{"id":2510,"title":"COMPREHENSIVE GENERAL LIABILITY INSURANCE PROPOSAL FORM","purpose":"proposal","insurer":{"slug":"bajaj-general-insurance","name":"Bajaj General Insurance Limited"},"source_pdf":"https://www.bajajgeneralinsurance.com/download-documents/commercial-insurance/Comprehensive-General-Liability/Comprehensive-General-Liability-pf.pdf","sha256":"9c082102d52bc11017c824cebb86b1bb7aa9a8639b31cc54eae3f7d590cb5750","pages":12,"collected":"2026-10-17","instructions":{"about":"This form is used by firms or businesses applying for comprehensive general liability insurance coverage. The proposer (applicant firm) fills it out to provide detailed information about their business, operations, products, premises, and previous insurance history.","notes":["Answer all questions fully and accurately; attach separate sheets if space is insufficient.","Liability of the company commences only after acceptance of proposal and receipt of premium as per Section 64VB of Insurance Act, 1938.","Use block letters where applicable.","Provide original and complete information to avoid rejection of claim or policy avoidance.","Physical proposal form declarations include questions about Politically Exposed Persons (PEPs).","Policyholder can update contact and bank details via app, WhatsApp, call center, SMS, email, website, agent, or branch."],"title":"COMPREHENSIVE GENERAL LIABILITY INSURANCE PROPOSAL FORM","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"SECTION A - GENERAL INFORMATION","fields":[{"help":"","type":"text","label":"Name of Firm","options":[],"required":true,"pdf_field":""},{"help":"Provide all addresses and responsible persons for each","type":"text","label":"i) Address of Firm If more than one, please give each address and indicate Partner or Principal who is responsible for work at each address.","options":[],"required":true,"pdf_field":""},{"help":"Mark the applicable constitution","type":"choice","label":"ii) Applicant is Sole Proprietor (     ) Partnership (     ) Corporation (     ) Other (     )","options":["Sole Proprietor","Partnership","Corporation","Other"],"required":true,"pdf_field":""},{"help":"Provide establishment year or experience details if new","type":"text","label":"When was the Firm established? If new kindly provide details of experience of the key employees?","options":[],"required":true,"pdf_field":""},{"help":"Mark yes or no and provide details if yes","type":"yes-no","label":"During the past five years has the name of the firm been changed or has other business been purchased or any merger or consolidation taken place? If “YES”, please give details YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Mark applicable constitution details and provide DARPAN details if NGO/NPO","type":"choice","label":"Yes No If Yes Specify Constitution","options":["Partnership Firm","Limited Liability/Partnership Firm","NGO/NPO","Company","Trust","Society","Section 8 Company","Proprietorship Firm","Others (Please specify)"],"required":null,"pdf_field":""},{"help":"Provide start and end dates of insurance period","type":"date","label":"Period of Insurance required From To Day Month Year Day Month Year","options":[],"required":true,"pdf_field":""},{"help":"Describe your business activities in detail","type":"text","label":"Please provide a full description of your business activities.","options":[],"required":true,"pdf_field":""},{"help":"Mark yes or no","type":"yes-no","label":"i) Are you a subsidiary of another entity or does the applicant have any subsidiaries? YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"List overseas divisions and indicate coverage requirement","type":"yes-no","label":"ii) If “YES”, Please list all of your overseas divisions or affiliates. Do you require them to be covered under this policy? YES (     ) NO (     )","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Provide insurer, period, and limit details if yes","type":"yes-no","label":"iii) Is General Liability insurance held by such divisions of affiliates? If “YES” please provide details.","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Provide names and contractual relationships","type":"text","label":"List additional parties to be mentioned in the policy as co-insured if any and their relationship contractually to the Proposer","options":[],"required":false,"pdf_field":""},{"help":"Mark yes or no","type":"yes-no","label":"Will you, or your employees, handle or come into contact with any industrial dust of known harmful nature (e.g. asbestos, silica, cotton), radioactive materials, or any other substance harmful to health? YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Mark yes or no","type":"yes-no","label":"Is there an occupational deafness hazard associated with your trade? YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide details of hazards, safety procedures, and exposure duration","type":"text","label":"If “YES” to 10 and 11 give details and state safety procedures and length of exposure in years past","options":[],"required":false,"pdf_field":""},{"help":"Mark yes or no","type":"yes-no","label":"Have you been prosecuted during the last 5 years under any safety legislation? YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide employee descriptions, travel numbers, and estimated wages by category","type":"table","label":"i) Description of all employee ii) Number of employees that travel abroad annually iii) Estimated wages/salaries for Next 12 months (but not fees of working directors should be included) a) Professional b) Technical c) Administrative d) All Others (specify)","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"SECTION B - PREMISES AND OPERATIONS","fields":[{"help":"Provide details for each premise","type":"table","label":"Details of your premises (if you have more than 2 premises, please provide the details on an additional sheet) a) Address b) Occupancy (eg, office, factory ,warehouse etc) c) Construction e) No of Storeys Premise 1 Premise 2","options":[],"required":true,"pdf_field":""},{"help":"Mark yes or no and provide security details if no","type":"yes-no","label":"i) Do you engage professional