{"id":790,"title":"Cyber+ Insurance Policy (Commercial) CLAIMS FORM","purpose":"claim","insurer":{"slug":"magma-general-insurance","name":"Magma General Insurance Limited"},"source_pdf":"https://www.magmainsurance.com/documents/5553002/5571279/Claims+Form+-+Cyber%2B+Insurance+Policy+%28Commercial%29.pdf/dd954016-b220-0132-09fb-91721f201527?t=1789042377097","sha256":"0e472053e63c6108e6f5ce90adc49a9fcf2d313e5644afed3cc79fbe3a788576","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured to report and claim under the Cyber+ Insurance Policy (Commercial) for cyber-related incidents.","notes":["Attach copies of all relevant documents as requested.","The form may be forwarded with incomplete particulars and updated later.","Use the contact details provided on the form for any queries."],"title":"Cyber+ Insurance Policy (Commercial) CLAIMS FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Insured Details","fields":[{"help":"","type":"text","label":"Policy No.","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Claim No.","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Name of Insured:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Address :","options":[],"required":null,"pdf_field":""},{"help":"Name of the person to contact regarding the claim","type":"text","label":"Contact Person :","options":[],"required":null,"pdf_field":""},{"help":"Phone number of the contact person","type":"phone","label":"Contact Number:","options":[],"required":null,"pdf_field":""},{"help":"Policy coverage period","type":"text","label":"Period of the Policy:","options":[],"required":null,"pdf_field":""},{"help":"Coverage limits as per the policy","type":"text","label":"Limits of Indemnity under the Policy:","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Particulars of Incident","fields":[{"help":"Describe the incident in detail","type":"text","label":"Detailed note on incident:","options":[],"required":null,"pdf_field":""},{"help":"Date when the incident happened","type":"date","label":"Date of occurrence:","options":[],"required":null,"pdf_field":""},{"help":"Time of incident with AM/PM","type":"text","label":"Time:","options":[],"required":null,"pdf_field":""},{"help":"Location where the incident occurred","type":"text","label":"Place of incident:","options":[],"required":null,"pdf_field":""},{"help":"Date when the insured first became aware of the incident","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":""}],"filled_by":"insured"},{"title":"Particulars of Consequences 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":"Indicate if a contract exists and attach a copy if yes","type":"choice","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.","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Estimated Amount of Claim","fields":[{"help":"Estimated amount of your own financial loss","type":"amount","label":"Own Financial Loss","options":[],"required":null,"pdf_field":""},{"help":"Estimated amount claimed by third parties","type":"amount","label":"Financial Loss claimed by third party","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Reporting to Authorities and Other Insurance","fields":[{"help":"Provide details of authority reported to and attach report copy","type":"text","label":"Has the incident been reported to any authority? If so, state to whom and attach a copy of the report submitted.","options":[],"required":null,"pdf_field":""},{"help":"Describe any action taken by the authority","type":"text","label":"What action, if any, has been taken by the authority?","options":[],"required":null,"pdf_field":""},{"help":"Details of other insurance policies covering the same risk","type":"text","label":"Give particulars of any other insurance, if any, in respect of the same risk.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration and Signature","fields":[{"help":"Signature of the insured","type":"signature","label":"Insured’s Signature : ______________","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date : ____________________","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Cyber+ Insurance Policy (Commercial)","attachments":["Copy of the notification received if claim made in writing","Copy of the bill if submitted","Copy of contract if applicable","Copy of report submitted to authority"],"declarations":["The issuance of this form is not an admission of liability.","Completion and return of this form should not be delayed even if some particulars are not immediately available.","If any false or fraudulent statement or concealment is made, the claim shall be forfeited and the policy null and void.","The insured warrants the truth of the statements to the best of their knowledge and belief."],"dropped_labels":1},"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/790-cyber-insurance-policy-commercial-claims-form"}