{"id":190,"title":"GOLFER'S INSURANCE CLAIM FORM","purpose":"claim","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited"},"source_pdf":"https://www.generalicentralinsurance.com/downloads/other-insurance/golfers-insurance/claim-forms/golfers-insurance-retail-claim-form.pdf","sha256":"1ead9b649131edef1f87bcc4c86140ae625f4f549ead4c72ab294132be6931ca","pages":4,"collected":"2026-10-17","instructions":{"about":"This form is for policyholders to claim insurance benefits under the Golfer's Insurance policy for various types of losses or damages related to golfing equipment, personal accidents, hospitalization, and other covered events.","notes":["Please complete all relevant sections of this form for your claim.","The Company does not admit liability by the issuance of this form.","Please attach all original bills and receipts.","Do not admit liability to third parties in Public Liability claims.","Use original documents for medical certificates and reports if possible.","Section 41 of the Insurance Act 1938 prohibits rebates except as allowed by the insurer's published prospectus or tables."],"title":"GOLFER'S INSURANCE CLAIM FORM","submit":{"to":"Generali Central Insurance Company Limited","how":"","address":"Unit No. 801 & 802, 8th Floor, Tower C, Embassy 247 Park, LBS Marg, Vikhroli (West), Mumbai – 400083"},"purpose":"claim","sections":[{"title":"GENERAL INFORMATION","fields":[{"help":"","type":"text","label":"Policy Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"City:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"State:","options":[],"required":null,"pdf_field":""},{"help":"Enter landline number","type":"phone","label":"Contact Phone Number:","options":[],"required":null,"pdf_field":""},{"help":"Enter mobile number","type":"phone","label":"Mobile Number:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Occupation:","options":[],"required":null,"pdf_field":""},{"help":"Enter valid email address","type":"email","label":"E-mail:","options":[],"required":null,"pdf_field":""},{"help":"Name to whom claim amount should be paid","type":"text","label":"Payee's Name (in the event the claim is payable)","options":[],"required":null,"pdf_field":""},{"help":"Select Yes or No","type":"yes-no","label":"Do you have any other insurance that will cover this loss?","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Provide membership number if applicable","type":"text","label":"Membership No","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"I. DAMAGE TO GOLFING EQUIPMENT","fields":[{"help":"Describe how the damage or loss happened","type":"text","label":"1. State the circumstances under which the loss/damage took place. Please enclose police report (Applicable to Loss claims only)","options":[],"required":null,"pdf_field":""},{"help":"Provide last known location and time","type":"text","label":"2. When and where was the property last seen by you?","options":[],"required":null,"pdf_field":""},{"help":"Provide details of discovery","type":"text","label":"3. Date, time and where the loss or damage discovered and by whom?","options":[],"required":null,"pdf_field":""},{"help":"List witnesses if any","type":"text","label":"4. Name of persons who witnessed the loss/damage","options":[],"required":null,"pdf_field":""},{"help":"Select Yes or No","type":"yes-no","label":"5. Are you the sole owner of the equipment? If not, give name of owner","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"If not sole owner, provide owner's name","type":"text","label":"Name of Owner:","options":[],"required":null,"pdf_field":""},{"help":"Select Yes or No","type":"yes-no","label":"6. Are you claiming under any other insurance? if so, please provide Name of insurer, Policy Number and the amount clamed","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Other insurer's name if applicable","type":"text","label":"Name of Insurer:","options":[],"required":null,"pdf_field":""},{"help":"Other insurer's policy number","type":"text","label":"Policy Number:","options":[],"required":null,"pdf_field":""},{"help":"Amount claimed from other insurer","type":"amount","label":"Amount Claimed","options":[],"required":null,"pdf_field":""},{"help":"Provide details of previous incidents","type":"text","label":"7. Have you previously sustained any theft, loss or damage to property? if so, please state particulars.","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"II. THEFT OF GOLFING EQUIPMENT","fields":[{"help":"Describe how the theft happened","type":"text","label":"1. State the circumstances under which the theft took place. Please enclose police report (Applicable to Loss claims only)","options":[],"required":null,"pdf_field":""},{"help":"Provide last known location and time","type":"text","label":"2. When and where was the property last seen by you?","options":[],"required":null,"pdf_field":""},{"help":"Provide details of discovery","type":"text","label":"3. Date, time and where the theft was discovered and by whom?","options":[],"required":null,"pdf_field":""},{"help":"Select Yes or No","type":"yes-no","label":"4. Are you claiming under any other