{"id":765,"title":"CLAIM FORM MARINE CARGO SPECIFIC VOYAGE POLICY (RETAIL)","purpose":"claim","insurer":{"slug":"magma-general-insurance","name":"Magma General Insurance Limited"},"source_pdf":"https://www.magmainsurance.com/documents/5553002/5571162/Claim+Form+-+Marine+Cargo+Specific+Voyage+Policy.pdf/e4f63725-6729-84ab-0c22-5771f59da041?t=1789043206789","sha256":"173a396b1b87ec3cc680f2bef4ece345780a44b73f426e2be36a45f2269c6632","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured or claimant to file a claim for loss or damage under a Marine Cargo Specific Voyage Policy (Retail).","notes":["Issue of this Claim Form is not to be taken as an Admission of Liability.","The list of documents required is not exhaustive; surveyor or insurer may call for other relevant documents based on the nature of loss."],"title":"CLAIM FORM MARINE CARGO SPECIFIC VOYAGE POLICY (RETAIL)","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Policy and Claim Details","fields":[{"help":"","type":"text","label":"Claim Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Policy Number","options":[],"required":null,"pdf_field":""}],"filled_by":""},{"title":"A. DETAILS OF INSURED/CLAIMANT","fields":[{"help":"Name exactly as on the insurance policy","type":"text","label":"Name as per Policy","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"City","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"Postal PIN code","type":"number","label":"Pin","options":[],"required":null,"pdf_field":""},{"help":"Landline phone number","type":"phone","label":"Phone","options":[],"required":null,"pdf_field":""},{"help":"Mobile phone number","type":"phone","label":"Mobile","options":[],"required":null,"pdf_field":""},{"help":"Email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"B. DETAILS OF CONSIGNMENT","fields":[{"help":"","type":"text","label":"Certificate / Declaration No.","options":[],"required":null,"pdf_field":""},{"help":"Full name and address of the consignor","type":"text","label":"1) Name and address of the Consignor","options":[],"required":null,"pdf_field":""},{"help":"Full name and address of the consignee","type":"text","label":"2) Name and address of the Consignee","options":[],"required":null,"pdf_field":""},{"help":"Describe the goods and specify quantity","type":"text","label":"3) Nature of the goods & number of items","options":[],"required":null,"pdf_field":""},{"help":"Invoice or cost value of the goods","type":"amount","label":"4) Cost/Invoice value of the Consignment","options":[],"required":null,"pdf_field":""},{"help":"Describe the packing type","type":"text","label":"5) Nature of packing","options":[],"required":null,"pdf_field":""},{"help":"Origin location and dispatch date","type":"text","label":"6) Place of Origin & Date of despatch","options":[],"required":null,"pdf_field":""},{"help":"Destination location and arrival date","type":"text","label":"7) Place of Destination & Date of arrival","options":[],"required":null,"pdf_field":""},{"help":"Select the mode of transport","type":"choice","label":"8) Mode of transport –","options":["Rail","Road","By sea","Air","Courier","Multi model transport"],"required":null,"pdf_field":""},{"help":"Select the type of carrier receipt","type":"choice","label":"Carrier’s receipt","options":["Bill of Loding","Airway Bill","Others details"],"required":null,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"C. DETAILS OF LOSS / DAMAGE","fields":[{"help":"Describe condition at delivery","type":"text","label":"1) Date of delivery taken and what is the external condition of the consignment. Are there any damages to the packing and any suspicious internal damages to the goods?","options":[],"required":null,"pdf_field":""},{"help":"Carrier's remarks on condition at dispatch","type":"text","label":"2) Remarks of the carrier on outward condition or packing at the time of despatch.","options":[],"required":null,"pdf_field":""},{"help":"Date and person who noticed loss/damage","type":"text","label":"3) When was loss/damages noticed and by whom?","options":[],"required":null,"pdf_field":""},{"help":"Indicate if claim was made against carrier","type":"yes-no","label":"4) Has claim been made against the Carrier? (Note: The claim has to be lodged within the stipulated time frame)","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Describe the loss or