{"id":1707,"title":"Key Feature Document Cum Proposal Form","purpose":"proposal","insurer":{"slug":"indiafirst-life-insurance","name":"IndiaFirst Life Insurance Company Limited"},"source_pdf":"https://www.indiafirstlife.com/content/dam/ifliwebsite/in/en/download-center/all-product-related-documents/withdrawn-products/indiafirst-life-pos-cash-back-plan-app-form.pdf","sha256":"da9c9c2539973abd416c5c15363e962d1b62e919672d7880bc0e89cae93e4d7d","pages":5,"collected":"2026-10-17","instructions":{"about":"This form is a proposal form for the IndiaFirst Life POS Cash Back Plan, to be filled by the proposer or life to be assured to apply for the insurance policy.","notes":["Use latest photograph.","If life to be assured cannot read or understand the language, help from a person other than advisor or employee may be used.","Fill all details completely including email and mobile number.","Do not hand over premium to insurance advisors; pay directly at nearest branch.","Encashment of cheque/DD does not mean policy approval; company may call for additional requirements.","Policy may lapse if premiums are not paid as per terms; revival possible within two years.","Policy available without medicals based on declaration of good health.","Signature authentication is done via OTP sent to registered mobile number.","Attach cancelled cheque copy for payout mode selection.","Section 45 of Insurance Act applies to policy contestability and claims."],"title":"Key Feature Document Cum Proposal Form","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Plan Details","fields":[{"help":"","type":"choice","label":"Policy Term","options":["9","12","15"],"required":null,"pdf_field":""},{"help":"","type":"choice","label":"Premium Payment Term","options":["5","7","10"],"required":null,"pdf_field":""},{"help":"","type":"amount","label":"Sum Assured","options":[],"required":null,"pdf_field":""},{"help":"","type":"amount","label":"Installment Premium","options":[],"required":null,"pdf_field":""},{"help":"","type":"choice","label":"Premium Frequency","options":[],"required":null,"pdf_field":""}],"filled_by":""},{"title":"Proposer / Policy Owner Details","fields":[{"help":"Select title and enter full name","type":"text","label":"Name","options":["Mr.","Ms.","Mx."],"required":true,"pdf_field":""},{"help":"Full postal address","type":"text","label":"Address","options":[],"required":true,"pdf_field":""},{"help":"DD/MM/YYYY format","type":"date","label":"Date of Birth","options":[],"required":true,"pdf_field":""},{"help":"","type":"choice","label":"Gender","options":["Male","Female","Transgender"],"required":true,"pdf_field":""},{"help":"","type":"text","label":"State","options":[],"required":true,"pdf_field":""},{"help":"6 digit postal code","type":"number","label":"Pin","options":[],"required":true,"pdf_field":""},{"help":"Residential phone number","type":"phone","label":"Tel (Res)","options":[],"required":false,"pdf_field":""},{"help":"Mobile phone number","type":"phone","label":"Mobile","options":[],"required":true,"pdf_field":""},{"help":"Valid email address","type":"email","label":"Email","options":[],"required":true,"pdf_field":""},{"help":"12 digit Aadhaar number","type":"number","label":"Aadhaar Number","options":[],"required":true,"pdf_field":""},{"help":"LG code for Banca or Agent Code for Agency","type":"text","label":"LG / Agent Code","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"BDM/ RM Code","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Branch Code","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Channel Code","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Branch Manager Code","options":[],"required":false,"pdf_field":""},{"help":"","type":"phone","label":"BDM Mobile No.","options":[],"required":false,"pdf_field":""},{"help":"Specify channel","type":"text","label":"Bancassurance/ Agency/ Broker/ Corporate Agency/ Direct Sales/ Marketing Associate, Any Others (pls specify)","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Point of Sales Person Details","fields":[{"help":"12 digit Aadhaar number","type":"number","label":"Aadhaar Card Number","options":[],"required":false,"pdf_field":""},{"help":"PAN