{"id":2474,"title":"PORTABILITY FORM","purpose":"proposal","insurer":{"slug":"bajaj-general-insurance","name":"Bajaj General Insurance Limited"},"source_pdf":"https://www.bajajgeneralinsurance.com/download-documents/health-insurance/Portability-Form.pdf","sha256":"4ef953ae0e6c8fb4efd31fd911339fa3901a5ec2caed22a213a9ecc35c06efc5","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is used by a policyholder to apply for portability of their health insurance policy from a previous insurer to Bajaj General Insurance Limited.","notes":["It is mandatory to keep your policy updated with contact details (Mobile No., Email ID, PAN Card) and bank account details for faster service.","You can update details via Caringlyours App, WhatsApp Service, 24-Hour Call Center, missed call, SMS, email, website, agent or branch."],"title":"PORTABILITY FORM","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Part I - Policyholder and Insurance Details","fields":[{"help":"","type":"text","label":"First Name of Insured","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Details of Previous Health Insurance Policy / Policy No.","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Health ID Card number","options":[],"required":null,"pdf_field":""},{"help":"","type":"amount","label":"Sum Insured","options":[],"required":null,"pdf_field":""},{"help":"","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"","type":"signature","label":"Signature of Proposer","options":[],"required":null,"pdf_field":""},{"help":"","type":"signature","label":"Signature of Policyholder","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Name of the Policyholder / insured (s)","options":[],"required":null,"pdf_field":""},{"help":"Enter date of birth or age","type":"date","label":"Date of Birth / Age","options":[],"required":null,"pdf_field":""},{"help":"Full address","type":"text","label":"Address of policyholder /insured","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Details of existing insurer - i. Name of the product","options":[],"required":null,"pdf_field":""},{"help":"Name of new insurance product","type":"text","label":"Details of the proposed insurance - i. Name of the product proposed/intended to take","options":[],"required":null,"pdf_field":""},{"help":"Explain reason(s) for portability","type":"text","label":"Reason (s) of portability","options":[],"required":null,"pdf_field":""},{"help":"Number of family members to port","type":"number","label":"No of family member to be included in the policy to be ported","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Whether the PED exclusions / time bound exclusion have longer exclusion period than existing policy (Please indicate Yes /No)","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Write consent statement agreeing to additional waiting period","type":"text","label":"If yes , please give written consent to the declaration below","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"},{"title":"Part II - Declarations","fields":[{"help":"PEP means Politically Exposed Persons as defined","type":"yes-no","label":"Are you or any of the proposal applicants a PEP* or a close relative of PEP*? (Yes / No)","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details if PEP or close relative","type":"text","label":"If yes, please share the details","options":[],"required":null,"pdf_field":""}],"filled_by":"policyholder"}],"deadlines":[],"applies_to":"health insurance portability proposals","attachments":["Photocopy of the existing policy documents"],"declarations":["I/we consent to identity/address verification through CERSAI or NSDL for KYC purposes.","I/we declare that premiums are paid from legally acquired sources and will continue to be so.","I/we consent to sharing personal information with Bajaj General Insurance and its group companies."],"dropped_labels":10},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"customer-care","channel":"email","value":"careforyou@bajajgeneral.com","label":"Customer Service Email","level":null,"hours":null,"applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/forms/form-online-grievance.html","quote":"in a new tab\nBajaj General Insurance Limited\nTollfree: For sales :\n1800-209-0144\nFor service :\n1800-209-5858\nEmail id:\ncareforyou@bajajgeneral.com\nFor senior citizens:\nseniorcitizen@bajajgeneral.com\nFor senior citizens:\n1800-209-5858\nFax no:\n020-30512246\nRegistered","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"1800-209-5858","label":"Service Toll Free Number","level":null,"hours":null,"applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/forms/form-online-grievance.html","quote":"Careers\nBecome\n                                An Agent\nAwards\nUpdate KYC\nMY ABHA\nBuy Policy:\n1800-209-0144\n| Service:\n1800-209-5858\nService Chat:\n+91 75074 25858\nInsure\nHealth Insurance\nIndividual Health Insurance\nFamily Health Insurance\nInternational","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"1800-209-0144","label":"Sales Toll Free Number","level":null,"hours":null,"applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/forms/form-online-grievance.html","quote":"nsurance\nSupport\nAbout Us\nCareers\nBecome\n                                An Agent\nAwards\nUpdate KYC\nMY ABHA\nBuy Policy:\n1800-209-0144\n| Service:\n1800-209-5858\nService Chat:\n+91 75074 25858\nInsure\nHealth Insurance\nIndividual Health Insurance\nFamily Healt","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"phone","value":"1800-209-5858","label":"Customer Service Toll Free Number","level":1,"hours":null,"applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/about-us/customer-service.html","quote":"ted servicing team to help you meet your service needs.\nCustomer Service - We're Here to Help\nDial our Toll Free Number\n1800-209-5858\nEmail us on\ncareforyou@bajajgeneral.com\nToll free No. Intermediary\n1800-209-7073\nBOING BOT\nConnect with us on BOING Cha","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"email","value":"ggro@bajajgeneral.com","label":"Grievance Redressal Officer Email Mr. Jerome Vincent","level":2,"hours":null,"applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/about-us/customer-service.html","quote":"fied with the response given to you by our team, you may write to our Grievance Redressal Officer Mr. Jerome Vincent at\nggro@bajajgeneral.com\nLevel 3\nHead Customer Service\nif you are still not satisfied with the solutions provided, or have some feedback for us,","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"phone","value":"1800-209-7073","label":"Toll free No. Intermediary","level":null,"hours":null,"applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/about-us/customer-service.html","quote":"Here to Help\nDial our Toll Free Number\n1800-209-5858\nEmail us on\ncareforyou@bajajgeneral.com\nToll free No. Intermediary\n1800-209-7073\nBOING BOT\nConnect with us on BOING Chatbot\nConnect with us on WhatsApp +91 7507425858\nFor Support\nBajaj General App\nPle","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"whatsapp","value":"+91 7507425858","label":"BOING WhatsApp Chatbot","level":null,"hours":"24x7","applies_to":"all","source_url":"https://www.bajajgeneralinsurance.com/about-us/customer-service.html","quote":"ral.com\nToll free No. Intermediary\n1800-209-7073\nBOING BOT\nConnect with us on BOING Chatbot\nConnect with us on WhatsApp +91 7507425858\nFor Support\nBajaj General App\nPlease scan and download\nMissed Call Facility\nMissed Call - 80809 45060 Short code - SMS","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/bajaj-general-insurance/2474-portability-form"}