{"id":2393,"title":"Zuno Group Overseas Travel Insurance Policy Claim Form","purpose":"claim","insurer":{"slug":"zuno-general-insurance","name":"Zuno General Insurance Ltd"},"source_pdf":"https://cms.hizuno.com/uploads/Zuno_Group_Overseas_Travel_Insurance_claim_form_V_1_1_945aa2bc2f.pdf?updated_at=2024-09-27T11:55:44.251Z","sha256":"91de9d848225e715e1938cc9989f98d9432b952c1a7b981be264ffbd1e8fb9ef","pages":9,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured or claimant to file a claim under the Zuno Group Overseas Travel Insurance Policy for various covered benefits.","notes":["Fill the form in capital letters and sign it.","Attach copies or originals of bills, receipts, credit card slips related to the claim.","If copies are submitted, originals are required before payment.","Attach copies of visible Photo ID proof like PAN card, Voter ID card, Passport, etc.","If space is insufficient, use a separate sheet and attach it.","Complete the correct section of the claim form and carefully read the instructions relating to supporting documents.","Original bills only.","Use block letters."],"title":"Zuno Group Overseas Travel Insurance Policy Claim Form","submit":{"to":"Submit the claim form with required documents to the following address; include OSP’s address (Which service provider and which location address)","how":"post","address":""},"purpose":"claim","sections":[{"title":"Claim and Policy Details","fields":[{"help":"","type":"text","label":"Claim No","options":[],"required":null,"pdf_field":""},{"help":"Date when claim was informed","type":"date","label":"Date of intimation","options":[],"required":null,"pdf_field":""},{"help":"Time when claim was informed","type":"text","label":"Time of intimation","options":[],"required":null,"pdf_field":""},{"help":"Your insurance policy number","type":"text","label":"Policy No","options":[],"required":null,"pdf_field":""},{"help":"Full name of the insured person","type":"text","label":"Name of the insured","options":[],"required":true,"pdf_field":""},{"help":"Full current residential address","type":"text","label":"Current address of the insured","options":[],"required":true,"pdf_field":""},{"help":"Date of birth of the insured","type":"date","label":"Date of birth","options":[],"required":true,"pdf_field":""},{"help":"Select one","type":"choice","label":"Is the insured self-employed or salaried? Yes No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Select one","type":"choice","label":"Sex: Male Female Other","options":["Male","Female","Other"],"required":null,"pdf_field":""},{"help":"Primary mobile number","type":"phone","label":"Mobile No. 1","options":[],"required":true,"pdf_field":""},{"help":"Secondary mobile number (optional)","type":"phone","label":"Mobile No. 2","options":[],"required":false,"pdf_field":""},{"help":"Country or place of travel","type":"text","label":"Trip destination","options":[],"required":true,"pdf_field":""},{"help":"Trip start date","type":"date","label":"Date of start of trip","options":[],"required":true,"pdf_field":""},{"help":"Planned return date","type":"date","label":"Scheduled return date","options":[],"required":true,"pdf_field":""},{"help":"Select one","type":"choice","label":"Does the insured have any other travel or health/accident insurance? Yes No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"If yes, name of other insurer","type":"text","label":"Name of Insurer","options":[],"required":false,"pdf_field":""},{"help":"Other policy number","type":"text","label":"Policy No","options":[],"required":false,"pdf_field":""},{"help":"Start and end dates of other policy","type":"date","label":"Policy period: From to","options":[],"required":false,"pdf_field":""},{"help":"Start date of trip","type":"date","label":"Date trip commenced","options":[],"required":false,"pdf_field":""},{"help":"Scheduled return date","type":"date","label":"Scheduled return date","options":[],"required":false,"pdf_field":""},{"help":"If different from insured, claimant or nominee name","type":"text","label":"Name of the claimant /nominee","options":[],"required":false,"pdf_field":""},{"help":"Address of claimant/nominee","type":"text","label":"Claimant’s address","options":[],"required":false,"pdf_field":""},{"help":"Mobile number of claimant/nominee","type":"phone","label":"Mobile No","options":[],"required":false,"pdf_field":""},{"help":"Relationship to insured","type":"text","label":"Relationship with the policy holder","options":[],"required":false,"pdf_field":""},{"help":"Passport number of claimant/nominee","type":"text","label":"Passport No.","options":[],"required":false,"pdf_field":""},{"help":"If yes, name of other insurance company","type":"text","label":"Name of the insurance company","options":[],"required":false,"pdf_field":""},{"help":"Other policy number","type":"text","label":"Policy No.","options":[],"required":false,"pdf_field":""},{"help":"Sum insured under other policy","type":"amount","label":"Sum insured","options":[],"required":false,"pdf_field":""},{"help":"Amount