damage","type":"text","label":"5) Nature and extent of loss/damages observed","options":[],"required":null,"pdf_field":""},{"help":"Explain the main cause of loss","type":"text","label":"6) State the proximate cause of loss","options":[],"required":null,"pdf_field":""},{"help":"Estimated monetary loss","type":"amount","label":"7) Estimated loss","options":[],"required":null,"pdf_field":""},{"help":"Attach if available","type":"checkbox","label":"8) Pre-inspection report","options":["Attached"],"required":null,"pdf_field":""},{"help":"Estimated repair cost if applicable","type":"amount","label":"9) If the damages can be repaired what could be the estimated repair charges.","options":[],"required":null,"pdf_field":""},{"help":"Details of duties paid and recovery chances","type":"text","label":"10) Duties paid on the consignment and chances of recovery/adjusted towards the damaged items.","options":[],"required":null,"pdf_field":""},{"help":"Details of any other insurance policies","type":"text","label":"11) Give the details of other insurance, if any covering the same loss.","options":[],"required":null,"pdf_field":""},{"help":"Additional information relevant to claim","type":"text","label":"12) Any other relevant information.","options":[],"required":false,"pdf_field":""},{"help":"State if you want to keep salvage and your offer","type":"text","label":"Are you interested in retaining the salvage/damaged items; if yes what is your offer.","options":[],"required":false,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"Discharge Voucher","fields":[{"help":"Cheque number received","type":"text","label":"Received the Cheque number","options":[],"required":null,"pdf_field":""},{"help":"Date of cheque","type":"date","label":"dated","options":[],"required":null,"pdf_field":""},{"help":"Name in favour of cheque","type":"text","label":"in favour of","options":[],"required":null,"pdf_field":""},{"help":"Amount received","type":"amount","label":"the sum of Rs.","options":[],"required":null,"pdf_field":""},{"help":"Policy number related to claim","type":"text","label":"Policy number","options":[],"required":null,"pdf_field":""},{"help":"Cause of loss","type":"text","label":"regarding the loss to our property due to","options":[],"required":null,"pdf_field":""},{"help":"Date of loss","type":"date","label":"dated","options":[],"required":null,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Signature of the insured or claimant","type":"signature","label":"Signature of the Insured","options":[],"required":true,"pdf_field":""},{"help":"Company stamp and seal if applicable","type":"attachment","label":"Stamp & Seal (for companies)","options":[],"required":false,"pdf_field":""}],"filled_by":"insured/claimant"},{"title":"Declaration","fields":[{"help":"Date of declaration","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Place of declaration","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Signature confirming declaration","type":"signature","label":"Signature of the Insured","options":[],"required":true,"pdf_field":""},{"help":"Company stamp if applicable","type":"attachment","label":"Company’s stamp (in case of company)","options":[],"required":false,"pdf_field":""}],"filled_by":"insured/claimant"}],"deadlines":["The claim has to be lodged within the stipulated time frame"],"applies_to":"Marine Cargo Specific Voyage Policy (Retail)","attachments":["Policy copy and certificate of insurance/declaration","Total invoices of the consignment with packing list","Bill of Lading/Air way bill/Lorry receipt/Rail receipt/courier note - Original","Claim Bill","Survey report, if appointed by insured","Monetary claim lodged on the transporter/port/vessel/whoever responsible for loss","Damage certificate issued by transporter","Pre-inspection report","Lob reports, if any","Details on duties paid with proof"],"declarations":["The information provided is correct to the best of the claimant's knowledge.","If any information is found false or incorrect, the policy shall be void and rights to recover claims forfeited.","The insured agrees to help the insurer recover loss amounts from responsible parties.","The insured agrees to provide additional information if required."],"dropped_labels":3},"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/765-claim-form-marine-cargo-specific-voyage-policy-retail"}