security company to man the premise? If “No” kindly provide details of the premise security arrangements? ii) Physical protection of the premises (eg. Locked, fenced, security access card etc) iii) Third party (customer, supplier, visitor etc) entry procedures? Are they permitted to enter premises unaccompanied? YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Mark yes or no for each question","type":"yes-no","label":"i) Do you vet the insurance arrangements of subcontractors? ii) Do You require to Sub contractors extension? YES (     ) NO (     ) YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide subcontracted work details and insurance confirmation","type":"yes-no","label":"Do you subcontract any work? If “YES” please provide the following information i) Details of the work subcontracted and estimated payment for the next 12 months ii) Do you ensure that the sub-contractors have adequate liability insurance in force with an indemnity at least as high as that which you are arranging and do you ensure that such insurance are maintained in force? YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Mark yes or no","type":"yes-no","label":"Are your premises together with your plant, equipment and machinery in good condition and well maintained? YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Mark yes or no and provide details if yes","type":"yes-no","label":"Are you represented in any form (eg. Branch office, subsidiary or associated company, sales office, agent holding power of attorney) in another country? If “YES” please provide details :- YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"SECTION C - PRODUCTS AND COMPLETED OPERATIONS","fields":[{"help":"Mark yes or no","type":"yes-no","label":"Do you require Product Liability Coverage? If “YES” please answer the following question under this section (Section C). If “NO”, please proceed to the sub section D YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide product details, years manufactured, and turnover by territory for last, current, and next year","type":"table","label":"Please give details of i) Individual products or groups of products and purpose of use ii) length of times they have been manufactured or supplied by you iii) Estimated turnover (breakdown according to territory) Please provide specimen brochures or leaflets describing the products if available i) Product / Purpose of Use ii) Years iii) Last Financial Year Turnover of the Company In Rs Crores India US / Canada OECD Countries Non-OECD Countries Current Financial Year Turnover of the Company In Rs Crores India US / Canada OECD Countries Non-OECD Countries Estimated Next 12 months Turnover of the Company In Rs Crores India US / Canada OECD Countries Non-OECD Countries","options":[],"required":true,"pdf_field":""},{"help":"Explain if you manufacture complete product or parts purchased","type":"text","label":"Do you manufacture the complete product? If not, what components or parts that are purchased by you?","options":[],"required":true,"pdf_field":""},{"help":"Mark applicable capacities and specify if other","type":"choice","label":"Indicate in which of the following capacities you are acting :- Manufacturer (     ) Processor (     ) Assembler (     ) Importer (     ) Wholesaler (     ) Retailer (     ) Other please specify…………………..","options":["Manufacturer","Processor","Assembler","Importer","Wholesaler","Retailer","Other"],"required":true,"pdf_field":""},{"help":"Mark yes or no for each question and provide insurer details if yes","type":"yes-no","label":"i) Do you comply with USA/Canadian/Federal Laws/Other International Law applicable to each product of export to such countries YES (     ) NO (     ) ii) Is insurance arranged on your behalf in the USA or Canada in respect of Product Liability? YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide duration of export in years for each territory","type":"text","label":"How long have you been exporting to these countries? a) USA and Canada b) OECD c) Rest of the world","options":[],"required":true,"pdf_field":""},{"help":"Provide detailed product information as listed","type":"text","label":"Please furnish details of products to be considered for insurance which are manufactured and/or designed: a) Name of the Product: b) Principal Component: c) Annual units produced: d) Annual Turnover e) How long has it been in the market: f) Expected life: g) Intended customer/end user: h) Warranties :","options":[],"required":true,"pdf_field":""},{"help":"Mark yes or no for each question and provide nature of work and wages","type":"yes-no","label":"Will you undertake any manual work away from your premises (other than collection & delivery)? If “YES” please provide the following info i) The nature of this work and the total estimated wages for the next 12 months ii) Does any of this work involve : - a) the application of heat(eg.use of welding, flame cutting, equipment, blowlamps or hot air strippers? YES (     ) NO (     ) b) any work on ships, at airport, chemical works, offshore structure, oil or gas refineries? YES (     ) NO (     ) c) any work outside the country? YES (     ) NO (     ) d) work at a height above 10 metres or underground YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide details and approximate wage proportion","type":"text","label":"If “YES” to any question of (8ii), please provide details and indicate the approximate proportion of work away wages","options":[],"required":false,"pdf_field":""},{"help":"Mark yes or no and provide details if yes","type":"yes-no","label":"Will you supply any products that you do not manufacture? If “YES” please provide the following information i) Do you retain rights of recovery against the manufacturers? ii) Do you alter, adapt or change the form of any product which you do not manufacturer? If “YES” please provide details, including the product involved purpose of use, source of supply and type of alteration, adaptation or change made YES (     ) NO (     ) YES (     ) NO (     ) YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Mark yes or no and provide product and turnover details