{"id":2369,"title":"CLAIM FORM – TATA AIG SMART MUTLI ASSURE POLICY","purpose":"claim","insurer":{"slug":"tata-aig-general-insurance","name":"Tata AIG General Insurance Company Limited"},"source_pdf":"https://www.tataaig.com/s3/tata_aig_smart_multi_assure_policy_claims_form_b359bd225a.pdf","sha256":"2c4f6b08dea3213536c3cd3e34ce9b0d9ddb8f6c2a8bfeb7b4d216b77b8182a4","pages":10,"collected":"2026-10-17","instructions":{"about":"This form is used by policyholders to notify and claim losses under the Tata AIG Smart Multi Assure Policy.","notes":["Use the claim form available at branches or on the website.","Submit photographs of loss or physical damage wherever possible.","Do not carry out repairs unless urgent and insurer cannot be contacted.","Attach all relevant documents as specified for each claim type.","Ensure timely reporting to police and other authorities as required.","Keep copies of all submitted documents for your records."],"title":"CLAIM FORM – TATA AIG SMART MUTLI ASSURE POLICY","submit":{"to":"Tata AIG General Insurance Company Limited, 8th Floor, Romell Tech Park, Cama Industrial Estate, Western Express Highway, Goregaon(E), Mumbai, Maharashtra - 400063.","how":"Courier","address":"8th Floor, Romell Tech Park, Cama Industrial Estate, Western Express Highway, Goregaon(E), Mumbai, Maharashtra - 400063."},"purpose":"claim","sections":[{"title":"Claim Details","fields":[{"help":"Enter your insurance certificate number.","type":"text","label":"Certificate No.:","options":[],"required":null,"pdf_field":""},{"help":"Enter your customer ID.","type":"text","label":"Customer ID:","options":[],"required":null,"pdf_field":""},{"help":"Provide the estimated amount of loss.","type":"amount","label":"Estimated Loss Amount:","options":[],"required":null,"pdf_field":""},{"help":"Tick the cover(s) under which you are claiming loss.","type":"choice","label":"Coverage under which loss is claimed (please tick as applicable)","options":["Home Building and Home Contents","Key Replacement Cover","Loss of Rent and Rent for Alternative Accommodation","Cover for Home Valuable Contents (On agreed value basis)","Identity Theft","Digital Theft of Funds","Fraudulent Charge on Loss of Card","ATM Assault and Robbery","Lost Wallet Coverage","Unauthorized Fund Transfer and Forgery Protection","Personal Accident","Loss of Income (Involuntary)","Loss of Income (Commercial Vehicle)","Loss of Income (Disability & Critical illness)","Garage Cash (Private Vehicles)","Terrorism Cover","Temporary Resettlement Expenses Cover","Personal Liability Cover","Accidental Damage - General Contents","Accidental and Liquid Damage (Portable electrical and electronic devices)","Brokerage Expenses","Burglary & Theft","Breakdown of Domestic, Electric and Electronic Appliances Cover","Delay in Salary Payment","Rescinding of Offer Letter","Vacation Cancellation Cover"],"required":null,"pdf_field":""},{"help":"Enter the date when the loss occurred (DD MM YYYY).","type":"date","label":"Loss Details – Date of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Enter time of loss with AM/PM.","type":"text","label":"Time of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Enter the date when the loss was discovered (DD MM YYYY).","type":"date","label":"Date of Discovery –","options":[],"required":null,"pdf_field":""},{"help":"Enter time of discovery with AM/PM.","type":"text","label":"Time of Discovery:","options":[],"required":null,"pdf_field":""},{"help":"Provide full address where the loss occurred.","type":"text","label":"Place of Loss (Full Address):","options":[],"required":null,"pdf_field":""},{"help":"Describe briefly how the loss or incident happened.","type":"text","label":"A brief note on how the loss occurred/Incident Note:","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Identity Theft and Related Covers","fields":[{"help":"Date when the identity theft or related loss occurred (DD MM YYYY).","type":"date","label":"Date of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Address where the loss occurred.","type":"text","label":"Place of Loss (Full Address):","options":[],"required":null,"pdf_field":""},{"help":"Time of loss (DD MM YYYY) for fraudulent charge on loss of card.","type":"date","label":"Time