{"id":930,"title":"Navi Bharat Griha Raksha Policy Insurance Claim Form","purpose":"claim","insurer":{"slug":"navi-general-insurance","name":"Navi General Insurance Limited"},"source_pdf":"https://public-navi-docs.s3.ap-south-1.amazonaws.com/NaviInsurance/NaviBharatGrihaRakshaPolicy/2020-2021/January/NaviBharatGrihaRakshaPolicy%20Claim%20Form.pdf","sha256":"30b339b962ed44e35439dd094953d9ea70c791aea2b567008200023bc0dd1790","pages":1,"collected":"2026-10-17","instructions":{"about":"This form is for the policyholder or claimant to report and claim for loss or damage under the Navi Bharat Griha Raksha insurance policy.","notes":["Fill the form completely.","Issue of the form is not admission of liability."],"title":"Navi Bharat Griha Raksha Policy Insurance Claim Form","submit":{"to":"Navi General Insurance Limited","how":"","address":"E: insurance.help@navi.com"},"purpose":"claim","sections":[{"title":"Details of Policy Holder","fields":[{"help":"","type":"text","label":"Policy No.:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"CLAIM No.:","options":[],"required":null,"pdf_field":""},{"help":"Enter start and end date of insurance period","type":"date","label":"Period of Insurance: FROM   D D /  M M /  Y Y Y Y    to   D D /  M M /  Y Y Y Y","options":[],"required":null,"pdf_field":""},{"help":"Full name of the insured or claimant","type":"text","label":"Insured / CLAIMANT’S NAME:","options":[],"required":null,"pdf_field":""},{"help":"Full postal address","type":"text","label":"Address:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"City:","options":[],"required":null,"pdf_field":""},{"help":"6 digit postal code","type":"number","label":"Pin Code:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"State:","options":[],"required":null,"pdf_field":""},{"help":"Mobile phone number","type":"phone","label":"Mobile No.:","options":[],"required":null,"pdf_field":""},{"help":"Optional landline number","type":"phone","label":"Landline No.:","options":[],"required":false,"pdf_field":""},{"help":"Email address","type":"email","label":"EMAIL ID:","options":[],"required":false,"pdf_field":""},{"help":"If applicable, details of mortgagee(s)","type":"text","label":"Details of Mortgagee(s):","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder/claimant"},{"title":"Loss Details","fields":[{"help":"Date and time when the loss occurred","type":"date","label":"Date of Loss:   D D /  M M /  Y Y Y Y   TIME of Loss:  H H / M M  AM/PM","options":[],"required":true,"pdf_field":""},{"help":"Location where the loss happened","type":"text","label":"Loss Location:","options":[],"required":true,"pdf_field":""},{"help":"Brief description of the loss or damage","type":"text","label":"Description of Loss:","options":[],"required":true,"pdf_field":""},{"help":"List damaged items with description and amount claimed; columns: S. No., Description of Damaged Item, Amount Claimed","type":"table","label":"Items affected","options":[],"required":null,"pdf_field":""},{"help":"Select if the premises were unoccupied at time of loss","type":"yes-no","label":"Were the PREMISE unoccupied at the TIME of loss:","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Date or duration since premises were unoccupied","type":"text","label":"If Yes, then since when it was unoccupied:","options":[],"required":false,"pdf_field":""},{"help":"Indicate if any injury or death occurred","type":"yes-no","label":"Any Injury/Death:","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Name of injured or deceased person if applicable","type":"text","label":"NAME of Injured/Deceased Person:","options":[],"required":false,"pdf_field":""},{"help":"Relationship to the insured person","type":"text","label":"Relationship with Insured:","options":[],"required":false,"pdf_field":""},{"help":"Address for inspection of loss","type":"text","label":"Address where the inspection can be carried out:","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder/claimant"},{"title":"Police & Fire Brigade Details","fields":[{"help":"Indicate if police report was filed","type":"yes-no","label":"Police report lodged:","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Police report number","type":"text","label":"If Yes, Report No.:","options":[],"required":false,"pdf_field":""},{"help":"Date of police report","type":"date","label":"Date: D D / M M / Y Y Y Y","options":[],"required":false,"pdf_field":""},{"help":"Name of police station","type":"text","label":"Police Station:","options":[],"required":false,"pdf_field":""},{"help":"District