{"id":927,"title":"National Drone Insurance Policy CLAIM FORM","purpose":"claim","insurer":{"slug":"national-insurance","name":"National Insurance Company Limited"},"source_pdf":"https://nationalinsurance.nic.co.in/sites/default/files/2026-09/Drone%20Claim%20Form%20%28Retail%29.pdf","sha256":"86af22886962e8fc090c0a61dc3e3147817d9d1375532a1e87d12aae6ddba11e","pages":4,"collected":"2026-10-17","instructions":{"about":"This form is used by the insured or claimant to file a claim under the National Drone Insurance Policy for losses related to drone damage, legal liability, personal accident, or medical expenses.","notes":["The issue of this form is not to be considered as an Admission of Liability.","Attach weather report if weather caused the accident.","Attach medical certificate for death or permanent total disability claims.","Submit detailed estimates for damage to buildings and contents.","Protect salvage from deterioration without removing debris until permission is given."],"title":"National Drone Insurance Policy CLAIM FORM","submit":{"to":"","how":"","address":""},"purpose":"claim","sections":[{"title":"Insured and Claimant Details","fields":[{"help":"","type":"text","label":"Name of the Insured:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Policy No.:","options":[],"required":null,"pdf_field":""},{"help":"Include phone number and email","type":"text","label":"Address of the Insured (with phone/email):","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Broker /Agency Code:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Name of the Claimant/Registered owner","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Address of the claimant/registered owner","options":[],"required":null,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Claim Details","fields":[{"help":"Select the applicable section(s) for the claim","type":"choice","label":"Please mention the section under which loss has been claimed?","options":["Section I: Physical damage to Drone Hull","Section II: Legal Liability to Third party","Section III: Personal Accident cover to operator","Section IV: Medical expenses","Optional covers"],"required":null,"pdf_field":""},{"help":"Provide date, time (hour and part of day), and place of loss","type":"text","label":"Date, Time & Place of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Date and mode of claim intimation","type":"text","label":"Date of Claim Intimation/Mode:","options":[],"required":null,"pdf_field":""},{"help":"Describe the loss briefly","type":"text","label":"Brief Description of Loss:","options":[],"required":null,"pdf_field":""},{"help":"Enter amount in rupees","type":"amount","label":"Amount of Loss:","options":[],"required":null,"pdf_field":""}],"filled_by":"claimant"},{"title":"Other Insurance Details","fields":[{"help":"Provide details of other insurance policies if any","type":"text","label":"Do you have any other policies covering the same incident? If yes, please give details of insurer, policy no., etc.","options":[],"required":null,"pdf_field":""}],"filled_by":"claimant"},{"title":"Section I: Physical Damage to Drone Hull","fields":[{"help":"Provide drone registration and identification details","type":"text","label":"Drone Registration number, make, model, serial no.","options":[],"required":null,"pdf_field":""},{"help":"Describe the work or purpose when accident occurred","type":"text","label":"Nature of work/purpose at time of accident","options":[],"required":null,"pdf_field":""},{"help":"Provide permit details if applicable","type":"text","label":"Valid permit details of the work","options":[],"required":null,"pdf_field":""},{"help":"Describe weather conditions during flight","type":"text","label":"Flight Visibility, temperature, wind direction","options":[],"required":null,"pdf_field":""},{"help":"Attach weather report if weather caused accident and state if briefing was obtained","type":"yes-no","label":"If weather was involved in accident, please attach weather report. State if weather briefing was obtained?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Describe any mechanical failures and last maintenance details","type":"text","label":"Mechanical failure/malfunctions. Details of last maintenance/overhaul of drone involved in accident","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Did fire follow impact?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Any Third party loss?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Tick all applicable parts where failure occurred","type":"checkbox","label":"Failure occurred in Structure, Engine, Propeller, Accessories/equipment","options":["Structure","Engine","Propeller","Accessories/equipment"],"required":null,"pdf_field":""},{"help":"Provide pilot/operator name and address","type":"text","label":"Pilot/Operator Information: a. Name and address","options":[],"required":null,"pdf_field":""},{"help":"Provide licence number and validity period","type":"text","label":"Pilot/operator licence no. and validity","options":[],"required":null,"pdf_field":""},{"help":"Provide UAV training date and location","type":"text","label":"Date and place of UAV training","options":[],"required":null,"pdf_field":""},{"help":"Describe total loss and repair loss","type":"text","label":"Total Loss and repair Loss","options":[],"required":null,"pdf_field":""},{"help":"Provide estimated repair cost in rupees","type":"amount","label":"Total Estimated repair cost.","options":[],"required":null,"pdf_field":""}],"filled_by":"claimant"},{"title":"Section II: Legal Liability to Third Party","fields":[{"help":"Provide name and address of third party/parties","type":"text","label":"Name of