of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Date when police was informed (DD MM YYYY).","type":"date","label":"Intimation to Police:","options":[],"required":null,"pdf_field":""},{"help":"Date when card issuer was informed (DD MM YYYY).","type":"date","label":"Intimation to Card Issuer:","options":[],"required":null,"pdf_field":""},{"help":"Explain how you received information about the loss.","type":"text","label":"How was the information of loss (of cards/theft/burglary/etc.) received?","options":[],"required":null,"pdf_field":""},{"help":"Date when company was informed (DD MM YYYY).","type":"date","label":"Intimation to Company:","options":[],"required":null,"pdf_field":""},{"help":"Provide witness details if applicable.","type":"text","label":"Were there any witnesses (if relevant), kindly share their names, addresses and phone numbers:","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Personal Accident and Loss of Income","fields":[{"help":"Enter employer's name.","type":"text","label":"Name of the Employer:","options":[],"required":null,"pdf_field":""},{"help":"Date when you joined the employer (DD MM YYYY).","type":"date","label":"Date of Joining:","options":[],"required":null,"pdf_field":""},{"help":"Your designation and department.","type":"text","label":"Designation & Department with Employer:","options":[],"required":null,"pdf_field":""},{"help":"Explain reason for job loss.","type":"text","label":"Cause of Loss of Job/Employment:","options":[],"required":null,"pdf_field":""},{"help":"Provide HR contact details.","type":"text","label":"Contact details of Existing Employer’s Human Resource (HR) personnel – Designation, Name mobile, email id, address:","options":[],"required":null,"pdf_field":""},{"help":"Date when insured lost job (DD MM YYYY).","type":"date","label":"Date of Loss of Job of Insured:","options":[],"required":null,"pdf_field":""},{"help":"Provide loan account details if applicable.","type":"text","label":"Details of Loan Account no. & Financier:","options":[],"required":false,"pdf_field":""},{"help":"Outstanding EMI amount if any.","type":"amount","label":"Outstanding EMI amount:","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Loss of Income (Commercial Vehicle)","fields":[{"help":"Date of accident or theft (DD MM YYYY).","type":"date","label":"Date of Accident/Theft:","options":[],"required":null,"pdf_field":""},{"help":"Date when claim was intimated (DD MM YYYY).","type":"date","label":"Date of Claim Intimation to the Insured:","options":[],"required":null,"pdf_field":""},{"help":"Date police was informed (DD MM YYYY). Attach FIR or police complaint with acknowledgement.","type":"date","label":"Date of Intimation to Police in case of Theft:","options":[],"required":null,"pdf_field":""},{"help":"Date vehicle was reported to repairer (DD MM YYYY). Attach copy of Repair Order.","type":"date","label":"Date of Vehicle reported at Repairer:","options":[],"required":null,"pdf_field":""},{"help":"Date of repair invoice (DD MM YYYY). Attach Repairer GST Invoice & Claim Settlement Letter/Email from Insurer.","type":"date","label":"Date of Repair Invoice:","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Loss of Income (Disability & Critical illness)","fields":[{"help":"Date illness was diagnosed (DD MM YYYY).","type":"date","label":"Date of Illness Diagnosed:","options":[],"required":null,"pdf_field":""},{"help":"Date claim was intimated (DD MM YYYY).","type":"date","label":"Date of Claim Intimation to the Insured:","options":[],"required":null,"pdf_field":""},{"help":"Describe the disability or critical illness.","type":"text","label":"Brief Note on Disability & Critical Illness occurred –","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Garage Cash (Private Vehicles)","fields":[{"help":"Date claim was intimated (DD MM YYYY).","type":"date","label":"Date of Claim Intimation to the Insured:","options":[],"required":null,"pdf_field":""},{"help":"Date vehicle was surveyed (DD MM YYYY). Attach copy of Approved Estimate by the Insurance Surveyor.","type":"date","label":"Date of Vehicle Surveyor:","options":[],"required":null,"pdf_field":""},{"help":"Date vehicle was reported for repair (DD MM YYYY). Attach