{"id":220,"title":"PRADHAN MANTRI FASAL BIMA YOJNA (PMFBY)-INTIMATION-CUM CLAIM FORM","purpose":"claim","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited"},"source_pdf":"https://www.generalicentralinsurance.com/downloads/rural-insurance/pradhan-mantri-fasal-bima-yojna-(pmfby)/claim-forms/pradhan-mantri-fasal-bima-yojna-claim-form.pdf","sha256":"4fcdfda55bc53512977deb515324d271890b5d851ad41fc687cd30de9bd9335c","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is for farmers insured under the Pradhan Mantri Fasal Bima Yojna (PMFBY) to notify and claim crop loss due to specified perils.","notes":["Please send this form duly filled up to the insurer on the given fax number/e-mail or submit to the surveyor.","The issue of this form is not an admission of liability.","Use original documents for proof of ownership and premium receipt."],"title":"PRADHAN MANTRI FASAL BIMA YOJNA (PMFBY)-INTIMATION-CUM CLAIM FORM","submit":{"to":"Generali Central Insurance Company Limited or surveyor","how":"send by fax, e-mail or submit to the surveyor","address":""},"purpose":"claim","sections":[{"title":"Particulars of the Insured","fields":[{"help":"","type":"text","label":"Name of the Insured Farmer (Mr. /Ms.)","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Name of the father/spouse of Insured (Shri/Smt.)","options":[],"required":null,"pdf_field":""},{"help":"Provide full postal address","type":"text","label":"Address for communication","options":[],"required":null,"pdf_field":""},{"help":"Include country and area code if applicable","type":"phone","label":"Telephone/Mobile No","options":[],"required":null,"pdf_field":""},{"help":"","type":"email","label":"E mail ID","options":[],"required":false,"pdf_field":""}],"filled_by":"insured farmer"},{"title":"Particulars of Crop Insurance Scheme","fields":[{"help":"Usually PMFBY","type":"text","label":"Scheme","options":[],"required":null,"pdf_field":""},{"help":"Specify the crop season","type":"text","label":"Crop season","options":[],"required":null,"pdf_field":""},{"help":"Specify the year of the crop season","type":"number","label":"Crop year","options":[],"required":null,"pdf_field":""},{"help":"Tick one option","type":"choice","label":"If insured through a bank branch: 1.Loanee       2. Non-Loanee        ( Tick as appropriate)","options":["Loanee","Non-Loanee"],"required":null,"pdf_field":""},{"help":"Bank account number","type":"text","label":"(a).Account No","options":[],"required":null,"pdf_field":""},{"help":"Full name of bank and branch","type":"text","label":"(b) Name Of Bank & Branch","options":[],"required":null,"pdf_field":""},{"help":"Premium amount paid","type":"amount","label":"(c).Amount of Premium","options":[],"required":null,"pdf_field":""},{"help":"Date premium was deducted or receipt date","type":"date","label":"(d) Date of deduction of Premium /Receipt","options":[],"required":null,"pdf_field":""},{"help":"Fill only if applicable","type":"text","label":"If Insured through other Channels/ Intermediary (Broker/GIPSA/Direct)","options":[],"required":false,"pdf_field":""},{"help":"Name of broker or intermediary","type":"text","label":"(a).Name of Intermediary","options":[],"required":false,"pdf_field":""},{"help":"Identification number from intermediary","type":"text","label":"(b).Farmer ID/Proposal No./Cover Note No.","options":[],"required":false,"pdf_field":""}],"filled_by":"insured farmer"},{"title":"Address of the farm where losses occurred","fields":[{"help":"District name","type":"text","label":"District","options":[],"required":null,"pdf_field":""},{"help":"Taluka name","type":"text","label":"Taluka","options":[],"required":null,"pdf_field":""},{"help":"Revenue circle or cluster name","type":"text","label":"Revenue Circle/Cluster","options":[],"required":null,"pdf_field":""},{"help":"Village name","type":"text","label":"Village","options":[],"required":null,"pdf_field":""}],"filled_by":"insured farmer"},{"title":"Details of other insurances","fields":[{"help":"Indicate if other insurance exists","type":"yes-no","label":"Are there any other insurances against the same crop mentioned above Yes/No.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Name of other insurer if applicable","type":"text","label":"Name of the insurance company","options":[],"required":false,"pdf_field":""},{"help":"Policy or cover note number of other insurance","type":"text","label":"Cover Note/ Policy  No.","options":[],"required":false,"pdf_field":""},{"help":"Sum insured under other policy","type":"amount","label":"Sum Insured (Rs.)","options":[],"required":false,"pdf_field":""},{"help":"Area insured under other policy","type":"number","label":"Area Insured (ha)","options":[],"required":false,"pdf_field":""}],"filled_by":"insured farmer"},{"title":"Declaration and Signature","fields":[{"help":"Date of signing the declaration","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Sign or put thumb impression","type":"signature","label":"Signature/Thumb Impression of farmer","options":[],"required":true,"pdf_field":""},{"help":"Provide witness details if thumb impression used","type":"text","label":"Name and address of witness in case of thumb impression","options":[],"required":false,"pdf_field":""}],"filled_by":"insured farmer"},{"title":"For Bank/ Intermediary","fields":[{"help":"Authorized signatory signature","type":"signature","label":"Signature","options":[],"required":null,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Name and designation of authorized signatory","type":"text","label":"Name and Designation","options":[],"required":null,"pdf_field":""}],"filled_by":"bank or intermediary"}],"deadlines":["The Loss will not be assessed if premium has been paid/ debited after occurrence of peril","Claim is liable to be rejected if premium has not been paid to the bank/ intermediary before the date of occurrence of peril"],"applies_to":"PMFBY crop insurance claims","attachments":["proof of ownership of land record/tenancy/sharecropper agreement","copy of Cover note/premium receipt"],"declarations":["The insured declares the time and occurrence of the peril causing crop damage.","The insured assures not to remove or alter the affected crop until survey is completed."],"dropped_labels":8},"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/220-pradhan-mantri-fasal-bima-yojna-pmfby-intimation-cum-claim-form"}