{"id":2358,"title":"MOTOR TRADE (ROAD RISKS) INSURANCE POLICY CLAIM FORM","purpose":"claim","insurer":{"slug":"sbi-general-insurance","name":"SBI General Insurance Company Limited"},"source_pdf":"https://content.sbigeneral.in/uploads/4081a2ba9bd24c5b8c9ac8561ef62b47.pdf","sha256":"7ee54088d8cc3fb2e848535806258b34a4b0a96f2bab47f53fe9e431327d4ea5","pages":5,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured or claimant to report and claim for loss, damage, or accident under the Motor Trade (Road Risks) 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; other particulars may be sent later.","Sketch the accident using the diagram on page 4.","Please furnish original documents for verification where indicated.","Additional documents may be requested as needed."],"title":"MOTOR TRADE (ROAD RISKS) INSURANCE POLICY CLAIM 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":"date","label":"Period of Insurance","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Claim Number","options":[],"required":null,"pdf_field":""},{"help":"Name of insured as per policy","type":"text","label":"Name as per  Policy","options":[],"required":null,"pdf_field":""},{"help":"Full postal 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":"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":"Enter amount in rupees","type":"amount","label":"Limits of Indemnity under the Policy/IDV  (Rs.)","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"B. DETAILS OF LOSS/DAMAGE /ACCIDENT","fields":[{"help":"Date in DD/MM/YYYY format","type":"date","label":"Date of Loss/Damage/ Accident","options":[],"required":null,"pdf_field":""},{"help":"Specify time and AM or PM","type":"text","label":"Time of Loss","options":["A.M.","P.M."],"required":null,"pdf_field":""},{"help":"Full address where loss/damage/accident occurred","type":"text","label":"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":"Name of contact person at location","type":"text","label":"Contact Details of person/s at Location - Name","options":[],"required":null,"pdf_field":""},{"help":"Relationship to insured","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":"Email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"Describe cause; sketch accident on page 4","type":"text","label":"Describe Cause of Loss/Damage/ Accident","options":[],"required":null,"pdf_field":""},{"help":"Estimated amount of loss in rupees","type":"amount","label":"Estimated Loss (Rs.)","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"Witness Details and Information to Authority","fields":[{"help":"","type":"choice","label":"Were there any witnesses to the loss /Damage/ accident?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Address of witnesses","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 number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"","type":"choice","label":"Has the loss been reported to an Authority?","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":""},{"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":"Contact person at authority","type":"text","label":"Contact Person/s","options":[],"required":null,"pdf_field":""},{"help":"Address of authority","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 number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"C. VEHICLE DETAILS","fields":[{"help":"Vehicle registration number","type":"text","label":"Reg. No.","options":[],"required":null,"pdf_field":""},{"help":"Vehicle manufacturer","type":"text","label":"Make","options":[],"required":null,"pdf_field":""},{"help":"Vehicle model","type":"text","label":"Model","options":[],"required":null,"pdf_field":""},{"help":"Chassis number","type":"text","label":"Chassis No.","options":[],"required":null,"pdf_field":""},{"help":"Engine number","type":"text","label":"Engine No.","options":[],"required":null,"pdf_field":""},{"help":"Vehicle Identification Number","type":"text","label":"VIN No.","options":[],"required":null,"pdf_field":""},{"help":"Date in DD/MM/YYYY format","type":"date","label":"Date of Registration","options":[],"required":null,"pdf_field":""},{"help":"RTO office jurisdiction","type":"text","label":"RTO Jurisdiction","options":[],"required":null,"pdf_field":""},{"help":"Date in DD/MM/YYYY format","type":"date","label":"Date