{"id":2532,"title":"Group Asset Protection Policy","purpose":"proposal","insurer":{"slug":"bajaj-general-insurance","name":"Bajaj General Insurance Limited"},"source_pdf":"https://www.bajajgeneralinsurance.com/download-documents/commercial-insurance/group-asset-protection-policy/Group-Asset-Protection-pf.pdf","sha256":"8d06a28e1bc1ee42939de14919835b4d8a66c2200cd969b9637b4bc1f8e5d2fa","pages":6,"collected":"2026-10-17","instructions":{"about":"This form is a proposal for insurance under the Group Asset Protection Policy, to be filled by the proposer who is seeking insurance coverage for a group or association.","notes":["If proposer is a company, partnership, or proprietorship, provide full legal names as specified.","Sum insured for an asset should represent its original purchase price.","Nil deductible option attracts additional premium of Rs-75 per asset.","This proposal form is also deemed to be a renewal proposal form.","Use separate sheet if space is insufficient.","The Insurance Act 1938 Section 41 prohibits rebates on commission or premium."],"title":"Group Asset Protection Policy","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Proposer Details","fields":[{"help":"Full incorporated name if company; full name and partners if partnership; proprietorship firm and proprietor name if proprietorship","type":"text","label":"Name of the Proposer ( in full )","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"PAN/TAN Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Address for Communication","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Telephone Number","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Description of Proposers Business","options":[],"required":null,"pdf_field":""},{"help":"Provide details of the group or association whose members are covered","type":"text","label":"Please mention detail of the Group/ Association/ Institution/ Corporate Body whose members are being covered under the Policy?","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Is the group being formed with the sole purpose of obtaining Insurance?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Select the constitution type of the group","type":"choice","label":"If Yes Specify Constitution","options":["Partnership Firm","Limited Liability/Partnership Firm","NGO/NPO- Provide DARPAN Portal Registration, if applicable","Company","Trust","Society","Section 8 Company","Proprietorship Firm","Others (Please specify)"],"required":null,"pdf_field":""},{"help":"Provide DARPAN Portal Registration if applicable","type":"text","label":"DARPAN DETAILS","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"If answer to Question 7 is No please mention the relationship between the members and the group manager for services other than Insurance","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Please state whether all members of the Group/ Association/ Institution/ Corporate Body are proposed for Insurance?","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"","type":"number","label":"Please mention the total number of persons to be covered initially:","options":[],"required":null,"pdf_field":""},{"help":"","type":"number","label":"Please mention the expected no of persons to be covered during the policy period?","options":[],"required":null,"pdf_field":""},{"help":"If Nil deductible is chosen, additional premium of Rs-75 will be applicable per asset covered under the policy","type":"choice","label":"*Amount of deductible opted for each and every claim?","options":["500 Rs.","Nil"],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"Has any company/Insurer in respect of Insurance Declined your Proposal?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Cancelled or refused to renew your policy?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Accepted your proposal on special terms and conditions?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"If Yes, provide details below","type":"yes-no","label":"Past Claims Experience, if any","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"For past claims","type":"date","label":"Date of Occurrence","options":[],"required":null,"pdf_field":""},{"help":"Describe the loss details","type":"text","label":"Details of loss","options":[],"required":null,"pdf_field":""},{"help":"Amount claimed for loss","type":"amount","label":"Amount of loss Rs.","options":[],"required":null,"pdf_field":""},{"help":"Name of insurer and policy number for past claims","type":"text","label":"Name of the Insurer & Policy Number","options":[],"required":null,"pdf_field":""},{"help":"Fill details for each insured beneficiary: Sr. No, Insured Beneficiary Name, Asset Make/Model, Asset Serial Number, Year of Manufacture, Invoice Date, Invoice Number, Manf. Warranty Expiry Date, Asset Value (original purchase price), Cover Period (Year 1, Year 2, Year 3)","type":"table","label":"Insured Beneficiary Details","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declarations","fields":[{"help":"","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"","type":"signature","label":"Signature of the Proposer","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Tick if you agree","type":"checkbox","label":"The salient features of the policy, terms and conditions of this proposal have been explained to me/us in vernacular language, and I/We agree to the same. (Please tick in case same is agreed).","options":["Agree"],"required":null,"pdf_field":""},{"help":"To be filled if proposal form is not filled by proposer","type":"text","label":"Name of the Intermediary/Officer of the Company","options":[],"required":null,"pdf_field":""},{"help":"To be filled if proposal form is not filled by proposer","type":"text","label":"Code Number/Employee Number","options":[],"required":null,"pdf_field":""},{"help":"To be filled if proposal form is not filled by proposer","type":"text","label":"Place and Date","options":[],"required":null,"pdf_field":""},{"help":"To be filled if proposal form is not filled by proposer","type":"signature","label":"Signature of Intermediary/Officer of the Company","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Additional Declarations and Consent","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*?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details if PEP","type":"text","label":"If yes, please share the details","options":[],"required":null,"pdf_field":""},{"help":"Consent for KYC verification","type":"yes-no","label":"I/we hereby give my/our consent to the Company to verify and obtain my/our identity/address proof through CERSAI records or National Securities Depository Limited Portal for the purpose of undertaking KYC verification.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Declaration of legal source of premium payment","type":"yes-no","label":"I/we hereby declare and confirm that the premium has been paid out of legally acquired sources of income and the subsequent premiums if any, will continue to be paid out of legally declared and assessed source of income.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Consent to share personal information","type":"yes-no","label":"I/We hereby give voluntary consent to Bajaj General/Company to share my/our personal information and data provided in this proposal form with its group companies or any other person in connection with the Insurance Policy or otherwise, including for providing products and services of group companies that may be of interest to me/us, to be used in accordance with their respective privacy policies and subject to appropriate measures being in place to safeguard my/our personal information","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"}],"deadlines":[],"applies_to":"Group Asset Protection Policy","attachments":["If there is insufficient space in this proposal for you to provide relevant information, please attach a separate sheet"],"declarations":["The statements and particulars given in this proposal form are true and complete to the best of my knowledge and belief.","I am authorized to propose on behalf of all persons proposed to be insured.","The information provided will form the basis of the insurance policy and is subject to the underwriting policy of the Company.","If any information is found incorrect, untrue, suppressed or misleading, the Company shall have no liability and may cancel the policy and forfeit premium.","I agree to immediately inform the Company of any changes in this proposal form or risk after submission.","I agree to accept the Standard Terms and Conditions and form of the policy issued by the Company.","The contract of Insurance will be effective only upon Company acceptance and receipt of full premium.","The salient features of the policy and terms have been explained in vernacular language and I agree to the same.","I consent to KYC verification through specified portals.","I declare that premiums are paid from legally acquired sources.","I consent to sharing my personal information with group companies as per privacy policies."],"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/2532-group-asset-protection-policy"}