{"id":1500,"title":"Notification of Physical Loss or Damage","purpose":"claim","insurer":{"slug":"zurich-kotak-general-insurance","name":"Zurich Kotak General Insurance Company (India) Limited"},"source_pdf":"https://www.zurichkotak.com/docs/documents/commercial/claim-forms/zkbsus-claim-form-zk-v1-24-25-12072024.pdf","sha256":"6545c309aed58474ae9daebd42c70195c195c65a004555ae6de7782e48e9024c","pages":4,"collected":"2026-10-17","instructions":{"about":"This form is for notifying and claiming physical loss or damage under the Zurich Kotak Bharat Sookshma Udyam Suraksha insurance policy. It is filled by the insured claimant.","notes":["A fire insurance policy is a contract of indemnity; claims must be based on actual value of goods at time of fire, excluding profit.","Attach copies of other insurance policies if applicable.","Attach original blank cancelled cheque signed by payee and PAN card copy for EFT payment.","The RTGS/NEFT facility will be activated within 15 days of receipt of mandate form.","The company is not responsible for verification of bank details provided by customer.","Customer must indemnify the company against any claims or losses arising from RTGS/NEFT transactions.","Customer can terminate RTGS/NEFT facility with 15 days prior written notice to the company.","Submission of documents or bank details does not imply admission of liability.","Use exact names and details as per bank records for EFT payment."],"title":"Notification of Physical Loss or Damage","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Details of Other Insurance","fields":[{"help":"","type":"text","label":"Name of Insurer","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Policy No. (s).","options":[],"required":null,"pdf_field":""},{"help":"","type":"amount","label":"Sum Insured (`)","options":[],"required":null,"pdf_field":""},{"help":"Start date of insurance period","type":"date","label":"Period From","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Details of Insured","fields":[{"help":"","type":"text","label":"Name","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Address for correspondence","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Contact Number","options":[],"required":null,"pdf_field":""},{"help":"If applicable, provide details of mortgagee or other interested parties","type":"text","label":"Name and Address of Mortgagee(s) or other persons having financial interest in the property.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Details of Loss","fields":[{"help":"Provide exact time and date of the loss event","type":"date","label":"Time & Date of Fire / Loss","options":[],"required":null,"pdf_field":""},{"help":"Describe the cause of the fire or loss","type":"text","label":"Cause of Fire / Loss","options":[],"required":null,"pdf_field":""},{"help":"Describe the insured item affected by the loss","type":"text","label":"Item of Policy affected (give description)","options":[],"required":null,"pdf_field":""},{"help":"State the use or occupation of the premises when loss occurred","type":"text","label":"Occupation of the premises at the time of Fire / Loss","options":[],"required":null,"pdf_field":""},{"help":"Yes or No and reasons if not reported","type":"text","label":"Has the Fire / Loss been reported to Fire Brigade? ( If not, give reasons )","options":[],"required":null,"pdf_field":""},{"help":"Yes or No and reasons if not reported","type":"text","label":"Has the Fire / Loss been reported to Police? (If not, give reasons)","options":[],"required":null,"pdf_field":""},{"help":"Provide location address for inspection","type":"text","label":"Address where the loss can be inspected.","options":[],"required":null,"pdf_field":""},{"help":"Describe the extent of loss in detail","type":"text","label":"Extent of Loss (as more particularly described in the statement overleaf)","options":[],"required":null,"pdf_field":""},{"help":"Provide any other relevant details","type":"text","label":"Any additional information relevant to processing of claim.","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"Direct Fund Transfer / EFT Mandate Form","fields":[{"help":"Select Yes to use existing NEFT details or No to provide new details","type":"choice","label":"Would you like to continue with the NEFT details provided in the proposal form for Claim payment?