number","type":"text","label":"Pan Card Number","options":[],"required":false,"pdf_field":""},{"help":"Select title and enter full name","type":"text","label":"Name","options":["Mr.","Ms.","Mx."],"required":false,"pdf_field":""}],"filled_by":"point of sales person"},{"title":"Life to be Assured Details","fields":[{"help":"Select title and enter full name","type":"text","label":"Name","options":["Mr.","Ms.","Mx."],"required":true,"pdf_field":""},{"help":"Full postal address","type":"text","label":"Address","options":[],"required":true,"pdf_field":""},{"help":"DD/MM/YYYY format","type":"date","label":"Date of Birth","options":[],"required":true,"pdf_field":""},{"help":"","type":"choice","label":"Gender","options":["Male","Female","Transgender"],"required":true,"pdf_field":""},{"help":"","type":"text","label":"State","options":[],"required":true,"pdf_field":""},{"help":"6 digit postal code","type":"number","label":"Pin","options":[],"required":true,"pdf_field":""},{"help":"Residential phone number","type":"phone","label":"Tel (Res)","options":[],"required":false,"pdf_field":""},{"help":"Mobile phone number","type":"phone","label":"Mobile","options":[],"required":true,"pdf_field":""},{"help":"Valid email address","type":"email","label":"Email","options":[],"required":true,"pdf_field":""},{"help":"12 digit Aadhaar number","type":"number","label":"Aadhaar Number","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer or life to be assured"},{"title":"Nominee(s) Details","fields":[{"help":"Full name of nominee","type":"text","label":"Nominee(s) Name","options":[],"required":true,"pdf_field":""},{"help":"Share percentage of nominee","type":"number","label":"Percentage Share","options":[],"required":true,"pdf_field":""},{"help":"Date of birth of nominee","type":"date","label":"DOB of Nominee","options":[],"required":true,"pdf_field":""},{"help":"Relationship to proposer/life assured","type":"text","label":"Relationship of Nominee","options":[],"required":true,"pdf_field":""},{"help":"Name of appointee if nominee is minor","type":"text","label":"Appointee Name (if applicable)","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Benefit Payment Mode","fields":[{"help":"Choose only one mode","type":"choice","label":"Mode selected will be used by the Company to pay the proposer according to the terms of the plan. If none of the below electronic payout option is chosen, the Company reserves the right to use any alternative payout option.","options":["ECS","Direct Credit (Bank of Baroda)","NEFT"],"required":true,"pdf_field":""},{"help":"Name of bank for payout","type":"text","label":"Bank Name","options":[],"required":true,"pdf_field":""},{"help":"Select account type","type":"choice","label":"Account Type","options":["Current","Savings"],"required":true,"pdf_field":""},{"help":"Bank branch name","type":"text","label":"Branch Name","options":[],"required":true,"pdf_field":""},{"help":"Mandatory for ECS mode","type":"number","label":"MICR","options":[],"required":true,"pdf_field":""},{"help":"Mandatory for NEFT mode","type":"text","label":"IFSC Code","options":[],"required":true,"pdf_field":""},{"help":"Bank account number","type":"number","label":"Bank Account No.","options":[],"required":true,"pdf_field":""},{"help":"Name as per bank records","type":"text","label":"Customer’s Name as per the Bank Account.","options":[],"required":true,"pdf_field":""},{"help":"Attach cancelled cheque copy","type":"attachment","label":"Please provide a cancelled copy of your cheque if any of the above option is selected","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declarations and Signatures","fields":[{"help":"Consent for due diligence","type":"yes-no","label":"AML-eKYC declaration","options":[],"required":true,"pdf_field":""},{"help":"Consent to debit bank account for initial premium","type":"yes-no","label":"Direct Debit/ECS declaration","options":[],"required":true,"pdf_field":""},{"help":"","type":"signature","label":"Signature or Thumb Impression of the Life to be Insured","options":[],"required":true,"pdf_field":""},{"help":"Confirm health and truthfulness of information","type":"yes-no","label":"Declaration by the Life