claimed under other policy","type":"amount","label":"Claimed amount","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section A: Accident & sickness and related benefits","fields":[{"help":"Date when accident or illness occurred","type":"date","label":"Date of accident","options":[],"required":false,"pdf_field":""},{"help":"Time of accident or illness","type":"text","label":"Time","options":[],"required":false,"pdf_field":""},{"help":"Location of accident or illness","type":"text","label":"Place of accident","options":[],"required":false,"pdf_field":""},{"help":"Explain how the injury or illness happened","type":"text","label":"Please describe in detail the circumstances of the injury/illness/accident","options":[],"required":false,"pdf_field":""},{"help":"Describe injuries or illness nature","type":"text","label":"Please describe the nature of Injures","options":[],"required":false,"pdf_field":""},{"help":"Name of hospital where treated","type":"text","label":"Hospital name","options":[],"required":false,"pdf_field":""},{"help":"Name of treating doctor","type":"text","label":"Doctor’s name","options":[],"required":false,"pdf_field":""},{"help":"Address of hospital","type":"text","label":"Hospital address","options":[],"required":false,"pdf_field":""},{"help":"Hospital phone number","type":"phone","label":"Hospital telephone No","options":[],"required":false,"pdf_field":""},{"help":"Hospital fax number","type":"text","label":"Fax No","options":[],"required":false,"pdf_field":""},{"help":"Doctor's mobile number","type":"phone","label":"Mobile No. of the treating doctor","options":[],"required":false,"pdf_field":""},{"help":"Hospital admission date","type":"date","label":"Date of admission","options":[],"required":false,"pdf_field":""},{"help":"Hospital discharge date","type":"date","label":"Date of discharge","options":[],"required":false,"pdf_field":""},{"help":"Select if authorities were informed","type":"choice","label":"Were the police or any other authorities informed about the accident? Yes No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Details of police or authority report","type":"text","label":"If yes, please provide us with the details","options":[],"required":false,"pdf_field":""},{"help":"Total amount claimed","type":"amount","label":"Total claim amount","options":[],"required":false,"pdf_field":""},{"help":"Claim amount in words","type":"text","label":"In words","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section B: Medical evacuation/repatriation of remains","fields":[{"help":"Explain reason for evacuation or death","type":"text","label":"Cause/circumstances of medical evacuation/death","options":[],"required":false,"pdf_field":""},{"help":"Date of evacuation or death","type":"date","label":"Date of Medical Evacuation / Death of Insured","options":[],"required":false,"pdf_field":""},{"help":"List description, date, and amount of each expense","type":"table","label":"Details of expenses of repatriation of remains/funeral/medical evacuation","options":[],"required":false,"pdf_field":""},{"help":"Total amount of expenses","type":"amount","label":"Total","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section C: Accidental death and dismemberment benefit","fields":[{"help":"Date of accident","type":"date","label":"Date of accident","options":[],"required":false,"pdf_field":""},{"help":"Time of accident","type":"text","label":"Time","options":[],"required":false,"pdf_field":""},{"help":"Location of accident","type":"text","label":"Place of accident","options":[],"required":false,"pdf_field":""},{"help":"Travel mode and details during accident","type":"text","label":"Mode of travel and its details","options":[],"required":false,"pdf_field":""},{"help":"Explain what happened","type":"text","label":"Describe the incident","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section D: Checked baggage loss benefit","fields":[{"help":"Date baggage was lost/damaged/delayed","type":"date","label":"Date of loss/damage/delay","options":[],"required":false,"pdf_field":""},{"help":"Time of baggage loss/damage/delay","type":"text","label":"Time of loss/damage/delay","options":[],"required":false,"pdf_field":""},{"help":"Airline or carrier name","type":"text","label":"Name of the carrier","options":[],"required":false,"pdf_field":""},{"help":"Flight number","type":"text","label":"Flight No.","options":[],"required":false,"pdf_field":""},{"help":"Scheduled flight arrival/departure","type":"text","label":"Scheduled arrival/departure date & time","options":[],"required":false,"pdf_field":""},{"help":"Select if loss was reported","type":"choice","label":"Was the loss reported to the relevant authority? Yes No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Details of report","type":"text","label":"If yes, please provide us with the details","options":[],"required":false,"pdf_field":""},{"help":"Amount claimed for baggage loss","type":"amount","label":"Total claim