{"id":269,"title":"MONEY 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/CLAIM%20FORM-MONEY_0.pdf","sha256":"5e4d5f593279769bd6505620b4171f735960054e50463e30529306e86df34ec6","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is for the insured person to claim money insurance after a loss of money in transit or custody.","notes":["The issue of this form does not constitute admission of liability.","Attach copies of written statements and police complaints as applicable."],"title":"MONEY INSURANCE CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Insured Details","fields":[{"help":"","type":"text","label":"Name of Insured (in full)","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Business","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Loss Details","fields":[{"help":"Include both date and time","type":"date","label":"Date and time of occurrence of loss","options":[],"required":null,"pdf_field":""},{"help":"","type":"date","label":"Date of discovery of loss","options":[],"required":null,"pdf_field":""},{"help":"Specify origin and destination places","type":"text","label":"What were the places between which money was in transit?","options":[],"required":null,"pdf_field":""},{"help":"Specify exact location of loss","type":"text","label":"Where did the loss occur?","options":[],"required":null,"pdf_field":""},{"help":"Attach copy of written statement","type":"text","label":"By whom was the loss reported? (A copy of written statement to be attached)","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Custody and Accompanying Persons","fields":[{"help":"","type":"text","label":"In whose custody was the money at the time of the loss?","options":[],"required":null,"pdf_field":""},{"help":"List names or descriptions","type":"text","label":"Who were the other persons accompanying the person carrying the money?","options":[],"required":null,"pdf_field":""},{"help":"Number of accompanying persons","type":"number","label":"How many persons accompanied him?","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Circumstances of Loss","fields":[{"help":"Describe the incident in detail","type":"text","label":"Brief details as to the exact circumstances under which the loss occurred","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Carrying Details","fields":[{"help":"","type":"text","label":"How was the money carried? (whether in pocket, bag, box etc.)","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Whether such bags, boxes, etc. were securely locked?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Specify vehicle or mode of transport","type":"text","label":"By what conveyance was the money carried?","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Amount Details","fields":[{"help":"Specify currency and amount","type":"amount","label":"What was the amount of money being carried?","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Was the total amount checked at the time of handing it over to the messenger?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Was any acknowledgement received from him?","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Loss Amount","fields":[{"help":"Specify currency and amount lost","type":"amount","label":"What was the amount of loss?","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Police Complaint","fields":[{"help":"Attach copy of police complaint if available","type":"yes-no","label":"Has a complaint been made to the Police? If so, attach a copy thereof, If not, this may be done immediately.","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Recovery Steps","fields":[{"help":"Describe any recovery efforts","type":"text","label":"What steps have been taken to recover the lost money?","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Employee Details","fields":[{"help":"","type":"date","label":"When did the employee concerned enter your service?","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Was any one of them involved in a similar loss before?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Are you satisfied the version given by them is correct?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide policy details if applicable","type":"text","label":"Are any of them covered under any Fidelity Guarantee Policy? If so, give details.","options":[],"required":null,"pdf_field":""},{"help":"Specify type and amount of security held","type":"text","label":"Do you hold any cash deposit or any other security from them?","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Previous Losses","fields":[{"help":"Describe previous similar losses if any","type":"text","label":"Have you ever before sustained a loss of this nature? If so give particulars","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Other Insurances","fields":[{"help":"List other insurance policies covering the money","type":"text","label":"Are there any other insurances upon the same money? If so, give particulars.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration","fields":[{"help":"Location where form is signed","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Sign the form","type":"signature","label":"Signature of Insured.","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":["Please return the form completed within Fourteen days of the loss together with the relevant vouchers etc."],"applies_to":"","attachments":["Relevant vouchers","Copy of written statement reporting the loss","Copy of police complaint if made"],"declarations":["The particulars given are true and correct in every respect."],"dropped_labels":1},"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/269-money-insurance-claim-form"}