{"id":255,"title":"Marine Insurance Claim Form","purpose":"claim","insurer":{"slug":"iffco-tokio-general-insurance","name":"IFFCO TOKIO General Insurance Company Limited"},"source_pdf":"https://www.iffcotokio.co.in/content/dam/iffcotokio/iffco-pdf/sites/default/files/pdf/Marine%20Insurance%20Claim%20Form.pdf","sha256":"24317dd86f51b7cefce1f4b3951cfff63a0d654015b47d4118062ce5bd80a446","pages":1,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured party to claim for loss or damage under a marine insurance policy.","notes":["Fill in all blanks and provide complete details.","If space is insufficient, attach a separate sheet.","This form is issued without prejudice to the terms and conditions of the policy."],"title":"Marine Insurance Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Claim Details","fields":[{"help":"Enter the claim number if available","type":"text","label":"Claim No.","options":[],"required":null,"pdf_field":""},{"help":"Date when the form is issued","type":"date","label":"Date of Issue","options":[],"required":null,"pdf_field":""},{"help":"Enter your policy or cover number","type":"text","label":"Policy / Cover No.","options":[],"required":true,"pdf_field":""},{"help":"Enter certificate number and date if applicable","type":"text","label":"Certificate No. / Date","options":[],"required":null,"pdf_field":""},{"help":"Full name and address of the claimant or insured party","type":"text","label":"Interested Party (Name & complete Address)","options":[],"required":true,"pdf_field":""},{"help":"Date when the loss or damage was first noticed","type":"date","label":"When the Loss was detected","options":[],"required":true,"pdf_field":""},{"help":"Indicate if damage certificate from carriers has been obtained","type":"yes-no","label":"Damage Certificate from Carriers Obtained","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Indicate if monetary claim on carriers has been lodged","type":"yes-no","label":"Monetary Claim on Carriers Lodged","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Specify the start and end points of the voyage or journey covered","type":"text","label":"Voyage / Journey Covered (From:, To:)","options":[],"required":true,"pdf_field":""},{"help":"Describe the goods that were being transported","type":"text","label":"Description of Goods in transit","options":[],"required":true,"pdf_field":""},{"help":"Specify the mode of transportation (e.g. sea, air, road)","type":"text","label":"Mode of Transportation","options":[],"required":true,"pdf_field":""},{"help":"Describe the type of packing used for the goods","type":"text","label":"Type of Packing","options":[],"required":true,"pdf_field":""},{"help":"Describe the type of damage sustained","type":"text","label":"Type of Damage","options":[],"required":true,"pdf_field":""},{"help":"Describe the extent or severity of the damage","type":"text","label":"Extent of Damage","options":[],"required":true,"pdf_field":""},{"help":"Provide invoice number and date related to the goods","type":"text","label":"Invoice No. / Date","options":[],"required":true,"pdf_field":""},{"help":"Provide bill of lading or airway bill number and date","type":"text","label":"Bill of Lading / Airway Bill No. / Date","options":[],"required":true,"pdf_field":""},{"help":"Provide bill of entry number and date if applicable","type":"text","label":"Bill of Entry No. / Date","options":[],"required":null,"pdf_field":""},{"help":"Provide consignment note number and date if applicable","type":"text","label":"Consignment Note No. / Date","options":[],"required":null,"pdf_field":""},{"help":"Provide material receipt report number and date if applicable","type":"text","label":"Material Receipt Report No. / Date","options":[],"required":null,"pdf_field":""},{"help":"State the basis on which the valuation of goods is done","type":"text","label":"Basis of Valuation","options":[],"required":true,"pdf_field":""},{"help":"Enter the amount being claimed","type":"amount","label":"Amount Claimed","options":[],"required":true,"pdf_field":""},{"help":"Provide name & address of company, policy number, and sum insured for other insurances","type":"table","label":"Details of Other Existing Insurances","options":[],"required":null,"pdf_field":""}],"filled_by":"claimant / insured party"},{"title":"Declaration","fields":[{"help":"Name of the person signing the form","type":"text","label":"Name:","options":[],"required":true,"pdf_field":""},{"help":"Signature of the claimant or insured party","type":"signature","label":"Signature:","options":[],"required":true,"pdf_field":""},{"help":"Date of signing the form","type":"date","label":"Date:","options":[],"required":true,"pdf_field":""}],"filled_by":"claimant / insured party"}],"deadlines":["Please return this form, duly filled & signed, within 7 days from the date of its issuance."],"applies_to":"","attachments":[],"declarations":["The claimant confirms that the details given are true and correct to the best of their knowledge.","Issuance of this form does not imply admission of liability by the insurer."],"dropped_labels":0},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"address","value":"policy issuing Branch","label":"Walk in claim intimation","level":null,"hours":"Mon- Fri 09:30 AM to 06:00 PM (Except for National Holidays)","applies_to":"all","source_url":"https://www.iffcotokio.co.in/claims/register-a-claim","quote":"65 days.\nToll No. 1800-103-5499\nWalk in\nShall you wish to intimate your claim in person, please feel free to visit your policy issuing Branch Mon- Fri 09:30 AM to 06:00 PM (Except for National Holidays). Please refer to our\nBranch Locator\nfor information on our","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"support@iffcotokio.co.in","label":"Email","level":null,"hours":null,"applies_to":"all","source_url":"https://www.iffcotokio.co.in/contact-us/customer-services/grievance-redressal","quote":"se\nTelugu\nOriya\nPolicy Copy\nService Request\nLocators\nClaims\nRegister Claim\nClaim Status\nToll free: 1800-103-5499\nEmail: support@iffcotokio.co.in\nSay Hi to IRA: 7993407777\nEnglish\nHindi\nMarathi\nGujarati\nPunjabi\nMalayalam\nTamil\nBengali\nKannada\nAssamese\nTelugu\nOriya","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800-103-5499","label":"Toll free","level":null,"hours":"24 X 7","applies_to":"all","source_url":"https://www.iffcotokio.co.in/contact-us/customer-services/grievance-redressal","quote":"engali\nKannada\nAssamese\nTelugu\nOriya\nPolicy Copy\nService Request\nLocators\nClaims\nRegister Claim\nClaim Status\nToll free: 1800-103-5499\nEmail: support@iffcotokio.co.in\nSay Hi to IRA: 7993407777\nEnglish\nHindi\nMarathi\nGujarati\nPunjabi\nMalayalam\nTamil\nBengal","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"sms","value":"56161","label":"SMS “CLAIM” to 56161","level":null,"hours":null,"applies_to":"all","source_url":"https://www.iffcotokio.co.in/claims/register-a-claim","quote":"avor to take customer service at newer heights, we now bring claim Intimation at your fingertips. Please SMS “CLAIM” to 56161 and one of our Claims representatives will get in touch with you in 4 Working Hours.\n* Note:\nPlease have all the detail","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"whatsapp","value":"7993407777","label":"Say Hi to IRA","level":null,"hours":null,"applies_to":"all","source_url":"https://www.iffcotokio.co.in/contact-us/customer-services/grievance-redressal","quote":"est\nLocators\nClaims\nRegister Claim\nClaim Status\nToll free: 1800-103-5499\nEmail: support@iffcotokio.co.in\nSay Hi to IRA: 7993407777\nEnglish\nHindi\nMarathi\nGujarati\nPunjabi\nMalayalam\nTamil\nBengali\nKannada\nAssamese\nTelugu\nOriya\nCustomer Login\nAgent Login","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/iffco-tokio-general-insurance/255-marine-insurance-claim-form"}