{"id":279,"title":"BILLING AND SETTLEMENT INSURANCE (IATA) 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/Billing-and-Settlement-Insurance-IATA-claim-form.pdf","sha256":"b1a84d0c1851fedfb42d176726aecf9dca2f7017b63f18efe26d427515e4d2b1","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is used by the International Air Transport Association (IATA) to claim insurance for an agent in default under the Billing and Settlement Plan (BSP) or CASS. It is filled by the IATA office making the claim.","notes":["Please complete all sections with all original additional information to be sent to IFFCO-TOKIO"],"title":"BILLING AND SETTLEMENT INSURANCE (IATA) CLAIM FORM","submit":{"to":"IFFCO-TOKIO","how":"","address":""},"purpose":"claim","sections":[{"title":"Section 1: Address of IATA Office Making Claim","fields":[{"help":"Enter the full address of the IATA office making the claim","type":"text","label":"ADDRESS OF IATA OFFICE MAKING CLAIM","options":[],"required":null,"pdf_field":""},{"help":"Enter the country of the IATA office","type":"text","label":"COUNTRY","options":[],"required":null,"pdf_field":""},{"help":"Enter the email address of the IATA office","type":"email","label":"EMAIL ADDRESS","options":[],"required":null,"pdf_field":""},{"help":"Enter telephone number with area code","type":"phone","label":"TELEPHONE NUMBER (Area Code)","options":[],"required":null,"pdf_field":""},{"help":"Enter facsimile number with area code","type":"phone","label":"FASCIMLIE NUMBER (Area Code)","options":[],"required":null,"pdf_field":""}],"filled_by":"IATA office making claim"},{"title":"Section 2: Agent in Default Details","fields":[{"help":"Enter full name and any trading names of the agent in default","type":"text","label":"AGENT IN DEFAULT (Full name and any Trading Names)","options":[],"required":null,"pdf_field":""},{"help":"Enter the IATA number of the agent","type":"text","label":"IATA NUMBER","options":[],"required":null,"pdf_field":""},{"help":"Enter the full address of the agent in default","type":"text","label":"ADDRESS OF THE AGENT","options":[],"required":null,"pdf_field":""},{"help":"Enter contact number of the agent","type":"phone","label":"CONTACT NUMBER OF THE AGENT","options":[],"required":null,"pdf_field":""},{"help":"Enter email address of the agent","type":"email","label":"EMAIL ADDRESS OF THE AGENT","options":[],"required":null,"pdf_field":""},{"help":"Enter the date the agency was declared in default","type":"date","label":"DATE AGENCY DECLARED IN DEFAULT","options":[],"required":null,"pdf_field":""},{"help":"Enter the date the agency was declared in termination","type":"date","label":"DATE AGENCY DECLARED IN TERMINATION","options":[],"required":null,"pdf_field":""},{"help":"Enter the defaulted amount with currency","type":"amount","label":"DEFAULTED AMOUNT (please state currency)","options":[],"required":null,"pdf_field":""},{"help":"Enter the amount being claimed with currency","type":"amount","label":"AMOUNT CLAIMING (please state currency)","options":[],"required":null,"pdf_field":""}],"filled_by":"IATA office making claim"},{"title":"Additional Documents Required","fields":[{"help":"Attach copies of all relevant letters","type":"attachment","label":"Copy of IATA’s letter(s) declaring the Agent in default and all other letters sent to the agent in connection with the default","options":[],"required":null,"pdf_field":""},{"help":"Attach BSP billing analysis documents","type":"attachment","label":"The BSP Billing Analysis for the relevant period(s)","options":[],"required":null,"pdf_field":""},{"help":"Attach statement of agent's net sales for the specified period","type":"attachment","label":"A statement of the Agent's net sales through BSP during the 12 months immediately preceding the month when determination of the SUM Insured was made in respect of the agent","options":[],"required":null,"pdf_field":""}],"filled_by":"IATA office making claim"},{"title":"Declaration","fields":[{"help":"Signature of the IATA Manager","type":"signature","label":"Signed on behalf of IATA (Manager only)","options":[],"required":true,"pdf_field":""},{"help":"Print name of the signing manager","type":"text","label":"Print Name","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""}],"filled_by":"IATA Manager"}],"deadlines":[],"applies_to":"Claims related to agency defaults under BSP or CASS","attachments":["Copy of IATA’s letter(s) declaring the Agent in default and all other letters sent to the agent in connection with the default","The BSP Billing Analysis for the relevant period(s)","A statement of the Agent's net sales through BSP during the 12 months immediately preceding the month when determination of the SUM Insured was made in respect of the agent"],"declarations":["IATA confirms the information is correct and agrees to give full legal subrogation rights to IFFCO-TOKIO upon settlement of the claim","IATA understands this claim forms part of the policy terms and conditions","IATA agrees to complete a release of claim and subrogation receipt supplied by IFFCO-TOKIO"],"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/279-billing-and-settlement-insurance-iata-claim-form"}