{"id":29,"title":"ACKO PROPERTY PROTECT POLICY CLAIM FORM","purpose":"claim","insurer":{"slug":"acko-life-insurance","name":"Acko Life Insurance Limited"},"source_pdf":"https://acko-cms.ackoassets.com/Acko_Property_Protect_Policy_Claim_form_ad328129ff.pdf","sha256":"09fb69dd2a2310869f9fa85f695ba7b9388869a8febb2442828c492df5384733","pages":7,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured person or claimant to file a claim under the Acko Property Protect Policy for various insured events.","notes":["Complete the form in CAPITAL LETTERS.","Do not leave any column unanswered; mention 'N/A' if not applicable.","Attach all original witness statements if already obtained.","Attach original blank cancelled cheque signed by the payee and PAN card copy for EFT.","Use original bills and documents as required per section.","Submission of claim form does not imply admission of liability by Acko."],"title":"ACKO PROPERTY PROTECT POLICY CLAIM FORM","submit":{"to":"Acko General Insurance Ltd.","how":"","address":"2nd Floor, #36/5, Hustlehub One East, Somasandrapalya 27th Main Rd, Sector 2, HSR Layout, Bengaluru, Karnataka, 560102"},"purpose":"claim","sections":[{"title":"I. DETAILS OF INSURED","fields":[{"help":"Enter your policy number","type":"text","label":"Policy No","options":[],"required":true,"pdf_field":""},{"help":"Enter the name of the insured person","type":"text","label":"Insured Name","options":[],"required":true,"pdf_field":""},{"help":"Enter full address","type":"text","label":"Address","options":[],"required":true,"pdf_field":""},{"help":"Enter city name","type":"text","label":"City","options":[],"required":true,"pdf_field":""},{"help":"Enter state name","type":"text","label":"State","options":[],"required":true,"pdf_field":""},{"help":"Enter postal pin code","type":"number","label":"Pin Code","options":[],"required":true,"pdf_field":""},{"help":"Enter telephone number","type":"phone","label":"Telephone number","options":[],"required":false,"pdf_field":""},{"help":"Enter mobile number","type":"phone","label":"Mobile","options":[],"required":true,"pdf_field":""},{"help":"Enter office phone number","type":"phone","label":"Office","options":[],"required":false,"pdf_field":""},{"help":"Enter email address if available","type":"email","label":"Email (Optional)","options":[],"required":false,"pdf_field":""}],"filled_by":"Insured Person / Claimant"},{"title":"II. DETAILS OF THE INSURED IN RESPECT OF WHOM CLAIM IS MADE","fields":[{"help":"Enter claimant's full name","type":"text","label":"Name of claimant","options":[],"required":true,"pdf_field":""},{"help":"Enter claimant's full address","type":"text","label":"Address","options":[],"required":true,"pdf_field":""},{"help":"Enter city name","type":"text","label":"City","options":[],"required":true,"pdf_field":""},{"help":"Enter state name","type":"text","label":"State","options":[],"required":true,"pdf_field":""},{"help":"Enter postal pin code","type":"number","label":"Pin Code","options":[],"required":true,"pdf_field":""},{"help":"Enter telephone number","type":"phone","label":"Telephone number","options":[],"required":false,"pdf_field":""},{"help":"Enter mobile number","type":"phone","label":"Mobile","options":[],"required":true,"pdf_field":""},{"help":"Enter office phone number","type":"phone","label":"Office","options":[],"required":false,"pdf_field":""},{"help":"Enter email address if available","type":"email","label":"Email (Optional)","options":[],"required":false,"pdf_field":""},{"help":"Enter policy or certificate number","type":"text","label":"Policy/Certificate No","options":[],"required":true,"pdf_field":""},{"help":"Enter date of incident in DD/MM/YYYY format","type":"date","label":"Date of Incident","options":[],"required":true,"pdf_field":""},{"help":"Enter time of incident in HH:MM hrs format","type":"text","label":"Time","options":[],"required":true,"pdf_field":""},{"help":"Enter location of incident","type":"text","label":"Place of Incident","options":[],"required":true,"pdf_field":""},{"help":"Describe the incident in detail","type":"text","label":"Details of Incident","options":[],"required":true,"pdf_field":""},{"help":"Select Yes or No","type":"choice","label":"Whether reported to Police","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide police station details if reported","type":"text","label":"If Yes, Name, Address and Contact of Police Station","options":[],"required":false,"pdf_field":""},{"help":"Enter FIR number if available","type":"text","label":"First Information Report (FIR) No","options":[],"required":false,"pdf_field":""},{"help":"Enter FIR date in DD/MM/YYYY format if available","type":"date","label":"FIR Date","options":[],"required":false,"pdf_field":""}],"filled_by":"Insured Person / Claimant"},{"title":"III. DETAILS OF WITNESSES","fields":[{"help":"Select Yes or No","type":"choice","label":"Was there any witness to the Incident","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Enter witness name if applicable","type":"text","label":"Name of claimant","options":[],"required":false,"pdf_field":""},{"help":"Enter witness address if