{"id":281,"title":"Bank Locker 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/Claim-Form-Bank-locker-protector.pdf","sha256":"b4f4cebe6fd7373c7204699e85679f5637c7aa80ab14e3914cc96e359bc552e3","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is for the insured person to claim loss under the Bank Locker Protector Policy by providing details of the loss and related information.","notes":["Fill in all blanks and provide complete details; attach separate sheet if space is insufficient.","Attach original or certified copy of FIR and quotation for repair if applicable."],"title":"Bank Locker Protector Policy 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":false,"pdf_field":""},{"help":"Enter your policy number","type":"text","label":"Policy Number","options":[],"required":true,"pdf_field":""},{"help":"Enter the name of the insured as per policy","type":"text","label":"Insured Name","options":[],"required":true,"pdf_field":""},{"help":"Enter sum insured amounts for both categories","type":"text","label":"Sum Insured under the policy 1) Loss of Jewellery and Valuables 2) Loss of documents","options":[],"required":true,"pdf_field":""},{"help":"Enter the date and time when the loss occurred","type":"date","label":"Date & Time of Loss","options":[],"required":true,"pdf_field":""},{"help":"Describe how and when the loss happened","type":"text","label":"Circumstances of loss (Brief write up on circumstances under which loss occurred & when it was detected)","options":[],"required":true,"pdf_field":""},{"help":"Provide your view on what caused the loss","type":"text","label":"Your opinion about the Cause of Loss","options":[],"required":false,"pdf_field":""},{"help":"List all items lost or damaged","type":"text","label":"Item/s affected by loss (Please provide the complete list itemwise)","options":[],"required":true,"pdf_field":""},{"help":"Enter the police station name where FIR was filed","type":"text","label":"Name of the Police Station where the incident has been reported","options":[],"required":true,"pdf_field":""},{"help":"Provide FIR number and date; attach copy of FIR","type":"text","label":"FIR No. and date (Please enclose original or certified copy of FIR)","options":[],"required":true,"pdf_field":""},{"help":"Enter repair cost if any and attach quotation","type":"amount","label":"Cost of Repair, if applicable (attach copy of Quotation)","options":[],"required":false,"pdf_field":""},{"help":"Provide any additional relevant information","type":"text","label":"Any other information which you would like to provide","options":[],"required":false,"pdf_field":""},{"help":"Provide details of any other insurance covering the same loss","type":"text","label":"Details of Other Existing Insurances Name & Address of Company Policy Number Sum Insured","options":[],"required":false,"pdf_field":""}],"filled_by":"claimant (insured)"},{"title":"Bank Account Details for Claim Settlement","fields":[{"help":"Enter your PAN number","type":"text","label":"PAN","options":[],"required":true,"pdf_field":""},{"help":"Enter your bank account number for claim payment","type":"text","label":"Account Number","options":[],"required":true,"pdf_field":""},{"help":"Enter your bank's name and branch","type":"text","label":"Bank Name and Branch","options":[],"required":true,"pdf_field":""},{"help":"Enter name to which cheque or demand draft should be payable","type":"text","label":"Cheque/ DD Payable details","options":[],"required":false,"pdf_field":""},{"help":"Enter the IFSC code of your bank branch","type":"text","label":"IFSC Code","options":[],"required":true,"pdf_field":""}],"filled_by":"claimant (insured)"},{"title":"Declaration and Signature","fields":[{"help":"Enter your full name","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"Sign the form","type":"signature","label":"Signature","options":[],"required":true,"pdf_field":""},{"help":"Enter the date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""}],"filled_by":"claimant (insured)"},{"title":"Details of items affected by loss","fields":[{"help":"List each lost item with serial number, description, quantity, and value in rupees","type":"table","label":"Details of items affected by loss – S. No., Description of item, Quantity, Value (in Rs.)","options":[],"required":true,"pdf_field":""}],"filled_by":"claimant (insured)"}],"deadlines":["Please return this form, duly filled & signed, within 15 days, from the date of occurrence."],"applies_to":"claims under Bank Locker Protector Policy","attachments":["original or certified copy of FIR","copy of Quotation for repair (if applicable)"],"declarations":["All statements made on this form are true to the best of my/our knowledge and belief.","The articles and property described belong to the persons named, with no other person having any interest.","If any false or fraudulent statement or concealment is made, the claim shall be forfeited and the policy null and void."],"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/281-bank-locker-protector-policy-claim-form"}