of transfer","options":[],"required":null,"pdf_field":""},{"help":"Fuel type used by vehicle","type":"text","label":"Type of Fuel","options":[],"required":null,"pdf_field":""},{"help":"Vehicle color","type":"text","label":"Colour of Vehicle","options":[],"required":null,"pdf_field":""},{"help":"Select vehicle class","type":"choice","label":"Vehicle Class","options":["Two Wheeler","Pvt. Car","Commercial","Miscellaneous","Others(specify)"],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"D. DETAILS OF OTHER INSURANCE","fields":[{"help":"","type":"choice","label":"Is the loss/damage covered under any other Insurance","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Name of other insurer if applicable","type":"text","label":"Name of Insurer","options":[],"required":null,"pdf_field":""},{"help":"Address of other insurer","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 number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"Policy number of other insurance","type":"text","label":"Policy No.","options":[],"required":null,"pdf_field":""},{"help":"Start and end dates","type":"date","label":"Period of Insurance","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/claimant"},{"title":"E. DETAILS OF OTHER INTEREST","fields":[{"help":"","type":"choice","label":"Is the Insured the Sole Owner of the property?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Describe nature of interest","type":"text","label":"If ‘No’, specify Nature of Interest","options":[],"required":null,"pdf_field":""},{"help":"Names of persons with interest","type":"text","label":"Person/s who has/have interest on property","options":[],"required":null,"pdf_field":""},{"help":"Address of persons with interest","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 number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"F. DRIVER DETAILS","fields":[{"help":"Full name of driver","type":"text","label":"Name of Driver","options":[],"required":null,"pdf_field":""},{"help":"Relationship to insured","type":"text","label":"Relationship with Insured","options":[],"required":null,"pdf_field":""},{"help":"","type":"choice","label":"Gender","options":["Male","Female"],"required":null,"pdf_field":""},{"help":"Date in DD/MM/YYYY format","type":"date","label":"Date of Birth","options":[],"required":null,"pdf_field":""},{"help":"Driver's full 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":"Landline number","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Mobile number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"Driver's license number","type":"text","label":"Driving License No.","options":[],"required":null,"pdf_field":""},{"help":"License issue date","type":"date","label":"Date of Issue","options":[],"required":null,"pdf_field":""},{"help":"License expiry date","type":"date","label":"Date of Expiry","options":[],"required":null,"pdf_field":""},{"help":"RTO that issued license","type":"text","label":"Issuing RTO","options":[],"required":null,"pdf_field":""},{"help":"","type":"choice","label":"Type of License","options":["Permanent","Temporary"],"required":null,"pdf_field":""},{"help":"Select license class","type":"choice","label":"Class","options":["M-Cycle W/G","M-Cycle Wo/G","LMV","Transport","Non-Transport","HGV","Passenger","Goods"],"required":null,"pdf_field":""},{"help":"Any special endorsements on license","type":"text","label":"Special Endorsements, if any","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"G. ACCIDENT/THEFT DETAILS","fields":[{"help":"Speed in kilometers per hour","type":"number","label":"Speed at the time of accident (kmph)","options":[],"required":null,"pdf_field":""},{"help":"Select applicable loss type","type":"checkbox","label":"Type of Loss","options":["Own Damage","Theft","Partial Theft","Others (specify)"],"required":null,"pdf_field":""},{"help":"Specify other type of loss if selected","type":"text","label":"Others (specify)","options":[],"required":null,"pdf_field":""},{"help":"Tick if applicable","type":"checkbox","label":"Third Party Death","options":[],"required":null,"pdf_field":""},{"help":"Tick if applicable","type":"checkbox","label":"Third Party Injury","options":[],"required":null,"pdf_field":""},{"help":"Tick if