{"id":780,"title":"Claim Form – Machinery Loss of Profit","purpose":"claim","insurer":{"slug":"magma-general-insurance","name":"Magma General Insurance Limited"},"source_pdf":"https://www.magmainsurance.com/documents/5553002/5571231/Claim+Form+%E2%80%93+Machinery+Loss+of+Profit.pdf/3d122cd3-5fb1-7ed9-9efd-ded365ff2e56?t=1789042339159","sha256":"dae8c0ef9a4222c08ca2bf62db98afb7d106e91208c13aa9450f912a47297ee1","pages":5,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured to claim loss of profit under the Machinery Loss of Profit Policy (Commercial) after an insured loss event.","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 General Insurance.","This form is issued without prejudice to policy terms and is not admission of liability.","Make no offer or admission of liability to third parties.","Any communications regarding the accident should be sent to the company immediately.","Use separate sheet if space is insufficient."],"title":"Claim Form – Machinery Loss of Profit","submit":{"to":"Company/Surveyor","how":"immediately return this form","address":""},"purpose":"claim","sections":[{"title":"A. The Insured","fields":[{"help":"","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"Full postal address","type":"text","label":"Address","options":[],"required":true,"pdf_field":""},{"help":"Office telephone number","type":"phone","label":"Tel No. : Office","options":[],"required":false,"pdf_field":""},{"help":"Mobile phone number","type":"phone","label":"Mobile","options":[],"required":false,"pdf_field":""},{"help":"Email address","type":"email","label":"email","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"B. Policy Details of Machinery/Boiler loss of profit Insurance","fields":[{"help":"Policy number for Machinery Loss of Profit","type":"text","label":"Policy No.","options":[],"required":true,"pdf_field":""},{"help":"Start date of policy period","type":"date","label":"Period of Insurance : From","options":[],"required":true,"pdf_field":""},{"help":"End date of policy period","type":"date","label":"to","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"C. Policy details of MBD / BPP Policy under which material damage loss has been preferred","fields":[{"help":"Policy number for Material Damage or Burglary policy","type":"text","label":"Policy No.","options":[],"required":true,"pdf_field":""},{"help":"Start date of MBD/BPP policy period","type":"date","label":"Period of Insurance : From","options":[],"required":true,"pdf_field":""},{"help":"End date of MBD/BPP policy period","type":"date","label":"to","options":[],"required":true,"pdf_field":""},{"help":"Name of insurer for MBD/BPP policy","type":"text","label":"Name of the Insurer","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"D. Loss Details","fields":[{"help":"Date of loss","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Time of loss with am/pm","type":"text","label":"Time","options":[],"required":true,"pdf_field":""},{"help":"Date and time loss was discovered","type":"text","label":"Date/Time Discovered","options":[],"required":true,"pdf_field":""},{"help":"Person who discovered the loss","type":"text","label":"By whom","options":[],"required":true,"pdf_field":""},{"help":"Full address where loss occurred","type":"text","label":"Location/Address of Loss","options":[],"required":true,"pdf_field":""},{"help":"City of loss location","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":"State of loss location","type":"text","label":"State","options":[],"required":true,"pdf_field":""},{"help":"Description of premises usage","type":"text","label":"Premises occupied as","options":[],"required":true,"pdf_field":""},{"help":"Detailed description of loss event","type":"text","label":"Describe fully circumstances of Loss, how it happened, what caused the Loss","options":[],"required":true,"pdf_field":""},{"help":"Start and end dates of business interruption","type":"date","label":"Period for which your business has been interrupted :from to","options":[],"required":true,"pdf_field":""},{"help":"Normal business output or turnover","type":"amount","label":"What is the Standard Output / Turnover","options":[],"required":true,"pdf_field":""},{"help":"Estimated loss in output or turnover","type":"amount","label":"What is the estimated reduction in output / turnover","options":[],"required":true,"pdf_field":""},{"help":"Estimated gross profit loss","type":"amount","label":"What is the estimated Loss of Gross Profit","options":[],"required":true,"pdf_field":""},{"help":"Details of any add-on cover claims","type":"text","label":"Claim under Add on covers","options":[],"required":false,"pdf_field":""},{"help":"Total claim amount","type":"amount","label":"Total Claim under all Sections (Separate Claim Bill may be attached)","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"D. General","fields":[{"help":"Tick Yes or No","type":"choice","label":"Is there any other insurance in force providing cover for this loss or damage?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide details if other insurance exists","type":"text","label":"If yes, please provide name of Insurer(s), policy no. and copy of Policy","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"choice","label":"Whether any change or alteration has been made in the business, premises or process after obtaining insurance?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Details of changes or alterations","type":"text","label":"If yes, please provide details of the same","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"choice","label":"Have you ever suffered any loss or damage leading to interruption in Production in the past?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Details of past losses","type":"text","label":"If yes, please provide Date, Amount of Loss and Name of Insurer","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"choice","label":"Did you take any measures to minimize the loss?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Details of loss minimization measures","type":"text","label":"If yes, please provide details of the same","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"choice","label":"Are there any steps taken to prevent a reoccurrence?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Details of preventive steps","type":"text","label":"If yes, please provide details (please attach separate sheet if required)","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"choice","label":"Was there another person/Organisation, in your opinion, responsible for the loss or damage?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Details of responsible party","type":"text","label":"If yes, please provide name, address & phone no.","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"choice","label":"Was there any witness(es) to the incident?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Witness details and statement","type":"text","label":"If yes, please provide name, address, phone no. and enclose statement from the witness","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"choice","label":"Are you the sole owner of the premises/property?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Details of other owners or interested parties","type":"text","label":"If not, please provide details of other interested parties","options":[],"required":false,"pdf_field":""},{"help":"Details of repairs and reinstatement","type":"text","label":"Whether required repairs / replacements are carried out in respect of material damage claim under MBD policy and whether the machinery is fully re-instated to its full working capacity. If so please provide complete details thereof","options":[],"required":false,"pdf_field":""},{"help":"Estimated time for repairs if not completed","type":"text","label":"If not please indicate the time required for the same?","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration and Signature","fields":[{"help":"Sign here","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":"Company stamp if applicable","type":"text","label":"Company’s stamp","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Machinery Loss of Profit Policy (Commercial)","attachments":["Separate sheet if insufficient space","Copy of other insurance policy if applicable","Separate claim bill if total claim under all sections","Statement from witness if applicable","Details of preventive steps if on separate sheet"],"declarations":["The insured declares all statements are 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/780-claim-form-machinery-loss-of-profit"}