{"id":2359,"title":"MOTOR TRADE (INTERNAL 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/569c4b75be7740b1889794fc6476a2ac.pdf","sha256":"577ccb1cad40b182a030d4853283554035f304df58ec1e21f8c886227c02a385","pages":6,"collected":"2026-10-17","instructions":{"about":"This form is for insured persons or claimants to report and claim for loss, damage, or accident under the Motor Trade (Internal Risks) Insurance Policy.","notes":["Issue of this claim form is not an admission of liability.","If any detail is not readily available, send the form without delay and provide particulars later.","Sketch the accident using the diagram on page 4.","Original documents may be required for verification.","Additional documents may be requested by the company as needed."],"title":"MOTOR TRADE (INTERNAL 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 of insurance period","type":"date","label":"Period of Insurance to","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Claim Number","options":[],"required":null,"pdf_field":""},{"help":"Enter name exactly as in policy","type":"text","label":"Name as per  Policy","options":[],"required":null,"pdf_field":""},{"help":"Full postal address including city, state, and pin code","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":"","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"Include STD code if applicable","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"","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":"Use DD/MM/YYYY format","type":"date","label":"Date of Loss/Damage/ Accident","options":[],"required":null,"pdf_field":""},{"help":"Specify time and select A.M. or P.M.","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":"","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 of contact person to insured","type":"text","label":"Relationship with Insured","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"Describe cause; use diagram on page 4 to sketch accident","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":"","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"","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 authority where reported","type":"text","label":"Name of Authority","options":[],"required":null,"pdf_field":""},{"help":"Provide report or reference number and date","type":"text","label":"Information Report No./Authority Reference No. and Date","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":"","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"","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 of vehicle","type":"text","label":"Chassis No.","options":[],"required":null,"pdf_field":""},{"help":"Engine number of vehicle","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 vehicle was registered","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 vehicle was transferred","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; specify if Others","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":"","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"","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 of other insurance","type":"date","label":"Period of Insurance 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/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":"Names of other interested persons","type":"text","label":"Person/s who has/have interest on property","options":[],"required":null,"pdf_field":""},{"help":"Address of other interested persons","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":"","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"F. DRIVER DETAILS","fields":[{"help":"Name of driver at time of accident","type":"text","label":"Name of Driver","options":[],"required":null,"pdf_field":""},{"help":"Relationship of driver 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":"Driver's date of birth","type":"date","label":"Date of Birth","options":[],"required":null,"pdf_field":""},{"help":"Driver's 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":"","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"","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":"Mention 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; specify if Others","type":"checkbox","label":"Type of Loss","options":["Own Damage","Theft","Partial Theft","Others (specify)"],"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 person holding keys","type":"text","label":"In case of theft, keys in the possession of? Name","options":[],"required":null,"pdf_field":""},{"help":"Contact number of key holder","type":"phone","label":"Contact No.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"H. 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/repairer","type":"text","label":"Name of Contact person","options":[],"required":null,"pdf_field":""},{"help":"Full address of garage/repairer","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":"","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"email","label":"Email ID","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 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":null,"pdf_field":""},{"help":"Print name of insured/claimant","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":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Print name","type":"text","label":"Name of Insured/Claimant","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"}],"deadlines":[],"applies_to":"Motor Trade (Internal Risks) Insurance Policy claims","attachments":["Proof of insurance - Policy / Cover note copy","Copy of Registration Book, Tax Receipt (original for verification)","Copy of Motor Driving License of the person driving the vehicle at the time of accident (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)"],"declarations":["The insured warrants the truth of all statements and agrees that any false or fraudulent statement will forfeit the claim and policy rights.","The insured acknowledges receipt of the list of required documents and understands that non-fulfillment may delay claim settlement.","The insured agrees to provide additional information and documentation if required."],"dropped_labels":13},"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/2359-motor-trade-internal-risks-insurance-policy-claim-form"}