Insurance Claim Submission — shared by the community
Priya N. shared this 16-question build with 3 conditional rules already wired up. Test it below, then take a copy.
A ready-to-use finance, insurance & tax form for advisers, brokers and finance teams: 16 questions, 2 pages, 3 conditional rules.
- Shared by
- Priya N. · Operations lead
- Questions
- 16
- Replies
- 3
- Copies taken
- 56
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Live preview and test console
This is the real form. Answer it to test the flow — nothing is sent or stored.
Page 1 of 2 — Policyholder
This template runs as a straight sequence — no branching rules.
Works for you? Take Priya N.'s copy into your own workspace — questions, rules and settings included.
Who this template is for
Insurance Claim Submission is built for advisers, brokers and finance teams who need to collect structured financial detail with a clear audit trail.
- Advisers, brokers and finance teams working in finance, insurance & tax.
- Teams who need to collect structured financial detail with a clear audit trail without writing code or paying for a custom build.
- Anyone replacing incomplete applications that fail compliance review with one structured record per enquiry.
- Respondents are clients and applicants — the form asks them 16 questions across 2 screens.
Why this form is useful
It removes the cost of incomplete applications that fail compliance review and turns each submission into a record your team can act on immediately.
- 9 questions are required, so submissions arrive complete instead of needing a follow-up email.
- It collects a verified email address so replies and confirmations land.
- It captures a phone number for urgent follow-up.
- It accepts a document or photo upload as evidence.
- It records a signature you can keep as proof of agreement.
- It pins the request to a specific date.
- It captures a full postal address.
- It captures a numeric value you can filter and sort on.
How to use this template
From copy to live form is a few minutes of work, and every step is reversible.
- 1Press “Use this template” — a fresh copy of Insurance Claim Submission lands in your workspace, ready to edit.
- 2Rename or delete any question, and change what is required. Nothing here is fixed.
- 3Open Notifications and add the email addresses that should be alerted on each submission; add an auto-reply to the respondent if the form collects an email address.
- 4Check the upload limits on the file question so respondents can attach what you actually need.
- 5Publish it, then either share the link directly or paste the embed snippet into your site — the embedded form resizes to fit and loads no marketing or advertising trackers.
- 6Watch responses land in Submissions, where you can filter, label and export them to CSV or PDF.
Logic and conditions blueprint
Exactly how this form behaves as it is answered — 3 conditional rules ship with it.
- Features conditional validation: if “Have the authorities been informed?” is Yes, “Crime or incident reference number” becomes mandatory before the form can be sent.
- Features conditional validation: if “Was anyone injured?” is Yes — hospital treatment, “Upload photos, receipts or reports” becomes mandatory before the form can be sent.
- Features conditional validation: if “Type of cover” is Motor, “Where did it happen?” becomes mandatory before the form can be sent.
- All 3 rules are editable in the Logic tab, and the built-in checker warns about rules that contradict each other.
What this form asks
Page 1 — Policyholder
- Policyholder namerequired
- Email addressrequired
- Phone number
- Policy numberrequired
- Type of coverrequired
Page 2 — The incident
- Date of incidentrequired
- Approximate time
- Where did it happen?
- Describe what happenedrequired
- Estimated value of the loss
- Was anyone injured?required
- Have the authorities been informed?
- Crime or incident reference number
- Upload photos, receipts or reports
- Agreementrequired
- Signaturerequired
Conditional logic in this build
- When “Have the authorities been informed?” is Yes, require “Crime or incident reference number”.
- When “Was anyone injured?” is Yes — hospital treatment, require “Upload photos, receipts or reports”.
- When “Type of cover” is Motor, require “Where did it happen?”.
Questions about this shared form
What is a first notice of loss form?
The first structured record of a claim: who is claiming, under which policy, what happened, what it is worth and what evidence exists. It starts the clock and the file.
Can claimants upload photographs?
Yes — photos, receipts and reports attach to the submission so the evidence stays with the account.
Can we route by claim type?
Yes. Route on the type of cover so motor, home and travel claims reach different handlers automatically.
Is the declaration legally binding?
It is a dated signed statement, which is what a claim file needs. Use your own approved wording rather than the sample.
Is the Insurance Claim Submission template free to use?
Yes. You can preview and test Insurance Claim Submission on this page without an account, and take a copy into your own HelloForms workspace on the free plan. There is nothing to install and no card required to publish it.
What does the Insurance Claim Submission template ask for?
It asks 16 questions across 2 pages, 9 of which are required. Every question is listed in full further down this page, and each one can be renamed, reordered, made optional or deleted after you copy the template.
Can I edit the Insurance Claim Submission form after copying it?
Yes — the copy is entirely yours. Change wording, add or remove questions, switch between the classic layout, restyle it to match your brand, and set who gets notified on each submission.
How does the conditional logic in this finance, insurance & tax form work?
3 conditional rules ship with the template: Features conditional validation: if “Have the authorities been informed?” is Yes, “Crime or incident reference number” becomes mandatory before the form can be sent. Features conditional validation: if “Was anyone injured?” is Yes — hospital treatment, “Upload photos, receipts or reports” becomes mandatory before the form can be sent. Features conditional validation: if “Type of cover” is Motor, “Where did it happen?” becomes mandatory before the form can be sent. All rules are editable in the Logic tab.
Where do responses to the Insurance Claim Submission form go?
Submissions land in your workspace under Submissions, where you can search, filter, label and export them to CSV or PDF. You can also email a notification to your team on every submission and send the respondent an auto-reply.
Can I embed the Insurance Claim Submission form on my own website?
Yes. Publish the form and paste the embed snippet into any page or share the direct link. The embedded form resizes to fit its container and loads no advertising or marketing trackers inside the iframe.
Can respondents upload files?
Yes. This template includes a file upload question, so respondents can attach documents or photos with their answers. You can adjust the accepted file types and size limits on that question.
Is the signature on this form legally usable?
The template captures a drawn signature and stores it with the submission, along with the timestamp, so you keep evidence of who agreed and when. Whether that is sufficient depends on your jurisdiction and the agreement itself.
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