{"id":2061,"title":"ACKO BHARAT LAGHU UDYAM SURAKSHA Proposal Form","purpose":"proposal","insurer":{"slug":"acko-life-insurance","name":"Acko Life Insurance Limited"},"source_pdf":"https://acko-cms.ackoassets.com/acko_bharat_laghu_udyam_suraksha_proposal_form_3961d4de1a.pdf","sha256":"5ccdf516f5a9b31114d26cef760354e2724287c660430ffc87e8b8d4a720ab7d","pages":4,"collected":"2026-10-17","instructions":{"about":"This form is used by enterprises with insurable assets between ₹5 Crore and ₹50 Crore to apply for fire and allied perils insurance coverage. The proposer (enterprise owner or authorized representative) fills this form.","notes":["Read the Prospectus/Key Features Document/Policy Wordings before filling the form.","The property is not covered until the proposal is accepted and premium paid.","Kutcha construction means walls/roofs made of wooden planks, thatched leaves, bamboo, plastic cloth, etc.","Pucca construction means buildings other than Kutcha.","Strike off options not applicable where indicated.","Provide original and accurate information to avoid delays or rejection."],"title":"ACKO BHARAT LAGHU UDYAM SURAKSHA Proposal Form","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Details About Proposer and Policy Period","fields":[{"help":"","type":"text","label":"Name of the Proposer:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Address of the Proposer:","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Telephone No. (Landline)","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Mobile No.","options":[],"required":null,"pdf_field":""},{"help":"","type":"email","label":"Email","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Contact person details (where proposer is not an individual) a. Name","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Contact person details (where proposer is not an individual) b. Designation","options":[],"required":null,"pdf_field":""},{"help":"List all parties with insurable interest including financial institutions","type":"text","label":"Policy to be issued in favor of (List of all the parties who have insurable interest) including the financial institutions","options":[],"required":null,"pdf_field":""},{"help":"Start date of insurance coverage","type":"date","label":"Period of Insurance From :","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Business and Location of Business","fields":[{"help":"Describe the nature of the business","type":"text","label":"Business of Proposer","options":[],"required":null,"pdf_field":""},{"help":"Fill in address, pin code, occupancy, age of unit, and floor for each location","type":"table","label":"Location of risk/business to be covered - full postal address with Pin Code.","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Details About Business Covered at the Insured Location","fields":[{"help":"Tick Yes or No","type":"yes-no","label":"b. Industrial / Manufacturing risks Yes / No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Tick Yes or No","type":"yes-no","label":"c. Storage Outside Industrial / Manufacturing Risks Yes / No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Tick Yes or No","type":"yes-no","label":"d. Tanks / Gas Holders Outside Industrial / Manufacturing Risks Yes / No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Tick Yes or No","type":"yes-no","label":"e. Utilities Located Outside Industrial/Manufacturing Risks. Yes / No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Tick Yes or No","type":"yes-no","label":"f. Boundary wall Yes / No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Tick Yes or No; if Yes, specify value stored SI: ₹","type":"yes-no","label":"g. Basement storage Yes / No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Specify other types of insured property if any","type":"text","label":"h. Others (please specify)","options":[],"required":false,"pdf_field":""},{"help":"List goods stored if applicable","type":"text","label":"If used as warehouse / godown (not located in a manufacturing unit), please give the list of goods stored.","options":[],"required":false,"pdf_field":""},{"help":"List products manufactured","type":"text","label":"If used as an Industrial Manufacturing unit give products manufactured at the location proposed (detailed block plan showing various facilities to be enclosed wherever applicable.)","options":[],"required":false,"pdf_field":""},{"help":"State factory status","type":"text","label":"If used as an Industrial Manufacturing unit, please state whether the factory is working or silent?","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"yes-no","label":"Indicate whether AMC (Annual Maintenance contract) for the Fire Protection Appliances is in force Yes / No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Select construction type for walls","type":"choice","label":"Construction details a. Please state material used i. Walls Kutcha / Pucca","options":["Kutcha","Pucca"],"required":null,"pdf_field":""},{"help":"Select construction type for floor","type":"choice","label":"Construction details a. Please state material used ii. Floor Kutcha / Pucca","options":["Kutcha","Pucca"],"required":null,"pdf_field":""},{"help":"Select construction type for roof","type":"choice","label":"Construction details a. Please state material used iii. Roof Kutcha / Pucca","options":["Kutcha","Pucca"],"required":null,"pdf_field":""},{"help":"Enter number of floors","type":"number","label":"Number of Floors","options":[],"required":null,"pdf_field":""},{"help":"Specify distance","type":"text","label":"Distance between the risk to be covered and nearest Fire Brigade","options":[],"required":null,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"Whether You have insured the same property with any other Insurance Company with the same type of coverage. (Give details)","options":[],"required":null,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"Whether Insurance was declined by any other Company (Give details)","options":[],"required":null,"pdf_field":""},{"help":"Fill year-wise premium