{"id":532,"title":"CLAIM FORM FOR CATTLE INSURANCE POLICY","purpose":"claim","insurer":{"slug":"icici-lombard-general-insurance","name":"ICICI LOMBARD General Insurance Company Limited"},"source_pdf":"https://www.icicilombard.com/docs/default-source/default-document-library/claim-form_cattle-insurance.pdf","sha256":"d413675c2f7dd32dd8b005fde31c2e20f9f0b50aa6009360e42e5deb9712f60d","pages":3,"collected":"2026-10-20","instructions":{"about":"This form is for filing a claim under a cattle insurance policy and is to be filled by the cattle owner and the authorized veterinary doctor.","notes":["Attach copies of Aadhar and PAN cards as mandatory documents.","Photographs must be minimum 6\" X 4\" size with clear visibility of identification tag and farmer with dead animal; group photographs are not accepted.","Attach separate sheets if details do not fit in the form.","Postmortem report from veterinary doctor is required.","In case of vehicular accident, attach FIR, Spot Panchnama, and Police Closing Report.","Section II must be completed by an authorized veterinary doctor.","Use clear handwriting and provide all requested documents to avoid delays."],"title":"CLAIM FORM FOR CATTLE INSURANCE POLICY","submit":{"to":"Cattle Claims Team, Plot No.: 12, Financial District, Nanakaramgud, Gachibowli, Hyderabad 500032","how":"post or as per company instructions","address":"Cattle Claims Team, Plot No.: 12, Financial District, Nanakaramgud, Gachibowli, Hyderabad 500032"},"purpose":"claim","sections":[{"title":"Details of Owner of Insured Cattle","fields":[{"help":"","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Address for correspondence","options":[],"required":true,"pdf_field":""},{"help":"Provide a valid phone number","type":"phone","label":"Contact Number","options":[],"required":true,"pdf_field":""},{"help":"Attach a copy of Aadhar card","type":"text","label":"Aadhar No. (Copy Mandatory)","options":[],"required":true,"pdf_field":""},{"help":"Attach a copy of PAN card","type":"text","label":"PAN No. (Copy Mandatory)","options":[],"required":true,"pdf_field":""}],"filled_by":"policyholder (owner of insured cattle)"},{"title":"Details of the animal Insured","fields":[{"help":"Provide the identification tag or RFID number of the cattle","type":"text","label":"Tag /RFID Number of Insured Cattle","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Breed of Cattle","options":[],"required":true,"pdf_field":""},{"help":"Provide age in years or months","type":"number","label":"Age of Cattle","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Colour of Cattle","options":[],"required":true,"pdf_field":""},{"help":"Describe any unique marks on the cattle","type":"text","label":"Identification Marks","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder (owner of insured cattle)"},{"title":"Type of claim and related details","fields":[{"help":"Select the type of claim","type":"choice","label":"Type of claim","options":["Death","Permanent Total Disablement"],"required":true,"pdf_field":""},{"help":"Explain the reason for death if claim is for death","type":"text","label":"Reasons for Death","options":[],"required":false,"pdf_field":""},{"help":"Provide details of accident; attach separate sheet if needed","type":"text","label":"Details for Accidental Death","options":[],"required":false,"pdf_field":""},{"help":"Provide place, date and time of accident","type":"text","label":"Place, Date and Time of Accident","options":[],"required":false,"pdf_field":""},{"help":"Indicate if accident was reported to police","type":"yes-no","label":"Whether Reported to Police","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide time of police report if applicable","type":"text","label":"Time of Report","options":[],"required":false,"pdf_field":""},{"help":"Provide date and time of death","type":"date","label":"Date and Time of Death","options":[],"required":false,"pdf_field":""},{"help":"Provide details of disease related death; attach separate sheet if needed","type":"text","label":"Details for Other Disease Related Death","options":[],"required":false,"pdf_field":""},{"help":"Provide time period of disease","type":"text","label":"Time of Disease","options":[],"required":false,"pdf_field":""},{"help":"Describe treatment given; attach separate sheet if needed","type":"text","label":"Treatment Given","options":[],"required":false,"pdf_field":""},{"help":"Provide details of veterinary doctor contacted","type":"text","label":"Details of the Doctor Contacted","options":[],"required":false,"pdf_field":""},{"help":"Provide date and time when disease was noticed","type":"date","label":"Date and Time of Disease Incidence","options":[],"required":false,"pdf_field":""},{"help":"Describe type of permanent total disablement if applicable","type":"text","label":"Type of disablement","options":[],"required":false,"pdf_field":""},{"help":"Explain reason for disablement","type":"text","label":"Reason for disablement","options":[],"required":false,"pdf_field":""},{"help":"Describe medical treatment given for disablement","type":"text","label":"Medical Treatment given","options":[],"required":false,"pdf_field":""},{"help":"Answer if you or proposed applicants are Politically Exposed Persons or related","type":"yes-no","label":"Are you or any of the proposed applicants a PEP* or Family member / Close relatives / Associates of PEP*?