{"id":310,"title":"Claim Form- IFFCO-Tokio Bharat Laghu Udyam Suraksha","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-bharat-laghu-udyam-suraksha.pdf","sha256":"a37ec1c01a4187666cbc8d64b26a8b528a7e1c2c447216ad14bed49053bb09a5","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is for filing a claim under the Bharat Laghu Udyam Suraksha insurance policy and is to be filled by the insured claimant.","notes":["Fill all details in CAPITAL Letters.","If space provided is insufficient, annex a separate sheet.","This form is issued without prejudice to the terms and conditions of the policy and does not admit liability."],"title":"Claim Form- IFFCO-Tokio Bharat Laghu Udyam Suraksha","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Insured’s Details","fields":[{"help":"Enter your insurance policy number.","type":"text","label":"Policy No.","options":[],"required":true,"pdf_field":""},{"help":"Provide the exact date and time when the loss occurred.","type":"date","label":"Date and time of loss","options":[],"required":true,"pdf_field":""},{"help":"Full address where the insured risk is located.","type":"text","label":"Complete risk location address.","options":[],"required":true,"pdf_field":""},{"help":"City of the risk location.","type":"text","label":"City","options":[],"required":true,"pdf_field":""},{"help":"State of the risk location.","type":"text","label":"State","options":[],"required":true,"pdf_field":""},{"help":"Postal code of the risk location.","type":"number","label":"Pin Code","options":[],"required":true,"pdf_field":""},{"help":"Name of the person to contact regarding the claim.","type":"text","label":"Contact Person’s name","options":[],"required":true,"pdf_field":""},{"help":"Mobile phone number of the contact person.","type":"phone","label":"Mobile No.","options":[],"required":true,"pdf_field":""},{"help":"Designation of the contact person.","type":"text","label":"Designation","options":[],"required":false,"pdf_field":""},{"help":"Email address of the contact person.","type":"email","label":"Email Address","options":[],"required":false,"pdf_field":""},{"help":"Office landline number and availability hours.","type":"phone","label":"Telephone no. (O) (Landline) Availability between - ___ hrs to ___hrs","options":[],"required":false,"pdf_field":""},{"help":"Residence landline number and availability hours.","type":"phone","label":"Telephone no. (R) (Landline) Availability between - ___ hrs to ___hrs","options":[],"required":false,"pdf_field":""}],"filled_by":"claimant"},{"title":"Nature of Insured Event and Claim Amount","fields":[{"help":"Describe how the loss happened, spread, and control efforts.","type":"text","label":"Circumstances of loss (Brief details as to how loss look place and how it spread, how loss minimization efforts made & how finally if could be controlled)","options":[],"required":true,"pdf_field":""},{"help":"Indicate if the premises was occupied during the loss.","type":"yes-no","label":"Was the premises occupied at the time of loss?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide your opinion on what caused the loss.","type":"text","label":"Your Opinion about the cause of loss","options":[],"required":true,"pdf_field":""}],"filled_by":"claimant"},{"title":"Fire Insurance Claim - Estimate of Loss","fields":[{"help":"Provide details of loss estimate as per schedule with columns: S No., Block Name, Building, Plant & Machinery, Stocks, Packing Material.","type":"table","label":"S No., Block Name, Building, Plant & Machinery, Stocks, Packing Material","options":[],"required":true,"pdf_field":""}],"filled_by":"claimant"},{"title":"Description of Item affected (Plant & Machinery)","fields":[{"help":"Provide make, model and manufacturing year of the item.","type":"text","label":"Make / Model/ Year of Mfg.","options":[],"required":false,"pdf_field":""},{"help":"Serial number of the item if available.","type":"text","label":"Serial No of item if any","options":[],"required":false,"pdf_field":""},{"help":"Identification number of the item.","type":"text","label":"Identification No of Item","options":[],"required":false,"pdf_field":""},{"help":"Indicate if the item was used as per manufacturer instructions.","type":"yes-no","label":"Was the Item used as prescribed by the Manufacture?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Location where the item can be inspected.","type":"text","label":"Where can it be examined now?","options":[],"required":false,"pdf_field":""},{"help":"Indicate if the item has been dismantled.","type":"yes-no","label":"Has item been dismantled?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Indicate if the item is covered under Annual Maintenance Contract.","type":"yes-no","label":"Is Item covered under any A.M.C","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Indicate if the item is under warranty.","type":"yes-no","label":"Is Item under warranty?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Describe the extent of damage or loss.","type":"text","label":"Extent of damage / Loss","options":[],"required":false,"pdf_field":""},{"help":"Provide estimated repair cost or quote if available.","type":"amount","label":"Estimated amount for repair / Quote if any","options":[],"required":false,"pdf_field":""}],"filled_by":"claimant"},{"title":"Add-on Cover Claims","fields":[{"help":"Enter claim amount for accidental damage add-on cover.","type":"amount","label":"Accidental Damage (UIN: IRDAN106RP0003V03202021/A0007V02202122) ₹","options":[],"required":false,"pdf_field":""},{"help":"Enter claim amount for snowfall damage add-on cover.","type":"amount","label":"Snowfall Damage (UIN: IRDAN106RP0003V03202021/A0008V02202122) ₹","options":[],"required":false,"pdf_field":""},{"help":"Enter claim amount for additional removal of debris add-on cover.","type":"amount","label":"Additional Removal of Debris (UIN: IRDAN106RP0003V03202021/A0009V02202122) ₹","options":[],"required":false,"pdf_field":""}],"filled_by":"claimant"},{"title":"Details of other Existing Insurances","fields":[{"help":"Provide name and address of other insurance companies if any.","type":"text","label":"Name & Address of Insurance Company","options":[],"required":false,"pdf_field":""},{"help":"Policy number of other insurance.","type":"text","label":"Policy No","options":[],"required":false,"pdf_field":""},{"help":"Sum insured under other policies.","type":"amount","label":"Sum Insured","options":[],"required":false,"pdf_field":""},{"help":"Expiry date of other insurance policies.","type":"date","label":"Policy Expiry date","options":[],"required":false,"pdf_field":""}],"filled_by":"claimant"},{"title":"Declaration","fields":[{"help":"Date of signing the declaration.","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Place where the declaration is signed.","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Full name of the claimant signing the form.","type":"text","label":"Name of the claimant","options":[],"required":true,"pdf_field":""},{"help":"Signature of the claimant.","type":"signature","label":"Signature of the claimant","options":[],"required":true,"pdf_field":""}],"filled_by":"claimant"}],"deadlines":["Please return this form, duly filled & signed, within 30 days, from the date of its issuance."],"applies_to":"","attachments":[],"declarations":["The information furnished in this claim form is true and correct to the best of the claimant's knowledge and belief.","If any false or untrue statement, suppression or concealment of any material fact is made, the right to claim reimbursement shall be forfeited.","All documents for the purpose of this claim have been included."],"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/310-claim-form-iffco-tokio-bharat-laghu-udyam-suraksha"}