{"id":160,"title":"DOG HEALTH COVER 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-health-cover/claim-forms/dog-health-cover-claim-form.pdf","sha256":"631e903bc287e7b83f669c963c012e49c3b68ddd8ceb4d506f266c2db4ea6bde","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is for the insured to claim benefits under the Dog Health Cover insurance policy by providing details about the insured dog and the claim.","notes":["The issue of this claim form is not to be taken as an admission of liability.","All facts and statements must be factual and unbiased.","If any detail is not readily available, do not delay dispatching the form; such particulars may be sent later."],"title":"DOG HEALTH COVER CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Insured Details","fields":[{"help":"","type":"text","label":"NAME OF THE INSURED","options":[],"required":null,"pdf_field":""},{"help":"Include City, State, Pin code","type":"text","label":"ADDRESS","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"CONTACT DETAILS Phone No.","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Mobile No.","options":[],"required":null,"pdf_field":""},{"help":"","type":"email","label":"Email Id:","options":[],"required":null,"pdf_field":""},{"help":"Policy number as per your insurance documents","type":"text","label":"POLICY NUMBER","options":[],"required":null,"pdf_field":""},{"help":"If already assigned, else leave blank","type":"text","label":"CLAIM NO.","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"Details of Insured Dog","fields":[{"help":"Name(s) of the insured dog(s)","type":"text","label":"Name of Pet Dog(s)","options":[],"required":null,"pdf_field":""},{"help":"Select Male or Female","type":"choice","label":"Sex(M/F)","options":["M","F"],"required":null,"pdf_field":""},{"help":"Age in years and months","type":"text","label":"Age(YY/MM)","options":[],"required":null,"pdf_field":""},{"help":"Breed of the dog","type":"text","label":"Breed","options":[],"required":null,"pdf_field":""},{"help":"Weight in kilograms","type":"number","label":"Weight of the Insured Pet Dog when it is 15-18 months old","options":[],"required":null,"pdf_field":""},{"help":"Any unique marks or features to identify the dog","type":"text","label":"Identification features/marks","options":[],"required":null,"pdf_field":""},{"help":"Sum insured amount in rupees","type":"amount","label":"Sum Insured (Rs.)","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Details of the Claim","fields":[{"help":"Specify the cover name and claim details","type":"text","label":"Name of the Cover in which claim has incurred along with details","options":[],"required":null,"pdf_field":""},{"help":"Date when the loss or event occurred","type":"date","label":"Date of Loss","options":[],"required":null,"pdf_field":""},{"help":"Location where the loss occurred","type":"text","label":"Place of Loss","options":[],"required":null,"pdf_field":""},{"help":"Estimated amount being claimed","type":"amount","label":"Estimated Claim Amount","options":[],"required":null,"pdf_field":""},{"help":"Check if claim is under this cover","type":"checkbox","label":"Base Covers Surgery and Hospitalisation Cover","options":["Yes"],"required":false,"pdf_field":""},{"help":"Check if claim is under this cover","type":"checkbox","label":"OPD Cover","options":["Yes"],"required":false,"pdf_field":""},{"help":"Check all applicable optional covers for the claim","type":"checkbox","label":"Optional Covers","options":["Terminal Illness Cover","Lost and Stolen Cover","Long-Term Care Cover","Funeral Cost Cover","Veterinary on Call (Home Visits)","Emergency Pet Minding Cover","Third Party Liability Cover"],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"Additional Information for Lost and Stolen Cover","fields":[{"help":"Details of police report for lost/stolen dog","type":"text","label":"Police’s General Diary details","options":[],"required":null,"pdf_field":""},{"help":"Confirm if advertisement was or will be given","type":"yes-no","label":"Pls confirm if any advertisement is given or proposed to be given for lost Insured Dog.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Explain how and by whom the dog was found","type":"text","label":"In case the lost Insured Dog is found, please confirm how and who traced the Insured Dog.