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide details if answer to previous question is yes","type":"text","label":"If yes, please give details (Nature of relationship and position held by PEP)","options":[],"required":false,"pdf_field":""},{"help":"Provide the insurance coverage period","type":"text","label":"Period of Insurance","options":[],"required":false,"pdf_field":""},{"help":"Provide date of death of insured cattle","type":"date","label":"Date of Death","options":[],"required":false,"pdf_field":""},{"help":"Provide claim number if available","type":"text","label":"Claim Number","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder (owner of insured cattle)"},{"title":"Declarations and Signature","fields":[{"help":"Enter place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Enter date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Sign or provide thumb impression","type":"signature","label":"Thumb imprint/Signature of the Cattle Owner","options":[],"required":true,"pdf_field":""}],"filled_by":"policyholder (owner of insured cattle)"},{"title":"Documents required to be submitted","fields":[{"help":"Attach all listed documents","type":"attachment","label":"Documents required to be submitted","options":[],"required":true,"pdf_field":""}],"filled_by":""},{"title":"Section II (To be completed by authorised veterinary)","fields":[{"help":"","type":"text","label":"Name and address of the authorized Veterinary doctor","options":[],"required":true,"pdf_field":""},{"help":"","type":"date","label":"In case of death, date of admission of dead cattle","options":[],"required":false,"pdf_field":""},{"help":"","type":"date","label":"Date of medical examination of dead cattle","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"(i)Reason of death","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"(ii) Particulars of medical examination conducted","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"(iii) Remarks and comments","options":[],"required":false,"pdf_field":""},{"help":"Indicate if treatment was given and provide details if yes","type":"yes-no","label":"(iv) Treatment Given Yes / No, If yes provide in attached format.","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide market value in INR","type":"amount","label":"Market value of the insured Cattle prior to insured event (INR)","options":[],"required":false,"pdf_field":""},{"help":"Date of veterinary certification","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Signature of authorized veterinary doctor","type":"signature","label":"Signature of Vet. Doctor","options":[],"required":true,"pdf_field":""},{"help":"Name of veterinary doctor","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"Qualification of veterinary doctor","type":"text","label":"Qualification","options":[],"required":true,"pdf_field":""},{"help":"Registration number of veterinary doctor","type":"text","label":"Registration No.","options":[],"required":true,"pdf_field":""},{"help":"Address of veterinary doctor","type":"text","label":"Address","options":[],"required":false,"pdf_field":""}],"filled_by":"authorised veterinary doctor"}],"deadlines":[],"applies_to":"Cattle Insurance Policy claims","attachments":["Duly completed claim form","Identification tags of Insured Animal","Postmortem Report from veterinary doctor containing the name of disease & reason for death","Three photographs of minimum 6\" X 4\" size of the Insured Animal (one showing identification tag number clearly, one full body with tag visible, one of farmer with dead animal)","Papers related to Treatment, Diagnosis & Vaccination record from Veterinary doctor (if death due to disease covered under policy)","FIR, Spot Panchnama, Closing Report from Police (if death due to vehicular accident)","Certificate of insurance / policy copy in original"],"declarations":["The statements/information 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 or documents does not constitute admission of claim liability by the company.","Consent is given to the company to verify identity/address proof through Central KYC Registry or UIDAI or other modes."],"dropped_labels":0},"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/icici-lombard-general-insurance/532-claim-form-for-cattle-insurance-policy"}