{"id":862,"title":"Invoice Protect (Add-on to Two Wheeler Package Policy) 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%20Invoice%20Protect_5.pdf","sha256":"25df8e714b636c09d75d69c123b7f8dff40d65c26bbecbb1fd27aff73002d7f9","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is for policyholders to claim under the Invoice Protect add-on for total loss, constructive total loss, or total theft of the insured two-wheeler vehicle.","notes":["This form is in addition to the Two Wheeler Package Policy Claim Form.","Fill this form only in case of Total Loss, Constructive Total Loss, or Total Theft of the insured vehicle.","Issue of this form is not an admission of liability.","Fill the form completely without leaving any space blank or putting dashes.","Produce documentary proof of first time Registration Tax paid, Road Tax paid, and Road Tax Refund received."],"title":"Invoice Protect (Add-on to Two Wheeler Package Policy) Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Policy Details","fields":[{"help":"","type":"text","label":"Policy No","options":[],"required":null,"pdf_field":""},{"help":"Enter start and end dates in DD/MM/YYYY format","type":"date","label":"Period of Insurance","options":[],"required":null,"pdf_field":""},{"help":"Tick all documents you are submitting with this claim","type":"checkbox","label":"Please tick the documents enclosed","options":["1st Time Registration Charge Receipt","Road Tax Receipt","Road Tax Refund Receipt","Court Acceptance of FPR","Policy Copy","First Information Report"],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Declaration by Insured","fields":[{"help":"","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Enter date of signing in DD/MM/YYYY format","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of the Insured","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"}],"deadlines":[],"applies_to":"Total Loss or Constructive Total Loss or Total Theft of the Insured Vehicle under Invoice Protect add-on","attachments":["Duly filled and signed claim form","Proof of Document of Registration Charges Paid","Proof of Document of Road Tax Paid","Proof of Document of Road Tax Refund, if received any","Certified copy of FIR and copy of the acceptance by the court of the final police report (in case of theft)"],"declarations":["The insured warrants the truth of the statements and agrees that any false or fraudulent statement or concealment of material fact will void the policy and forfeit all rights to recover."],"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/862-invoice-protect-add-on-to-two-wheeler-package-policy-claim-form"}