{"id":789,"title":"Commercial Crime Insurance (Commercial) CLAIM FORM","purpose":"claim","insurer":{"slug":"magma-general-insurance","name":"Magma General Insurance Limited"},"source_pdf":"https://www.magmainsurance.com/documents/5553002/5571276/Claims+Form+-+Commercial+Crime+Insurance+%28Commercial%29.pdf/5d26c827-32f3-e825-0508-7737209c7a6a?t=1789042375114","sha256":"cbaac5d616e8d81ba4710627c5e8ddf781fea86e14bda249bf4dc7346f885813","pages":5,"collected":"2026-10-17","instructions":{"about":"This form is for filing a claim under the Commercial Crime Insurance policy and must be completed and signed by a Director, Partner, or Principal Officer of the Insured organization.","notes":["The form must be completed and signed by a Director, Partner or Principal Officer of the Insured.","Appointment of legal representatives should not occur without prior consent of Magma General Insurance Ltd.","If any detail or information is not readily available, do not delay dispatch of this form; detailed particulars may be sent later."],"title":"Commercial Crime Insurance (Commercial) CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"A. INSURED","fields":[{"help":"","type":"text","label":"Full name of Insured Organisation","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Registered address of Insured Organisation","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Contact Person","options":[],"required":null,"pdf_field":""},{"help":"Include area code if applicable","type":"phone","label":"Telephone Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"email","label":"Email Address","options":[],"required":null,"pdf_field":""}],"filled_by":"Insured"},{"title":"B. PARTICULARS OF THE INCIDENT","fields":[{"help":"Date when the incident occurred","type":"date","label":"Date of incident","options":[],"required":null,"pdf_field":""},{"help":"Location where the incident took place","type":"text","label":"Place of incident","options":[],"required":null,"pdf_field":""},{"help":"Date when the incident was first discovered","type":"date","label":"When did you first come to know of the incident","options":[],"required":null,"pdf_field":""},{"help":"Date when the incident was reported to the insured","type":"date","label":"When was the incident reported to you","options":[],"required":null,"pdf_field":""},{"help":"Date when the insurer was first informed about the claim","type":"date","label":"When was the claim first notified to the insurer","options":[],"required":null,"pdf_field":""},{"help":"Provide a detailed description of the incident","type":"text","label":"Detailed note on the incident","options":[],"required":null,"pdf_field":""}],"filled_by":"Insured"},{"title":"D. PARTICULARS OF THE CONSEQUENCE OF THE INCIDENT","fields":[{"help":"Provide details of any claims made against you and attach copies if available","type":"text","label":"Has any Claim been made upon You by any person? If so, state by whom and give full particulars (if the Claim has been made in writing, attach a copy of the notification received and of the bill, if submitted)","options":[],"required":null,"pdf_field":""},{"help":"Attach contract or correspondence if available; describe oral communication if applicable","type":"text","label":"Was there a contract between the Insured and the claimant who has lodged the complaint? If Yes, please provide a copy of the contract or details of contract. If received by you in writing, please provide a copy of the correspondence. If oral, please give a first person account of the conversation","options":[],"required":null,"pdf_field":""},{"help":"Provide estimated amounts separately for own loss and third party loss","type":"amount","label":"Estimated amount of Claim separately under (a) Own Financial Loss (b) Financial Loss claimed by third party","options":[],"required":null,"pdf_field":""},{"help":"Provide your response and opinion regarding the claim amount","type":"text","label":"What are your comments in response to the claim and your opinion on the quantum of claim","options":[],"required":null,"pdf_field":""},{"help":"Provide any additional relevant information and attach supporting documents","type":"text","label":"Are there any other details that you might wish to share with Magma or which could be of interest so that We might have a better understanding of the circumstances leading to the claim. Please provide documents, if any.","options":[],"required":null,"pdf_field":""},{"help":"Provide details of legal representatives if engaged","type":"text","label":"As of now, have you engaged any legal representative to act for you. If so, please provide name, firm, address and charge out rates","options":[],"required":null,"pdf_field":""},{"help":"Provide details of authorities informed, actions taken, and other insurance coverage","type":"text","label":"Has the incident been reported to any authority? If so, state to whom and attach a copy of the report submitted. What action, if any, has been taken by the authority? Give particulars of any other insurance, if any, in respect of the same risk.","options":[],"required":null,"pdf_field":""}],"filled_by":"Insured"},{"title":"E. DECLARATION AND AUTHORIZATION","fields":[{"help":"Signature of the authorized person","type":"signature","label":"Signature of the Insured","options":[],"required":true,"pdf_field":""},{"help":"Name of the person signing the form","type":"text","label":"Full Name of Person Signing","options":[],"required":true,"pdf_field":""},{"help":"Designation of the person signing the form","type":"text","label":"Designation of the Person Signing","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Place where the form is signed","type":"text","label":"Place","options":[],"required":true,"pdf_field":""}],"filled_by":"Insured"}],"deadlines":["Notify the Company without delay as soon as a loss or potential loss causing circumstances become known"],"applies_to":"Commercial Crime Insurance (Commercial)","attachments":["Copy of the notification received if claim made in writing","Copy of the bill if submitted","Copy of the contract or correspondence if applicable","Documents supporting additional details if any","Copy of the report submitted to authority if incident reported"],"declarations":["The information and answers given above are true, correct and complete in every detail.","The claim may be refused if information is not true or is withheld.","Authorization for Magma General Insurance Ltd. to exchange information with other insurers, government bureaus or any other agency for decision on indemnity."],"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/789-commercial-crime-insurance-commercial-claim-form"}