{"id":954,"title":"CLAIM FORM Deterioration Of Stock Insurance","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/deterioration-of-stocks-insurance/Claim%20form.pdf","sha256":"27464d225f1e9840d1d3e336d537deace4c16fb763fb44fa552dcd21ac2cc94b","pages":5,"collected":"2026-10-17","instructions":{"about":"This form is for policyholders to claim for deterioration of stock insurance losses by providing details of the loss and related information.","notes":["The issue of this form is not to be taken as an admission of liability by the Company.","All questions must be fully answered.","Please use additional pages if required."],"title":"CLAIM FORM Deterioration Of Stock Insurance","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Policy and Contact 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":"Enter start and end dates of insurance period","type":"date","label":"Period Of Insurance From                   To","options":[],"required":null,"pdf_field":""},{"help":"Name of the policyholder","type":"text","label":"Name","options":[],"required":null,"pdf_field":""},{"help":"Address of the policyholder","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"Mobile phone number","type":"phone","label":"Contact Details :Mobile","options":[],"required":null,"pdf_field":""},{"help":"Email address","type":"email","label":"Email id","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Business Description","fields":[{"help":"Describe your business or occupation briefly","type":"text","label":"Brief Description of Business/Industry/Occupation","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Deterioration Loss Details","fields":[{"help":"Date and time of loss or damage","type":"date","label":"When did the loss or damage occur ? ( date and Time )","options":[],"required":null,"pdf_field":""},{"help":"Address where loss occurred","type":"text","label":"Loss Location Address","options":[],"required":null,"pdf_field":""},{"help":"Describe how the loss happened","type":"text","label":"Nature and Cause of Loss (Please describe the circumstances leading to the loss)","options":[],"required":null,"pdf_field":""},{"help":"Witness details","type":"text","label":"Give the name and address of the witness to the occurrence.","options":[],"required":null,"pdf_field":""},{"help":"Specify cold storage, quantity, value, and types of goods spoiled","type":"table","label":"Deterioration Loss details : Cold Storage [Specify] Quantity Value Types of Goods spoilt","options":[],"required":null,"pdf_field":""},{"help":"Specify cold storage, quantity, value, and types of goods sold due to loss","type":"table","label":"Cold Storage [Specify] Quantity Value Types of Goods sold as a consequence of the loss event.","options":[],"required":null,"pdf_field":""},{"help":"Describe any loss minimization actions","type":"text","label":"What other actions is being taken to minimise the loss?","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Machinery / Equipment Loss Details","fields":[{"help":"Date and time of machinery loss or damage","type":"date","label":"When did the loss or damage occur ? ( date and Time )","options":[],"required":null,"pdf_field":""},{"help":"Address where machinery loss occurred","type":"text","label":"Loss Location Address","options":[],"required":null,"pdf_field":""},{"help":"Describe how the machinery loss happened","type":"text","label":"Nature and Cause of Loss (Please describe the circumstances leading to the loss)","options":[],"required":null,"pdf_field":""},{"help":"Witness details","type":"text","label":"Give the name and address of the witness to the occurrence.","options":[],"required":null,"pdf_field":""},{"help":"Provide detailed information about damaged machinery","type":"text","label":"What was damaged ? (a) Item of the Inventory (b) Sum Insured (c) Type of machine output of capacity (d) Manufacturers and year of manufacture (Full details on maker's plate to be given) (e) What is the cost of replacement of the Contract works machine by a new machine of the same size and capacity.","options":[],"required":null,"pdf_field":""},{"help":"Select if the property was new or used","type":"choice","label":"(a) Was the property brand new or second hand ?","options":["Brand new","Second hand"],"required":null,"pdf_field":""},{"help":"Date or details of last maintenance or overhaul","type":"text","label":"(b) What was the last occasion before the damage when the machine was overhauled or attended to for maintenance or damage","options":[],"required":null,"pdf_field":""},{"help":"Indicate if the property is completely destroyed","type":"yes-no","label":"Is the damaged property totally destroyed ?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Additional details on damaged machinery","type":"text","label":"(a) Item of the Inventory (b) Sum Insured (c) Type of machine output of capacity (d) Manufacturers and year of manufacture (Full details on maker's plate to be given) (e) What is the cost of replacement of the machine by a new machine of the same size and capacity","options":[],"required":null,"pdf_field":""},{"help":"Confirm if property is totally destroyed","type":"yes-no","label":"Is the damaged property totally destroyed ?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Describe damage extent and parts needing replacement","type":"text","label":"What has occurred and which parts of the property are damaged to such an extend the replacement is necessary?","options":[],"required":null,"pdf_field":""},{"help":"State if guarantee expired and date","type":"text","label":"Has the period of guarantee expired? If so, when ?","options":[],"required":null,"pdf_field":""},{"help":"Provide estimated loss amount","type":"amount","label":"What is the estimated amount of loss or Damage?","options":[],"required":null,"pdf_field":""},{"help":"Detailed cause and description of damage; attach sketch if possible","type":"text","label":"What was the cause of the damage and how did it occur? (This question must be answered in detail and a sketch given wherever possible)","options":[],"required":null,"pdf_field":""},{"help":"Describe any previous repairs","type":"text","label":"Has the property undergone any repairs previously (a) What was the nature of such repairs ?","options":[],"required":null,"pdf_field":""},{"help":"Workshop details for repairs","type":"text","label":"Give the name and address of the workshop where repairs will be executed : (Provisional repairs will be indemnified)","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Declaration and Signature","fields":[{"help":"Sign the form","type":"signature","label":"Signature","options":[],"required":true,"pdf_field":""}],"filled_by":"policyholder"},{"title":"ECS Details of the Insured","fields":[{"help":"Name as per bank account","type":"text","label":"Name of the Insured (as appearing in the Bank Account)","options":[],"required":null,"pdf_field":""},{"help":"Name of bank","type":"text","label":"Bank Name","options":[],"required":null,"pdf_field":""},{"help":"Bank branch and address","type":"text","label":"Branch and address","options":[],"required":null,"pdf_field":""},{"help":"Bank account number","type":"text","label":"Bank Account No.","options":[],"required":null,"pdf_field":""},{"help":"Type of bank account","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":"policyholder"}],"deadlines":[],"applies_to":"Deterioration Of Stock Insurance","attachments":[],"declarations":["The policyholder declares to have answered all questions conscientiously and faithfully and is liable for the correctness and completeness of the statement."],"dropped_labels":1},"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/954-claim-form-deterioration-of-stock-insurance"}