Vehicle Repair Order.","type":"date","label":"Date of Vehicle reported at Repair:","options":[],"required":null,"pdf_field":""},{"help":"Date of repair invoice (DD MM YYYY). Attach Repairer GST Invoice & Claim Settlement Letter.","type":"date","label":"Date of Repair Invoice:","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Terrorism Cover","fields":[{"help":"Date of loss (DD MM YYYY).","type":"date","label":"Date of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Date claim was intimated (DD MM YYYY).","type":"date","label":"Date of Claim Intimation to the Insured:","options":[],"required":null,"pdf_field":""},{"help":"Describe the incident.","type":"text","label":"Brief Note on Occurred Incident –","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Temporary Resettlement Expenses Cover","fields":[{"help":"Provide address of alternate accommodation.","type":"text","label":"Address of Alternate Accommodation:","options":[],"required":null,"pdf_field":""},{"help":"Enter amount claimed for transportation/packaging/unpackaging.","type":"amount","label":"Claim amount for – Cost of Transportation/Packaging/Unpackaging –","options":[],"required":null,"pdf_field":""},{"help":"Enter amount claimed for emergency purchase.","type":"amount","label":"Cost of Emergency Purchase –","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Personal Liability Cover","fields":[{"help":"Explain how the loss occurred.","type":"text","label":"Brief Note on how the Loss occurred -","options":[],"required":null,"pdf_field":""},{"help":"Provide details of injury or property damage.","type":"text","label":"Please provide details of injury/property damaged -","options":[],"required":null,"pdf_field":""},{"help":"Attach copy of legal notice if received.","type":"text","label":"Have you received a legal notice? If Yes, please provide a furnished copy -","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Accidental Damage - General Contents","fields":[{"help":"Enter make and model of damaged item.","type":"text","label":"Make/Model:","options":[],"required":null,"pdf_field":""},{"help":"Date of loss (DD MM YYYY).","type":"date","label":"Date of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Estimated amount of loss.","type":"amount","label":"Estimated Loss Amount:","options":[],"required":null,"pdf_field":""},{"help":"Cause of the loss.","type":"text","label":"Cause of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Describe how the loss occurred.","type":"text","label":"A brief note on how the loss occurred/Incident Note:","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Accidental and Liquid Damage (Portable electrical and electronic devices)","fields":[{"help":"Enter IMEI or serial number of device.","type":"text","label":"IMEI/Serial No.:","options":[],"required":null,"pdf_field":""},{"help":"Date of loss (DD MM YYYY).","type":"date","label":"Date of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Make and model of device.","type":"text","label":"Make/Model:","options":[],"required":null,"pdf_field":""},{"help":"Estimated loss amount.","type":"amount","label":"Estimated Loss Amount:","options":[],"required":null,"pdf_field":""},{"help":"Cause of loss.","type":"text","label":"Cause of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Describe the incident.","type":"text","label":"A brief note on how the loss occurred/Incident Note:","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Brokerage Expenses","fields":[{"help":"Enter estimated brokerage expenses.","type":"amount","label":"Estimated Expense Amount:","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Burglary & Theft","fields":[{"help":"Explain how the loss occurred.","type":"text","label":"Brief Note on how the Loss occurred -","options":[],"required":null,"pdf_field":""},{"help":"List items claimed.","type":"text","label":"List of Claimed Item","options":[],"required":null,"pdf_field":""},{"help":"Estimated loss amount.","type":"amount","label":"Estimated Loss -","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Breakdown of Domestic, Electric and Electronic Appliances Cover","fields":[{"help":"Make and model of appliance.","type":"text","label":"Make/Model:","options":[],"required":null,"pdf_field":""},{"help":"Date