{"id":266,"title":"Electronic Equipment 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/eel-claim-form.pdf","sha256":"232260893596b348ba55b4f0aa017db03ad9513693ca29936082c1abc2b60c4c","pages":1,"collected":"2026-10-17","instructions":{"about":"This form is for policyholders to claim insurance for electronic equipment breakdown under their policy.","notes":["This Claim Form is issued without prejudice to the terms and conditions of the policy and issuance of this form should not be construed as admission of Liability.","Fill in all blanks and provide complete details; attach separate sheet if space is insufficient."],"title":"Electronic Equipment Insurance Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Claim Details","fields":[{"help":"","type":"text","label":"Claim No.","options":[],"required":null,"pdf_field":""},{"help":"","type":"date","label":"Date of Issue","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Policy No","options":[],"required":null,"pdf_field":""},{"help":"Provide the exact date and time when the equipment broke down","type":"date","label":"Date & Time of breakdown","options":[],"required":true,"pdf_field":""},{"help":"Provide full address where the equipment was installed","type":"text","label":"Equipment which broke down was installed at (Complete Address of Location)","options":[],"required":true,"pdf_field":""},{"help":"Describe how and when the breakdown was detected","type":"text","label":"Circumstances of loss: (Brief write up on circumstances under which the equipment broke down and how & when it was detected)","options":[],"required":true,"pdf_field":""},{"help":"If burglary caused the loss, describe actions taken and FIR details","type":"text","label":"IMP: in case the loss is due to Burglary, please also inform the action taken immediately after the detection. Also inform whether any FIR has been lodged.","options":[],"required":null,"pdf_field":""},{"help":"Provide your view on what caused the breakdown","type":"text","label":"Your opinion about the Cause of Breakdown","options":[],"required":true,"pdf_field":""},{"help":"Mention the schedule item as per your policy","type":"text","label":"Schedule Item of Policy","options":[],"required":null,"pdf_field":""},{"help":"Describe the equipment that broke down","type":"text","label":"Description of Equipment","options":[],"required":true,"pdf_field":""},{"help":"Provide specifications of the equipment","type":"text","label":"Specification of Equipment","options":[],"required":null,"pdf_field":""},{"help":"Describe the damage extent","type":"text","label":"Extent of Damage","options":[],"required":true,"pdf_field":""},{"help":"Provide estimated repair cost and attach quotation","type":"amount","label":"Cost of Repair (please attach copy of Quotation)","options":[],"required":true,"pdf_field":""},{"help":"List data lost and how it is being restored, if applicable","type":"text","label":"Loss to External Data Media (if applicable); please list out the type of data lost and the way the same is being replaced/reconstructed","options":[],"required":null,"pdf_field":""},{"help":"Provide details of any increased working costs due to breakdown","type":"text","label":"Increased Cost of working (if applicable); specific details of the increased cost likely to be incurred may please be provided","options":[],"required":null,"pdf_field":""},{"help":"Provide details of any other insurance covering this equipment","type":"text","label":"Details of Other Existing Insurances Name & Address of Company Policy No. Sum Insured","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Declaration","fields":[{"help":"Name of the person signing the form","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"Designation of the person signing","type":"text","label":"Designation","options":[],"required":null,"pdf_field":""},{"help":"Sign the form here","type":"signature","label":"Signature","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Place where the form is signed","type":"text","label":"Place","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"}],"deadlines":["Please submit this form, duly filled & signed, within 15 days, from the date of occurrence."],"applies_to":"","attachments":["copy of Quotation for Cost of Repair"],"declarations":["The statements made in the claim form are true to the best of the claimant's knowledge and belief.","No material information relevant to the claim has been withheld."],"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/266-electronic-equipment-insurance-claim-form"}