{"id":201,"title":"PACK & PROTECT CLAIMS FORM","purpose":"claim","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited"},"source_pdf":"https://www.generalicentralinsurance.com/downloads/other-insurance/pack-protect/claim-forms/pack-and-protect-claims-form.pdf","sha256":"886016536890f05b2f238ecddbe80753f4fe010c7bd5f1b53c6782834508c472","pages":4,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured to file a claim for loss or damage under the Pack & Protect insurance policy.","notes":["Issue of this claim form is not an admission of liability.","If any detail or information is not readily available, do not delay dispatch of this form; additional particulars may be sent later.","The claim form must be duly filled and signed by the insured.","All facts and statements must be factual and unbiased."],"title":"PACK & PROTECT CLAIMS FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"A. DETAILS OF INSURED/CLAIMANT","fields":[{"help":"","type":"text","label":"Policy Number","options":[],"required":null,"pdf_field":""},{"help":"Enter start and end dates","type":"text","label":"Period of Insurance","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Claim Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Name of the Insured","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":"6-digit postal code","type":"number","label":"Pin code","options":[],"required":null,"pdf_field":""},{"help":"Landline number","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Mobile phone number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Valid email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"Describe your business or profession briefly","type":"text","label":"Brief Description of Business / Occupation/Profession","options":[],"required":null,"pdf_field":""},{"help":"Enter amount in rupees","type":"amount","label":"Sum Insured under the Policy (Rs.)","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"B. DETAILS OF LOSS/ACCIDENT","fields":[{"help":"DD/MM/YYYY format","type":"date","label":"Date of Loss","options":[],"required":null,"pdf_field":""},{"help":"Specify time with AM or PM","type":"text","label":"Time of Loss","options":[],"required":null,"pdf_field":""},{"help":"Full address where loss occurred","type":"text","label":"Loss Location 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":"6-digit postal code","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Relation to insured person","type":"text","label":"Relationship with Insured","options":[],"required":null,"pdf_field":""},{"help":"Landline number","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Mobile phone number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Valid email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"Explain how the loss or damage happened","type":"text","label":"Describe Cause of Loss/Damage","options":[],"required":null,"pdf_field":""},{"help":"Estimated amount of loss in rupees","type":"amount","label":"Estimated Loss (Rs.)","options":[],"required":null,"pdf_field":""},{"help":"Select Yes or No","type":"choice","label":"Were there any witnesses to the loss / accident? (Yes) (No)","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Witness address","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":"6-digit postal code","type":"number","label":"Pin code","options":[],"required":null,"pdf_field":""},{"help":"Witness landline number","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Witness mobile number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Witness email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"Select Yes or No","type":"choice","label":"Has the loss been reported to an Authority? (Yes) (No)","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Explain why not reported","type":"text","label":"If ‘No’, reason for not reporting","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Authority Details","fields":[{"help":"Name of reporting authority","type":"text","label":"Name of Authority","options":[],"required":null,"pdf_field":""},{"help":"Report or reference number and date","type":"text","label":"Information Report No./Authority Reference No. and Date","options":[],"required":null,"pdf_field":""},{"help":"Name of contact person at authority","type":"text","label":"Contact Person/s","options":[],"required":null,"pdf_field":""},{"help":"Authority address","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":"6-digit postal code","type":"number","label":"Pin code","options":[],"required":null,"pdf_field":""},{"help":"Authority landline number","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Authority mobile number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Authority email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"C. DETAILS OF OTHER INSURANCE","fields":[{"help":"Select Yes or No","type":"choice","label":"Is the loss/damage covered under any other Insurance (Yes) (No)","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide insurer details and attach policy copy","type":"text","label":"If ‘Yes’, specify details and attach a copy of the policy","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Name of Insurer","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":"6-digit postal code","type":"number","label":"Pin code","options":[],"required":null,"pdf_field":""},{"help":"Insurer landline number","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Insurer mobile number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Insurer email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Policy No.","options":[],"required":null,"pdf_field":""},{"help":"Start date of other policy","type":"date","label":"Period of Insurance From:","options":[],"required":null,"pdf_field":""},{"help":"End date of other policy","type":"date","label":"To:","options":[],"required":null,"pdf_field":""},{"help":"Sum insured under other policy","type":"amount","label":"Sum Insured (Rs.)","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"D. DETAILS OF OTHER INFORMATION","fields":[{"help":"Select Yes or No","type":"choice","label":"Do you wish to provide any other information? (Yes) (No)","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide any additional information","type":"text","label":"If ‘Yes’, specify","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration and Signature","fields":[{"help":"Location where form is signed","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Signature of insured/claimant","type":"signature","label":"Signature","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Print full name","type":"text","label":"Name of Insured/Claimant","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Pack & Protect insurance policy claims","attachments":["Copy of other insurance policy if loss/damage is covered under any other insurance"],"declarations":["I/We agree to provide additional information to the Company if required.","I/We warrant the truth of the foregoing statement to the best of my/our knowledge and belief.","If any false or fraudulent statement or concealment is made, the claim shall be forfeited and the policy void."],"dropped_labels":3},"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/201-pack-and-protect-claims-form"}