of loss (DD MM YYYY).","type":"date","label":"Date of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Estimated loss amount.","type":"amount","label":"Estimated Loss Amount:","options":[],"required":null,"pdf_field":""},{"help":"Cause of loss.","type":"text","label":"Cause of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Describe the incident.","type":"text","label":"A brief note on how the loss occurred/Incident Note:","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Delay in Salary Payment","fields":[{"help":"Enter employer's name.","type":"text","label":"Name of Existing Employer:","options":[],"required":null,"pdf_field":""},{"help":"Date of joining (DD MM YYYY).","type":"date","label":"Date of Joining:","options":[],"required":null,"pdf_field":""},{"help":"Your designation and department.","type":"text","label":"Designation & Department with the Employer:","options":[],"required":null,"pdf_field":""},{"help":"Date salary was credited (DD MM YYYY).","type":"date","label":"Date of Credit Salary:","options":[],"required":null,"pdf_field":""},{"help":"Provide HR contact details.","type":"text","label":"Contact details of Existing Employer’s Human Resource (HR) personnel – Designation, Name, mobile, email id, address:","options":[],"required":null,"pdf_field":""},{"help":"Loan account details if applicable.","type":"text","label":"Details of Loan Account No. & Financier:","options":[],"required":false,"pdf_field":""},{"help":"Outstanding EMI amount.","type":"amount","label":"Outstanding EMI amount:","options":[],"required":false,"pdf_field":""},{"help":"EMI due date (DD MM YYYY).","type":"date","label":"EMI Due Date:","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Rescinding of Offer Letter","fields":[{"help":"Existing employer's name.","type":"text","label":"Name of Existing Employer:","options":[],"required":null,"pdf_field":""},{"help":"Prospective employer's name.","type":"text","label":"Name of Prospective Employer:","options":[],"required":null,"pdf_field":""},{"help":"Designation and department with employer.","type":"text","label":"Designation & Department with the Employer:","options":[],"required":null,"pdf_field":""},{"help":"Date of offer letter (DD MM YYYY).","type":"date","label":"Date of Offer Letter from Prospective Employer:","options":[],"required":null,"pdf_field":""},{"help":"HR contact details of existing employer.","type":"text","label":"Contact details of Existing Employer’s Human Resource (HR) personnel – Designation, Name, mobile, email id, address:","options":[],"required":null,"pdf_field":""},{"help":"HR contact details of prospective employer.","type":"text","label":"Contact details of Prospective Employer’s Human Resource (HR) personnel – Designation, Name, mobile, email id, address:","options":[],"required":null,"pdf_field":""},{"help":"Date of resignation (DD MM YYYY).","type":"date","label":"Date of Resignation with Existing Financier:","options":[],"required":null,"pdf_field":""},{"help":"Loan account details if applicable.","type":"text","label":"Details of Loan Account No. & Financier:","options":[],"required":false,"pdf_field":""},{"help":"EMI due date (DD MM YYYY).","type":"date","label":"EMI Due Date:","options":[],"required":false,"pdf_field":""},{"help":"EMI amount.","type":"amount","label":"EMI Amount:","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Vacation Cancellation Cover","fields":[{"help":"Date of planned departure (DD MM YYYY).","type":"date","label":"Date of Departure:","options":[],"required":null,"pdf_field":""},{"help":"Date trip was cancelled (DD MM YYYY).","type":"date","label":"Date of Trip Cancellation:","options":[],"required":null,"pdf_field":""},{"help":"Explain reason for cancellation.","type":"text","label":"Reason for Trip Cancellation:","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Claim Submission Details and Instructions","fields":[{"help":"Indicate if FIR has been filed.","type":"yes-no","label":"FIR Has the Fire/Loss been reported to fire brigade and/or Police?