amount","options":[],"required":false,"pdf_field":""},{"help":"Claim amount in words","type":"text","label":"In words","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section E: Loss of passport benefit","fields":[{"help":"Date passport was lost","type":"date","label":"Date of loss","options":[],"required":false,"pdf_field":""},{"help":"Select if police report was filed","type":"choice","label":"Was a police report lodged? Yes No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Amount claimed for passport loss","type":"amount","label":"Total claim amount","options":[],"required":false,"pdf_field":""},{"help":"Claim amount in words","type":"text","label":"In words","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section F: Personal liability benefit","fields":[{"help":"Date of incident","type":"date","label":"Date","options":[],"required":false,"pdf_field":""},{"help":"Time of incident","type":"text","label":"Time","options":[],"required":false,"pdf_field":""},{"help":"Location of incident","type":"text","label":"Place of accident","options":[],"required":false,"pdf_field":""},{"help":"Name of medical provider","type":"text","label":"Name of treating doctor/hospital/clinic","options":[],"required":false,"pdf_field":""},{"help":"Describe claim nature","type":"text","label":"Nature of claim being made","options":[],"required":false,"pdf_field":""},{"help":"Name of court handling case","type":"text","label":"Court where the case Is being heard","options":[],"required":false,"pdf_field":""},{"help":"Amount claimed","type":"amount","label":"Total claim amount","options":[],"required":false,"pdf_field":""},{"help":"Claim amount in words","type":"text","label":"In words","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section G: Hijack distress compensation","fields":[{"help":"Airline name","type":"text","label":"Name of the airline","options":[],"required":false,"pdf_field":""},{"help":"Travel start date","type":"date","label":"Date of start of Travel","options":[],"required":false,"pdf_field":""},{"help":"Flight number","type":"text","label":"Flight No","options":[],"required":false,"pdf_field":""},{"help":"Flight route during hijack","type":"text","label":"Route on which the hijack took place","options":[],"required":false,"pdf_field":""},{"help":"Scheduled and actual arrival times","type":"text","label":"Arrival time: Scheduled Actual","options":[],"required":false,"pdf_field":""},{"help":"Amount claimed","type":"amount","label":"Total claim amount","options":[],"required":false,"pdf_field":""},{"help":"Claim amount in words","type":"text","label":"In Words","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section H: Emergency cash advance","fields":[{"help":"Date of loss","type":"date","label":"Date of loss","options":[],"required":false,"pdf_field":""},{"help":"Time of loss","type":"text","label":"Time of loss","options":[],"required":false,"pdf_field":""},{"help":"Location of loss","type":"text","label":"Place of loss","options":[],"required":false,"pdf_field":""},{"help":"Select if police report was filed","type":"choice","label":"Was a police report lodged? Yes No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Amount claimed","type":"amount","label":"Total claim amount","options":[],"required":false,"pdf_field":""},{"help":"Claim amount in words","type":"text","label":"In words","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section I: Flight delay / trip delay / missed connection / trip cancellation","fields":[{"help":"Explain reason for trip interruption","type":"text","label":"Reason for trip cancellation / Missed connection / Missed departure","options":[],"required":false,"pdf_field":""},{"help":"Date of event","type":"date","label":"Date of trip cancellation / missed connection / missed departure","options":[],"required":false,"pdf_field":""},{"help":"Original planned travel date","type":"date","label":"Original travel date","options":[],"required":false,"pdf_field":""},{"help":"Time of event","type":"text","label":"Time","options":[],"required":false,"pdf_field":""},{"help":"Amount claimed","type":"amount","label":"Total claim amount","options":[],"required":false,"pdf_field":""},{"help":"Claim amount in words","type":"text","label":"In words","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section J: Compassionate visit","fields":[{"help":"Name of hospitalized person","type":"text","label":"Name of the person hospitalized (If not the insured)","options":[],"required":false,"pdf_field":""},{"help":"Relationship to insured","type":"text","label":"Relationship with the insured","options":[],"required":false,"pdf_field":""},{"help":"Hospital details","type":"text","label":"Name, address & telephone No. of the hospital/ clinic","options":[],"required":false,"pdf_field":""},{"help":"Doctor's office and mobile numbers","type":"phone","label":"Telephone No. of the treating doctor:(Off) (M)","options":[],"required":false,"pdf_field":""},{"help":"Hospitalization period","type":"date","label":"Dates