{"id":297,"title":"Claim Form –Jan Kavach Yojna (Micro Insurance)","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/Jan-Kavach-Yojna-MI-Claim-Form.pdf","sha256":"a2ff412caf0efe68bb62d54a152c72442a6c9e36735cc1a9cbcad7776688ee7b","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is for policyholders to claim insurance benefits under the Jan Kavach Yojna (Micro Insurance) scheme.","notes":["Fill in all blanks and give complete details.","If space is insufficient, annex a separate sheet."],"title":"Claim Form –Jan Kavach Yojna (Micro Insurance)","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Policy and Loss Details","fields":[{"help":"Enter your insurance 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":"Provide any one of the listed identification details.","type":"text","label":"Identification details (Kisan Credit Card /RSBY Card / Ration Card / Voter ID Card/ Aadhar Card)","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":"Provide the full address where the loss took place.","type":"text","label":"Location of Loss (Complete Address of Location)","options":[],"required":true,"pdf_field":""},{"help":"Select the nature of the loss under Section 1.","type":"choice","label":"Nature of Loss (Sec.1) Fire (dwelling)/ Fire(contents)/ Burglary","options":["Fire (dwelling)","Fire (contents)","Burglary"],"required":true,"pdf_field":""},{"help":"Describe how the loss occurred and efforts made to control it.","type":"text","label":"Circumstances of loss (Brief write up as to how the fire took place and how it spread, fire fighting efforts made and how finally it could be controlled)","options":[],"required":true,"pdf_field":""},{"help":"Provide details if claiming under Sections 2A or 2B and attach required documents.","type":"text","label":"In case of a claim under Section 2A Personal accident and Section 2B Education Protection, please give name of affected Person with age and details of the injury/death suffered in an accident. Also attach FIR, Post mortem report and documents in support of physical disability and treatment taken","options":[],"required":false,"pdf_field":""},{"help":"List items lost or damaged with their values; columns: Sr. No., Item, Value of item.","type":"table","label":"Estimate of Loss for Section-1 (Give list of items lost / damaged)","options":[],"required":true,"pdf_field":""},{"help":"Provide the total estimated loss amount.","type":"amount","label":"Total estimate of loss","options":[],"required":true,"pdf_field":""},{"help":"Provide details of any other insurance policies on the affected property.","type":"text","label":"Details of Other Existing Insurances on the property affected","options":[],"required":false,"pdf_field":""},{"help":"Name and address of other insurance company, if any.","type":"text","label":"Name & Address of Company","options":[],"required":false,"pdf_field":""},{"help":"Policy number of other insurance, if any.","type":"text","label":"Policy No.","options":[],"required":false,"pdf_field":""},{"help":"Sum insured under other insurance policies, if any.","type":"amount","label":"Sum Insured","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Claimant's Bank Account Details","fields":[{"help":"Provide your bank account number for claim payment.","type":"text","label":"Account Number","options":[],"required":false,"pdf_field":""},{"help":"Name and branch of your bank.","type":"text","label":"Bank Name and Branch","options":[],"required":false,"pdf_field":""},{"help":"Details for cheque or demand draft payment.","type":"text","label":"Cheque/ DD Payable details","options":[],"required":false,"pdf_field":""},{"help":"Bank IFSC code for electronic transfer.","type":"text","label":"IFSC Code","options":[],"required":false,"pdf_field":""},{"help":"Name of the claimant signing the form.","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"Signature of the claimant.","type":"signature","label":"Signature","options":[],"required":true,"pdf_field":""},{"help":"Date of signing the form.","type":"date","label":"Date","options":[],"required":true,"pdf_field":""}],"filled_by":"claimant"}],"deadlines":["Please return this form, duly filled & signed, within 15 days, from the date of occurrence."],"applies_to":"","attachments":["FIR","Post mortem report","Documents in support of physical disability and treatment taken"],"declarations":["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."],"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/297-claim-form-jan-kavach-yojna-micro-insurance"}