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Enter FIR number if applicable.","type":"text","label":"FIR No.:","options":[],"required":false,"pdf_field":""},{"help":"Enter fire brigade report number if applicable.","type":"text","label":"Fire Brigade Report No.:","options":[],"required":false,"pdf_field":""},{"help":"Explain why FIR was not filed.","type":"text","label":"If No, please give reasons:","options":[],"required":false,"pdf_field":""},{"help":"Indicate if premises were occupied.","type":"yes-no","label":"Was the premise occupied at the time of loss?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Date since premises were unoccupied (DD MM YYYY).","type":"date","label":"If No, since when was it unoccupied?","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder"}],"deadlines":["Submit claim form within 30 days from the date you first notice the loss or damage.","If claim is disclaimed, suit must be filed within 12 months from date of disclaimer."],"applies_to":"Claims under various covers of the Tata AIG Smart Multi Assure Policy including Home Building, Home Contents, Identity Theft, Personal Accident, Loss of Income, Garage Cash, Terrorism Cover, Temporary Resettlement Expenses, Personal Liability, Accidental Damage, Burglary & Theft, Breakdown of Appliances, Delay in Salary Payment, Rescinding of Offer Letter, and Vacation Cancellation Cover.","attachments":["FIR or any police complaint with an acknowledgement (where applicable)","Copy of Repair Order (for vehicle repairs)","Repairer GST Invoice & Claim Settlement Letter/Email from Insurer (for vehicle repairs)","Copy of Approved Estimate by the Insurance Surveyor (for vehicle survey)","Vehicle Repair Order (for vehicle repairs)","Copy of legal notice if received"],"declarations":["You must immediately notify the insurer of any loss or damage.","You must take all reasonable steps to prevent further loss or damage.","You must not dispose of damaged items before insurer's consent.","You must report loss or damage to appropriate legal authorities immediately.","You must submit claim form with full details and cooperate with insurer's investigation.","False or fraudulent claims will lead to denial of claim, cancellation of insurance, and legal action.","If you have other insurance covering the same loss, you must disclose it.","Insurer has the right to recover amounts from third parties responsible for the loss."],"dropped_labels":1},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"address","value":"TATA AIG General Insurance Company Limited, 5th and 6th Floor, Imperial Towers, H.No 7-1-6-617/A, GHMC No - 615,616, Ameerpet, Hyderabad – 500016, Telangana","label":"Claims Submission Address","level":null,"hours":null,"applies_to":"health","source_url":"https://www.tataaig.com/s3/medicare_select_cis_e7df7ce2ec.pdf","quote":"tion or procedure. Submit claim documents within 15 days of occurrence of incident. Kindly send the claim documents to: TATA AIG General Insurance Company Limited, 5th and 6th Floor, Imperial Towers, H.No 7-1- 6-617/A, GHMC No - 615,616, Ameerpet, Hyderabad – 500016, Telangana, Phone-040-66864900 Assistance: 1. Website www.tataaig.com or Call 24*7 Customer Support No.: 022 6489 8282/1800 267 1","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"healthclaimsupport@tataaig.com","label":"Health Claims Support Email","level":null,"hours":null,"applies_to":"health","source_url":"https://www.tataaig.com/s3/medicare_select_prospectus_efd23b0ad6.pdf","quote":"al Towers, H.No 7-1-6-617/A, GHMC No - 615,616, Ameerpet, Hyderabad – 500016, Telangana, Phone: 040-66864900\nEmail ID | healthclaimsupport@tataaig.com\nCustomer Support Number: | 022 6489 8282 / 1800 267 1955 (nly for senior citizen policy holders)\nWebsite | www.tataaig.","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"040-66864900","label":"Claims Administrator Phone","level":null,"hours":null,"applies_to":"health","source_url":"https://www.tataaig.com/s3/medicare_select_prospectus_efd23b0ad6.pdf","quote":"th and 6th Floor, Imperial Towers, H.No 7-1-6-617/A, GHMC No - 615,616, Ameerpet, Hyderabad – 500016, Telangana, Phone: 040-66864900\nEmail ID | healthclaimsupport@tataaig.com\nCustomer Support Number: | 022 6489 8282 / 1800 267 1955 (nly for senior citi","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/tata-aig-general-insurance/2369-claim-form-tata-aig-smart-mutli-assure-policy"}