{"id":753,"title":"STANDARD FIRE AND SPECIAL PERILS POLICY (RETAIL) Claim Form","purpose":"claim","insurer":{"slug":"magma-general-insurance","name":"Magma General Insurance Limited"},"source_pdf":"https://www.magmainsurance.com/documents/5553002/5571027/Claim+Form+%E2%80%93+Standard+Fire+and+Special+Perils.pdf/05c264fb-18b7-8811-bca0-411bd016d339?t=1789042987607","sha256":"0cc43e5ffdb2fca15f9e0f2b09a6081b5cee73497ea229a298e744ff5835f9f2","pages":5,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured to claim for loss or damage under the Standard Fire and Special Perils Policy (Retail). The policyholder or insured person fills it.","notes":["All questions must be answered fully; incomplete forms will be returned.","Do not dispose of or destroy damaged property without consent of surveyor/Magma Insurance.","This form is not an admission of liability by the insurer.","Use separate sheets if space is insufficient.","Make no offer or admission of liability to third parties.","Send any communications regarding the accident to the company immediately."],"title":"STANDARD FIRE AND SPECIAL PERILS POLICY (RETAIL) Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"A. The Insured","fields":[{"help":"","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Address :","options":[],"required":true,"pdf_field":""},{"help":"","type":"phone","label":"Tel No.:- Office :","options":[],"required":false,"pdf_field":""},{"help":"","type":"phone","label":"Mobile :","options":[],"required":false,"pdf_field":""},{"help":"","type":"email","label":"email :","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Contact name :","options":[],"required":false,"pdf_field":""},{"help":"","type":"phone","label":"Mobile :","options":[],"required":false,"pdf_field":""},{"help":"","type":"email","label":"email :","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"B. Policy Details","fields":[{"help":"","type":"text","label":"Policy No.:","options":[],"required":true,"pdf_field":""},{"help":"Start date of policy coverage","type":"date","label":"Period of Insurance : From","options":[],"required":true,"pdf_field":""},{"help":"End date of policy coverage","type":"date","label":"to","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"C. Loss Details","fields":[{"help":"Date when loss occurred","type":"date","label":"Date :","options":[],"required":true,"pdf_field":""},{"help":"Time when loss occurred, specify am or pm","type":"text","label":"Time : am/pm","options":[],"required":true,"pdf_field":""},{"help":"Date and time when loss was discovered","type":"text","label":"Date/Time Discovered :","options":[],"required":true,"pdf_field":""},{"help":"Name of person who discovered the loss","type":"text","label":"By whom :","options":[],"required":true,"pdf_field":""},{"help":"Address where loss occurred","type":"text","label":"Location/Address of Loss :","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"City :","options":[],"required":true,"pdf_field":""},{"help":"Postal code of loss location","type":"number","label":"Pin Code :","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"State :","options":[],"required":true,"pdf_field":""},{"help":"Describe the use or occupation of the premises","type":"text","label":"Premises occupied as :","options":[],"required":true,"pdf_field":""},{"help":"Provide detailed description of the loss event","type":"text","label":"Describe fully circumstances of Loss, how it happened, what caused the Loss :","options":[],"required":true,"pdf_field":""},{"help":"List each damaged item with amounts as columns","type":"table","label":"What is Lost & Extent of Loss (Attach separate sheet if more than 1 items) Item damaged Amount insured Market value at the time of loss Market value after the loss Salvage value Amount claimed* *Should constitute only value of the claimed item(s) without including profit of any kind","options":[],"required":true,"pdf_field":""},{"help":"Enter amount claimed under extra benefits if any","type":"amount","label":"Claim under Extra Benefits Rs.","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"D. General","fields":[{"help":"Tick yes or no; if yes attach FIR/Fire Brigade Report","type":"yes-no","label":"Has the loss or damage been reported to the Police/Fire Brigade?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Tick yes or no; if yes attach meteorological report or newspaper clipping","type":"yes-no","label":"Has the loss/damage been caused due to flood, earthquake, storm or any other Act of God","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, provide insurer name, policy no. and copy of policy","type":"yes-no","label":"Is there any other insurance in force providing cover for this loss or damage?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, provide date, amount of loss and insurer name","type":"yes-no","label":"Have you ever suffered a loss or damage in the past?