Claim Notification Form
First notice of loss — report the incident fast, with the details an insurer needs to open a file.
A ready-to-use finance, insurance & tax form for advisers, brokers and finance teams: 14 questions, 2 pages, 4 conditional rules.
- Questions
- 14
- Pages
- 2
- Layouts
- classic · card
- Conditional rules
- 4
Searches this template answers
- claim notification form
- claim form
- insurance claim notification
- notification of claim
- first notice of loss form
- incident claim form
Also filed under
Live preview and test console
This is the real form. Answer it to test the 2 conditional rules — nothing is sent or stored.
Page 1 of 2 — The incident
Every question on this page is currently visible.
Compliance checklist
- Payment items priced — passingEvery payment question charges a real amount, so a submission always records a payment.
- Conditional logic resolves — passingEvery rule points at a question or page that exists in this template.
- Financial disclaimer present — passingThis form does not provide financial, tax or legal advice. Any figures shown are indicative only and are not an offer of credit or a guarantee of terms. Please seek advice from a regulated adviser before making a decision.
- Question labels unique — passingLogic and exports address questions by label, so duplicates are ambiguous.
What happens after submit: nothing is stored in this preview. On your own copy, every response triggers an instant email notification and lands in your response dashboard, ready to export or forward.
Happy with it? Take a copy into your workspace — every question, rule and setting comes with it.
Who this template is for
Claim Notification Form 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 14 questions across 2 screens.
- Mobile-heavy audiences, thanks to the one-question-per-screen card layout.
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.
- 7 questions are required, so submissions arrive complete instead of needing a follow-up email.
- It captures a phone number for urgent follow-up.
- It accepts a document or photo upload as evidence.
- 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.
- Conditional logic hides 4 questions until they are relevant — shorter forms convert better than long ones.
- Splitting the form across 2 pages keeps each screen short and shows respondents how much is left.
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 Claim Notification Form 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 — 4 conditional rules ship with it.
- Features advanced show logic: if “Was anyone injured?” is Yes, the form dynamically exposes “Injury details”. Otherwise that question never appears.
- Features conditional validation: if “Was anyone injured?” is Yes, “Injury details” becomes mandatory before the form can be sent.
- Features advanced show logic: if “Were police or emergency services involved?” is Yes, the form dynamically exposes “Crime or incident reference”. Otherwise that question never appears.
- Features conditional validation: if “Type of loss” is Other, “What happened?” becomes mandatory before the form can be sent.
- All 4 rules are editable in the Logic tab, and the built-in checker warns about rules that contradict each other.
About this template
A claim notification is the phone call that used to happen at eight in the morning, written down properly. Its job is speed: capture the policyholder, the policy number, when and where the loss happened, what type of loss it was and what actually occurred, then get a file open and a reference issued. Page two covers the three facts that change how a claim is handled from the outset — whether anyone was injured, whether police or emergency services attended, and roughly what the loss is worth — plus a contact number a handler can ring back on. It is deliberately not the same form as the Insurance Claim Submission template, which is the full documented claim: schedules of loss, receipts, repair quotes, third-party details and a signed declaration. Notification is the first report; submission is the evidenced case built afterwards. Running both means nothing waits on paperwork that has not been gathered yet. Three rules keep the form honest: an injury opens a required injury-details question, police involvement opens the crime reference field, and choosing an unusual loss type forces a written description rather than a shrug.
What this form asks
Every question is editable — rename it, make it optional, or delete it entirely.
Page 1 — The incident
- Policyholder namerequired
- Policy numberrequired
- Date of incidentrequired
- Time of incident
- Location of the incident
- Type of lossrequired
- What happened?required
Page 2 — Details & contact
- Was anyone injured?required
- Injury details
- Were police or emergency services involved?
- Crime or incident reference
- Photos or documents
- Estimated loss value
- Best contact phonerequired
14 questions in total.
How the form changes as it's filled in
This template ships with 4 conditional rules, grouped into 4 behaviours driven by 3 questions. Everything below is already set up — edit or delete any rule once the template is in your workspace.