insurance? If so, please provide Name of Insurer, Policy Number and the amount claimed.","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Other insurer's name if applicable","type":"text","label":"Name of Insurer:","options":[],"required":null,"pdf_field":""},{"help":"Other insurer's policy number","type":"text","label":"Policy Number:","options":[],"required":null,"pdf_field":""},{"help":"Amount claimed from other insurer","type":"amount","label":"Amount Claimed","options":[],"required":null,"pdf_field":""},{"help":"Provide details of previous incidents","type":"text","label":"5. Have you previously sustained any theft, loss or damage to property? If so, please state particulars.","options":[],"required":null,"pdf_field":""},{"help":"Select Yes or No and attach report if Yes","type":"yes-no","label":"6. Was the loss reported to the police or relevant authorities managing the place eg airport authorities, club management, shopping mall etc? If yes, please attach a copy of report","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Describe recovery efforts","type":"text","label":"7. What steps have you taken to recover the lost article(s)?","options":[],"required":null,"pdf_field":""},{"help":"Select Yes or No","type":"yes-no","label":"8. Do you have any suspect in mind? If Yes, please provide name:","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Name of suspect if applicable","type":"text","label":"Name:","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Claim details for Sections I & II","fields":[{"help":"List each item with purchase details, price, wear & tear deduction, and claim amount","type":"table","label":"Describe items lost damaged, Where & When Purchased?, Original Purchase Price, Deduction for Wear & Tear, Amount Claimed","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"III. Public Liability","fields":[{"help":"Describe accident details","type":"text","label":"1. Details of accident","options":[],"required":null,"pdf_field":""},{"help":"Provide details of injured or property owner","type":"text","label":"3. Name and address of any persons injured or the owner of the property damaged","options":[],"required":null,"pdf_field":""},{"help":"Describe injuries sustained","type":"text","label":"4. Full details of personal injuries","options":[],"required":null,"pdf_field":""},{"help":"Describe property damage","type":"text","label":"5. Full details of damages to property","options":[],"required":null,"pdf_field":""},{"help":"Provide witness details","type":"text","label":"6. Name and address of witness of accident","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"IV. PERSONAL ACCIDENT FOR INSURED","fields":[{"help":"Provide accident details","type":"text","label":"1. Date, time and place of accident","options":[],"required":null,"pdf_field":""},{"help":"Describe accident","type":"text","label":"2. Details of accident","options":[],"required":null,"pdf_field":""},{"help":"Describe injury","type":"text","label":"3. Nature of injury","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"V. PERSONAL ACCIDENT FOR CADDY","fields":[{"help":"Provide accident details","type":"text","label":"1. Date, time and place of accident","options":[],"required":null,"pdf_field":""},{"help":"Describe accident","type":"text","label":"2. Details of accident","options":[],"required":null,"pdf_field":""},{"help":"Provide medical treatment details and attach certificates","type":"text","label":"3. Please give medical advice or treatment undertaken, and the Doctors certificates in original, if possible","options":[],"required":null,"pdf_field":""},{"help":"Attach if applicable","type":"attachment","label":"4. Death certificate /Postmortem report (if required)","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"VI. HOSPITALIZATION COVER","fields":[{"help":"Provide diagnosis details","type":"text","label":"1. Nature of disease/illness contracted or injury suffered or complete diagnosis","options":[],"required":null,"pdf_field":""},{"help":"Date when accident was reported","type":"date","label":"2. Date of accident reported","options":[],"required":null,"pdf_field":""},{"help":"Provide past medical history","type":"text","label":"3. Past history of disease/ Illness with duration of disease/Illness (if any)","options":[],"required":null,"pdf_field":""},{"help":"Doctor's name and address","type":"text","label":"4. a. Name and address of attending medical practitioner","options":[],"required":null,"pdf_field":""},{"help":"Doctor's qualification","type":"text","label":"b. Qualification/Degree","options":[],"required":null,"pdf_field":""},{"help":"Doctor's registration number","type":"text","label":"c. Registration no","options":[],"required":null,"pdf_field":""},{"help":"Doctor's contact number","type":"phone","label":"d. Contact No","options":[],"required":null,"pdf_field":""},{"help":"Hospital or clinic name and address","type":"text","label":"5. a. Name and address of Hospital/ Nursing Home/ Clinic (where patient hospitalized or treatment taken)","options":[],"required":null,"pdf_field":""},{"help":"Hospital