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Legal and Other Insurance Details","fields":[{"help":"Indicate if any legal notice was received","type":"yes-no","label":"Have you received any legal notice from a third party with regard to injury caused by Insured Dog? Yes/ No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details of the legal notice if applicable","type":"text","label":"If Yes, please provide details:","options":[],"required":false,"pdf_field":""},{"help":"Name of the veterinary clinic or hospital","type":"text","label":"Name of the Vet Clinic/Hospital:","options":[],"required":null,"pdf_field":""},{"help":"Name of the treating veterinarian","type":"text","label":"Name of the Vet:","options":[],"required":null,"pdf_field":""},{"help":"Contact number of the vet or clinic","type":"phone","label":"Contact no:","options":[],"required":null,"pdf_field":""},{"help":"Email of the vet or clinic","type":"email","label":"Email id:","options":[],"required":null,"pdf_field":""},{"help":"Provide details of any other pet dog insurance policies","type":"text","label":"Do you have any other Pet Dog Insurance Policy? If yes, give details.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Documents Checklist","fields":[{"help":"Check all documents you are submitting with the claim","type":"checkbox","label":"Please confirm if below documents are enclosed with this form:","options":["Vaccination Certificates","Death Certificate along with colored photographs of the Insured Dog (in case of Claim under Funeral Cover)","Vet Medical Papers and Bill (in case of Claims under Surgery & Hospitalisation Cover, OPD Cover, Long-Term Care cover)","Copy of General Diary Entry lodged by Police (in case of Claim under Lost and Stolen Cover)","FIR (in case of Claim under Third Party Liability Cover)","Copy of advertisement (in case of Claim under Lost and Stolen Cover)","Hospitalization bill (in case of Claim under Surgery & Hospitalization Cover)","Court Orders (in case of Claim under Third Party Liability Cover)","Diagnostics Report (in case of Claim under OPD Cover, Long-Term Care Cover, Terminal Illness Cover, and Veterinary On Call Cover)","Hospital bills of the Policyholder/Death Certificate of Insured or Family members for Emergency Pet Minding Cover and self-declaration on non-availability of Family members","Any other documents if required by the Company to process the Claim"],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Other Information","fields":[{"help":"Provide any additional information relevant to the claim","type":"text","label":"Any Other Relevant Information","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration and Signature","fields":[{"help":"Date of signing the form","type":"date","label":"Date:","options":[],"required":true,"pdf_field":""},{"help":"Place where the form is signed","type":"text","label":"Place:","options":[],"required":true,"pdf_field":""},{"help":"Signature of the insured person","type":"signature","label":"Signature of Insured:","options":[],"required":true,"pdf_field":""},{"help":"Print the name of the insured person","type":"text","label":"Name of the Insured:","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Dog Health Cover claims","attachments":["Vaccination Certificates","Death Certificate along with colored photographs of the Insured Dog (in case of Claim under Funeral Cover)","Vet Medical Papers and Bill (in case of Claims under Surgery & Hospitalisation Cover, OPD Cover, Long-Term Care cover)","Copy of General Diary Entry lodged by Police (in case of Claim under Lost and Stolen Cover)","FIR (in case of Claim under Third Party Liability Cover)","Copy of advertisement (in case of Claim under Lost and Stolen Cover)","Hospitalization bill (in case of Claim under Surgery & Hospitalization Cover)","Court Orders (in case of Claim under Third Party Liability Cover)","Diagnostics Report (in case of Claim under OPD Cover, Long-Term Care Cover, Terminal Illness Cover, and Veterinary On Call Cover)","Hospital bills of the Policyholder/Death Certificate of Insured or Family members for Emergency Pet Minding Cover and self-declaration on non-availability of Family members","Any other documents if required by the Company to process the Claim"],"declarations":["I/We agree to provide additional information to the Company, if required.","I/We warrant the truth of the foregoing statement in every respect to the best of my/our knowledge and belief.","If any false or fraudulent statement, suppression or concealment is made, the claim shall be forfeited and the policy void."],"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/160-dog-health-cover-claim-form"}