if yes","type":"yes-no","label":"Will any of your products be used i) in aircraft or marinecraft ii) off-shore If “YES” to either (i) or (ii) please state purpose of use and estimated turnover applicable for the next 12 months for each product YES (     ) NO (     ) YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide hazard details and samples if yes","type":"yes-no","label":"i) Please detail any major hazards associated with the products that you supply (eg.Inflammable / explosive, radioactive,harmful to health,poisonous by themselves or any combination with other) ii) Have you warned users of these hazards? If “YES” please provide sample of any brochures, labels of instructions? YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide quality control details and compliance status","type":"yes-no","label":"i) Do you have a system of quality control relating to your products and are records maintained to verify such a system? If “YES” please provide brief details (eg at what stages are control checks carried out, nature of checks) YES (     ) NO (     ) ii) Do the insuring products comply with standards like ISO or any other Standards?","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide copies of agreements if yes","type":"yes-no","label":"Have you accepted extra liability by agreement or contract with any customers, suppliers or sellers? If “YES” please provide copies of the agreement or contract YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide details of any government enquiries or investigations","type":"text","label":"Have your product ever been subject to any enquiry or investigation by any Government Agency for whatsoever reason? If so, please give full details","options":[],"required":false,"pdf_field":""},{"help":"Provide details if yes","type":"yes-no","label":"Has any product been discontinued during the last 5 years? If “YES”, please provide details YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide recall details if yes","type":"yes-no","label":"Has any product been recalled during the last 5 years? If “YES”, please provide detail YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide retention period in years for customer and supplier stock records","type":"text","label":"Please indicate period of time, in years, that you retain stock records of : Customers Supplier","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"SECTION D - COVERAGE AND LOSS INFORMATION","fields":[{"help":"Provide indemnity limits, retroactive date, and deductible amounts in INR","type":"amount","label":"i) Limit of indemnity required : General Aggregate Limit Per Claim Limit Retroactive Date (only for claim made form) Deductible to be borne you","options":[],"required":true,"pdf_field":""},{"help":"Provide sub limits for each coverage type in INR","type":"amount","label":"ii) Sub Limit Of indemnity Required 1. Premises and Operations Hazard Coverage 2. Products and Completed Operations Hazard Coverage 3. Personal Injury and Advertising Injury Liability Coverage 4. Premises Medical Payments Coverage 5. Fire Legal Liability Coverage - Real Property 6. Accidental Pollution Coverage – 72 hours basis 7. Additional Insured Vendors Coverage 8. Acts of God Perils Coverage 9. Motor Contingent Liability Coverage - Non Owned Only","options":[],"required":false,"pdf_field":""},{"help":"Provide year, number of claims, amount paid, and amount outstanding","type":"table","label":"Loss Experience: Please indicate below all Third Party Liability losses paid or now reserved(whether or not resulting in claims) occurring during the past 5 years","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"SECTION E - PREVIOUS INSURANCE DETAILS","fields":[{"help":"Mark yes or no","type":"yes-no","label":"i) Are you aware of any incidents, conditions, defects, circumstances or suspected defects which may result in claim? YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide details if yes","type":"yes-no","label":"ii) Has any Insurer ever declined or cancelled or refused to renew insurance or imposed special terms. If “YES” please give details including the name of the insurer YES (     ) NO (     )","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Provide insurer name, year, limit, deductible, premium, number of claims, amount paid, and amount outstanding","type":"table","label":"iii) Previous details of insurance held during past 3 years including Name of the Insurer, Limit, Deductible and Premium","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"DECLARATION","fields":[{"help":"Date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Signature of authorized signatory","type":"signature","label":"Signature of Principal/Partner/Directors For and on behalf of (Insert name of Firm)","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"}],"deadlines":[],"applies_to":"Comprehensive General Liability Insurance","attachments":["Specimen brochures or leaflets describing the products if available","Copies of agreements or contracts if extra liability accepted"],"declarations":["The statements and particulars in this proposal are true and no material facts are misstated or suppressed.","This proposal and any other information supplied form the basis of the insurance contract.","The proposer undertakes to inform insurers of any material alteration to these facts before or after completion of the contract.","No person shall offer or accept any rebate of commission or premium except as allowed by the insurer's published prospectus or tables.","Failure to comply with the prohibition of rebates is punishable with a fine up to ten lakh rupees.","Consent is given to verify identity/address proof through CERSAI or NSDL portals for KYC verification.","Premiums are declared to be paid from legally acquired sources of income.","Consent is given to share personal information with group companies for insurance and related services.","It is mandatory to keep policy updated with contact and bank details for faster service."],"dropped_labels":0},"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/2510-comprehensive-general-liability-insurance-proposal-form"}