{"id":1008,"title":"NEON SIGN CLAIM FORM","purpose":"claim","insurer":{"slug":"oriental-insurance","name":"The Oriental Insurance Company Limited"},"source_pdf":"https://oicl-cms-media.s3.ap-south-1.amazonaws.com/Neon_Sign_Insurance_Claim_Form_f7f776ad51.pdf","sha256":"be8c889cf5fbb5a5e77a9df44d87c1834bb820f7586c391883cf0405b1ae3ae4","pages":1,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured person to claim insurance for damage to a neon sign covered under their policy.","notes":[],"title":"NEON SIGN CLAIM FORM","submit":{"to":"Issuing Office","how":"","address":""},"purpose":"claim","sections":[{"title":"Claim Details","fields":[{"help":"","type":"text","label":"Name of the Insured","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"Enter your insurance policy number","type":"text","label":"Policy Number","options":[],"required":null,"pdf_field":""},{"help":"Enter the start and end dates of the insurance coverage period","type":"date","label":"Period of Insurance From_____________to____________","options":[],"required":null,"pdf_field":""},{"help":"Provide the installation date of the sign board and the amount insured or damaged","type":"text","label":"Date of Installation of damage Sign Board and Amount","options":[],"required":null,"pdf_field":""},{"help":"Enter the date when the damage or accident happened","type":"date","label":"State when the accident occurred","options":[],"required":null,"pdf_field":""},{"help":"Describe how the accident or damage occurred","type":"text","label":"How did it occurred","options":[],"required":null,"pdf_field":""},{"help":"Select whether the loss is total or partial","type":"choice","label":"Whether total loss/Partial loss:","options":["Total loss","Partial loss"],"required":null,"pdf_field":""},{"help":"Enter the estimated amount needed for repair or replacement","type":"amount","label":"Estimated amount required","options":[],"required":null,"pdf_field":""},{"help":"Provide the name and address of any witness to the accident","type":"text","label":"Name and Address of witness to accident","options":[],"required":null,"pdf_field":""},{"help":"Provide the name and address of the person or company who will repair the sign","type":"text","label":"Name and address of repairer","options":[],"required":null,"pdf_field":""},{"help":"Enter the total amount you are claiming","type":"amount","label":"Amount claimed","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration","fields":[{"help":"Enter the date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Enter the place of signing","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Sign the form","type":"signature","label":"Signature of Insured","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"","attachments":[],"declarations":["The statements made are true in all respects.","No information has been concealed from the company."],"dropped_labels":0},"pdf_fields":null,"fillable_pdf":false,"send_to":[],"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/oriental-insurance/1008-neon-sign-claim-form"}