{"id":619,"title":"SIGNAGE INSURANCE - CLAIM FORM","purpose":"claim","insurer":{"slug":"indusind-general-insurance","name":"IndusInd General Insurance Company Limited"},"source_pdf":"https://www.indusindinsurance.com/downloads/indusind-signage-insurance-claim-form","sha256":"9c8bbf9316e3cad68d9d936d14f27c2048ae21a5c0414e1f4aeb14a979d10de3","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is for filing a signage insurance claim by the insured policyholder to report loss or damage and request claim settlement.","notes":["Fill the form in BLOCK LETTERS.","Issuance of this form does not imply acceptance of liability.","Attach self-attested copies of PAN card/Form 60 and Aadhaar Card as mandatory as per IRDAI guidelines.","Attach cancelled cheque leaf if opting for NEFT payment."],"title":"SIGNAGE INSURANCE - CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"SECTION 1 - INSURED DETAILS","fields":[{"help":"","type":"text","label":"Policy Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Claim Number","options":[],"required":null,"pdf_field":""},{"help":"Enter date in DD/MM/YYYY format","type":"date","label":"Date of Registration","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Area Office Code/ Service Centre Code","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Broker/Agent Name","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Code","options":[],"required":null,"pdf_field":""},{"help":"Select title and enter full name in block letters","type":"text","label":"Name of the Insured","options":["Mr.","Mrs.","Ms."],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Customer ID","options":[],"required":null,"pdf_field":""},{"help":"Include Plot No./Flat No., Building Name, Road, Area, City, State, Pin Code","type":"text","label":"Address of the Insured","options":[],"required":null,"pdf_field":""},{"help":"Enter landline phone number","type":"phone","label":"Phone Number","options":[],"required":null,"pdf_field":""},{"help":"Enter mobile phone number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Enter valid email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"Enter Aadhaar number","type":"text","label":"UID Aadhar No.","options":[],"required":null,"pdf_field":""},{"help":"Attach self-attested copy of PAN card or Form 60","type":"text","label":"PAN No.","options":[],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"Do you have a GST Registration Number","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Enter GST Registration Number if applicable","type":"text","label":"If Yes, please specify","options":[],"required":false,"pdf_field":""},{"help":"Select applicable source of funds","type":"choice","label":"Source of Funds","options":["Business","Profession","Salary","Agricultural Income","Savings","Others"],"required":null,"pdf_field":""},{"help":"Select applicable monthly income range","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":null,"pdf_field":""},{"help":"Enter date in DD/MM/YYYY and time in HH:MM AM/PM format","type":"date","label":"Date & time of loss","options":[],"required":null,"pdf_field":""},{"help":"Describe the nature and cause of loss in detail","type":"text","label":"Nature & cause of loss with detailed description","options":[],"required":null,"pdf_field":""},{"help":"List item/property affected, sum insured as per policy, and amount claimed in INR","type":"table","label":"Details of property in which loss is reported","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"SECTION 2 - DETAILS OF THIRD PARTY LOSS REPORTED","fields":[{"help":"Provide details if applicable","type":"text","label":"Death of / bodily injury to third party","options":[],"required":false,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"Third party property damage","options":[],"required":false,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"Give details of insurance with any other insurance company on the risk involved","options":[],"required":false,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"If insured is not sole owner, the nature of his/their interest in the property and details of other interests","options":[],"required":false,"pdf_field":""},{"help":"Tick applicable option(s)","type":"checkbox","label":"Whether the loss is intimated to Police / Fire Brigade","options":["Police","Fire Brigade"],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"SECTION 3 - BANK DETAILS","fields":[{"help":"If yes, enclose a cancelled cheque leaf","type":"yes-no","label":"Would you like to Opt for NEFT Payment?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Bank Name","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Branch Name","options":[],"required":false,"pdf_field":""},{"help":"Enter account holder name exactly as per bank records","type":"text","label":"A/C Holder Name as in Bank Record","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"City","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"State","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Account No.","options":[],"required":false,"pdf_field":""},{"help":"Enter 11 digit IFSC code printed on your cheque leaf","type":"text","label":"IFSC Code","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"DECLARATION BY INSURED","fields":[{"help":"Enter date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Enter place of signing","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Sign the form","type":"signature","label":"Signature of Insured","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":["Please return the form completed within Fourteen days of the loss together with the relevant vouchers, documents etc."],"applies_to":"Signage Insurance claims","attachments":["Self attested copy of PAN card/Form 60 & Aadhaar Card","Cancelled cheque leaf (if opting for NEFT payment)","Relevant vouchers, documents related to the loss"],"declarations":["The statements made in this claim form are true to the best of the insured's knowledge and belief.","The address mentioned shall be taken as address on record for the purpose of GST."],"dropped_labels":1},"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/619-signage-insurance-claim-form"}