{"id":2066,"title":"Aviva Nayi Grameen Suraksha - Hindi","purpose":"proposal","insurer":{"slug":"aviva-life-insurance","name":"Aviva Life Insurance Company India Limited"},"source_pdf":"https://www.avivaindia.com/sites/default/files/Grameen-Hindi.pdf","sha256":"c1c7b21dd5e3c6c76fadb37c31b5b642ebf7628dc419fc23a94d9d6dcf5253b4","pages":5,"collected":"2026-10-17","instructions":{"about":"This form is a proposal for insurance under the Aviva Nayi Grameen Suraksha plan, to be filled by the applicant (proposer) and their advisor.","notes":["प्रस्तावक को पॉलिसी की प्रमुख विशेषताओं की विवरणिका ध्यान से पढ़नी चाहिए।","आयु का प्रमाण अनिवार्य है।","चेक जमा करने की स्थिति में वापसी राशि चेक द्वारा ही दी जाएगी।","प्रस्ताव पत्र पर हस्ताक्षर आवश्यक हैं।","Section 45 के तहत पॉलिसी के विवाद के नियम लागू होंगे।"],"title":"Aviva Nayi Grameen Suraksha - Hindi","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"प्रस्तावक का विवरण (Proposer Details)","fields":[{"help":"Advisor code","type":"text","label":"सलाहकार dk uke","options":[],"required":null,"pdf_field":""},{"help":"Father's/Husband's name","type":"text","label":"firk@ifr dk uke","options":[],"required":null,"pdf_field":""},{"help":"Occupation","type":"text","label":"i=kpkj dk irk","options":[],"required":null,"pdf_field":""},{"help":"Full permanent address","type":"text","label":"Permanent Address स्थायी पता","options":[],"required":null,"pdf_field":""},{"help":"Select proof of address document","type":"choice","label":"Proof of Address irs dk izek.k","options":["Çyx","iq#\"k","efgyk","chekjf{kr O;fä dh okÆ\"kd vk; #- &"],"required":null,"pdf_field":""},{"help":"Mode of payment","type":"choice","label":"नकद / चेक / णिमांि ड्राफ्ि / vU; chekjf{kr jkf'k","options":["नकद","चेक","णिमांि ड्राफ्ि","vU;"],"required":null,"pdf_field":""},{"help":"Signature of proposer","type":"text","label":"ukekadu dk C;kSjk","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"चिकित्सा विवरण (Medical Information)","fields":[{"help":"Whether you have any medical conditions","type":"yes-no","label":"chekjf{kr O;fä ds vPNs LokLF; dh ?kks\"k.kk","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Whether you are disabled","type":"yes-no","label":"D;k vki xHkZorh gSa","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"रजिस्ट्रेशन और दस्तावेज़ (Registration and Documents)","fields":[{"help":"Date of receipt of signed proposal form","type":"date","label":"chek j{kk fd, tkus okys O;fä ds gLrk{kj*@vaxwBs dh Nki*","options":[],"required":null,"pdf_field":""},{"help":"Advisor code","type":"text","label":"सलाहकार dk uke","options":[],"required":null,"pdf_field":""}],"filled_by":"advisor / proposer"}],"deadlines":["चेक जमा करने के 45 दिनों के भीतर पहचान प्रस्तुत करना अनिवार्य है"],"applies_to":"Insurance proposal for Aviva Nayi Grameen Suraksha policy","attachments":["आवश्यक पहचान और पते के प्रमाण पत्र","चेक / डिमांड ड्राफ्ट या कंपनी द्वारा स्वीकृत अन्य भुगतान माध्यम की रसीद"],"declarations":["मैं प्रस्ताव पत्र के सभी प्रश्नों को समझता हूँ और अपनी इच्छा से भरा हूँ।","मेरे द्वारा दिए गए सभी बयान और तथ्य सही हैं और अनुबंध का आधार होंगे।","यदि कोई असत्य या छुपाया गया तथ्य पाया गया तो कंपनी पॉलिसी रद्द कर सकती है।","मेरे स्वास्थ्य संबंधी जानकारी कंपनी को दी जा सकती है।","कंपनी द्वारा भुगतान किसी सहायक के माध्यम से किया गया तो कंपनी जिम्मेदार नहीं होगी जब तक भुगतान स्वीकार न किया गया