applicable","type":"text","label":"Address","options":[],"required":false,"pdf_field":""},{"help":"Enter witness city if applicable","type":"text","label":"City","options":[],"required":false,"pdf_field":""},{"help":"Enter witness state if applicable","type":"text","label":"State","options":[],"required":false,"pdf_field":""},{"help":"Enter witness pin code if applicable","type":"number","label":"Pin Code","options":[],"required":false,"pdf_field":""},{"help":"Enter witness telephone number if applicable","type":"phone","label":"Telephone number","options":[],"required":false,"pdf_field":""},{"help":"Enter witness mobile number if applicable","type":"phone","label":"Mobile","options":[],"required":false,"pdf_field":""},{"help":"Enter witness office number if applicable","type":"phone","label":"Office","options":[],"required":false,"pdf_field":""}],"filled_by":"Insured Person / Claimant"},{"title":"IV. DETAILS OF BENEFITS CLAIMED","fields":[{"help":"Fill Yes or No for claim made and amount if known for each cover listed under sections i to vii","type":"table","label":"Section Name of the Covers Claim made (Yes/No) Claim Amount (If known)","options":[],"required":true,"pdf_field":""}],"filled_by":"Insured Person / Claimant"},{"title":"VI. DETAILS OF BANK ACCOUNT FOR CLAIM PAYMENT","fields":[{"help":"Enter bank name","type":"text","label":"Bank Name","options":[],"required":true,"pdf_field":""},{"help":"Enter bank branch name","type":"text","label":"Bank Branch","options":[],"required":true,"pdf_field":""},{"help":"Enter bank account number","type":"text","label":"Bank Account Number","options":[],"required":true,"pdf_field":""},{"help":"Enter IFSC code","type":"text","label":"IFSC Code","options":[],"required":true,"pdf_field":""},{"help":"Enter MICR code if available","type":"text","label":"MICR Code","options":[],"required":false,"pdf_field":""}],"filled_by":"Insured Person / Claimant"},{"title":"VII. DECLARATION","fields":[{"help":"Enter date of signing in DD/MM/YYYY format","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Sign the form","type":"signature","label":"Signature of Claimant","options":[],"required":true,"pdf_field":""},{"help":"Enter place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":""}],"filled_by":"Claimant"},{"title":"VIII. DIRECT FUND TRANSFER / EFT MANDATE FORM","fields":[{"help":"Select Yes or No","type":"choice","label":"Would you like to opt for Electronic Fund Transfer as mode of payment?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Enter payee name as per bank records","type":"text","label":"Payee Name (as per bank records)","options":[],"required":true,"pdf_field":""},{"help":"Enter payee bank account number","type":"text","label":"Payee Account No.","options":[],"required":true,"pdf_field":""},{"help":"Enter type of bank account","type":"text","label":"Type of Account","options":[],"required":true,"pdf_field":""},{"help":"Enter bank name","type":"text","label":"Name of the Bank","options":[],"required":true,"pdf_field":""},{"help":"Enter bank branch name","type":"text","label":"Branch Name","options":[],"required":true,"pdf_field":""},{"help":"Enter bank branch address","type":"text","label":"Address of the Bank","options":[],"required":true,"pdf_field":""},{"help":"Enter IFSC code","type":"text","label":"IFSC Code of the Bank","options":[],"required":true,"pdf_field":""},{"help":"Enter MICR code if available","type":"text","label":"MICR Code No. of the Bank","options":[],"required":false,"pdf_field":""},{"help":"Enter PAN number","type":"text","label":"Permanent Account Number (PAN) of Payee","options":[],"required":true,"pdf_field":""},{"help":"Enter date of signing in DD/MM/YYYY format","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Sign the form","type":"signature","label":"Signature of Claimant","options":[],"required":true,"pdf_field":""},{"help":"Enter place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":""}],"filled_by":"Claimant"}],"deadlines":[],"applies_to":"Claims under Acko Property Protect Policy","attachments":["Original witness statements if already obtained","Photographs (if required by insurer)","Repair Estimates or Bills of business premise","Shop License / Registration Certificate","Proof of Business Interruption like Bank statement showing drop in revenue, GST returns, Sales ledgers, Accountant’s certificate (if asked)","Fire Department Report (if applicable)","Municipal/Local Authority Certificate (if applicable)","FIR / police complaint copy","Detailed loss statement and claim estimate","Cash records (books, registers, or logs)","Proof of transit (route, time, personnel details)","Authorization proof of employee carrying cash","Records of cash carried in transit","Evidence of incident (if available)","Cash records maintained separately from safe/vault","Proof of safe/strong room security and access controls","Evidence of burglary/robbery/hold-up","Records verifying amount of cash stored","Copy of FIR filed with police authorities / cyber cell or complaint letter acknowledgement from the police","Proof of Disabling of Card facility at core banking","Card Statement/ Account Statement for last 6 months indicating Fraudulent Transactions/Unauthorized Use and loss liability","Card Copy / Declaration from the Bank/ financial institution","Medical bills in case of bodily injury","Original invoice/ proof of purchase of the lost wallet","Receipt of cost incurred as replacement costs for the new wallet","Receipts for fee payable to the concerned authorities incurred to applying for / obtain new personal papers and/ or cards","Copy of vehicle RC and driver’s license, if vehicle is damaged as an asset","Receipts for replacing locks and/or keys","Repair invoice and job card","Proof of asset downtime","Income proof","Original pre-authorisation request","Copy of pre-authorisation approval letter(s)","Copy of Photo ID of Insured Person verified by the Hospitals","Original discharge/death summary","Operation theatre notes (if applicable)","Original Hospital main bill and break up bill","Original investigation reports, X Ray, MRI, CT Films, HPE","Medical Practitioner’s reference slips for investigations/pharmacy","Original pharmacy bills","MLC/FIR report/post mortem report (if applicable and conducted)","Original Policy (Wherever applicable)","Invoice of the Equipment/Proof of ownership, care or custody (Wherever applicable)","Manufacturer Warranty Certificate (if not submitted during the issuance of policy wherever necessary)","Proof of non-settlement of defects/breakdown by the OEM (optional)","Invoice or certificate/card issued by wholesaler or retailer or Service Contractor (optional)","FIR or Police Complaint (especially in case of injury or significant property damage)","Written compensation claim or demand from third party","Identity and Address Proof","Legal Notice or Court Summons","Legal fee proof","Original blank cancelled cheque signed by the Payee","PAN CARD copy of Payee"],"declarations":["The information furnished in this claim form is true, complete and accurate to the best of my knowledge and belief.","If any false or untrue statement is made or material fact is concealed, the right to claim benefits under the Policy shall be forfeited.","I consent and authorize Acko General Insurance Ltd to seek necessary documents from the Service Provider who serviced the person against whom this claim is made.","Submission of documents or bank details or any other information does not imply admission of liability by the company.","The details provided in the EFT mandate form shall be considered final and Acko is not responsible for cross verification.","RTGS/NEFT facility will be effective within 15 days of receipt of the mandate form or as reasonably required.","There may be risk of non-payment on the day of credit due to regulatory or other reasons beyond Acko's control.","The customer agrees to indemnify Acko and its agents against any claims or losses arising from RTGS/NEFT transactions.","Acko may subcontract agents to carry out obligations under RTGS/NEFT facility.","Customer may terminate RTGS/NEFT facility with 15 days prior written notice to Acko at its corporate address.","Confirmation of termination notice will be acknowledged by Acko; termination is effective only after confirmation.","RTGS/NEFT transactions may attract charges borne by the customer.","Acko may amend terms and conditions with prior notice of ten days wherever feasible.","Notices may be given by hand, email, website, or post to the customer's last address.","These terms and conditions are governed by Indian laws and legal proceedings shall be in Mumbai courts."],"dropped_labels":0},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"address","value":"Claims Department, ACKO LIFE INSURANCE LIMITED., 36/5, Hustle Hub One East, Somasandrapalya, 27th Main Road, Sector 2, HSR Layout, Somasandrapalya HSR 2nd Sector Bus Stop, Bengaluru, Bengaluru Urban, Karnataka, 560102","label":"Claims postal address","level":null,"hours":null,"applies_to":"life","source_url":"https://acko-cms.ackoassets.com/2_Acko_Life_Group_Term_Protect_Micro_Insurance_Master_Policy_Document_ca9093f4de.pdf","quote":"at claims.life@acko.com or by sending the documents to the address mentioned below or any other office of the Company:\nClaims Department, ACKO LIFE INSURANCE LIMITED., 36/5, Hustle Hub One East, Somasandrapalya, 27th Main Road, Sector 2, HSR Layout, Somasandrapalya HSR 2nd Sector Bus Stop, Bengaluru, Bengaluru Urban, Karnataka, 560102\n\nAny person claiming the Death Benefit under this Policy can download the claim request documents from Our website www.","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800-210-1992","label":"Claims phone number","level":null,"hours":"9:00 AM – 8:00 PM","applies_to":"life","source_url":"https://www.acko.com/life/claims/","quote":"t us\nSupport\nRenewals\nNew to ACKO?\nRenew life insurance\nExisting ACKO Customer\nLogin and renew policy\nClaims\nCall us at\n1800-210-1992\nEmail us at\n[email protected]\nLogin\nACKO Life Home\n/\nACKO Life Insurance Claims Process\nGroup Claims Process\nClaims Pro","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/acko-life-insurance/29-acko-property-protect-policy-claim-form"}