{"id":578,"title":"INDUSIND HOME LOAN PROTECT POLICY - CLAIM FORM","purpose":"claim","insurer":{"slug":"indusind-general-insurance","name":"IndusInd General Insurance Company Limited"},"source_pdf":"https://www.indusindinsurance.com/downloads/indusind-home-loanprotect-policy-claim-form-atod","sha256":"f60b2813ae0175160d3d22ffa2870a189754f97b37f63c04f2e51ed0928fe261","pages":5,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured or claimant to file a claim under the IndusInd Home Loan Protect Policy for various covered events such as personal accident, critical illness, loss of employment, child care allowance, home cover, or home contents.","notes":["Fill all mandatory fields marked with *.","Use BLOCK LETTERS to fill the form.","Attach original cancelled cheque and PAN card copy for bank details verification.","Attach self-attested Aadhaar card copy for Aadhaar based payment.","All payments to insured are made only through electronic mode as per IRDAI guidelines."],"title":"INDUSIND HOME LOAN PROTECT POLICY - CLAIM FORM","submit":{"to":"Rcare Health: IndusInd General Insurance","how":"","address":"No. 1-89/3/B/40 to 42/ks/301, 3rd floor, Krishe Block, Krishe Sapphire, Madhapur, Hyderabad - 500081. Email: healthcare@indusindinsurance.com"},"purpose":"claim","sections":[{"title":"Policy and Customer Details","fields":[{"help":"","type":"text","label":"*Policy No.","options":[],"required":true,"pdf_field":""},{"help":"Enter start date of policy period","type":"date","label":"Period From","options":[],"required":true,"pdf_field":""},{"help":"Enter end date of policy period","type":"date","label":"Period To","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"*Customer ID","options":[],"required":true,"pdf_field":""},{"help":"","type":"date","label":"Date of Registration","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Area Office Code/ Service Centre Code","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Broker/Agent Name","options":[],"required":false,"pdf_field":""},{"help":"Broker/Agent code","type":"text","label":"Code","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder/claimant"},{"title":"Details of Insured","fields":[{"help":"Fill in full name in block letters","type":"text","label":"*lnsured's Name","options":["Mr.","Mrs.","Ms."],"required":true,"pdf_field":""},{"help":"Include Flat/Building/Door/Block No., Road/Street/Sector, Nearest Landmark, Area, City, Pin Code, State, Country","type":"text","label":"*Address","options":[],"required":true,"pdf_field":""},{"help":"Enter landline phone number","type":"phone","label":"*Phone No.","options":[],"required":true,"pdf_field":""},{"help":"Enter mobile phone number","type":"phone","label":"*Mobile No.","options":[],"required":true,"pdf_field":""},{"help":"Enter email address","type":"email","label":"E-mail Id","options":[],"required":false,"pdf_field":""},{"help":"Enter Aadhaar number","type":"text","label":"*Aadhaar (UIDAI) No.","options":[],"required":true,"pdf_field":""},{"help":"Enter PAN number","type":"text","label":"PAN No.","options":[],"required":false,"pdf_field":""},{"help":"","type":"date","label":"Date of Birth","options":[],"required":false,"pdf_field":""},{"help":"","type":"choice","label":"Gender","options":["Male","Female"],"required":false,"pdf_field":""},{"help":"","type":"choice","label":"Monthly Income","options":["Upto ` 20,000","` 20,001 to ` 50,000","` 50,001 to ` 1,00,000","` 1,00,001 and above"],"required":false,"pdf_field":""},{"help":"","type":"choice","label":"Profession/Occupation","options":["Business","Profession","Salary","Agricultural Income","Savings","Others"],"required":false,"pdf_field":""},{"help":"Enter loan account number","type":"text","label":"Loan A/C No.","options":[],"required":false,"pdf_field":""},{"help":"Provide details of other insurance policies if any","type":"text","label":"Do you have any other Insurance If so state name & address of company or companies & amount insured","options":[],"required":false,"pdf_field":""},{"help":"Select the claim type","type":"choice","label":"Claim pertains to","options":["Personal Accident","Critical Illness","Loss of employment","Child Care allowance","Home Cover","Home Contents"],"required":false,"pdf_field":""}],"filled_by":"policyholder/claimant"},{"title":"Details of the Insured/Claimant - Bank Details","fields":[{"help":"Provide NEFT details for claim payment","type":"text","label":"NEFT details of the Insured/Claimant","options":[],"required":false,"pdf_field":""},{"help":"Fill claimant's full name","type":"text","label":"Name of the Claimant","options":["Mr.","Mrs.","Ms."],"required":false,"pdf_field":""},{"help":"Enter claimant's mobile number","type":"phone","label":"Mobile","options":[],"required":false,"pdf_field":""},{"help":"Name as per bank records","type":"text","label":"Customer Name (As per Bank records)","options":["Mr.","Mrs.","Ms."],"required":false,"pdf_field":""},{"help":"Enter bank account number","type":"text","label":"Bank Account No.","options":[],"required":false,"pdf_field":""},{"help":"Select account type","type":"choice","label":"Account","options":["Saving","Current"],"required":false,"pdf_field":""},{"help":"Enter bank name","type":"text","label":"Name of the Bank","options":[],"required":false,"pdf_field":""},{"help":"Enter bank branch address","type":"text","label":"Address of Bank","options":[],"required":false,"pdf_field":""},{"help":"Enter PAN number","type":"text","label":"PAN No.","options":[],"required":false,"pdf_field":""},{"help":"Enter 9 digit MICR code","type":"text","label":"MICR Code (9 digit MICR code number of the bank and branch appearing on the cheque issued by the bank)","options":[],"required":false,"pdf_field":""},{"help":"Enter 11 character IFSC code","type":"text","label":"IFSC Code (11 character code appearing on your cheque leaf)","options":[],"required":false,"pdf_field":""}],"filled_by":"claimant"},{"title":"Section (A) Personal Accident","fields":[{"help":"Date when accident or injury occurred","type":"date","label":"Date of loss/injury","options":[],"required":false,"pdf_field":""},{"help":"Time of accident with AM/PM","type":"text","label":"Time of Accident","options":[],"required":false,"pdf_field":""},{"help":"Location where accident/injury happened","type":"text","label":"Place of loss/injury","options":[],"required":false,"pdf_field":""},{"help":"Describe the loss or injury","type":"text","label":"Particulars