate sheet if insufficient space","Statement from witness if any"],"declarations":["I/We declare that I/We have not withheld any material information and that all statements made on this form are true to the best of my/our knowledge and belief.","I/We declare that the articles/property described belong to me/us and no other person has any interest except as mentioned in the Policy.","I/We understand that the claim may be refused if the information is untrue, inaccurate or concealed."],"dropped_labels":0},"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/1481-mega-risk-insurance-claim-form"}