registration number","type":"text","label":"b. Registration no of the Hospital","options":[],"required":null,"pdf_field":""},{"help":"Admission date","type":"date","label":"c. Date of admission","options":[],"required":null,"pdf_field":""},{"help":"Discharge date","type":"date","label":"d. Date of discharge","options":[],"required":null,"pdf_field":""},{"help":"Attach original bills and receipts","type":"attachment","label":"6. Schedule of expenses incurred by the claimant under hospitalization (To be supported by original bills/receipts, cash memos, etc)","options":[],"required":null,"pdf_field":""},{"help":"Enter amount spent in hospital","type":"amount","label":"7. Expenses incurred in the hospital (Rs.)","options":[],"required":null,"pdf_field":""},{"help":"Total benefit claimed","type":"amount","label":"8. Total Hospitalization Benefit","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"VII. DENTAL COVER","fields":[{"help":"Hospital name","type":"text","label":"1. Name of the Hospital where treatment was given","options":[],"required":null,"pdf_field":""},{"help":"Hospital address","type":"text","label":"2. Address of the Hospital where treatment was given","options":[],"required":null,"pdf_field":""},{"help":"Doctor's name","type":"text","label":"3. Name of the Treating Doctor","options":[],"required":null,"pdf_field":""},{"help":"Describe illness or ailment","type":"text","label":"4. Details of illness/allment","options":[],"required":null,"pdf_field":""},{"help":"Date when illness started","type":"date","label":"5. Date of Onset of illness/disease/allment","options":[],"required":null,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"6. If the illness/disease/ailment is preexisting/ aggravated due to pre-existing condition, mention the details","options":[],"required":null,"pdf_field":""},{"help":"Provide treatment start and end dates","type":"text","label":"7. Treatment Date From DD/MM/YY to DD/MM/YY","options":[],"required":null,"pdf_field":""},{"help":"Describe treatment given","type":"text","label":"8. Treatment Details","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"VIII. ACCIDENTAL PROPERTY DAMAGE","fields":[{"help":"Date incident occurred","type":"date","label":"1. Date of Incident","options":[],"required":null,"pdf_field":""},{"help":"Time of incident","type":"text","label":"2. Time Occurred","options":[],"required":null,"pdf_field":""},{"help":"Location of incident","type":"text","label":"3. Place Incident occurred","options":[],"required":null,"pdf_field":""},{"help":"List witnesses with contact details","type":"text","label":"4. Names and contact of persons who witnessed Incident","options":[],"required":null,"pdf_field":""},{"help":"Describe incident in detail","type":"text","label":"5. Detailed Description of Incident","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"IX. HOLE IN ONE","fields":[{"help":"Provide club or place name","type":"text","label":"1. Name of Club/place where Hole-in-One achieved","options":[],"required":null,"pdf_field":""},{"help":"Provide date and time and attach required documents","type":"text","label":"2. Date and time of Hole-in-One (Please enclose certificate, original score card and bills)","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"X. REIMBURSEMENT OF SUBSCRIPTIONS AND PRE-PAID FEES","fields":[{"help":"Provide club or place name","type":"text","label":"1. Name of Club/place where subscription fees are paid","options":[],"required":null,"pdf_field":""},{"help":"Attach certificate and bills","type":"attachment","label":"2. Please enclose certificate and bills of the subscription","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"DECLARATION AND SIGNATURE","fields":[{"help":"Sign the form","type":"signature","label":"Signature","options":[],"required":true,"pdf_field":""},{"help":"Enter date of signing","type":"date","label":"Date:  DD/MM/YYYY","options":[],"required":true,"pdf_field":""},{"help":"Print your name","type":"text","label":"Name:","options":[],"required":true,"pdf_field":""}],"filled_by":"policyholder"}],"deadlines":[],"applies_to":"claims under Golfer's Insurance policy including damage or theft of golfing equipment, public liability, personal accident for insured and caddy, hospitalization, dental cover, accidental property damage, hole in one, and reimbursement of subscriptions and pre-paid fees","attachments":["police report (Applicable to Loss claims only)","original bills and receipts","Doctors certificates in original, if possible","Death certificate /Postmortem report (if required)","Schedule of expenses incurred by the claimant under hospitalization (original bills/receipts, cash memos, etc)","certificate, original score card and bills for Hole-in-One","certificate and bills of the subscription"],"declarations":["The insured must advise the company of any other insurance covering the same risk.","I declare that all answers given are true and accept that insurers may deny liability if answers are false or inaccurate."],"dropped_labels":2},"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/190-golfer-s-insurance-claim-form"}