to be Assured","options":[],"required":true,"pdf_field":""},{"help":"Confirm OTP to authenticate signature","type":"yes-no","label":"Signature authentication: An OTP authentication number has been sent on your registered mobile number.","options":[],"required":true,"pdf_field":""},{"help":"Confirm OTP to accept product features","type":"yes-no","label":"Signature authentication (Single factor authentication): An OTP authentication number has been sent on your registered mobile number.","options":[],"required":true,"pdf_field":""},{"help":"Name of person signing","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Signature or thumb impression of witness","type":"signature","label":"Witness’s Signature or Thumb Impression","options":[],"required":true,"pdf_field":""},{"help":"Code of agent or company representative","type":"text","label":"Agent Code/ Company Representative ID","options":[],"required":false,"pdf_field":""},{"help":"","type":"signature","label":"Agent / Company Representative Signature","options":[],"required":false,"pdf_field":""}],"filled_by":"life to be assured / proposer"},{"title":"Declaration For Signing In Vernacular Or For Uneducated Persons","fields":[{"help":"Declarant confirms explanation of form contents to proposer","type":"text","label":"Vernacular Declaration by the person filling in the form","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Name of the Declarant","options":[],"required":true,"pdf_field":""},{"help":"","type":"signature","label":"Signature","options":[],"required":true,"pdf_field":""},{"help":"","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Address of the Declarant","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Name of the Declarant","options":[],"required":true,"pdf_field":""},{"help":"","type":"signature","label":"Signature","options":[],"required":true,"pdf_field":""},{"help":"","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Address of the Declarant","options":[],"required":true,"pdf_field":""}],"filled_by":"declarant"},{"title":"Insurance Repository Details","fields":[{"help":"Provide e-IA number and Insurance Repository name","type":"text","label":"Existing e - Insurance Account (e-IA) holder, please provide the e IA and IR name","options":[],"required":false,"pdf_field":""},{"help":"Select one repository if opening new account","type":"choice","label":"Open New e - Insurance Account - Please choose the repository from the below","options":["01. NSDL Database Management Limited","02. Central Insurance Repository Limited","04. Karvy Insurance Repository Limited","05. CAMS Repository Service Limited"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Intermediary Details","fields":[{"help":"","type":"text","label":"Name of the Intermediary","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"License Number","options":[],"required":true,"pdf_field":""},{"help":"","type":"signature","label":"Signature of the Agent / Specified Agents","options":[],"required":true,"pdf_field":""},{"help":"Stamp or seal of intermediary","type":"attachment","label":"Stamp of the Intermediary","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Name of the Agent / Specified Agents","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"License Code","options":[],"required":true,"pdf_field":""}],"filled_by":"agent or intermediary"}],"deadlines":["Free Look Period: 15 days for all channels except Distance Marketing or Electronic Mode where it is 30 days from receipt of your policy document"],"applies_to":"IndiaFirst Life POS Cash Back Plan","attachments":["Cancelled copy of your cheque if any electronic payout option is selected"],"declarations":["The proposer declares that all information provided is true, complete and correct and authorizes the company to verify health and other details.","The life to be assured declares good health and no history of specified diseases and understands consequences of misrepresentation.","Consent is given for AML-eKYC due diligence and direct debit of initial premium.","OTP authentication confirms acceptance of declarations and product features.","Declarations for vernacular or illiterate persons confirm explanation