{"id":795,"title":"HOUSEHOLDER’S PACKAGE POLICY (RETAIL) Breakdown of Domestic Appliances Claim Form","purpose":"claim","insurer":{"slug":"magma-general-insurance","name":"Magma General Insurance Limited"},"source_pdf":"https://www.magmainsurance.com/documents/5553002/5571045/Claim+Form+%E2%80%93+Householder%27s+Package+%281%29.pdf/4505cee3-51bf-4068-f453-b77eab304e53?t=1789043016146","sha256":"1453dca2f45ec70d8999eb3bd07634594c913c1dc5f54a8318a0a20cdc1f0cdf","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured policyholder to claim for breakdown of domestic appliances under the Householder’s Package Policy (Retail).","notes":["All questions must be answered fully; incomplete forms will be returned.","Do not dispose or destroy damaged parts/machinery without consent of surveyor or Magma General Insurance.","If there is insufficient space, use a separate sheet attached to the form."],"title":"HOUSEHOLDER’S PACKAGE POLICY (RETAIL) Breakdown of Domestic Appliances Claim Form","submit":{"to":"Magma General Insurance","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":"Enter start and end dates","type":"date","label":"Period of Insurance","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"C. Domestic Appliances details","fields":[{"help":"","type":"text","label":"Location of damaged appliances","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Description of damaged appliances","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Make","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Type","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Model","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Serial No.","options":[],"required":true,"pdf_field":""},{"help":"Enter year only","type":"number","label":"Year of manufacture","options":[],"required":true,"pdf_field":""},{"help":"Horsepower or Kilowatt rating","type":"text","label":"HP/KW","options":[],"required":false,"pdf_field":""},{"help":"DD/MM/YYYY","type":"date","label":"Date of expiry of manufacturer warranty","options":[],"required":false,"pdf_field":""},{"help":"","type":"amount","label":"Sum Insured","options":[],"required":true,"pdf_field":""},{"help":"","type":"amount","label":"Cost of replacement by a new machine of same type/capacity","options":[],"required":true,"pdf_field":""},{"help":"DD/MM/YYYY","type":"date","label":"Date of last maintenance service/overhaul of machine","options":[],"required":false,"pdf_field":""},{"help":"Describe any prior repairs","type":"text","label":"Details of previous repairs, if any","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"D. Loss details","fields":[{"help":"Date of incident","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Specify am or pm","type":"text","label":"Time","options":["am","pm"],"required":true,"pdf_field":""},{"help":"Describe the incident in detail","type":"text","label":"Describe what happened (Attach sketch if appropriate)","options":[],"required":true,"pdf_field":""},{"help":"Explain likely cause","type":"text","label":"Probable cause of damage","options":[],"required":false,"pdf_field":""},{"help":"Provide repairer's contact details","type":"text","label":"Name & Address of repairer","options":[],"required":false,"pdf_field":""},{"help":"Provide detailed cost estimate","type":"text","label":"Estimate of cost of repairs, itemized separately for parts and labour","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"E. Details of other insurances","fields":[{"help":"List other insurance policies if applicable","type":"text","label":"Provide details of other insurances, if any, covering the incident/damage or items","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"F. Details of previous losses","fields":[{"help":"Describe any prior claims or losses","type":"text","label":"Details of previous losses, if any","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"G. Steps taken to prevent future reoccurrence","fields":[{"help":"Explain measures to avoid repeat damage","type":"text","label":"Steps taken to prevent future reoccurrence","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration","fields":[{"help":"","type":"signature","label":"Signature of Insured","options":[],"required":true,"pdf_field":""},{"help":"","type":"date","label":"Date","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Breakdown of Domestic Appliances under Householder’s Package Policy (Retail)","attachments":["Attach sketch if appropriate"],"declarations":["The insured declares that no material information has been withheld and all statements are true to the best of their knowledge.","The articles/property described belong to the insured and no other person has interest except as mentioned in the policy.","The 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/795-householders-package-policy-retail-breakdown-of-domestic-appliances-claim-form"}