{"id":846,"title":"National Fuel Flip flop Add-on Claim Form","purpose":"claim","insurer":{"slug":"national-insurance","name":"National Insurance Company Limited"},"source_pdf":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/Fuel%20Flip%20Claim%20Form_0.pdf","sha256":"92288212e1ce1247ecdf2eb342076c7d5e1bc999e383dedfaf2baefbdc50487a","pages":1,"collected":"2026-10-17","instructions":{"about":"This form is for policyholders to claim under the National Fuel Flip flop Add-on for Private Car policies. It is to be filled by the insured person.","notes":[],"title":"National Fuel Flip flop Add-on Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"The Insured","fields":[{"help":"","type":"text","label":"Name in full","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Address for Correspondence","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Telephone Number, if any","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"The Insured Vehicle","fields":[{"help":"Vehicle manufacturer","type":"text","label":"Make","options":[],"required":null,"pdf_field":""},{"help":"Year vehicle was made","type":"number","label":"Year of Manufacture","options":[],"required":null,"pdf_field":""},{"help":"Engine number of the vehicle","type":"text","label":"Engine No.","options":[],"required":null,"pdf_field":""},{"help":"Chassis number of the vehicle","type":"text","label":"Chasis No.","options":[],"required":null,"pdf_field":""},{"help":"Vehicle registration number","type":"text","label":"Registration No.","options":[],"required":null,"pdf_field":""},{"help":"Indicate if loss is covered under warranty or recall","type":"yes-no","label":"Whether the loss is covered under the manufacturer’s warranty or product recall campaign?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Confirm if add-on cover is opted or allowed","type":"yes-no","label":"Is National Fuel Flip flop Add-on Cover opted/ allowed?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Only one claim is admissible under this add-on","type":"yes-no","label":"Have you claimed before under this add-on?","options":["Yes","No"],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"Private Car Package Policy and National Fuel Flip flop Add-on","attachments":[],"declarations":[],"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/national-insurance/846-national-fuel-flip-flop-add-on-claim-form"}