of hospitalization: From To","options":[],"required":false,"pdf_field":""},{"help":"When symptoms began","type":"date","label":"Date of start of symptoms","options":[],"required":false,"pdf_field":""},{"help":"Doctor's report summary","type":"text","label":"Report of the treating doctor","options":[],"required":false,"pdf_field":""},{"help":"Date doctor was contacted","type":"date","label":"Date on which the doctor was contacted","options":[],"required":false,"pdf_field":""},{"help":"Description of illness","type":"text","label":"Nature of ailment","options":[],"required":false,"pdf_field":""},{"help":"Details of diagnosis and treatment","type":"text","label":"Tell us about the diagnosis and nature of treatment provided","options":[],"required":false,"pdf_field":""},{"help":"Select if pregnancy related","type":"choice","label":"Was the ailment due to pregnancy? Yes No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Select if pre-existing condition worsened ailment","type":"choice","label":"Was the ailment worsened by any pre-existing condition? Yes No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Details of pre-existing condition","type":"text","label":"If yes, please give the details","options":[],"required":false,"pdf_field":""},{"help":"Select if evacuation possible","type":"choice","label":"Can the patient be evacuated back to India? Yes No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Estimated hospital stay duration","type":"text","label":"Estimated time the patient would continue to be in the hospital","options":[],"required":false,"pdf_field":""},{"help":"List of expenses with details and amounts","type":"table","label":"Details of expenses incurred","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section K: Emergency hotel extension","fields":[{"help":"Explain reason for hotel extension","type":"text","label":"Reason for the delay","options":[],"required":false,"pdf_field":""},{"help":"Detailed explanation of delay","type":"text","label":"Please tell us the details of the delay (how, where, when and why)","options":[],"required":false,"pdf_field":""},{"help":"Date when delay occurred","type":"date","label":"Date of delay","options":[],"required":false,"pdf_field":""},{"help":"Original planned travel dates","type":"date","label":"Original travel dates: From To","options":[],"required":false,"pdf_field":""},{"help":"Name and relation of affected person","type":"text","label":"Person affected and relationship with the insured","options":[],"required":false,"pdf_field":""},{"help":"List of expenses with details and amounts","type":"table","label":"Details of expenses incurred","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section L: Return of the minor child","fields":[{"help":"Select who was hospitalized","type":"choice","label":"In case of hospitalization, the person hospitalized: Insured / family member","options":["Insured","Family member"],"required":false,"pdf_field":""},{"help":"Name of hospitalized person","type":"text","label":"Name of the person hospitalized (if not the insured)","options":[],"required":false,"pdf_field":""},{"help":"Relation to insured","type":"text","label":"Relationship with the insured","options":[],"required":false,"pdf_field":""},{"help":"Hospital details","type":"text","label":"Name, address & telephone No. of the hospital/ clinic","options":[],"required":false,"pdf_field":""},{"help":"Doctor's phone numbers","type":"phone","label":"Telephone No. of the treating doctor:(Off) (Mob)","options":[],"required":false,"pdf_field":""},{"help":"Hospitalization period","type":"date","label":"Dates of hospitalization: From To","options":[],"required":false,"pdf_field":""},{"help":"Symptom start date","type":"date","label":"Date of onset of symptoms","options":[],"required":false,"pdf_field":""},{"help":"Details if insured died","type":"text","label":"In case of the death of the insured","options":[],"required":false,"pdf_field":""},{"help":"Explain cause of death","type":"text","label":"Cause/circumstances of death","options":[],"required":false,"pdf_field":""},{"help":"Date of death","type":"date","label":"Date of death of the insured","options":[],"required":false,"pdf_field":""},{"help":"Doctor's report on death or illness","type":"text","label":"Attending doctor's report","options":[],"required":false,"pdf_field":""},{"help":"Date doctor was contacted","type":"date","label":"Date on which the doctor was contacted","options":[],"required":false,"pdf_field":""},{"help":"Description of illness","type":"text","label":"Nature of ailment","options":[],"required":false,"pdf_field":""},{"help":"Details of diagnosis and treatment","type":"text","label":"Tell us about the diagnosis and the nature of treatment provided","options":[],"required":false,"pdf_field":""},{"help":"Select if pregnancy related","type":"choice","label":"Was the ailment due to pregnancy? 