{"id":949,"title":"Notification of Loss or Damage","purpose":"claim","insurer":{"slug":"new-india-assurance","name":"The New India Assurance Company Limited"},"source_pdf":"https://www.newindia.co.in/assets/docs/know-more/engineering/civil-engg-completed-risk-insurance/Claim%20form1.pdf","sha256":"2a563f7ab847cd21da3d4dc24fb32fa0b58141486d09d2f50b9306fb81eea0a3","pages":3,"collected":"2026-10-17","instructions":{"about":"This form is for the insured policyholder to notify The New India Assurance Company Limited about loss or damage to contract works, construction plant, or machinery under their insurance policy.","notes":["Please use additional pages, if required.","The issue of this form is not to be taken as an admission of liability."],"title":"Notification of Loss or Damage","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Loss or Damage 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":"Title of contract insured :","options":[],"required":null,"pdf_field":""},{"help":"Full name and address of the insured party","type":"text","label":"Name(s) and address(es) of Insured(s).","options":[],"required":null,"pdf_field":""},{"help":"Address where the contract work is located","type":"text","label":"Location and address of Contract Site:","options":[],"required":null,"pdf_field":""},{"help":"Name of the engineer supervising the contract","type":"text","label":"Name of Supervising Engineer","options":[],"required":null,"pdf_field":""},{"help":"Nearest railway station or airport to the contract site","type":"text","label":"Nearest Railway Station (Airport)","options":[],"required":null,"pdf_field":""},{"help":"Directions to reach the contract site","type":"text","label":"Advisable approach route to contract Site from railway station (airport) or otherwise","options":[],"required":null,"pdf_field":""},{"help":"Select all that apply","type":"choice","label":"Which items were damaged ? (a) Contract works (b) Construction plant and equipment (c) Construction machinery","options":["Contract works","Construction plant and equipment","Construction machinery"],"required":null,"pdf_field":""},{"help":"Provide exact date and time of loss or damage","type":"date","label":"When did the loss or damage occur? (State date and exact time)","options":[],"required":null,"pdf_field":""},{"help":"Describe cause and circumstances; attach supporting documents","type":"text","label":"How did the damage occur and what was its probable cause ? (Attach sketches, photos etc.)","options":[],"required":null,"pdf_field":""},{"help":"Describe stage of construction progress","type":"text","label":"How far had construction of the damaged item (s) progressed at the time of the occurrence of damage?","options":[],"required":null,"pdf_field":""},{"help":"Provide witness details if any","type":"text","label":"Give name and address of witness to the occurrence :","options":[],"required":null,"pdf_field":""},{"help":"Explain repair method","type":"text","label":"How will the damaged items be repaired.","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Will any alterations or improvements be made to design, construction or material when repairs are carried out ?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide estimated repair costs for each category","type":"amount","label":"What are the estimated costs for the repairs of damage to (a) Contract Works? (b) Construction plant and equipment ? (c) Construction machinery?","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Is Third Party Liability involved ?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Are existing buildings or surrounding property damaged ?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Any additional information","type":"text","label":"Remarks","options":[],"required":false,"pdf_field":""},{"help":"Signature of the insured","type":"signature","label":"Signature","options":[],"required":true,"pdf_field":""},{"help":"Place where form is issued","type":"text","label":"Issued at","options":[],"required":null,"pdf_field":""},{"help":"Date of signing","type":"date","label":"this day of","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"ECS Details of the Insured","fields":[{"help":"Name exactly as in bank records","type":"text","label":"Name of the Insured (as appearing in the Bank Account)","options":[],"required":null,"pdf_field":""},{"help":"Name of the bank","type":"text","label":"Bank Name","options":[],"required":null,"pdf_field":""},{"help":"Bank branch and its address","type":"text","label":"Branch and address","options":[],"required":null,"pdf_field":""},{"help":"Account number for ECS","type":"text","label":"Bank Account No.","options":[],"required":null,"pdf_field":""},{"help":"Type of bank account (e.g. Savings, Current)","type":"text","label":"Bank Account Type","options":[],"required":null,"pdf_field":""},{"help":"Bank IFSC code","type":"text","label":"IFSC Code","options":[],"required":null,"pdf_field":""},{"help":"Bank MICR code","type":"text","label":"MICR Code","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"","attachments":["sketches","photos"],"declarations":["The undersigned Insured declares to have answered the above questions conscientiously and truthfully."],"dropped_labels":0},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"nia.[office code]@newindia.co.in","label":"Email for Claim Intimation (replace [office code] with actual code)","level":null,"hours":null,"applies_to":"all","source_url":"https://www.newindia.co.in/assets/docs/know-more/motor/Customer%20Information%20Sheet%20%28CIS%29%20Two%20Wheeler%20Package%20Policy.pdf","quote":"laim to The New India Assurance Co Ltd via– • Website – www.newindia.co.in • Toll Free Number – 1800-209-1415 • Email – nia.[office code]@newindia.co.in • Details of procedure to be followed for cashless service as well as for reimbursement of claim • Intimation of claim","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800-209-1415","label":"Toll Free Number for Claims Intimation","level":null,"hours":null,"applies_to":"all","source_url":"https://www.newindia.co.in/assets/docs/know-more/motor/Customer%20Information%20Sheet%20%28CIS%29%20Two%20Wheeler%20Package%20Policy.pdf","quote":"claimant may intimate claim to The New India Assurance Co Ltd via– • Website – www.newindia.co.in • Toll Free Number – 1800-209-1415 • Email – nia.[office code]@newindia.co.in • Details of procedure to be followed for cashless service as well as for re","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/new-india-assurance/949-notification-of-loss-or-damage"}