of form contents and attestation of thumb impression.","The proposer agrees to notify the company of any adverse change in health, occupation or financial condition before policy issuance.","The proposer understands that policy cover commences only after approval and receipt of premium.","The proposer declares that premium is not from proceeds of criminal activities."],"dropped_labels":3},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"customer-care","channel":"email","value":"customer.first@indiafirstlife.com","label":"Service Requests Email","level":null,"hours":"24x7","applies_to":"life","source_url":"https://www.indiafirstlife.com/hi/customer-service/grievance-redressal","quote":"सी (सवाल, अनुरोध और शिकायतें) सेक्शन पर जाएँ और अनुरोध/शिकायत करें।\nहमें ईमेल करें:\nजीवन बीमा पॉलिसी के लिए:\nईमेल आईडी:\ncustomer.first@indiafirstlife.com\nहमें कॉल करें:\nहमारे टोल फ़्री नंबर\n1800-209-8700\nपर सोमवार से शनिवार, सुबह 9 बजे से शाम 7 बजे के बीच कॉल करें।\nहमारे कि","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"1800 209 8700","label":"Customer Care Number","level":null,"hours":"Monday - Saturday, 9 AM - 9 PM","applies_to":"life","source_url":"https://www.indiafirstlife.com/hi/customer-service/grievance-redressal","quote":"रें\nव्हाट्सएप नंबर\n+91 22 6274 9898\nहमें कॉल करें\nसोमवार-शनिवार, सुबह 9 बजे से रात 9 बजे तक\nकर मुक्त नंबर\n(आईवीआर फ्लो)\n1800 209 8700\nकेवल भारत के बाहर से कॉल करने वालो के लिए\n+91 22 62749898\nहमें ईमेल करें\nहम आपकी मदद के लिए 24x7 उपलब्ध हैं\nसेवा अनुरोध","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"+91 22 62749898","label":"NRI Contact Number","level":null,"hours":"Monday - Saturday, 9 AM - 9 PM","applies_to":"life","source_url":"https://www.indiafirstlife.com/hi/customer-service/grievance-redressal","quote":"-शनिवार, सुबह 9 बजे से रात 9 बजे तक\nकर मुक्त नंबर\n(आईवीआर फ्लो)\n1800 209 8700\nकेवल भारत के बाहर से कॉल करने वालो के लिए\n+91 22 62749898\nहमें ईमेल करें\nहम आपकी मदद के लिए 24x7 उपलब्ध हैं\nसेवा अनुरोध\ncustomer.first@indiafirstlife.com\nदावों के लिए\nclaims.sup","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"8828840199","label":"Online Purchases Number","level":null,"hours":"Monday - Saturday, 9AM - 7PM","applies_to":"life","source_url":"https://www.indiafirstlife.com/hi/customer-service/grievance-redressal","quote":"वों के लिए\nclaims.support@indiafirstlife.com\nऑनलाइन खरीदारी\nसोमवार-शनिवार, सुबह 9 बजे से शाम 7 बजे तक\nऑनलाइन परचेज़ नंबर\n8828840199\nहमें लिखें\nइंडियाफर्स्ट लाइफ इंश्योरेंस कंपनी लिमिटेड\n12वीं और 13वीं मंजिल, उत्तरी [सी] विंग, टॉवर 4, नेस्को आईटी पार्क","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"+91 22 6274 9898","label":"WhatsApp Number","level":null,"hours":null,"applies_to":"life","source_url":"https://www.indiafirstlife.com/mr/customer-service/grievance-redressal","quote":"pport and grievance redressal process for timely solutions.\nChat on WhatsApp\nSpeak to our friendly team\nWhatsapp Number\n+91 22 6274 9898\nCall Us\nMonday - Saturday, 9 AM - 9 PM\nToll Free Number\n(IVR FLow)\n1800 209 8700\nConnect with our Advisor\nMonday-Saturd","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"address","value":"Customer Care\nIndiaFirst Life Insurance Company Ltd\n12th and 13th Floor, North [C] wing, Tower 4,\nNesco IT Park, Nesco Center, Western Express Highway,\nGoregaon (East), Mumbai – 400063","label":"Customer Care Address","level":1,"hours":null,"applies_to":"life","source_url":"https://www.indiafirstlife.com/customer-service/grievance-redressal","quote":"ere\nto contact our grievance redressal officers in your city.\nMAIL/COURIER:\nWrite to us at the address mentioned below:\nCustomer Care\nIndiaFirst Life Insurance Company Ltd\n12th and 13th Floor, North [C] wing, Tower 4,\nNesco IT Park, Nesco Center, Western Express Highway,\nGoregaon (East), Mumbai – 400063\nA communication giving reasons of either redressing or rejecting the grievance will be sent to you within 14 (Fourteen)","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"email","value":"customer.first@indiafirstlife.com","label":"For Life Insurance Policy","level":1,"hours":"Monday to Saturday between 9am to 7pm","applies_to":"life","source_url":"https://www.indiafirstlife.com/customer-service/grievance-redressal","quote":"eries, Requests and Complaints) section and raise the request/complaint.