{"id":1503,"title":"Griha Raksha Plus Claim Form","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/grp-claim-form-zk-v1-24-25-16072024.pdf","sha256":"a5e49151f173a16c6ad6282060d6a5a517d591adff2b491e26e0629efef6f095","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured to notify and claim for physical loss or damage under the Griha Raksha Plus policy.","notes":["Attach copies of other insurance policies if applicable.","Attach an original blank cancelled cheque signed by the payee.","Attach a PAN card copy of the payee.","The claim must be based on the actual value of the goods at the time of fire, excluding any profit.","Use the exact bank details as per bank records for NEFT/RTGS payments."],"title":"Griha Raksha Plus Claim Form","submit":{"to":"Zurich Kotak General Insurance Company (India) Limited","how":"","address":"401, 4th Floor, Silver Metropolis, Jai Coach Compound, Off Western Express Highway, Goregaon (East), Mumbai - 400063, Maharashtra, India"},"purpose":"claim","sections":[{"title":"Details of Insured","fields":[{"help":"Enter your policy number","type":"text","label":"Policy No:","options":[],"required":null,"pdf_field":""},{"help":"For company use","type":"text","label":"Claim No:","options":[],"required":false,"pdf_field":""},{"help":"Enter the name of the insured","type":"text","label":"Name","options":[],"required":null,"pdf_field":""},{"help":"Enter your correspondence address","type":"text","label":"Address for correspondence.","options":[],"required":null,"pdf_field":""},{"help":"Enter your contact phone number","type":"phone","label":"Contact Number.","options":[],"required":null,"pdf_field":""},{"help":"Provide details of any mortgagee or other persons with financial interest","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 Other Insurance","fields":[{"help":"Enter name of other insurer if any","type":"text","label":"Name of Insurer","options":[],"required":null,"pdf_field":""},{"help":"Enter policy number(s) of other insurance","type":"text","label":"Policy No. (s).","options":[],"required":null,"pdf_field":""},{"help":"Enter sum insured under other policies","type":"amount","label":"Sum Insured Rs.","options":[],"required":null,"pdf_field":""},{"help":"Enter start date of other insurance","type":"date","label":"Period From","options":[],"required":null,"pdf_field":""},{"help":"Enter end date of other insurance","type":"date","label":"To","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Details of Loss","fields":[{"help":"Enter the time and date when the loss occurred","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 affected item(s) under the policy","type":"text","label":"Item of Policy affected (give description)","options":[],"required":null,"pdf_field":""},{"help":"State the occupation or use 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":"Indicate if the fire/loss was reported to the fire brigade","type":"yes-no","label":"Has the Fire / Loss been reported to Fire Brigade?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"If not reported to fire brigade, explain why","type":"text","label":"( If not, give reasons )","options":[],"required":false,"pdf_field":""},{"help":"Indicate if the fire/loss was reported to the police","type":"yes-no","label":"Has the Fire / Loss been reported to Police?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"If not reported to police, explain why","type":"text","label":"(If not, give reasons)","options":[],"required":false,"pdf_field":""},{"help":"Provide the address where the loss/damage can be inspected","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 information for claim processing","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":"Enter the payee name exactly as per bank records","type":"text","label":"Payee name (as per bank records)","options":[],"required":true,"pdf_field":""},{"help":"Enter the bank account number of the payee","type":"text","label":"Payee account no","options":[],"required":true,"pdf_field":""},{"help":"Select the type of bank account","type":"choice","label":"Type of account : Saving, Current, Others","options":["Saving","Current","Others"],"required":true,"pdf_field":""},{"help":"Enter the bank's name","type":"text","label":"Name of the bank","options":[],"required":true,"pdf_field":""},{"help":"Enter the bank branch name","type":"text","label":"Branch Name","options":[],"required":true,"pdf_field":""},{"help":"Enter the bank branch address","type":"text","label":"Address of the bank","options":[],"required":true,"pdf_field":""},{"help":"Enter the IFSC code of the bank branch","type":"text","label":"IFSC Code of the bank","options":[],"required":true,"pdf_field":""},{"help":"Enter the MICR code of the bank branch","type":"text","label":"MICR code of the Bank","options":[],"required":true,"pdf_field":""},{"help":"Enter the PAN number of the payee","type":"text","label":"PAN of the payee","options":[],"required":true,"pdf_field":""},{"help":"Sign here as the account holder","type":"signature","label":"Signature of the Account Holder","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"claims for physical loss or damage under the Griha Raksha Plus policy","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 form or policy endorsement.","No material information relevant to the claim has been withheld or not disclosed.","False or fraudulent statements or concealment of material information will void the policy and claims.","Receipt of this claim form or supporting documents does not constitute admission of liability by the company."],"dropped_labels":1},"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/1503-griha-raksha-plus-claim-form"}