{"id":352,"title":"Add-on Explore Plus - Claim Form","purpose":"claim","insurer":{"slug":"care-health-insurance","name":"Care Health Insurance Ltd"},"source_pdf":"https://cms.careinsurance.com/cms/public/uploads/download_center/add-on-explore-plus---claim-form.pdf","sha256":"5b4c553f38481ee515aff5e2b728ac635129f32fe81f53e88fa9708d18915030","pages":2,"collected":"2026-10-20","instructions":{"about":"This form is used by the insured person or claimant to file a claim under the Add-on Explore Plus insurance policy for travel-related incidents such as missed carriers, missed connections, trip delays, or baggage delays.","notes":["Please give the required information correctly and completely to enable prompt claim processing.","Use additional sheets if required.","The claim form should be supported by all documents as specified in the policy.","The issue of this form is not an admission of liability by the company."],"title":"Add-on Explore Plus - Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Section A - Details of the Policy","fields":[{"help":"Enter the policy number of the Add-on Explore Plus policy","type":"text","label":"Add-on Policy number","options":[],"required":null,"pdf_field":""},{"help":"Enter the base policy number linked to the add-on","type":"text","label":"Base Policy number","options":[],"required":null,"pdf_field":""},{"help":"Enter the full name of the insured person","type":"text","label":"Insured name","options":[],"required":null,"pdf_field":""},{"help":"Enter the certificate number of the insurance","type":"text","label":"Certificate of Insurance number","options":[],"required":null,"pdf_field":""}],"filled_by":"claimant"},{"title":"Section B - Details of Insured Person / Claimant","fields":[{"help":"Enter full name (Surname, First Name, Middle Name)","type":"text","label":"Name","options":[],"required":null,"pdf_field":""},{"help":"Enter full address including State, City, Pin Code, Country","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"Enter mobile phone number","type":"phone","label":"Mobile","options":[],"required":null,"pdf_field":""},{"help":"Enter email address","type":"email","label":"E-mail","options":[],"required":null,"pdf_field":""}],"filled_by":"claimant"},{"title":"Section C - Details of Claim","fields":[{"help":"Enter the name of the road transport used","type":"text","label":"Name of Road transport used","options":[],"required":null,"pdf_field":""},{"help":"Enter estimated arrival date in DDMMYYYY format","type":"date","label":"Estimated Time of Arrival to departure point: Date (DDMMYYYY)","options":[],"required":null,"pdf_field":""},{"help":"Enter actual arrival date in DDMMYYYY format","type":"date","label":"Actual Time of Arrival to departure point: Date (DDMMYYYY)","options":[],"required":null,"pdf_field":""},{"help":"Enter starting point of connecting common carrier route","type":"text","label":"For Missed Carrier only - Connecting Common Carrier route: From","options":[],"required":null,"pdf_field":""},{"help":"Enter destination point of connecting common carrier route","type":"text","label":"For Missed Carrier only - Connecting Common Carrier route: To","options":[],"required":null,"pdf_field":""},{"help":"Enter scheduled departure date","type":"date","label":"Scheduled departure: Date (DDMMYYYY)","options":[],"required":null,"pdf_field":""},{"help":"Describe the incident leading to the claim","type":"text","label":"Description of incident","options":[],"required":null,"pdf_field":""},{"help":"Enter total expenses incurred in Indian Rupees","type":"amount","label":"Total expenses","options":[],"required":null,"pdf_field":""},{"help":"Enter starting point of common carrier route","type":"text","label":"Common Carrier route: From","options":[],"required":null,"pdf_field":""},{"help":"Enter actual arrival date","type":"date","label":"Actual arrival: Date (DDMMYYYY)","options":[],"required":null,"pdf_field":""},{"help":"Enter scheduled arrival date","type":"date","label":"Scheduled arrival: Date (DDMMYYYY)","options":[],"required":null,"pdf_field":""},{"help":"Enter the name of the common carrier","type":"text","label":"Name of Common Carrier","options":[],"required":null,"pdf_field":""},{"help":"Enter actual departure date","type":"date","label":"Actual departure: Date (DDMMYYYY)","options":[],"required":null,"pdf_field":""},{"help":"Enter starting point of common carrier route","type":"text","label":"Common Carrier route: From","options":[],"required":null,"pdf_field":""},{"help":"Enter name of connecting common carrier","type":"text","label":"Name of Connecting Common Carrier","options":[],"required":null,"pdf_field":""},{"help":"Tick if claim is for missed carrier","type":"checkbox","label":"For Missed Connection only - Missed Carrier","options":["Missed Carrier"],"required":null,"pdf_field":""},{"help":"Enter name of common carrier for missed connection","type":"text","label":"Name of Common Carrier","options":[],"required":null,"pdf_field":""},{"help":"Enter scheduled departure date for missed connection","type":"date","label":"Scheduled departure: Date (DDMMYYYY)","options":[],"required":null,"pdf_field":""},{"help":"Enter date baggage was retrieved","type":"date","label":"Date and time of baggage retrieval Date","options":[],"required":null,"pdf_field":""},{"help":"Enter name of common carrier for baggage delay","type":"text","label":"Name of Common Carrier","options":[],"required":null,"pdf_field":""},{"help":"Enter arrival date for baggage delay","type":"date","label":"Date and time of arrival date","options":[],"required":null,"pdf_field":""},{"help":"Enter port where passenger disembarked","type":"text","label":"Port of disembarkation","options":[],"required":null,"pdf_field":""},{"help":"Tick if claim is for delay of checked-in baggage","type":"checkbox","label":"Delay of Checked-in Baggage","options":["Delay of Checked-in Baggage"],"required":null,"pdf_field":""},{"help":"Describe the baggage delay incident","type":"text","label":"Description of incident","options":[],"required":null,"pdf_field":""},{"help":"Enter total expenses related to baggage delay","type":"amount","label":"Total expenses","options":[],"required":null,"pdf_field":""},{"help":"Enter place where form is signed","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Enter date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Sign the form","type":"signature","label":"Signature of the Claimant","options":[],"required":true,"pdf_field":""}],"filled_by":"claimant"}],"deadlines":[],"applies_to":"Add-on Explore Plus travel insurance claims","attachments":["All documents as specified in the Policy"],"declarations":["The information/statements given in this claim form are true, correct and complete.","No material information relevant to the claim has been withheld or not disclosed.","If any false or fraudulent information is given, the policy shall be void and no claim rights will exist.","Receipt of this claim form and documents does not imply admission of liability by the company.","The claimant authorizes subrogation agency to obtain information and pursue recovery if applicable.","The claimant authorizes physicians, hospitals, police, government agencies or others to provide information to the insurer regarding the claim."],"dropped_labels":14},"pdf_fields":null,"fillable_pdf":false,"send_to":[],"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/care-health-insurance/352-add-on-explore-plus-claim-form"}