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FIRE - PROPERTY CLAIM FORM
The issue of this form is not to be taken as an admission of liability by the Insurers.
It is important that a complete answer be given to every question. If insufficient
space is provided for your answers, please attach a separate sheet. Fire and GA
Claims Department - Fax: 6225 9887
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Name of Policyholder
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*
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Policy No
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*
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NRIC No
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*
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Tel No
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Email
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Contact Person
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Residential Address
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Business Address
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Office No
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Occupation/Business
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State fully what happened
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Date
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Time
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Place of occurrence
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Nature of loss or damage
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Who discover this loss/damage?
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*
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Date discovered
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*
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Do you know who cause this damage?
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Please state name and address of this person
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The Police must be informed immediately if the property has been lost, stolen or
maliciously damaged. Please attach a copy of police report if applicable.
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Name of police station report was lodged
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Were the premises occupied at the time of the loss?
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by whom
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If No, give date and time they were last occupied
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and by whom
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If entry was illegal, how and between what hours it happened?
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State if rooms were ransacked.
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Please give details
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What is the total value at the time of
the loss of all the property insured by this policy?
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Do you own the property?
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Please give name and address of the owner
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Is the property subject to a hire purchase or loan agreement?
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Please give name of the finance
or lending company, their address and agreement number
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Was the property on loan or hire to another party?
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Please give name and address of party
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Is any other party interested in the property?
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Please give name of party and extent of
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Is there any other insurance on the property?
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Please provide details as follows:
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Company
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Policy No
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Sum
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If interest covered is different from that covered by our policy, give details
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Have you ever before sustained loss of this nature?
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Please give details
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Have you ever made a claim of this
nature on us or on any other insurer or underwriter?
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If Yes, give details
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Declaration: I/We hereby declare that these particulars are true to the best of
my/our knowledge and belief and I/we have in no manner caused the loss nor by any
fraud or misrepresentation sought to benefit thereby. I/We accept that insurers
would be at liberty to deny liability in part or in full if the above written answers
are false or inaccurate in any aspect
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Name
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Designation
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NRIC NO
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Please note that all personal information provided to TMiS is subject to the Personal Data Protection Policy Statement posted at www.tokiomarine.com.sg under privacy statement.
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NOTES
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- Wherever possible, claims should be accompanied by Builders', Architects' or Repairers'
estimates.
- A Fire Policy being a contract of Indemnity only, no profit or any kind should be
included in the amount claimed.
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- Claims in respect of Building should be based upon the cost of restoring them to
the condition they were in at the time of the loss. Contemplated improvements must
not be included.
- Claims for Furniture, Fittings, Machinery, Tools, Electrical Appliances, etc., must
not exceed their value at the time of the loss; that is, after due allowance has
been made for age, wear and tear and depreciation during the time they have been
in use. Where appropriate, the claim will be based on the cost of repairs or of
restoration.
- Claims for Stock-in-Trade should be based on values at the time of the loss after
deduction of all discounts or allowances. Due allowance must be made for out of
date and unsaleable stock
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