applicable","type":"checkbox","label":"Third Party Property Damage","options":[],"required":null,"pdf_field":""},{"help":"Tick if applicable","type":"checkbox","label":"Personal Accident","options":[],"required":null,"pdf_field":""},{"help":"Describe vehicle use purpose","type":"text","label":"Purpose for which the vehicle was being used at the time of accident/theft","options":[],"required":null,"pdf_field":""},{"help":"Number of occupants","type":"number","label":"No. of people travelling in the vehicle at the time of accident","options":[],"required":null,"pdf_field":""},{"help":"Enter weights: RLW, ULW, GVW, and weight carried","type":"text","label":"Weighment Details RLW, ULW, GVW, Weight Carried","options":[],"required":null,"pdf_field":""},{"help":"Name of key holder","type":"text","label":"In case of theft, keys in the possession of? 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GARAGE/BODYSHOP/REPAIRER DETAILS","fields":[{"help":"Name of garage or repairer","type":"text","label":"Name","options":[],"required":null,"pdf_field":""},{"help":"Contact person at garage","type":"text","label":"Name of Contact person","options":[],"required":null,"pdf_field":""},{"help":"Full address of garage","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 number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"J. DIAGRAM","fields":[{"help":"Draw or attach diagram of accident","type":"photo","label":"Sketch the accident using diagram on Page 4","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"K. DETAILS OF PREVIOUS LOSSES","fields":[{"help":"Columns: Date of Loss, Claim Description and Cause of Loss, Value of Loss (Rs.), Insurer","type":"table","label":"Losses during the 3 preceding years","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"L. DETAILS OF OTHER INFORMATION","fields":[{"help":"","type":"choice","label":"Do you wish to provide any other information?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Additional information if any","type":"text","label":"If ‘Yes’, specify","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"DECLARATION","fields":[{"help":"Place of signing","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":null,"pdf_field":""},{"help":"Print full name","type":"text","label":"Name of Insured/Claimant","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"DISCHARGE VOUCHER","fields":[{"help":"Claim number","type":"text","label":"Claim No.","options":[],"required":null,"pdf_field":""},{"help":"Policy number","type":"text","label":"Policy No.","options":[],"required":null,"pdf_field":""},{"help":"Vehicle registration number","type":"text","label":"Vehicle No.","options":[],"required":null,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Signature of insured/claimant","type":"signature","label":"Signature","options":[],"required":null,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Print full name","type":"text","label":"Name of Insured/Claimant","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"}],"deadlines":[],"applies_to":"Motor Trade (Road Risks) Insurance Policy claims","attachments":["Proof of insurance - Policy / Cover note copy","Copy of Registration Book, Tax Receipt [Please furnish original for verification]","Copy of Motor Driving License of the person driving the vehicle at the time of accident (Please furnish original for verification)","Police Panchanama /FIR (In case of Third Party property damage /Death / Body Injury)","Estimate for repairs from the repairer where the vehicle is to be repaired","Repair Bills/Invoices and payment receipts after the job is completed","Original Policy document (for Theft Claims)","Original Registration Book/Certificate and Tax Payment Receipt (for Theft Claims)","All the sets of keys/Service Booklet/Warranty Card/Original Purchase Invoice (for Theft Claims)","Police Panchanama/ FIR and Final Investigation Report/Non Traceable Report (for Theft Claims)","Acknowledged copy of letter addressed to RTO intimating theft and informing 'NON-USE' (for Theft Claims)","Form 28, 29 and 30 signed by the insured and Form 35 signed by the Financer, as the case may be, undated and blank (for Theft Claims)","Letter of Subrogation (for Theft Claims)","Consent towards agreed claim settlement value from yourself and