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Please give the details","options":[],"required":false,"pdf_field":""},{"help":"When illness started","type":"date","label":"Date of start of ailment","options":[],"required":false,"pdf_field":""},{"help":"Type of treatment given","type":"text","label":"Nature of treatment","options":[],"required":false,"pdf_field":""},{"help":"Hospitalization period","type":"date","label":"Dates of hospitalization: From To","options":[],"required":false,"pdf_field":""},{"help":"Reason for evacuation if any","type":"text","label":"Reason for medical evacuation (if applicable)","options":[],"required":false,"pdf_field":""},{"help":"Explain why studies were interrupted","type":"text","label":"Reason for not continuing studies abroad","options":[],"required":false,"pdf_field":""},{"help":"Amount of tuition fees paid","type":"amount","label":"Tuition fees paid in advance for the year","options":[],"required":false,"pdf_field":""},{"help":"Name of deceased sponsor or family member","type":"text","label":"Due to death of the sponsor or an immediate family member: Name of the sponsor/ immediate family member","options":[],"required":false,"pdf_field":""},{"help":"Cause of death","type":"text","label":"Cause of accident that led to the demise of the sponsor/ reason for the death of immediate family member","options":[],"required":false,"pdf_field":""},{"help":"Details of accident","type":"text","label":"Nature of accident causing the demise of the sponsor","options":[],"required":false,"pdf_field":""},{"help":"Location of accident","type":"text","label":"Place of accident","options":[],"required":false,"pdf_field":""},{"help":"Hospital details for sponsor/family member","type":"text","label":"Name, address and telephone No of hospital/ clinic, where the treatment was given to the sponsor/ immediate family member","options":[],"required":false,"pdf_field":""},{"help":"Doctor's name","type":"text","label":"Name of the treating doctor","options":[],"required":false,"pdf_field":""},{"help":"Treatment details","type":"text","label":"Details of medical/ surgical treatment","options":[],"required":false,"pdf_field":""},{"help":"Treatment period","type":"date","label":"Dates of medical / surgical treatment: From To","options":[],"required":false,"pdf_field":""},{"help":"Explain why studies stopped","type":"text","label":"Reason for not continuing studies abroad","options":[],"required":false,"pdf_field":""},{"help":"Tuition fees amount","type":"amount","label":"Tuition fees paid in advance for the year","options":[],"required":false,"pdf_field":""},{"help":"Attach medical reports and death certificate","type":"attachment","label":"Please attach medical reports, statements from the treating doctor and death certificate as proof","options":[],"required":true,"pdf_field":""},{"help":"Attach tuition fee receipts","type":"attachment","label":"Please also attach the receipts of the university fees paid","options":[],"required":true,"pdf_field":""},{"help":"Attach additional sheets if needed","type":"attachment","label":"Please attach more sheets to give details, if necessary","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section O: Self drive cover liability expense","fields":[{"help":"Provide rental vehicle details or invoice","type":"text","label":"Details /Invoice of the rental vehicle","options":[],"required":false,"pdf_field":""},{"help":"Date of incident","type":"date","label":"Date of the incident","options":[],"required":false,"pdf_field":""},{"help":"Time of incident","type":"text","label":"Time of the Incident","options":[],"required":false,"pdf_field":""},{"help":"Location of incident","type":"text","label":"Place of the incident","options":[],"required":false,"pdf_field":""},{"help":"Motor insurance company name","type":"text","label":"Name of the insurer- for motor","options":[],"required":false,"pdf_field":""},{"help":"Type of motor insurance","type":"text","label":"Type of motor insurance the vehicle is covered under","options":[],"required":false,"pdf_field":""},{"help":"Motor insurance period","type":"date","label":"Period of insurance: From To","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section P: Self drive cover: Loss of international driving licence - inconvenience fee","fields":[{"help":"International driving licence number","type":"text","label":"Licence No","options":[],"required":false,"pdf_field":""},{"help":"Date licence was lost","type":"date","label":"Date of loss","options":[],"required":false,"pdf_field":""},{"help":"Location where licence was lost","type":"text","label":"Place of loss","options":[],"required":false,"pdf_field":""},{"help":"Explain how licence was lost","type":"text","label":"Brief description of the incident","options":[],"required":false,"pdf_field":""},{"help":"Select if police report was filed","type":"choice","label":"Was this Incident reported to the police? Yes No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Attach police report if available","type":"attachment","label":"If yes, please share the report","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section