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Tick yes or no for each system","type":"yes-no","label":"Are the premises protected by a Fire Protection/Detection system? Hydrant","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"Sprinkler","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"Smoke Detector","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"Extinguisher(s)","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Indicate if fire protection/detection system was activated","type":"yes-no","label":"Was the same activated during the incident :","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"If yes, provide details","type":"yes-no","label":"Did you take any measures to minimize the loss?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, provide details (attach separate sheet if needed)","type":"yes-no","label":"Are there any steps taken to prevent a reoccurrence?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, provide name, address & phone no.","type":"yes-no","label":"Was there another person, in your opinion, responsible for the loss or damage?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, provide name, address, phone no. and enclose witness statement","type":"yes-no","label":"Was there any witness(es) to the incident?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, provide name & address of relevant parties/financial institution","type":"yes-no","label":"Is the property subject to a hire purchase or hypothecation agreement?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, provide details of changes/alterations","type":"yes-no","label":"Has there been any alteration in the occupation or use of the premises since the Policy was taken up?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If no, specify since when unoccupied","type":"yes-no","label":"Were the premises occupied at the time of the loss or damage?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If no, provide details of other interested parties","type":"yes-no","label":"Are you the sole owner of the premises/property?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"Are you responsible for repairs?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"","type":"amount","label":"At the time of loss, what was the total value of all property in the premises?","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration and Signature","fields":[{"help":"Sign to declare the truthfulness of the information","type":"signature","label":"Signature of Insured:","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date :","options":[],"required":true,"pdf_field":""},{"help":"For office use","type":"text","label":"Company’s stamp","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Standard Fire and Special Perils Policy (Retail)","attachments":["Legible copy of FIR/Fire Brigade Report if loss reported to Police/Fire Brigade","Copy of report from meteorological department or newspaper clipping if loss caused by Act of God","Copy of other insurance policy if applicable","Statement from witness(es) if any","Separate sheet if more items lost or for additional details"],"declarations":["The insured declares all information is true and no material information is withheld.","The articles/property described belong to the insured and no other person has interest except as mentioned in the policy.","Claim may be refused if information is untrue, inaccurate or concealed."],"dropped_labels":0},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"address","value":"Magma General Insurance Limited (Claims Hub), Srinilaya Cyber Spazio Suite 101, 102, Ground Floor, Road No. 2, Banjara Hills, Hyderabad, Telangana – 500034","label":"Claims Hub Address","level":null,"hours":null,"applies_to":"health","source_url":"https://www.magmainsurance.com/learn-about-claims","quote":"fe takes an unexpected turn. When that moment comes, a clear and dependable claims process makes all the difference. At Magma General Insurance, our aim is to make the process simple to understand, transparent to follow, and supportive at every step. This page explains how claims work across Health, Motor and Non‑Motor policies.\nClaim is easy at Magma General Insurance.\nRegister Claim\nHealth","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"customercare@magmainsurance.com","label":"Customer Care Email","level":null,"hours":null,"applies_to":"all","source_url":"https://www.magmainsurance.com/web/magmainsurance/claims","quote":"ma HDI General Insurance Company Limited) | All Rights Reserved\n| IRDAI Reg. No. 149 |\nwww.magmainsurance.com\n| E-mail:\ncustomercare@magmainsurance.com\n| Registered & Corporate Office: Equinox Business Park, Tower 3, Ambedkar Nagar, 2\nnd\nFloor, Unit Number 1B & 2B, LBS M","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 266 3202","label":"Claims Intimation Toll Free Number","level":null,"hours":null,"applies_to":"all","source_url":"https://www.magmainsurance.com/web/magmainsurance/claims","quote":"surance Claims - Motor & Health Insurance Claim Process - Magma Insurance - Magma\nSkip to Content\nOne-Line-Hearder-Test\n1800 266 3202\nNavigation\nCustomer Service\nSenior Citizen Services\nRoad side Assistance\nAnnual Health Check-up\nPolicy Servicing assist","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/magma-general-insurance/753-standard-fire-and-special-perils-policy-retail-claim-form"}