of loss/injury","options":[],"required":false,"pdf_field":""},{"help":"Explain cause of injury","type":"text","label":"Reason for injury","options":[],"required":false,"pdf_field":""},{"help":"Describe injury details including side affected","type":"text","label":"Nature of injury received (if to eye or limbs, please state left or right?)","options":[],"required":false,"pdf_field":""},{"help":"Describe type of disablement","type":"text","label":"Nature of disablement","options":[],"required":false,"pdf_field":""},{"help":"Current condition of disability","type":"text","label":"Present state of disability","options":[],"required":false,"pdf_field":""},{"help":"Include city, pin code, state, country, phone","type":"text","label":"Names & Addresses of treating physicians & hospitals","options":[],"required":false,"pdf_field":""}],"filled_by":"claimant"},{"title":"Section (B) Critical Illness","fields":[{"help":"Describe illness, injury or surgery","type":"text","label":"Nature of disease/illness contracted, injury sustained or surgery performed?","options":[],"required":false,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Is the disease/illness contracted or surgery performed due to any accident?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Describe accident details if applicable","type":"text","label":"If YES, please provide the details of accident","options":[],"required":false,"pdf_field":""},{"help":"","type":"date","label":"Date on which you first visited a doctor with complaints related to this illness/injury","options":[],"required":false,"pdf_field":""},{"help":"Name of treating doctor","type":"text","label":"Dr. Name","options":[],"required":false,"pdf_field":""},{"help":"Name of hospital","type":"text","label":"Hospital Name","options":[],"required":false,"pdf_field":""},{"help":"Admission date","type":"date","label":"Hospitalization Details - Date of admission","options":[],"required":false,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Have you ever been hospitalized before?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Have any of your blood relatives suffered from similar or related illness?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"If YES, give details of when it was initially diagnosed","options":[],"required":false,"pdf_field":""}],"filled_by":"claimant"},{"title":"Section (C) Loss of Employment","fields":[{"help":"","type":"text","label":"Name of the employer","options":[],"required":false,"pdf_field":""},{"help":"Include HR contact details","type":"text","label":"Address","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Designation","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Department","options":[],"required":false,"pdf_field":""},{"help":"","type":"date","label":"Date of joining the organization","options":[],"required":false,"pdf_field":""},{"help":"","type":"date","label":"Date of Separation","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Reason for separation","options":[],"required":false,"pdf_field":""}],"filled_by":"claimant"},{"title":"Section (D) Child Allowance","fields":[{"help":"","type":"date","label":"Date of Birth","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Birth Mark","options":[],"required":false,"pdf_field":""}],"filled_by":"claimant"},{"title":"Aadhaar Based Payment (For Reimbursement Claims)","fields":[{"help":"Attach self-attested Aadhaar card copy","type":"text","label":"Aadhaar Card No.","options":[],"required":false,"pdf_field":""},{"help":"Tick to receive claim amount in Aadhaar linked bank account","type":"checkbox","label":"I wish to collect claim reimbursement directly in my Bank account linked with my aforementioned Aadhaar Card.","options":["Yes"],"required":false,"pdf_field":""}],"filled_by":"claimant"},{"title":"Declarations and Signatures","fields":[{"help":"Enter place of signing","type":"text","label":"Place","options":[],"required":false,"pdf_field":""},{"help":"Enter date of signing","type":"date","label":"Date","options":[],"required":false,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of Insured Person/Claimant","options":[],"required":true,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"PEP Declaration: Are you a Politically Exposed Person (PEP)?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide position if PEP","type":"text","label":"If yes, please mention the position held","options":[],"required":false,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Is any of your close relation or family member a PEP?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"If yes, please mention the name and relation and the position held by such close relative/family member.","options":[],"required":false,"pdf_field":""},{"help":"Place of signing for proposer","type":"text","label":"Place","options":[],"required":false,"pdf_field":""},{"help":"Date of signing for proposer","type":"date","label":"Date","options":[],"required":false,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of Proposer","options":[],"required":true,"pdf_field":""}],"filled_by":"insured person/claimant and proposer"}],"deadlines":[],"applies_to":"Claims under IndusInd Home Loan Protect Policy for Personal Accident, Critical Illness, Loss of Employment, Child Care Allowance, Home Cover, and Home Contents","attachments":["Original cancelled cheque","Copy of PAN card","Self attested Aadhaar card copy"],"declarations":["The details given are true and correct to the best of my knowledge and belief.","If any information is found incorrect, all rights under the policy will be forfeited.","I agree to provide additional information if required and indemnify the company for any loss due to misstatement.","I agree not to receive any rebate other than that mentioned in the published prospectus as per Insurance Act provisions.","If I or my close relatives become Politically Exposed Persons (PEP) in future, I will inform the company.","All premiums have been/will be paid from bonafide sources and not from proceeds of crime.","The company has the right to call for documents to establish sources of funds.","The company can cancel the insurance contract if found guilty under money laundering laws.","I consent to verification of my KYC and PAN details and accept responsibility for any mismatch consequences."],"dropped_labels":5},"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/578-indusind-home-loan-protect-policy-claim-form"}