{"id":935,"title":"BUSINESS PACKAGE (COMMERCIAL) CLAIM FORM","purpose":"claim","insurer":{"slug":"navi-general-insurance","name":"Navi General Insurance Limited"},"source_pdf":"https://public-navi-docs.s3.ap-south-1.amazonaws.com/NaviInsurance/CocoBusinessPackageCommercialInsurance/2020-2021/January/CocoBusinessPackageCommercialInsurance%20Claim%20Form.pdf","sha256":"ba2de7d49b8537b5b6700d7b138501eb72b964b6e47d35236d179e5115695f6c","pages":1,"collected":"2026-10-17","instructions":{"about":"This form is used by the policyholder to claim insurance under the Coco Business Package (Commercial) policy for losses or damages incurred.","notes":["Please fill this form completely.","The issue of this form is not an admission of liability.","Attach a separate sheet if more space is needed for listing damaged or lost items.","Use the date format DD/MM/YYYY where applicable.","Company’s seal is required if the insured is a firm or company."],"title":"BUSINESS PACKAGE (COMMERCIAL) CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Details of Policy Holder","fields":[{"help":"","type":"text","label":"Policy No.:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Claim No.:","options":[],"required":null,"pdf_field":""},{"help":"Enter start date of insurance period in DD/MM/YYYY format","type":"date","label":"Period of Insurance: From","options":[],"required":null,"pdf_field":""},{"help":"Enter end date of insurance period in DD/MM/YYYY format","type":"date","label":"to","options":[],"required":null,"pdf_field":""},{"help":"Full name of the insured or claimant","type":"text","label":"Insured / Claimant’s Name:","options":[],"required":null,"pdf_field":""},{"help":"Full postal address","type":"text","label":"Address:","options":[],"required":null,"pdf_field":""},{"help":"City of residence","type":"text","label":"City:","options":[],"required":null,"pdf_field":""},{"help":"Postal PIN code","type":"number","label":"Pin Code:","options":[],"required":null,"pdf_field":""},{"help":"State of residence","type":"text","label":"State:","options":[],"required":null,"pdf_field":""},{"help":"Mobile phone number","type":"phone","label":"Mobile No.:","options":[],"required":null,"pdf_field":""},{"help":"Landline phone number (optional)","type":"phone","label":"Landline No.:","options":[],"required":false,"pdf_field":""},{"help":"Email address (optional)","type":"email","label":"Email ID:","options":[],"required":false,"pdf_field":""},{"help":"Details of any mortgagee or financier related to the insured property","type":"text","label":"Details of Mortgagee/Financiers (s):","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Loss Details","fields":[{"help":"Date when the loss occurred in DD/MM/YYYY format","type":"date","label":"Date of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Time of loss with AM/PM","type":"text","label":"Time of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Brief description of the loss event","type":"text","label":"Description of Loss:","options":[],"required":null,"pdf_field":""},{"help":"List damaged or lost items with Identification No. and Estimated Loss (Rs.)","type":"table","label":"Items affected (Attach separate sheet, if required):","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Police & Fire Brigade Details","fields":[{"help":"Indicate if a police report was filed","type":"yes-no","label":"Police report lodged:","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Police report number if applicable","type":"text","label":"If Yes, Report No.:","options":[],"required":false,"pdf_field":""},{"help":"Date of police report in DD/MM/YYYY format","type":"date","label":"Date:","options":[],"required":false,"pdf_field":""},{"help":"Name of police station","type":"text","label":"Police Station:","options":[],"required":false,"pdf_field":""},{"help":"District of police station","type":"text","label":"District:","options":[],"required":false,"pdf_field":""},{"help":"Indicate if fire brigade was informed","type":"yes-no","label":"Fire Brigade Intimation:","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Details of fire brigade report if applicable","type":"text","label":"If Yes, Report Details:","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Other Insurance Details","fields":[{"help":"Indicate if another insurance policy covers the loss","type":"yes-no","label":"Is the loss covered under any other insurance policy:","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"List other insurance companies, policy numbers, coverage period, and sum insured","type":"table","label":"If Yes, then give the details below","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Declaration","fields":[{"help":"Date of signing the declaration in DD/MM/YYYY format","type":"date","label":"Date:","options":[],"required":null,"pdf_field":""},{"help":"Signature of the insured or claimant","type":"signature","label":"Signature of Insured","options":[],"required":null,"pdf_field":""},{"help":"Place where the form is signed","type":"text","label":"Place:","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"}],"deadlines":[],"applies_to":"Coco Business Package (Commercial) insurance claims","attachments":["In event of Hospitalization, attach necessary medical records"],"declarations":["I/We agree to provide additional information to the Company if required.","I/We warrant the truth of the foregoing statement and understand that false or fraudulent statements will void the policy and forfeit rights to claim.","I/We understand the Company reserves the right to verify facts and documents related to the policy and claim.","I/We consent to the Company collecting, retaining, and sharing my/our information including sensitive personal information for servicing the insurance policy and claim settlement.","I/We understand that I/We can update or correct information by intimating the Company.","I/We understand that withdrawing consent may result in the Company not providing services."],"dropped_labels":0},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"insurance.help@navi.com","label":"Claims intimation","level":1,"hours":null,"applies_to":"all","source_url":"https://public-navi-docs.s3.ap-south-1.amazonaws.com/NaviCommercialVehicleLiabilityOnlyInsurance%20CIS.pdf","quote":"own damage claim\n12 | Policy Servicing Claim Intimation and Processing | 1. Call Us: Toll Free 1800 123 0004 2. Email: insurance.help@navi.com 3. Email for Senior Citizens- seniorcare@navi.com 4. Visit our website: https://www.naviinsurance.com/service/ 5. Walk","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"seniorcare@navi.com","label":"Email for Senior Citizens","level":1,"hours":null,"applies_to":"all","source_url":"https://public-navi-docs.s3.ap-south-1.amazonaws.com/NaviCommercialVehicleLiabilityOnlyInsurance%20CIS.pdf","quote":"on and Processing | 1. Call Us: Toll Free 1800 123 0004 2. Email: insurance.help@navi.com 3. Email for Senior Citizens- seniorcare@navi.com 4. Visit our website: https://www.naviinsurance.com/service/ 5. Walk in for assistance 6. Dispatch your letters to us a","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 123 0004","label":"Toll Free","level":1,"hours":null,"applies_to":"all","source_url":"https://public-navi-docs.s3.ap-south-1.amazonaws.com/NaviCommercialVehicleLiabilityOnlyInsurance%20CIS.pdf","quote":"nses - paid amount under own damage claim\n12 | Policy Servicing Claim Intimation and Processing | 1. Call Us: Toll Free 1800 123 0004 2. Email: insurance.help@navi.com 3. Email for Senior Citizens- seniorcare@navi.com 4. Visit our website: https://www.n","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"url","value":"https://www.naviinsurance.com/service/","label":"Customer Portal on website","level":1,"hours":null,"applies_to":"all","source_url":"https://public-navi-docs.s3.ap-south-1.amazonaws.com/NaviCommercialVehicleLiabilityOnlyInsurance%20CIS.pdf","quote":"1800 123 0004 2. Email: insurance.help@navi.com 3. Email for Senior Citizens- seniorcare@navi.com 4. Visit our website: https://www.naviinsurance.com/service/ 5. Walk in for assistance 6. Dispatch your letters to us at – Corporate Office: Navi General Insurance Limited, Vaishna","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/navi-general-insurance/935-business-package-commercial-claim-form"}