{"id":564,"title":"INDUSIND MOTOR VEHICLE EXTENDED WARRANTY FOR PASSENGER AND GOODS CARRYING COMMERCIAL VEHICLES (ICE) - CLAIM FORM","purpose":"claim","insurer":{"slug":"indusind-general-insurance","name":"IndusInd General Insurance Company Limited"},"source_pdf":"https://www.indusindinsurance.com/downloads/motor-vehicle-extended-warranty-for-pcv-and-gcv-ice","sha256":"d534cbf231c3d022da648d4ec912910e9972522685f82a7a5f35ba340dd6243b","pages":5,"collected":"2026-10-17","instructions":{"about":"This form is for policyholders to claim under the Motor Vehicle Extended Warranty for Passenger and Goods Carrying Commercial Vehicles (ICE).","notes":["Answer all questions fully and correctly; mention 'not applicable' if a question does not apply","Issuance of this form does not imply acceptance of liability","Attach all required documents as listed","For reimbursement claims, payments are made only through electronic mode as per IRDAI","Intimate claim immediately to avoid delay or denial","Use preferred cashless garages from the network list for cashless claims","Keep mobile number updated for SMS claim status updates","Original bills and proper service records are necessary to avoid claim repudiation","Any agent/surveyor of the Company may examine the insured asset as required"],"title":"INDUSIND MOTOR VEHICLE EXTENDED WARRANTY FOR PASSENGER AND GOODS CARRYING COMMERCIAL VEHICLES (ICE) - CLAIM FORM","submit":{"to":"IndusInd General Insurance Company Limited Call Centre","how":"intimate claim immediately by phone call","address":"Call Centre: 022 4890 3009 (Paid No.)"},"purpose":"claim","sections":[{"title":"Vehicle Details","fields":[{"help":"","type":"text","label":"MASTER POLICY HOLDER NUMBER:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Claim Form No.:","options":[],"required":null,"pdf_field":""},{"help":"Format DD/MM/YYYY","type":"date","label":"Date:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Vehicle Type","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Vehicle Make","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Vehicle Model & Variant","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Cubic Capacity","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"RTO Authority","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Vehicle Registration Number","options":[],"required":null,"pdf_field":""},{"help":"Format DD/MM/YYYY","type":"date","label":"Date of Registration","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Gross Vehicle Weight (GVW) / Cubic Capacity (C.C.)","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Vehicle Sub Class","options":[],"required":null,"pdf_field":""},{"help":"","type":"choice","label":"Goods Type (applicable only if GVW + 7500 KGs)","options":["Hazardous Goods","Non Hazardous Goods"],"required":null,"pdf_field":""},{"help":"","type":"number","label":"Max. 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from cheque","type":"text","label":"IFSC Code (11 character code appearing on your cheque leaf)","options":[],"required":true,"pdf_field":""},{"help":"Mandatory as per IRDAI","type":"checkbox","label":"I understand that any refund due on the premium payment / any payment / claims to be directly credited to my aforesaid Bank Account.*","options":[],"required":true,"pdf_field":""},{"help":"Attach cancelled cheque copy","type":"attachment","label":"*Please attach a copy of signed cancelled cheque of the Bank Account of the insured only","options":[],"required":true,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Aadhar Based Payment (For Reimbursement Claims)","fields":[{"help":"Attach self attested Aadhaar card copy","type":"text","label":"Aadhar Card No.:","options":[],"required":false,"pdf_field":""},{"help":"Claim amount credited to bank linked with Aadhaar","type":"checkbox","label":"I Wish to collect Claim reimbursement directly in my Bank account linked with aforementioned Aadhar Card.","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Declaration","fields":[{"help":"","type":"yes-no","label":"I/We hereby declare that the details given above are true and correct to the best of my belief and knowledge.","options":[],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"I agree that all right under the policy will be forfeited if information is incorrect.","options":[],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"I have received and read the Claim Procedure of the insurer attached to this Claim Form and retained it with me/us.","options":[],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"I agree to provide additional information to the Company if required.","options":[],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"I will indemnify and hold harmless the Company due to any loss arising out of misstatement in this form.","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"This Claim form was completed by Name:","options":[],"required":true,"pdf_field":""},{"help":"Format DD/MM/YYYY","type":"date","label":"Date:","options":[],"required":true,"pdf_field":""},{"help":"","type":"signature","label":"Signature of the Insured","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Place:","options":[],"required":true,"pdf_field":""},{"help":"Format DD/MM/YYYY","type":"date","label":"Date:","options":[],"required":true,"pdf_field":""},{"help":"","type":"signature","label":"Signature of Insurer & Company Seal","options":[],"required":true,"pdf_field":""}],"filled_by":"policyholder"}],"deadlines":["Event shall be intimated in writing to the Company within Fifteen (15) days of its occurrence","Information/documents requested by the Company must be furnished within 30 days of the date of such request"],"applies_to":"Motor Vehicle Extended Warranty For Passenger and Goods