{"id":158,"title":"DOG SURAKSHA CLAIM FORM","purpose":"claim","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited"},"source_pdf":"https://www.generalicentralinsurance.com/downloads/lifestyle-insurance/dog-suraksha/claim-forms/dog-suraksha-claim-form.pdf","sha256":"bb6b730836ba47b25d851d52564539d5a4535ef582f508c1170d2e22934c6605","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured person to claim insurance for their dog under the Dog Suraksha policy.","notes":["The issue of this claim form is not an admission of liability.","Fill all details clearly and truthfully."],"title":"DOG SURAKSHA CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Description of Animal Claimed For","fields":[{"help":"","type":"text","label":"Insurance Policy No.","options":[],"required":null,"pdf_field":""},{"help":"Enter the insurance coverage period","type":"text","label":"Period of Insurance","options":[],"required":null,"pdf_field":""},{"help":"Name of the insured","type":"text","label":"Name:","options":[],"required":null,"pdf_field":""},{"help":"Full postal address","type":"text","label":"Address:","options":[],"required":null,"pdf_field":""},{"help":"City of residence","type":"text","label":"City:","options":[],"required":null,"pdf_field":""},{"help":"Postal PIN code","type":"number","label":"Pin:","options":[],"required":null,"pdf_field":""},{"help":"Phone number with area code","type":"phone","label":"Contact Telephone :","options":[],"required":null,"pdf_field":""},{"help":"Email address","type":"email","label":"e-mail:","options":[],"required":null,"pdf_field":""},{"help":"Specify animal type (e.g. dog)","type":"text","label":"Type of Animal","options":[],"required":null,"pdf_field":""},{"help":"Breed of the dog","type":"text","label":"Breed","options":[],"required":null,"pdf_field":""},{"help":"Sex of the dog","type":"text","label":"Sex","options":[],"required":null,"pdf_field":""},{"help":"Age of the dog","type":"text","label":"Age","options":[],"required":null,"pdf_field":""},{"help":"Describe physical features to identify the dog","type":"text","label":"Detailed Description of Animal Like Colour, Tail, Height, Body marks, other distinct features","options":[],"required":null,"pdf_field":""},{"help":"Registration number if applicable","type":"text","label":"Kennel Club Registration No.(If registered)","options":[],"required":null,"pdf_field":""},{"help":"Market value of the dog before loss","type":"amount","label":"Value prior to Loss","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"Details of Loss or Injury","fields":[{"help":"Date when illness was first noticed","type":"date","label":"1.When was the animal first seen ill?","options":[],"required":null,"pdf_field":""},{"help":"Date when vet was informed","type":"date","label":"2. When was notice sent to Veterinary Doctor?","options":[],"required":null,"pdf_field":""},{"help":"Dates of first and last vet visits","type":"text","label":"3. When first and last seen by Veterinary Doctor?","options":[],"required":null,"pdf_field":""},{"help":"Full name and address of vet","type":"text","label":"4. Name and address of Veterinary Doctor who attended.","options":[],"required":null,"pdf_field":""},{"help":"Details of where and when loss occurred","type":"text","label":"5. Place, Date and Time of Death/Injury/loss.","options":[],"required":null,"pdf_field":""},{"help":"Explain cause of disease or accident","type":"text","label":"6. If from Disease, how do you account for it? If from Accident, how it occurred?","options":[],"required":null,"pdf_field":""},{"help":"Purpose of the dog before loss","type":"text","label":"7. Purpose for which used or employed before Death/Injury/Loss.","options":[],"required":null,"pdf_field":""},{"help":"State if dog was bred or purchased","type":"text","label":"8. Did you breed or buy the Animal?","options":[],"required":null,"pdf_field":""},{"help":"Date of last litter if applicable","type":"date","label":"9. Date of last whelping.","options":[],"required":null,"pdf_field":""},{"help":"Details of purchase if applicable","type":"text","label":"10. If bought, State: - a) From Whom? b) Date of purchase c) Price Paid","options":[],"required":null,"pdf_field":""},{"help":"Claim amount in rupees","type":"amount","label":"11. Amount of claim Rs.","options":[],"required":null,"pdf_field":""},{"help":"Details of other insurance or compensation","type":"text","label":"12. Is the animal insured elsewhere? Are you receiving compensation from any other source? If so, from whom.","options":[],"required":null,"pdf_field":""},{"help":"Detailed description of loss or injury","type":"text","label":"13. (Please give full description of Loss) a. If animal has not died, describe the nature of injury or nature of loss. Please state when it occurred & its duration b. When and Under What Circumstances the animal is lost or stolen? c. Whether FIR Lodged, If Yes Its Number d. When and Where the Dog show was arranged? e. How the animal was transported? f. Any other relevant information.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"Declaration","fields":[{"help":"Date of signing","type":"date","label":"Date:","options":[],"required":null,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place:","options":[],"required":null,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of Insured/ Claimant","options":[],"required":true,"pdf_field":""}],"filled_by":"insured/claimant"}],"deadlines":[],"applies_to":"Dog Suraksha insurance claims","attachments":[],"declarations":["The insured agrees to provide additional information if required.","The insured warrants the truth of the statements made in the form to the best of their knowledge.","If any false or fraudulent statement or concealment is made, the policy shall be void and rights to recover will be forfeited."],"dropped_labels":0},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"GCIcare@generalicentral.com","label":"Claim Intimation Email","level":null,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/motor-insurance/motor-claim-process","quote":"ses.\nCLAIM FORM\nYou can\nclick here\nand check our claim form\nCALL ON\n1800 220233\n1860 500 3333\n022 6783 7800\nEMAIL US AT\nGCIcare@generalicentral.com\nVISIT OUR BRANCH\nYou can check for your nearest branch\nhere\nClaim Process Simplified\nSimple steps to help you file a cl","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"GCIClaims@generalicentral.com","label":"Other Claim Intimation Email","level":null,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/other-claim-process","quote":"NLINE CLAIM INTIMATION\nYou can\nclick here\nto intimate claim\nCALL ON\n1800 220233\n1860 500 3333\n022 6783 7800\nEMAIL US AT\nGCIClaims@generalicentral.com\nVISIT OUR BRANCH\nYou can check for your nearest branch\nhere\nInitiate Quick Claim\nExtended Warranty\nMarine & Others\nProd","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 220 233","label":"Claim Intimation Phone","level":null,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/motor-insurance/motor-claim-process","quote":"aim under your insurance policy.\nCashless Claim Process\nReimbursement Claim Process\n1\nIntimate us online or  Call us on 1800 220 233\n2\nSurveyor will inspect the vehicle.\n3\nProvide requested documents to surveyor\n4\nApproved claim amount will be communic","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1860 500 3333","label":"Claim Intimation Phone","level":null,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/motor-insurance/motor-claim-process","quote":"Motor Claim Process | Generali Central\nGrievance Redressal\nQuick Pay\nNeed Analysis\n1860 500 3333\n|\n022 6783 7800\n1860 500 3333\n022 6783 7800\nProducts\nRenew\nClaim\nHelp & Support\nAbout Us\nTrending Searches\nHealth Insur","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022 6783 7800","label":"Claim Intimation Phone","level":null,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/motor-insurance/motor-claim-process","quote":"Motor Claim Process | Generali Central\nGrievance Redressal\nQuick Pay\nNeed Analysis\n1860 500 3333\n|\n022 6783 7800\n1860 500 3333\n022 6783 7800\nProducts\nRenew\nClaim\nHelp & Support\nAbout Us\nTrending Searches\nHealth Insurance\nDog Insuran","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/generali-central-insurance/158-dog-suraksha-claim-form"}