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide name exactly as per bank records if No above","type":"text","label":"Payee name (as per bank records)","options":[],"required":false,"pdf_field":""},{"help":"Provide bank account number if No above","type":"text","label":"Payee account no :","options":[],"required":false,"pdf_field":""},{"help":"Select account type if No above","type":"choice","label":"Type of account :","options":["Saving","Current","Others"],"required":false,"pdf_field":""},{"help":"Provide bank name if No above","type":"text","label":"Name of the bank:","options":[],"required":false,"pdf_field":""},{"help":"Provide bank branch name if No above","type":"text","label":"Branch Name :","options":[],"required":false,"pdf_field":""},{"help":"Provide bank branch address if No above","type":"text","label":"Address of the bank:","options":[],"required":false,"pdf_field":""},{"help":"Provide IFSC code if No above","type":"text","label":"IFSC Code of the bank :","options":[],"required":false,"pdf_field":""},{"help":"Provide MICR code if No above","type":"text","label":"MICR code of the Bank :","options":[],"required":false,"pdf_field":""},{"help":"Provide PAN card number of payee if No above","type":"text","label":"PAN of the payee:","options":[],"required":false,"pdf_field":""},{"help":"Sign to authorize the bank details","type":"signature","label":"Signature of the Account Holder","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"","attachments":["Copies of other insurance policies if insurance is effected with other companies","Original Blank Cancelled Cheque signed by the payee","PAN Card copy of Payee"],"declarations":["The statements/information given in this claim form are true, correct and complete.","All persons having an interest in the property are disclosed as per the proposal or policy endorsement.","No material information relevant to the claim has been withheld or not disclosed.","False or fraudulent statements or concealment of information will void the policy and claims.","Receipt of this claim form or documents does not constitute admission of liability by the company."],"dropped_labels":6},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"address","value":"Family Health Plan Insurance TPA Limited, Srinilaya – Cyber Spazio, Suite # 101,102,109&110, Ground Floor,Road No. 2, Banjara Hills, Hyderabad : 500034, Telangana , India","label":"Health claims department address","level":null,"hours":null,"applies_to":"health","source_url":"https://www.zurichkotak.com/services/claims","quote":"g address as early as possible, but no later than 30 days from the date of discharge.\nHealth claims department address:\nFamily Health Plan Insurance TPA Limited, Srinilaya – Cyber Spazio, Suite # 101,102,109&110, Ground Floor,Road No. 2, Banjara Hills, Hyderabad : 500034, Telangana , India\nIs there any time period for filing pre and post hospital claims?\nThe pre-hospitalisation claim documents duly complete","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"care@zurichkotak.com","label":"Email Address","level":null,"hours":null,"applies_to":"all","source_url":"https://www.zurichkotak.com/services/claims","quote":"in\nToll Number (INDIA And Overseas)\n+91-22-69417220\nToll Free Number\n1800 2120\nWhatsApp Number\n7998879988\nEmail Address\ncare@zurichkotak.com\nOur WhatsApp number cannot be used for calls. This is chat only number.\nAccessibility\nZoom in page\nZoom out page\nIncrea","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 2120","label":"Toll Free Number","level":null,"hours":null,"applies_to":"all","source_url":"https://www.zurichkotak.com/services/claims","quote":"age claims\nCustomer support\nGrievance redressal\nLogin\nToll Number (INDIA And Overseas)\n+91-22-69417220\nToll Free Number\n1800 2120\nWhatsApp Number\n7998879988\nEmail Address\ncare@zurichkotak.com\nOur WhatsApp number cannot be used for calls. This is cha","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"+91-22-69417220","label":"Toll Number (INDIA And Overseas)","level":null,"hours":"IST 8 am to 8 pm","applies_to":"all","source_url":"https://www.zurichkotak.com/services/claims","quote":"Download policy\nManage policy\nManage claims\nCustomer support\nGrievance redressal\nLogin\nToll Number (INDIA And Overseas)\n+91-22-69417220\nToll Free Number\n1800 2120\nWhatsApp Number\n7998879988\nEmail Address\ncare@zurichkotak.com\nOur WhatsApp number cannot be","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/zurich-kotak-general-insurance/1500-notification-of-physical-loss-or-damage"}