Driven by “Was anyone injured?”
- Reveals questions
If “Was anyone injured?” is Yes, the form reveals “Injury details”.
- Makes answers required
If “Was anyone injured?” is Yes, “Injury details” becomes required before the form can be submitted.
Driven by “Were police or emergency services involved?”
- Reveals questions
If “Were police or emergency services involved?” is Yes, the form reveals “Crime or incident reference”.
Driven by “Type of loss”
- Makes answers required
If “Type of loss” is Other, “What happened?” becomes required before the form can be submitted.
Set it up step by step
- 1
Put your policy wording behind it
Add one line on the cover confirming that notifying a claim is not an admission of liability and does not commit the insurer to cover.
- 2
Route by loss type
Send motor notifications to the motor desk and property to property using the loss-type answer, so the first handler is the right handler.
- 3
Issue a reference automatically
Use the confirmation email to send back a claim reference so the claimant has something to quote before anyone rings them.
- 4
Chase documents separately
Follow up with the full submission form rather than bloating this one — notification speed is the whole point.
- 5
Review the loss-value field weekly
Estimated values are rough by design; use them for reserving triage, not for reporting.
Mistakes to avoid
- Asking for evidence, valuations and repair quotes at first notice — the file needs opening today, and documents can follow.
- Leaving the time of the incident optional on motor and liability losses, where the hour decides which policy period and which witness account applies.
- Not capturing a crime or incident reference when the police attended, which delays every later conversation with the insurer.
What it pairs with
Most teams don't run this form on its own. These are the forms and systems it sits next to.
What to do with the responses
Acknowledge the notification the same working day with a claim reference, then send the claimant the full Insurance Claim Submission form to gather documents, valuations and the signed declaration.
Works in both layouts
Forms that overlap this one
These pages cover the same subject ground as the claim notification form, matched on the words people actually search for.
Insurance Claim Submission
accountingapplicationbrokerclaimclient
Credit Card Authorization Form
accountingapplicationclaimclientcredit
EIN Application Details Form
accountingapplicationclaimclientcredit
Insurance Quote Request Form
accountingapplicationbrokerclaimclient
Affiliate Payout Details
accountingapplicationclaimclientcredit
Business Formation Intake Form
accountingapplicationclaimclientcredit
Privacy & compliance
This form collects identity or financial details. Enable encrypted answers on the sensitive fields, avoid emailing full values in notifications, and delete responses once the check is complete.
Frequently asked questions
How is this different from the Insurance Claim Submission form?
This is first notice of loss: the fast initial report that opens a file. The submission form is the full documented claim with evidence, valuations and a declaration, sent once the file exists.
Should the estimated loss value be required?
No. At notification most people are guessing, and forcing a number produces bad data. Keep it optional and refine it at submission.
Can claimants upload photos here?
Yes — the file question accepts photos taken at the scene, which are often the best evidence anyone will ever get of the incident.
Does this form decide whether a claim is covered?
No. It records what happened so a handler can assess cover. Nothing on the form is a coverage decision or an admission of liability.
Is the Claim Notification Form template free to use?
Yes. You can preview and test Claim Notification Form 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 Claim Notification Form template ask for?
It asks 14 questions across 2 pages, 7 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 Claim Notification Form form after copying it?
Yes — the copy is entirely yours. Change wording, add or remove questions, switch between the classic and card layouts, 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?
4 conditional rules ship with the template: Features advanced show logic: if “Was anyone injured?” is Yes, the form dynamically exposes “Injury details”. Otherwise that question never appears. Features conditional validation: if “Was anyone injured?” is Yes, “Injury details” becomes mandatory before the form can be sent. Features advanced show logic: if “Were police or emergency services involved?” is Yes, the form dynamically exposes “Crime or incident reference”. Otherwise that question never appears. All rules are editable in the Logic tab.
Where do responses to the Claim Notification Form 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 Claim Notification Form 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.
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