Q: Fraudulent card payment benefit","fields":[{"help":"Details of fraudulent transaction","type":"text","label":"Date, time and place of the fraudulent activity","options":[],"required":false,"pdf_field":""},{"help":"Select if reported","type":"choice","label":"Was this incident reported to the police and bank authorities? Yes No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Attach police and bank reports","type":"attachment","label":"If yes, kindly share both the reports","options":[],"required":false,"pdf_field":""},{"help":"Explain fraudulent activity","type":"text","label":"Brief description of the incident","options":[],"required":false,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Section R: Out patient treatment cover","fields":[{"help":"Details of outpatient visit","type":"text","label":"Date, time and place of visit to the hospital / GP","options":[],"required":false,"pdf_field":""},{"help":"Explain how injury or illness occurred","type":"text","label":"Please describe in detail the circumstances of the injury / illness / accident","options":[],"required":false,"pdf_field":""},{"help":"Describe injuries or illness","type":"text","label":"Please describe the nature of injures","options":[],"required":false,"pdf_field":""},{"help":"Hospital or clinic 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pertaining to your claim","copies of visible Photo ID proof like PAN card, Voter ID card, Passport, etc.","court order mentioning the required amount as bail bond (Section M)","medical reports, statements from the treating doctor and death certificate (Section N and W)","receipts of the university fees paid (Section N)","police report if applicable (Sections D, E, H, P, Q, V)"],"declarations":["I authorize the insurance company, physician, hospital, or other healthcare provider or any other organization, institution or person that may have records, documents or knowledge regarding the insured to release any information requested regarding this claim and the loss reported.","I understand this information will be used by Zuno General Insurance Limited or its authorized representatives for the purpose of evaluating or determining the coverage of this claim.","I have the right to receive a copy of this authorization upon request and agree that a photographic or facsimile copy of this authorization is as valid as the original.","This authorization shall be valid for the duration of this claim.","I authorize the service providers to Zuno General Insurance Limited to provide medical information or records to process this claim.","I understand that any person knowingly and with intent to defraud or deceive any insurance company files a claim containing any material false, incomplete or misleading information may be subject to prosecution for insurance fraud.","I understand, declare, consent and authorize the company that personal health details, medical history and financial information, as provided to the company may be utilized for processing the claim made under this policy.","I understand, declare and consent that the company shall have the right to retain and disseminate the same to any service provider for providing services related to insurance.","I authorize Zuno General Insurance / Zuno authorized TPA to collect the relevant medical documents for purpose of my claim from the provider where I have taken the treatment."],"dropped_labels":8},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"support@hizuno.com","label":"Health claims support email","level":null,"hours":null,"applies_to":"health","source_url":"https://www.hizuno.com/health-insurance/health-claim","quote":"ls, you will need to submit a reimbursement claim. For cashless services at a common network hospital, you can write to\nsupport@hizuno.com\n, call us at 1800 12000, or connect with your TPA as mentioned on your card.\nWhen you’re covered by a health insurance","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 12000","label":"Health claims toll free number","level":null,"hours":null,"applies_to":"health","source_url":"https://www.hizuno.com/health-insurance/health-claim","quote":"imbursement claim. For cashless services at a common network hospital, you can write to\nsupport@hizuno.com\n, call us at 1800 12000, or connect with your TPA as mentioned on your card.\nWhen you’re covered by a health insurance policy and need to be ho","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022 423 12000","label":"Paid Landline","level":null,"hours":null,"applies_to":"all","source_url":"https://www.hizuno.com/contact-us","quote":"uote\nHome\nContact us\nReach out to us for any Query/ Request or Grievance\nCall us\nToll free - 1800 12000\nPaid Landline -\n022 423 12000\nSenior citizen -\n022 423 12001\nEmail address\nsupport@hizuno.com\nsenior.citizen@hizuno.com\nGrievance Redressal Officer\nM","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/zuno-general-insurance/2393-zuno-group-overseas-travel-insurance-policy-claim-form"}