\nEMAIL US:\nFor Life Insurance Policy:\nEmail ID:\ncustomer.first@indiafirstlife.com\nCALL US:\nOn our Toll free number\n1800-209-8700\nfrom Monday to Saturday between 9am to 7pm.\nWalk in to any of our\nIndiaF","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"phone","value":"1800-209-8700","label":"Toll free number","level":1,"hours":"Monday to Saturday between 9am to 7pm","applies_to":"life","source_url":"https://www.indiafirstlife.com/customer-service/grievance-redressal","quote":"aint.\nEMAIL US:\nFor Life Insurance Policy:\nEmail ID:\ncustomer.first@indiafirstlife.com\nCALL US:\nOn our Toll free number\n1800-209-8700\nfrom Monday to Saturday between 9am to 7pm.\nWalk in to any of our\nIndiaFirst Life\nbranch. Locate the nearest branch\nher","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"address","value":"Rajnish Kumar\nGrievance Redressal Officer\nIndiaFirst Life Insurance Company Ltd\n12th and 13th Floor, North [C] wing, Tower 4,\nNesco IT Park, Nesco Center, Western Express Highway,\nGoregaon (East), Mumbai – 400063","label":"Grievance Redressal Officer Address","level":2,"hours":null,"applies_to":"life","source_url":"https://www.indiafirstlife.com/customer-service/grievance-redressal","quote":"diafirstlife.com\n.\nAlternatively, you can also write to the Grievance Redressal Officer at the address mentioned below:\nRajnish Kumar\nGrievance Redressal Officer\nIndiaFirst Life Insurance Company Ltd\n12th and 13th Floor, North [C] wing, Tower 4,\nNesco IT Park, Nesco Center, Western Express Highway,\nGoregaon (East), Mumbai – 400063\nPlease quote your Complaint/Service Request ID. This would have been provided to you on registration of your complaint","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"email","value":"grievance.redressal@indiafirstlife.com","label":"Grievance Redressal Officer Email","level":2,"hours":null,"applies_to":"life","source_url":"https://www.indiafirstlife.com/customer-service/grievance-redressal","quote":"Grievance Officer at any of our branches\nClick here\nOr you may write to our Grievance Redressal Officer through email -\ngrievance.redressal@indiafirstlife.com\n.\nAlternatively, you can also write to the Grievance Redressal Officer at the address mentioned below:\nRajnish Kumar\nGr","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"phone","value":"91- 40 – 6678 9768","label":"IRDAI Grievance Cell Fax Number","level":3,"hours":null,"applies_to":"all","source_url":"https://www.indiafirstlife.com/customer-service/grievance-redressal","quote":"thority of India,\nSy. No. 115/1, Financial District, Nanakramguda\nGachibowli, Hyderabad- 500032, Telangana\nFAX:\nNumber: 91- 40 – 6678 9768\nTags\nSTEP 4: REACH OUT TO INSURANCE OMBUDSMAN\nQuestion\nSTEP 4: REACH OUT TO INSURANCE OMBUDSMAN\nSequence\nAnswer\nIn case","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"url","value":"Click here","label":"Insurance Ombudsman Address Finder","level":4,"hours":null,"applies_to":"all","source_url":"https://www.indiafirstlife.com/customer-service/grievance-redressal","quote":"ch. Locate the nearest branch\nhere\n.\nVISIT US:\nWalk in to any of our\nIndiaFirst Life\nbranch and submit your grievances.\nClick here\nto contact our grievance redressal officers in your city.\nMAIL/COURIER:\nWrite to us at the address mentioned below:\nCus","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"phone","value":"1800 209 8700","label":"Customer Care Number","level":null,"hours":"Monday - Saturday, 9 AM - 9 PM","applies_to":"life","source_url":"https://www.indiafirstlife.com/mr/customer-service/grievance-redressal","quote":"o our friendly team\nWhatsapp Number\n+91 22 6274 9898\nCall Us\nMonday - Saturday, 9 AM - 9 PM\nToll Free Number\n(IVR FLow)\n1800 209 8700\nConnect with our Advisor\nMonday-Saturday, 10AM - 6PM\nChat With Us\nEmail Us\nWe’re here to help 24x7\nService Requests\ncus","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/indiafirst-life-insurance/1707-key-feature-document-cum-proposal-form"}