{"id":858,"title":"Lock & Key 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/Claim%20Form%20for%20Lock%20%26%20Key%20Protect_0.pdf","sha256":"824d87b78cf185d9f3196f2c27b408143a7ff69d6333de224fd6da51f30ff9b8","pages":1,"collected":"2026-10-17","instructions":{"about":"This form is for policyholders to claim under the Lock & Key Protect Add-on of their private car insurance policy.","notes":[],"title":"Lock & Key Protect Add-on Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Policy and Insured Details","fields":[{"help":"Enter your insurance policy number","type":"text","label":"Policy Number :","options":[],"required":null,"pdf_field":""},{"help":"Enter the full name of the insured","type":"text","label":"Name in full                               :","options":[],"required":null,"pdf_field":""},{"help":"Enter your mailing address","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":"policyholder"},{"title":"Insured Vehicle Details","fields":[{"help":"Enter the vehicle's make and model","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":"policyholder"},{"title":"Loss and Replacement Details","fields":[{"help":"Describe the loss or damage to lock/key","type":"text","label":"Description of loss :","options":[],"required":null,"pdf_field":""},{"help":"Provide lock/key details as per your policy schedule","type":"text","label":"Lock and/ or Key details: A. As per Policy Schedule:","options":[],"required":null,"pdf_field":""},{"help":"Provide details of the replaced lock(s) and/or key(s)","type":"text","label":"B. Details of replaced Lock(s) and/ or Key(s):","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Claim Amount and Documents","fields":[{"help":"Enter the total claim amount with cost breakup","type":"amount","label":"Amount claimed (with breakup of material cost and labour):","options":[],"required":null,"pdf_field":""},{"help":"Attach copies of FIR, original bills, cash memos, or invoices","type":"attachment","label":"Supporting Documents: (Copy of FIR/ Original bills/ cash memo/ invoice)","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Original Items Deposited","fields":[{"help":"Provide details of original keys and locks submitted to the insurer","type":"text","label":"Details of the original key(s) and lock(s) deposited with the Company:","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Declaration and Signature","fields":[{"help":"Enter the place where 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":"policyholder"}],"deadlines":[],"applies_to":"Lock & Key Protect Add-on under Private Car Package Policy","attachments":["Copy of FIR","Original bills","Cash memo","Invoice"],"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/858-lock-and-key-protect-add-on-claim-form"}