Page 436 - IC38 GENERAL INSURANCE

Example

An example of information sought in a fire claim form is given here under:

i. Name of the insured, policy number and address
ii. Date, time, cause and circumstances of the fire
iii. Details of damaged property
iv. Sound value of the property at the time of fire. Where the insurance

consists of several items under which the claim is made. [The claim must
be based on actual value of property at the place and time of
occurrence after allowance for depreciation, wear and tear (unless the
policy in respect of building, plant and machinery is on “reinstatement
value” basis). It shall not include profit]
v. Amount claimed after deduction of salvage value
vi. Situation and occupancy of the premises in which the fire occurred
vii. Capacity in which the insured claims, whether as owner, mortgage or the
like
viii. If any other person is interested in the property damaged
ix. If any other insurance is in force upon such property if so, details thereof

This is followed by the declaration as to the truth and accuracy of the
statement of in the form and signature of the insured and the date.

A sample of fire claim form of an insurance company is given as “Exhibit 1” in
this chapter.

The issuance of claim form by the insurance company does not imply or mean
that liability for the claim is admitted by insurers. Claim forms are issued with
the remark „without prejudice‟.

a) Supporting documents

In addition to the claim form, certain documents are required to be
submitted by the claimant or secured by the insurers to substantiate the
claim.

i. For fire claims, a report from the Fire Brigade would be necessary.
ii. For cyclone damage, a report from the Meteorological office may be

called for
iii. In burglary claims, a report from the Police may be necessary.
iv. For fatal accident claims, reports may be necessary from the Coroner

and the Police.
v. For motor claims, the insurer may like to examine driving license,

registration book, police report etc.
vi. In marine cargo claims, the nature of documents varies according to the

type of loss i.e. total loss, particular average, inland or overseas transit
claims etc.

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