the Third Party/parties Address of Third party/parties","options":[],"required":null,"pdf_field":""},{"help":"Tick applicable nature of third party loss","type":"checkbox","label":"Nature of TP Loss A. Property damage B. Physical injury/Loss of Life","options":["Property damage","Physical injury/Loss of Life"],"required":null,"pdf_field":""},{"help":"Provide details of policy limits if applicable","type":"text","label":"Any one Accident/Any One Year Limit under the policy.","options":[],"required":null,"pdf_field":""},{"help":"Provide date and nature of legal notice or suit","type":"text","label":"Date of receipt of legal notice & Nature of suit case","options":[],"required":null,"pdf_field":""},{"help":"Describe loss claimed by third party","type":"text","label":"Details of loss claimed by third party","options":[],"required":null,"pdf_field":""},{"help":"Provide details of suit and amount claimed","type":"text","label":"Details of any suit filed and Amount of loss claimed","options":[],"required":null,"pdf_field":""}],"filled_by":"claimant"},{"title":"Section III: Personal Accident cover to Operator","fields":[{"help":"Provide operator or claimant name and age","type":"text","label":"Name of the operator along with age/name of the claimant.","options":[],"required":null,"pdf_field":""},{"help":"Provide contact address and phone number","type":"text","label":"Address of communication along with phone no.","options":[],"required":null,"pdf_field":""},{"help":"Provide licence details","type":"text","label":"Details of licence","options":[],"required":null,"pdf_field":""},{"help":"Provide sum insured amount","type":"amount","label":"Capital Sum Insured","options":[],"required":null,"pdf_field":""},{"help":"Indicate if death or disability and attach medical certificate","type":"yes-no","label":"Death or Permanent Total Disability? Please attach medical certificate.","options":["Death","Permanent Total Disability","No"],"required":null,"pdf_field":""},{"help":"Provide FIR or police complaint details","type":"text","label":"Details of police compliant/FIR","options":[],"required":null,"pdf_field":""},{"help":"Provide nominee or legal heir name","type":"text","label":"Name of Nominee/Legal Heir for death case","options":[],"required":null,"pdf_field":""}],"filled_by":"claimant"},{"title":"Section IV: Medical Expenses to authorised operator","fields":[{"help":"Provide hospital or nursing home name","type":"text","label":"Name of Hospital/Nursing home","options":[],"required":null,"pdf_field":""},{"help":"Provide hospitalization date","type":"date","label":"Date of hospitalization","options":[],"required":null,"pdf_field":""},{"help":"Provide amount spent on medical expenses","type":"amount","label":"Amount of expenditure incurred","options":[],"required":null,"pdf_field":""},{"help":"Provide sum insured amount","type":"amount","label":"Sum Insured","options":[],"required":null,"pdf_field":""},{"help":"Provide details of any other mediclaim policy","type":"text","label":"Existence of any mediclaim policy? If yes, please provide details.","options":[],"required":null,"pdf_field":""}],"filled_by":"claimant"},{"title":"Declaration and Signature","fields":[{"help":"Fill your name, address and claim amount","type":"text","label":"I/We................................. now residing at............................. do hereby declare that the above is a full, true and accurate statement and that the articles mentioned on the other side, being my property and issued under above numbered Policy or Policies were accidently destroyed or damaged without any design or procurement on my part by the aforesaid loss. According to the extent and value annexed; I further declare that I had not entered into any contract to sell or dispose of the said property where for I claim from the company, the sum of Rs.............","options":[],"required":true,"pdf_field":""},{"help":"Provide witness name","type":"text","label":"Witness:","options":[],"required":null,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date:","options":[],"required":null,"pdf_field":""},{"help":"Sign the form","type":"signature","label":"Signature of Claimant:","options":[],"required":true,"pdf_field":""}],"filled_by":"claimant"},{"title":"Detailed Statement of Property destroyed or damaged under section II","fields":[{"help":"Fill columns: Sl. No, Articles destroyed or damaged, Value of Property of Articles damaged or destroyed at the time of the fire, Value of Salvage, Amount Claimed i.e. Actual loss after deduction of Salvage value","type":"table","label":"Detailed Statement of Property destroyed or damaged under section II","options":[],"required":null,"pdf_field":""}],"filled_by":"claimant"}],"deadlines":[],"applies_to":"Claims under National Drone Insurance Policy covering physical damage, legal liability, personal accident, medical expenses, and optional covers","attachments":["Weather report if weather involved in accident","Medical certificate for death or permanent total disability","Detailed estimate by a builder or competent person for destruction or damage to buildings","Detailed statement of various articles claimed for destruction or damage to contents"],"declarations":["The claimant declares the information given is full, true and accurate.","The claimant declares the property was accidently destroyed or damaged without any design or procurement.","The claimant declares no contract to sell or dispose of the property was entered into before claiming.","The issue of this form is not an admission of liability by the company."],"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/927-national-drone-insurance-policy-claim-form"}