Financer (for Theft Claims)","NOC from the Financer if claim is to be settled in your favour (for Theft Claims)","Additional documents required by us if any, will be intimated to you as and when required"],"declarations":["The insured warrants the truth of all statements and agrees that any false or fraudulent statement will forfeit the claim and policy.","The insured acknowledges receipt of the list of required documents and understands that delays may occur if requirements are not fulfilled.","The insured agrees to provide additional information and documentation if required."],"dropped_labels":7},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"customer.care@sbigeneral.in","label":"Motor Claims Email","level":null,"hours":null,"applies_to":"motor","source_url":"https://www.sbigeneral.in/claim/motor","quote":"m\nRegister or Track Claim Status with one simple click\nIntimate Claim\nCheck Claim Status\n1800 102 1111\n(Available 24/7)\ncustomer.care@sbigeneral.in\nMail ID\nSmooth rides, smoother claims\nBecause you deserve worry-free journeys, always\nDownload SBIG App\nRegister or Tra","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"sbig.health@sbigeneral.in","label":"Health Claims Email","level":null,"hours":null,"applies_to":"health","source_url":"https://www.sbigeneral.in/claim/health","quote":"ailable 24/7\n1800 210 3366\n/\n1800 210 6366\nSMS Us:\n“HEALTHCLAIM”\nto\n561612\nEmail Us:\nseniorcitizen.health@sbigeneral.in\nsbig.health@sbigeneral.in\n18,000+\nNetwork Hospitals\nHealth Vertical Office:\nSBI General Insurance Company Limited,\n9th Floor, Westport, Pan Card","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"seniorcitizen.health@sbigeneral.in","label":"Senior Citizen Health Claims Email","level":null,"hours":null,"applies_to":"health","source_url":"https://www.sbigeneral.in/claim/health","quote":"Feel Free to Reach Out\nCall Us:\nAvailable 24/7\n1800 210 3366\n/\n1800 210 6366\nSMS Us:\n“HEALTHCLAIM”\nto\n561612\nEmail Us:\nseniorcitizen.health@sbigeneral.in\nsbig.health@sbigeneral.in\n18,000+\nNetwork Hospitals\nHealth Vertical Office:\nSBI General Insurance Company Limited,\n9th","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 102 1111","label":"Motor Claims Toll-free Number","level":null,"hours":"Available 24/7","applies_to":"motor","source_url":"https://www.sbigeneral.in/claim/motor","quote":"e Claim\nFAQs\nDownload Claim Form\nRegister or Track Claim Status with one simple click\nIntimate Claim\nCheck Claim Status\n1800 102 1111\n(Available 24/7)\ncustomer.care@sbigeneral.in\nMail ID\nSmooth rides, smoother claims\nBecause you deserve worry-free journ","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 210 3366","label":"Health Claims Toll-free Number","level":null,"hours":"Available 24/7","applies_to":"health","source_url":"https://www.sbigeneral.in/claim/health","quote":"e simple click\nCheck Claim Status\nIntimate Claim\nFor any Queries, Please Feel Free to Reach Out\nCall Us:\nAvailable 24/7\n1800 210 3366\n/\n1800 210 6366\nSMS Us:\n“HEALTHCLAIM”\nto\n561612\nEmail Us:\nseniorcitizen.health@sbigeneral.in\nsbig.health@sbigeneral.in","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 210 6366","label":"Health Claims Toll-free Number","level":null,"hours":"Available 24/7","applies_to":"health","source_url":"https://www.sbigeneral.in/claim/health","quote":"heck Claim Status\nIntimate Claim\nFor any Queries, Please Feel Free to Reach Out\nCall Us:\nAvailable 24/7\n1800 210 3366\n/\n1800 210 6366\nSMS Us:\n“HEALTHCLAIM”\nto\n561612\nEmail Us:\nseniorcitizen.health@sbigeneral.in\nsbig.health@sbigeneral.in\n18,000+\nNetwork","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"sms","value":"561612","label":"Health Claims SMS 'HEALTHCLAIM'","level":null,"hours":null,"applies_to":"health","source_url":"https://www.sbigeneral.in/claim/health","quote":"y Queries, Please Feel Free to Reach Out\nCall Us:\nAvailable 24/7\n1800 210 3366\n/\n1800 210 6366\nSMS Us:\n“HEALTHCLAIM”\nto\n561612\nEmail Us:\nseniorcitizen.health@sbigeneral.in\nsbig.health@sbigeneral.in\n18,000+\nNetwork Hospitals\nHealth Vertical Office","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/sbi-general-insurance/2358-motor-trade-road-risks-insurance-policy-claim-form"}