and claim amounts for past 36 months","type":"table","label":"Premium / Claim details for the past 36 months excluding the expiring policy period (Year, Premium ₹, Claim ₹)","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Sum Insured and Other Details of Insured Property","fields":[{"help":"Enter sum insured for building","type":"amount","label":"Description of Block Building Including Plinth, Basement and Additional Structures","options":[],"required":null,"pdf_field":""},{"help":"Enter sum insured for plant and machinery","type":"amount","label":"Plant & Machinery","options":[],"required":null,"pdf_field":""},{"help":"Enter sum insured for furniture and fixtures","type":"amount","label":"Furniture & Fixtures, Fittings and Other Equipment","options":[],"required":null,"pdf_field":""},{"help":"Enter sum insured for raw material","type":"amount","label":"Raw Material","options":[],"required":null,"pdf_field":""},{"help":"Enter sum insured for stock in process","type":"amount","label":"Stock in Process","options":[],"required":null,"pdf_field":""},{"help":"Enter sum insured for finished stock","type":"amount","label":"Finished Stock","options":[],"required":null,"pdf_field":""},{"help":"Specify and enter sum insured for other contents","type":"text","label":"Other Contents (Please Specify)","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Standard Add-On","fields":[{"help":"Strike off what is not applicable","type":"choice","label":"Do You want to opt for Floater Cover? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide location addresses if opting for floater cover","type":"text","label":"Floater Cover (for stocks at various locations) - Location (Postal Address with Pin Code)","options":[],"required":false,"pdf_field":""},{"help":"Enter maximum value insured at any one location","type":"amount","label":"Maximum value at any one location: ₹","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"yes-no","label":"Whether stocks stored in open: Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Strike off what is not applicable","type":"choice","label":"Do You want to opt for Declaration Policy? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Enter amount for declaration policy if opted","type":"amount","label":"Stocks which fluctuate in value to be covered on (monthly) declaration basis: Amount (₹):","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Premium Details","fields":[{"help":"Specify mode of payment","type":"text","label":"Mode of Payment","options":[],"required":null,"pdf_field":""},{"help":"Provide payment details","type":"text","label":"Payment Details","options":[],"required":null,"pdf_field":""},{"help":"Enter premium amount","type":"amount","label":"Amount","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declaration by Insured","fields":[{"help":"Date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of the Proposer:","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"}],"deadlines":[],"applies_to":"enterprises with total insurable assets exceeding ₹5 Crore but not exceeding ₹50 Crore, for Fire and Allied Perils insurance","attachments":["Detailed block plan showing various facilities (where applicable)"],"declarations":["The value of insurable assets is more than ₹5 Crore but less than ₹50 Crore.","The statements made in this Proposal Form are true to the best of the proposer's knowledge and belief.","This declaration forms the basis of the contract between the proposer and Acko General Insurance Limited.","Any additions or alterations in the risk after submission must be conveyed to the Company immediately.","No person shall offer or accept any rebate of commission or premium except as allowed by the insurer's published prospectus or tables.","Non-compliance with the rebate prohibition is punishable with a fine up to ten lakhs rupees."],"dropped_labels":5},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"customer-care","channel":"phone","value":"1800-210-1992","label":"Customer Care Number","level":null,"hours":"Monday to Sunday: 9:00 AM – 8:00 PM","applies_to":"life","source_url":"https://www.acko.com/life/contact-us/","quote":"t us\nSupport\nRenewals\nNew to ACKO?\nRenew life insurance\nExisting ACKO Customer\nLogin and renew policy\nClaims\nCall us at\n1800-210-1992\nEmail us at\n[email protected]\nLogin\nACKO Life Home\n/\nLife Insurance\n/\nAcko Life Insurance Customer Care | Customer Care","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"+91 8069067215","label":"Customer Care Phone Number for PERSONS WITH DISABILITIES (PwD)","level":null,"hours":"Monday to Sunday: 9:00 AM – 8:00 PM","applies_to":"life","source_url":"https://www.acko.com/life/contact-us/","quote":"y to Sunday: 9:00 AM – 8:00 PM\nACKO Life Insurance Customer Care Phone Number for PERSONS WITH DISABILITIES (PwD)\nCall: +91 8069067215\nMonday to Sunday: 9:00 AM – 8:00 PM\nProducts\nLife insurance\nTerm insurance\n1 crore term insurance\nCompany\nAbout us\nCare","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"phone","value":"1800-210-1992","label":"Grievance desk phone number","level":1,"hours":null,"applies_to":"life","source_url":"https://www.acko.com/life/customer-service/grievance-redressal/","quote":"t us\nSupport\nRenewals\nNew to ACKO?\nRenew life insurance\nExisting ACKO Customer\nLogin and renew policy\nClaims\nCall us at\n1800-210-1992\nEmail us at\n[email protected]\nLogin\nACKO Life Home\n/\nACKO Life Insurance Customer Service\n/\nACKO Life Insurance Grievan","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"address","value":"Ms. Komal Arawat (Grievance Redressal Officer) Acko Life Insurance Limited, 36/5 Hustlehub One East, Somasandrapalya, 27th Main Road, Sector 2, HSR Layout, Bangalore – 560102","label":"Grievance Redressal Officer postal address","level":2,"hours":null,"applies_to":"life","source_url":"https://www.acko.com/life/customer-service/grievance-redressal/","quote":null,"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/acko-life-insurance/2061-acko-bharat-laghu-udyam-suraksha-proposal-form"}