Carrying Commercial Vehicles (ICE)","attachments":["self – attested RC Copy (if vehicle designed for use of Blind/Handicapped/Mentally Challenged Person)","copy of bill for any service where reimbursement is required","copy of signed cancelled cheque of the Bank Account of the insured only","self attested Aadhaar card copy (if opting for Aadhaar based payment)","Manufacturer Warranty Copy","Copy of Motor Extended Warranty Policy","Original documents indicating the purchase invoice price or transfer of ownership documents","NOC from finance company, if hypothecated","Copy of all maintenance/service invoices/records prior to loss event","All documentary evidence pertaining to transfer of ownership, if applicable","Any other document applicable against the warranty claim"],"declarations":["The details given are true and correct to the best of the insured's knowledge","Incorrect information may lead to forfeiture of rights under the policy","The insured has received and read the Claim Procedure attached to the Claim Form","The insured agrees to provide additional information if required","The insured will indemnify and hold harmless the Company for any loss due to misstatement in the form"],"dropped_labels":0},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"services@indusindinsurance.com","label":"Health Insurance Claims Email","level":1,"hours":null,"applies_to":"health","source_url":"https://www.indusindinsurance.com/health-insurance-claims","quote":"nce Claim\nTravel Insurance Claim\nCommercial Insurance Claim\nSupport\nSign In\nSelf Help\nVideo Chat\nContact Us\nEmail us at\nservices@indusindinsurance.com\ngrievances@indusindinsurance.com\ncareers@indusindinsurance.com\nCall us at\n+91 22 48903009 (Paid Number)\n+91 22 65934185","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"indusind@europ-assistance.in","label":"Travel Insurance Claims Email","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/travel-insurance-claim","quote":"91-22-67347844\nInternational Travel (while in India):\n1800 209 5522\nWhatsApp:\n7400422200 for Inland Travel Claim\nEmail:\nindusind@europ-assistance.in\nMobile Application:\nIndusInd Insurance App\nWebsite:\nOnline Claim Intimation\nOffline Visit:\nLocate your nearest branch\nh","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"+91 22 48903009","label":"Car Insurance Claim Intimation","level":null,"hours":null,"applies_to":"motor","source_url":"https://www.indusindinsurance.com/car-insurance-claim","quote":"Us\nEmail us at\nservices@indusindinsurance.com\ngrievances@indusindinsurance.com\ncareers@indusindinsurance.com\nCall us at\n+91 22 48903009 (Paid Number)\n+91 22 65934185 (Senior Citizen)\n+91 7400422200 (WhatsApp)\n+91 22 48903051 (Become our Partner)\nVisit us:","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022 65934189","label":"Motor Claims Helpline","level":null,"hours":null,"applies_to":"motor","source_url":"https://www.indusindinsurance.com/car-insurance-claim","quote":"ation.\nNeed Guidance on Car Coverage?\nTalk to Our Professional Advisors\nCall Us\nCall Us!!\nHealth -\n022 65934188\nMotor -\n022 65934189\nTravel -\n022 65934184\nSteps to Take After a Car ​Accident\nThe following steps can expedite the road accident insurance","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022 65934188","label":"Health Claims Helpline","level":null,"hours":null,"applies_to":"health","source_url":"https://www.indusindinsurance.com/health-insurance-claims","quote":"your nearest location.\nExpert health advice you can trust\nGet in touch with our team today!\nCall Us\nCall Us!!\nHealth -\n022 65934188\nMotor -\n022 65934189\nTravel -\n022 65934184\nCommon Reasons for Health Insurance Claim Rejection\nIncomplete Documentation","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022 65934184","label":"Travel Claims Helpline","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/health-insurance-claims","quote":"e you can trust\nGet in touch with our team today!\nCall Us\nCall Us!!\nHealth -\n022 65934188\nMotor -\n022 65934189\nTravel -\n022 65934184\nCommon Reasons for Health Insurance Claim Rejection\nIncomplete Documentation\nYour claim gets rejected when you don't gi","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"+912248903009","label":"Inland Travel Helpline","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/travel-insurance-claim","quote":"rds your registered bank account.\nHow to Contact Us For Travel Insurance Claim?\nContact Details\nInland Travel Helpline:\n+912248903009\nInternational Travel (while abroad):\n91-22-67347843/ 91-22-67347844\nInternational Travel (while in India):\n1800 209 552","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"91-22-67347843","label":"International Travel Helpline (abroad)","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/travel-insurance-claim","quote":"For Travel Insurance Claim?\nContact Details\nInland Travel Helpline:\n+912248903009\nInternational Travel (while abroad):\n91-22-67347843/ 91-22-67347844\nInternational Travel (while in India):\n1800 209 5522\nWhatsApp:\n7400422200 for Inland Travel Claim\nEmail","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 209 5522","label":"International Travel Helpline (in India)","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/travel-insurance-claim","quote":"912248903009\nInternational Travel (while abroad):\n91-22-67347843/ 91-22-67347844\nInternational Travel (while in India):\n1800 209 5522\nWhatsApp:\n7400422200 for Inland Travel Claim\nEmail:\nindusind@europ-assistance.in\nMobile Application:\nIndusInd Insurance","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/indusind-general-insurance/564-indusind-motor-vehicle-extended-warranty-for-passenger-and-goods-carrying-commer"}