हो।"],"dropped_labels":5},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"customer-care","channel":"email","value":"customerservices@avivaindia.com","label":"General Enquiries- Customer Email","level":null,"hours":null,"applies_to":"all","source_url":"https://www.avivaindia.com/grievance-mechanism","quote":"stomer\nCall (All Days & Toll Free)\n1800-103-7766\n,\n0124-2709046\nCall (Toll Free) - For Kerala users\n1800-103-8000\nEmail\ncustomerservices@avivaindia.com\nSenior Citizen\nseniorcitizen@avivaindia.com\nGeneral Enquiries- Partner\nCall (All Days & Toll Free)\n1800-180-2111\nEmail","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"email","value":"weconnect@avivaindia.com","label":"General Enquiries- Partner Email","level":null,"hours":null,"applies_to":"all","source_url":"https://www.avivaindia.com/grievance-mechanism","quote":"Senior Citizen\nseniorcitizen@avivaindia.com\nGeneral Enquiries- Partner\nCall (All Days & Toll Free)\n1800-180-2111\nEmail\nweconnect@avivaindia.com\nContact Grievance Officer\nEmail\ncomplaints@avivaindia.com\nCall (Mon-Fri, 9am-6pm)\n+91 9999346907\nCustomer\nGroup\nAdvisor","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"1800-103-7766","label":"General Enquiries- Customer Toll Free","level":null,"hours":"All Days","applies_to":"all","source_url":"https://www.avivaindia.com/grievance-mechanism","quote":"Jeevan Bima Plan\nGuaranteed Savings Plan\nULIP Plans\nPAY PREMIUM\nGeneral Enquiries- Customer\nCall (All Days & Toll Free)\n1800-103-7766\n,\n0124-2709046\nCall (Toll Free) - For Kerala users\n1800-103-8000\nEmail\ncustomerservices@avivaindia.com\nSenior Citizen\ns","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"0124-2709046","label":"General Enquiries- Customer","level":null,"hours":"All Days","applies_to":"all","source_url":"https://www.avivaindia.com/grievance-mechanism","quote":"Guaranteed Savings Plan\nULIP Plans\nPAY PREMIUM\nGeneral Enquiries- Customer\nCall (All Days & Toll Free)\n1800-103-7766\n,\n0124-2709046\nCall (Toll Free) - For Kerala users\n1800-103-8000\nEmail\ncustomerservices@avivaindia.com\nSenior Citizen\nseniorcitizen@av","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"1800-103-8000","label":"Call (Toll Free) - For Kerala users","level":null,"hours":null,"applies_to":"all","source_url":"https://www.avivaindia.com/grievance-mechanism","quote":"eneral Enquiries- Customer\nCall (All Days & Toll Free)\n1800-103-7766\n,\n0124-2709046\nCall (Toll Free) - For Kerala users\n1800-103-8000\nEmail\ncustomerservices@avivaindia.com\nSenior Citizen\nseniorcitizen@avivaindia.com\nGeneral Enquiries- Partner\nCall (All","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"1800-180-2111","label":"General Enquiries- Partner Toll Free","level":null,"hours":null,"applies_to":"all","source_url":"https://www.avivaindia.com/grievance-mechanism","quote":"vices@avivaindia.com\nSenior Citizen\nseniorcitizen@avivaindia.com\nGeneral Enquiries- Partner\nCall (All Days & Toll Free)\n1800-180-2111\nEmail\nweconnect@avivaindia.com\nContact Grievance Officer\nEmail\ncomplaints@avivaindia.com\nCall (Mon-Fri, 9am-6pm)\n+91 99","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"0124-2709000/46","label":"Corporate Office Phone","level":null,"hours":null,"applies_to":"all","source_url":"https://www.avivaindia.com/grievance-mechanism","quote":"Office\n401-A, 4th Floor,\nBlock A, DLF Cyber Park,\nSector-20, NH-8, Gurugram,\nHaryana-122 016, India.