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  #2  
April 15th, 2017, 10:26 AM
Super Moderator
 
Join Date: Mar 2012
Re: Claim Form National Insurance Company

As you Asking for the Application form for the Motor Claim of the National Insurance Company the Application form Contains the Following Fields

1. THE INSURED
a) Name in full
__________________________________________________ ________________________________
b) Address for Correspondence
__________________________________________________ ___________________
c) Telephone Number, if any _______________________________________________


2. THE I NSURED VEHI CLE
a) Particulars of Vehicle
__________________________________________________ ________________________

b) Was the vehicle in proper working condition ?

c) For what purpose was the vehicle being used at
the time of accident ?

d) Was a trailer attached ?

The following additional information is required in case of M

e) Was a side Car attached ?

f) Was a pillion rider carried ?
The following additional questions need to be answered in ca

g) Registered laden weight :
_________________________________________________
h) Unladen weight :
_________________________________________________


i) Weight of goods carried :
__________________________________________________ _____
j) Nature of Permit :
__________________________________________________ _____
k) Nature of goods carried :
__________________________________________________ _____
l) Was the vehicle plying for hire :
____________________________
m) Number of passengers carried :
__________________________________________________ _____
n) Number of passengers permitted :
__________________________________________________ _____


Application form for the Motor Claim of the National Insurance Company







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