{"id":257,"title":"Jeweller’s Block Protector Policy 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/Jeweller%27s%20Block%20Claim%20Form.pdf","sha256":"6641c65db4e02ddee78d0ee8eb0c3af01fa4d2118c5654d4c043cd5c1935912e","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is for the insured person to claim loss under the Jeweller’s Block Protector Policy by providing details of the loss and related information.","notes":["The issuance of this form is not to be taken as an admission of liability","Please answer all questions fully"],"title":"Jeweller’s Block Protector Policy CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Claim Details","fields":[{"help":"","type":"text","label":"Claim No:","options":[],"required":null,"pdf_field":"Text Field 36"},{"help":"Enter your policy number","type":"text","label":"Policy No.","options":[],"required":true,"pdf_field":"Text Field 37"},{"help":"Enter start date of insurance period","type":"date","label":"Period of Insurance From","options":[],"required":true,"pdf_field":"Text Field 38"},{"help":"Enter end date of insurance period","type":"date","label":"To","options":[],"required":true,"pdf_field":"Text Field 40"},{"help":"Enter the name of the insured","type":"text","label":"Insured Name","options":[],"required":true,"pdf_field":"Text Field 41"},{"help":"Enter your mailing address","type":"text","label":"Address for correspondence","options":[],"required":true,"pdf_field":"Text Field 42"},{"help":"Enter your contact phone number","type":"phone","label":"Telephone No.","options":[],"required":true,"pdf_field":"Text Field 43"},{"help":"Enter the date when the loss occurred","type":"date","label":"Date of loss","options":[],"required":true,"pdf_field":"Text Field 44"},{"help":"Describe the items lost or damaged","type":"text","label":"Item/s affected by loss","options":[],"required":true,"pdf_field":"Text Field 45"},{"help":"Provide a short description of the loss","type":"text","label":"Brief Description of loss","options":[],"required":true,"pdf_field":"Text Field 46"},{"help":"Explain how the loss happened","type":"text","label":"Cause of loss","options":[],"required":true,"pdf_field":"Text Field 47"},{"help":"Indicate if you have reported the loss to the police","type":"yes-no","label":"Has the matter been reported to the Police","options":["Yes","No"],"required":true,"pdf_field":"Text Field 48"},{"help":"Enter the police station name if reported","type":"text","label":"Name of the Police Station","options":[],"required":false,"pdf_field":"Text Field 49"},{"help":"Provide FIR number and date; attach FIR copy","type":"text","label":"FIR No. and date (Please enclose original or certified copy of FIR)","options":[],"required":false,"pdf_field":"Text Field 50"},{"help":"Enter carrier or authority name if applicable","type":"text","label":"Name of the Carrier/Authority in whose custody the loss has taken place (if applicable)","options":[],"required":false,"pdf_field":"Text Field 51"},{"help":"Indicate if claim lodged on carrier/authority","type":"yes-no","label":"Has the claim been lodged on the Carrier/Authority","options":["Yes","No"],"required":false,"pdf_field":"Text Field 52"},{"help":"Enter date claim lodged on carrier/authority; attach correspondence copies","type":"date","label":"Date when the claim has been lodged on the Carrier/Authority (Please enclose copies of the correspondence exchanged with them)","options":[],"required":false,"pdf_field":"Text Field 53"},{"help":"Provide detailed estimate of loss with breakup","type":"text","label":"Estimate of loss (with complete breakup)","options":[],"required":true,"pdf_field":"Text Field 54"},{"help":"Add any additional relevant information","type":"text","label":"Any other information which you would like to provide","options":[],"required":false,"pdf_field":"Text Field 55"},{"help":"Enter the date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":"Text Field 56"},{"help":"Sign the form","type":"signature","label":"Signature of the Insured","options":[],"required":true,"pdf_field":"Text Field 57"},{"help":"Enter place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":"Text Field 58"}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Jeweller’s Block Protector Policy claims","attachments":["original or certified copy of FIR","copies of the correspondence exchanged with the Carrier/Authority"],"declarations":[],"dropped_labels":0},"pdf_fields":[{"name":"Text Field 36","page":1,"type":"text"},{"name":"Text Field 37","page":1,"type":"text"},{"name":"Text Field 38","page":1,"type":"text"},{"name":"Text Field 40","page":1,"type":"text"},{"name":"Text Field 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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/257-jewellers-block-protector-policy-claim-form"}