{"id":1714,"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withdrawn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-insurance-khata-plan-application.pdf","sha256":"6c44b377e37eef37e1f57e0fe343803f5e3f630579c31d11dd6f95895e1ed448","pages":4,"collected":"2026-10-17","instructions":{"about":"This form is used to apply for the IndiaFirst Life POS Insurance Khata Plan. It is filled by the person whose life is to be assured (the proposer).","notes":["Form to be filled electronically.","If proposer cannot read or understand the language, help from a person other than advisor or company employee may be used.","Do not hand over premium to insurance advisors; deposit premium directly at company or bank branches.","Encashment of cheque/DD does not mean policy approval; company may call for additional requirements.","Use latest photograph as required.","Signature authentication is done via OTP sent to registered mobile number.","Use block letters where applicable.","Attach cancelled cheque copy for electronic payout modes.","Section 45 of Insurance Act, 1938 applies to policy disputes and fraud."],"title":"Key Feature Document Cum Proposal Form","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Details of the Life to be Assured","fields":[{"help":"","type":"text","label":"Name:","options":[],"required":true,"pdf_field":""},{"help":"Select appropriate title","type":"choice","label":"Mr. Ms. Mx.","options":["Mr.","Ms.","Mx."],"required":true,"pdf_field":""},{"help":"","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":"Select gender","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 telephone 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"},{"title":"Nominee Details (under Section 39 of Insurance Act, 1938)","fields":[{"help":"","type":"text","label":"Nominee Name","options":[],"required":true,"pdf_field":""},{"help":"Percentage share 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","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":"Plan Details for IndiaFirst Life POS INSURANCE KHATA Plan","fields":[{"help":"Select policy term","type":"choice","label":"Policy Term","options":["5 years","7 years","10 years"],"required":true,"pdf_field":""},{"help":"Single premium payment","type":"text","label":"Premium Paying Term","options":["Single"],"required":true,"pdf_field":""},{"help":"Sum assured amount","type":"amount","label":"Sum Assured","options":[],"required":true,"pdf_field":""},{"help":"Premium amount between Rs. 500 and Rs. 15,000","type":"amount","label":"Single Premium","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Details of the Point of Sales Person","fields":[{"help":"12 digit Aadhaar number","type":"number","label":"Aadhaar Card Number:","options":[],"required":true,"pdf_field":""},{"help":"PAN number","type":"text","label":"Pan Card Number","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Name:","options":[],"required":true,"pdf_field":""},{"help":"Select appropriate title","type":"choice","label":"Mr. Ms. Mx.","options":["Mr.","Ms.","Mx."],"required":true,"pdf_field":""},{"help":"","type":"text","label":"LG / Agent Code (LG code to be written for Banca, Agent Code to be written for Agency.)","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":"Mobile number of BDM","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":"point of sales person"},{"title":"Benefit Payment Mode","fields":[{"help":"Select one payment mode","type":"choice","label":"Benefit Payment Mode (Choose any one mode only)","options":["ECS","Direct Credit (Bank of Baroda & Andhra Bank)","NEFT"],"required":true,"pdf_field":""},{"help":"Name of bank for payment","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":"MICR code for ECS","type":"text","label":"MICR: (Mandatory for ECS mode)","options":[],"required":false,"pdf_field":""},{"help":"IFSC code for NEFT","type":"text","label":"IFSC Code: (Mandatory for NEFT mode)","options":[],"required":false,"pdf_field":""},{"help":"Bank account number","type":"text","label":"Bank Account No.:","options":[],"required":true,"pdf_field":""},{"help":"Name as per bank account","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":"Declaration by the Life to be Assured","fields":[{"help":"Sign or thumb impression after OTP authentication","type":"signature","label":"Signature or Thumb Impression of the Life to be Insured","options":[],"required":true,"pdf_field":""},{"help":"Name of proposer","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":"Name of witness","type":"text","label":"Name:","options":[],"required":true,"pdf_field":""},{"help":"Address of witness","type":"text","label":"Address:","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declaration For Signing In Vernacular Or For Uneducated Persons","fields":[{"help":"Name of person explaining the form","type":"text","label":"Name of the Declarant","options":[],"required":true,"pdf_field":""},{"help":"Signature of declarant","type":"signature","label":"Signature:","options":[],"required":true,"pdf_field":""},{"help":"Date of declaration","type":"date","label":"Date:","options":[],"required":true,"pdf_field":""},{"help":"Address of declarant","type":"text","label":"Address of the Declarant","options":[],"required":true,"pdf_field":""},{"help":"Signature or thumb impression of proposer","type":"signature","label":"Signature or thumb impression of the person whose life is proposed to be assured","options":[],"required":true,"pdf_field":""},{"help":"Signature of declarant","type":"signature","label":"Signature:","options":[],"required":false,"pdf_field":""},{"help":"Date of declaration","type":"date","label":"Date:","options":[],"required":false,"pdf_field":""},{"help":"Address of declarant","type":"text","label":"Address of the Declarant","options":[],"required":false,"pdf_field":""}],"filled_by":"declarant"},{"title":"General Declaration","fields":[{"help":"Code of agent or company representative","type":"text","label":"Agent Code/ Company Representative ID","options":[],"required":false,"pdf_field":""},{"help":"Signature of agent or company representative","type":"signature","label":"Agent / Company Representative Signature","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Intermediary Details","fields":[{"help":"","type":"text","label":"Name of the Intermediary","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"License Number (Applicable for all channels except Individual Agents)","options":[],"required":false,"pdf_field":""},{"help":"","type":"signature","label":"Signature of the Agent / Specified Agents","options":[],"required":false,"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":false,"pdf_field":""},{"help":"","type":"text","label":"License Code","options":[],"required":false,"pdf_field":""}],"filled_by":"intermediary"}],"deadlines":["Free Look Period: Return policy within 15 days (30 days for Distance Marketing or Electronic Mode) from receipt of policy document"],"applies_to":"IndiaFirst Life POS Insurance Khata Plan","attachments":["Cancelled copy of your cheque if any electronic payout option is selected"],"declarations":["The proposer declares good health and correctness of age and accepts the health declaration via OTP.","The proposer authorizes the company to carry out due diligence and medical examinations as required.","The proposer declares full and truthful disclosure of all material facts and understands the policy terms and conditions.","The proposer agrees to inform the company of any adverse changes in occupation, health, or other insurance proposals before policy issuance.","The proposer declares that premiums are not from proceeds of criminal activities.","The proposer understands that cover commences only after policy approval and premium receipt.","The proposer accepts that non-credit or delay in bank transactions is not the company's responsibility.","The proposer agrees that the company may use alternative payout options if direct credit fails.","Declarations for signing in vernacular or for uneducated persons confirm that the form contents were fully explained and understood."],"dropped_labels":1},"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/1714-key-feature-document-cum-proposal-form"}