\nTelephone Number:\n0124-2709000/46\nEmail:\ncustomerservices@avivaindia.com\nToll Free Helpline:\n18001037766\n,\n0124-2709046\nGive a Missed Call:\n+91-767757677","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"+91-7677576775","label":"Give a Missed Call","level":null,"hours":null,"applies_to":"all","source_url":"https://www.avivaindia.com/grievance-mechanism","quote":"24-2709000/46\nEmail:\ncustomerservices@avivaindia.com\nToll Free Helpline:\n18001037766\n,\n0124-2709046\nGive a Missed Call:\n+91-7677576775\nSMS\n\"Aviva\"to 5676737\nInsurance is the subject matter of the solicitation.\nIRDAI Reg No.\n122\n|\nCIN\n              :\nU660","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"sms","value":"\"Aviva\"to 5676737","label":"SMS Service","level":null,"hours":null,"applies_to":"all","source_url":"https://www.avivaindia.com/grievance-mechanism","quote":":\ncustomerservices@avivaindia.com\nToll Free Helpline:\n18001037766\n,\n0124-2709046\nGive a Missed Call:\n+91-7677576775\nSMS\n\"Aviva\"to 5676737\nInsurance is the subject matter of the solicitation.\nIRDAI Reg No.\n122\n|\nCIN\n              :\nU66010DL2000PLC107880\nAviv","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"email","value":"complaints@avivaindia.com","label":"Contact Grievance Officer Email","level":1,"hours":null,"applies_to":"all","source_url":"https://www.avivaindia.com/grievance-mechanism","quote":"iries- Partner\nCall (All Days & Toll Free)\n1800-180-2111\nEmail\nweconnect@avivaindia.com\nContact Grievance Officer\nEmail\ncomplaints@avivaindia.com\nCall (Mon-Fri, 9am-6pm)\n+91 9999346907\nCustomer\nGroup\nAdvisor\nsearch\nTERM","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"phone","value":"+91 9999346907","label":"Contact Grievance Officer Phone","level":1,"hours":"Mon-Fri, 9am-6pm","applies_to":"all","source_url":"https://www.avivaindia.com/grievance-mechanism","quote":"0-2111\nEmail\nweconnect@avivaindia.com\nContact Grievance Officer\nEmail\ncomplaints@avivaindia.com\nCall (Mon-Fri, 9am-6pm)\n+91 9999346907\nCustomer\nGroup\nAdvisor\nsearch\nTERM\n                                                            INSURANCE\nAviva Smart Re","fetched_at":"2026-10-20"},{"purpose":"gro","channel":"address","value":"401-A, 4th Floor, Block A, DLF Cyber Park, Sector- 20, NH- 8, Gurugram, Haryana - 122016","label":"Complaint Redressal Officer (CRO) Address","level":2,"hours":null,"applies_to":"all","source_url":"https://www.avivaindia.com/grievance-mechanism","quote":"examine your issues and provide you impartial resolution. The CRO can be reached at :\nComplaint Redressal Officer(CRO).\n401-A, 4th Floor, Block A, DLF Cyber Park, Sector- 20, NH- 8, Gurugram, Haryana - 122016\nEmail :\ncro@avivaindia.com\nLevel 3\n: Insurance Ombudsman Scheme.\nThe insurance Ombudsman is empowered to receive and co","fetched_at":"2026-10-20"},{"purpose":"gro","channel":"email","value":"cro@avivaindia.com","label":"Complaint Redressal Officer (CRO) Email","level":2,"hours":null,"applies_to":"all","source_url":"https://www.avivaindia.com/grievance-mechanism","quote":"edressal Officer(CRO).\n401-A, 4th Floor, Block A, DLF Cyber Park, Sector- 20, NH- 8, Gurugram, Haryana - 122016\nEmail :\ncro@avivaindia.com\nLevel 3\n: Insurance Ombudsman Scheme.\nThe insurance Ombudsman is empowered to receive and consider complaints from any","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/aviva-life-insurance/2066-aviva-nayi-grameen-suraksha-hindi"}