{"id":832,"title":"MONEY INSURANCE POLICY (RETAIL) CLAIM FORM","purpose":"claim","insurer":{"slug":"magma-general-insurance","name":"Magma General Insurance Limited"},"source_pdf":"https://www.magmainsurance.com/documents/5553002/0/Claim+Form+-+Money+Insurance+Policy+%282%29.pdf/bed714d6-7360-ea2e-9167-9311a16a41da?t=1789044380888","sha256":"5289a4781881c7d5b26f6f2f65763aa117e6b4d6cf424e8e8b45c45bab10d417","pages":4,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured policyholder to claim for loss under the Money Insurance Policy (Retail).","notes":["All questions must be answered fully; incomplete forms will be returned.","If insufficient space, use a separate sheet and attach it.","The issue or acceptance of this form is not an admission of liability by the insurer."],"title":"MONEY INSURANCE POLICY (RETAIL) CLAIM FORM","submit":{"to":"","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":""}],"filled_by":"insured"},{"title":"B. Policy Details","fields":[{"help":"","type":"text","label":"Policy No.","options":[],"required":true,"pdf_field":""},{"help":"Start date of policy coverage","type":"date","label":"Period of Insurance : From","options":[],"required":true,"pdf_field":""},{"help":"End date of policy coverage","type":"date","label":"to","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"},{"title":"C. Loss Details","fields":[{"help":"Enter the amount of loss in rupees","type":"amount","label":"Amount of loss : Rs.","options":[],"required":true,"pdf_field":""},{"help":"Date when loss occurred","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 when loss was discovered","type":"text","label":"Date/Time Discovered","options":[],"required":true,"pdf_field":""},{"help":"Name of person who discovered the loss","type":"text","label":"By whom","options":[],"required":true,"pdf_field":""},{"help":"Exact location or address where loss occurred","type":"text","label":"Location/Address of Loss","options":[],"required":true,"pdf_field":""},{"help":"Describe the use of premises","type":"text","label":"Premises occupied as","options":[],"required":true,"pdf_field":""},{"help":"Specify location where cash was kept","type":"text","label":"Where was the cash kept","options":[],"required":true,"pdf_field":""},{"help":"Provide detailed description of loss circumstances","type":"text","label":"Describe fully circumstances of Loss, how it happened, what caused the Loss","options":[],"required":true,"pdf_field":""},{"help":"Select if loss was reported to police","type":"choice","label":"Is the loss reported to Police","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Explain if FIR not attached","type":"text","label":"If yes, attach copy of FIR. If not, why not?","options":[],"required":false,"pdf_field":""},{"help":"Provide details if loss occurred during transit","type":"text","label":"In case loss is due to money-in-transit","options":[],"required":false,"pdf_field":""},{"help":"Total money amount carried during transit","type":"amount","label":"Total Amount of money carried","options":[],"required":false,"pdf_field":""},{"help":"Specify origin and destination places","type":"text","label":"Places between which the money was in transit","options":[],"required":false,"pdf_field":""},{"help":"Describe mode of carrying money","type":"text","label":"How was the money being carried","options":[],"required":false,"pdf_field":""},{"help":"Name and designation of employee responsible","type":"text","label":"In whose custody was the money at the time of loss, name & designation of the employee","options":[],"required":false,"pdf_field":""},{"help":"Specify transport mode used","type":"text","label":"What means of transport were used by the employee carrying the money","options":[],"required":false,"pdf_field":""},{"help":"Select if armed guard was present","type":"choice","label":"Was an armed guard accompanying the employee carrying the money","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide date, time and place of loss","type":"text","label":"When and where did the loss occur","options":[],"required":false,"pdf_field":""},{"help":"Additional details on loss circumstances","type":"text","label":"Describe circumstances of the loss in detail","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"D. Details of other insurances","fields":[{"help":"List other insurance policies covering this loss","type":"text","label":"Provide details of other insurances, if any, covering the incident/damage","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"E. Details of previous losses","fields":[{"help":"Provide information on any prior losses","type":"text","label":"Details of previous losses, if any","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"F. General","fields":[{"help":"Provide Fidelity Guarantee policy details if applicable","type":"text","label":"Are the employees carrying Money covered under a Fidelity Guarantee policy? If yes, provide policy details","options":[],"required":false,"pdf_field":""},{"help":"Select if loss caused by employee dishonesty","type":"choice","label":"Is the loss due to fraud/dishonesty of the money carrying employee","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Duration money was with employee","type":"text","label":"If yes, how long was the money with the employee","options":[],"required":false,"pdf_field":""},{"help":"Select if preventive steps taken","type":"choice","label":"Any steps taken to prevent future recurrence","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Describe preventive measures taken","type":"text","label":"If yes, please provide details (attach separate sheet if required)","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration","fields":[{"help":"Sign the form","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":"Affix company stamp if applicable","type":"text","label":"Company’s stamp","options":[],"required":false,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Money Insurance Policy (Retail)","attachments":["Copy of FIR if loss reported to police","Details of preventive steps taken (if applicable, attach separate sheet)"],"declarations":["The insured declares all information is 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.","The claim may be refused if information is untrue, inaccurate or concealed."],"dropped_labels":2},"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/832-money-insurance-policy-retail-claim-form"}