{"id":851,"title":"Consumables Protect 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/Consumable%20Protect%20Claim%20Form_0.pdf","sha256":"8ed7746306b68e30a57b7f4b6aa3bbe20da0bb1e2810f18a715bcae0e12176cc","pages":1,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured policyholder to claim under the Consumables Protect Add-on of their private car insurance policy.","notes":[],"title":"Consumables Protect Add-on Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Policy and Insured Details","fields":[{"help":"","type":"text","label":"Policy Number :","options":[],"required":null,"pdf_field":""},{"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":"Enter a valid phone number","type":"phone","label":"Contact Number:","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Insured Vehicle Details","fields":[{"help":"","type":"text","label":"Make & Model","options":[],"required":null,"pdf_field":""},{"help":"Enter the year the vehicle was manufactured","type":"number","label":"Year of Manufacture","options":[],"required":null,"pdf_field":""},{"help":"Enter the engine number of the vehicle","type":"text","label":"Engine No.","options":[],"required":null,"pdf_field":""},{"help":"Enter the chassis number of the vehicle","type":"text","label":"Chassis No.","options":[],"required":null,"pdf_field":""},{"help":"Enter the vehicle registration number","type":"text","label":"Registration No.","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Description of Loss and Claim Details","fields":[{"help":"Describe the loss or damage to the consumables","type":"text","label":"Description of loss :","options":[],"required":null,"pdf_field":""},{"help":"Specify if the loss is covered under warranty or recall","type":"text","label":"Whether the loss is covered under the manufacturer’s warranty or product recall campaign?","options":[],"required":null,"pdf_field":""},{"help":"Confirm if the add-on was active when the loss occurred","type":"text","label":"Is Consumables Protect Add-on effective at time of claim?","options":[],"required":null,"pdf_field":""},{"help":"Indicate if previous claims were made under this add-on","type":"text","label":"Have you claimed before under this add-on?","options":[],"required":null,"pdf_field":""}],"filled_by":"insured"},{"title":"Declaration and Signature","fields":[{"help":"Enter the place where the form is signed","type":"text","label":"Place:","options":[],"required":null,"pdf_field":""},{"help":"Enter the date of signing","type":"date","label":"Date:","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":"Consumables Protect Add-on under Private Car Package Policy","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/851-consumables-protect-add-on-claim-form"}