of police station","type":"text","label":"District:","options":[],"required":false,"pdf_field":""},{"help":"Indicate if fire brigade was informed","type":"yes-no","label":"Fire Brigade INTIMATION:","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Details of fire brigade report","type":"text","label":"If Yes, Report Details:","options":[],"required":false,"pdf_field":""},{"help":"Place where form is signed","type":"text","label":"Place:","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder/claimant"},{"title":"Other Insurance Details","fields":[{"help":"Indicate if any other insurance covers the loss","type":"yes-no","label":"Is the loss covered under any other insurance policy:","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details: S. No., Name & Address of Insurance Company, Policy No., From, To, Sum Insured (Rs)","type":"table","label":"If Yes, then give the details below","options":[],"required":false,"pdf_field":""}],"filled_by":"policyholder/claimant"},{"title":"Declaration","fields":[{"help":"Date of signing declaration","type":"date","label":"Date: D D / M M / Y Y Y Y","options":[],"required":true,"pdf_field":""},{"help":"Signature of insured or company seal","type":"signature","label":"Signature of Insured (Company’s seal in case the insured is a firm/company)","options":[],"required":true,"pdf_field":""}],"filled_by":"policyholder/claimant"}],"deadlines":[],"applies_to":"claims under Navi Bharat Griha Raksha Policy","attachments":["Police report if lodged","Fire brigade report if intimated","Supporting documents for damaged items claimed"],"declarations":["The information provided is true to the best of my knowledge and belief.","False or fraudulent statements will void the policy and forfeit claim rights.","The company may verify facts and documents related to the claim.","Consent is given to the company to collect, retain, and share personal and sensitive information for servicing the policy and claim.","I will inform the company to update or correct my information as needed.","I understand that withdrawing consent may result in the company not providing services."],"dropped_labels":0},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"insurance.help@navi.com","label":"Claims intimation","level":1,"hours":null,"applies_to":"all","source_url":"https://public-navi-docs.s3.ap-south-1.amazonaws.com/NaviCommercialVehicleLiabilityOnlyInsurance%20CIS.pdf","quote":"own damage claim\n12 | Policy Servicing Claim Intimation and Processing | 1. Call Us: Toll Free 1800 123 0004 2. Email: insurance.help@navi.com 3. Email for Senior Citizens- seniorcare@navi.com 4. Visit our website: https://www.naviinsurance.com/service/ 5. Walk","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"seniorcare@navi.com","label":"Email for Senior Citizens","level":1,"hours":null,"applies_to":"all","source_url":"https://public-navi-docs.s3.ap-south-1.amazonaws.com/NaviCommercialVehicleLiabilityOnlyInsurance%20CIS.pdf","quote":"on and Processing | 1. Call Us: Toll Free 1800 123 0004 2. Email: insurance.help@navi.com 3. Email for Senior Citizens- seniorcare@navi.com 4. Visit our website: https://www.naviinsurance.com/service/ 5. Walk in for assistance 6. Dispatch your letters to us a","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 123 0004","label":"Toll Free","level":1,"hours":null,"applies_to":"all","source_url":"https://public-navi-docs.s3.ap-south-1.amazonaws.com/NaviCommercialVehicleLiabilityOnlyInsurance%20CIS.pdf","quote":"nses - paid amount under own damage claim\n12 | Policy Servicing Claim Intimation and Processing | 1. Call Us: Toll Free 1800 123 0004 2. Email: insurance.help@navi.com 3. Email for Senior Citizens- seniorcare@navi.com 4. Visit our website: https://www.n","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"url","value":"https://www.naviinsurance.com/service/","label":"Customer Portal on website","level":1,"hours":null,"applies_to":"all","source_url":"https://public-navi-docs.s3.ap-south-1.amazonaws.com/NaviCommercialVehicleLiabilityOnlyInsurance%20CIS.pdf","quote":"1800 123 0004 2. Email: insurance.help@navi.com 3. Email for Senior Citizens- seniorcare@navi.com 4. Visit our website: https://www.naviinsurance.com/service/ 5. Walk in for assistance 6. Dispatch your letters to us at – Corporate Office: Navi General Insurance Limited, Vaishna","fetched_at":"2026-10-20"}],"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/navi-general-insurance/930-navi-bharat-griha-raksha-policy-insurance-claim-form"}