{"id":871,"title":"National Invoice Protect (Applicable to Private Car) 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/National%20Invoice%20Protect-PC-Claim%20Form.pdf","sha256":"1970326520534f35999253b70f3733add0d69d8c3f1385c1f701337338ded9f1","pages":1,"collected":"2026-10-17","instructions":{"about":"This form is for policyholders to claim under the National Invoice Protect add-on for private car insurance policies.","notes":[],"title":"National Invoice Protect (Applicable to Private Car) Claim Form","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Insured Details","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":"Contact Number","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Policy Details","fields":[{"help":"","type":"text","label":"Policy No","options":[],"required":null,"pdf_field":""},{"help":"Enter start and end date of insurance period","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","Purchase Invoice copy"],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Declaration by Insured","fields":[{"help":"","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"","type":"signature","label":"Signature of the Insured","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"}],"deadlines":[],"applies_to":"National Invoice Protect Add-on (Applicable to Private Car)","attachments":["Duly filled and signed claim form","Purchase Invoice copy","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 made in this form to the best of their knowledge and belief.","If any false or fraudulent statement or concealment of material fact is made, the policy shall be void and all rights to recover under it shall be forfeited."],"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/871-national-invoice-protect-applicable-to-private-car-claim-form"}