{"id":2555,"title":"EVENT INSURANCE – LAGHU UDYAM SURAKSHA- PROPOSAL FORM","purpose":"proposal","insurer":{"slug":"bajaj-general-insurance","name":"Bajaj General Insurance Limited"},"source_pdf":"https://www.bajajgeneralinsurance.com/download-documents/commercial-insurance/commercial-pf/Event-Insurance-Laghu-Udyam-Suraksha-Proposal-form.pdf","sha256":"ec5753c08356556fb89524c8d3c86d0244cc29e8f21136ae9936cdc4fd1d3d18","pages":12,"collected":"2026-10-17","instructions":{"about":"This form is a proposal for event insurance to be filled by the proposer (policyholder) seeking insurance coverage for an event under the Laghu Udyam Suraksha scheme.","notes":["Answer all questions fully and accurately to avoid claim rejection or policy avoidance.","If insufficient space, attach separate sheets with relevant information.","This proposal form is also deemed to be a renewal proposal form.","Use block letters where applicable.","Original documents and truthful information are required.","Insurance Act 1938 Section 41 prohibits rebates as inducements for insurance."],"title":"EVENT INSURANCE – LAGHU UDYAM SURAKSHA- PROPOSAL FORM","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"General Information","fields":[{"help":"","type":"text","label":"Name of the Proposer","options":[],"required":null,"pdf_field":""},{"help":"List all parties with insurable interest","type":"text","label":"Policy to be issued in favour of (list out all the parties who have insurable interest) including the financial institutions","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"State","options":[],"required":null,"pdf_field":""},{"help":"","type":"number","label":"Pin Code","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Telephone No","options":[],"required":null,"pdf_field":""},{"help":"","type":"phone","label":"Mobile No","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Name of the Event","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Type of Event","options":[],"required":null,"pdf_field":""},{"help":"Enter start and end dates including setup and dismantle","type":"date","label":"Dates of Event (include set-up and dismantle): From: DD/MM/YYYY to: DD/MM/YYYY","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Location Address of Event","options":[],"required":null,"pdf_field":""},{"help":"","type":"number","label":"Number of people expected to attend the event","options":[],"required":null,"pdf_field":""},{"help":"Enter insurance start and end dates","type":"date","label":"Period of Insurance (The inception of the insurance can take effect prior to the beginning of the event): From: DD/MM/YYYY to: DD/MM/YYYY","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Do you require cover for an event, or part of an event, outside India? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Only if event is outside India","type":"text","label":"If Yes, Please provide following information: Name of the Countries where event will be held","options":[],"required":null,"pdf_field":""},{"help":"Only if event is outside India","type":"text","label":"Venue Address","options":[],"required":null,"pdf_field":""},{"help":"Only if event is outside India","type":"date","label":"Date of Event(s)","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Constitution Details","fields":[{"help":"","type":"yes-no","label":"Partnership Firm","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Limited Liability/Partnership Firm","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide DARPAN registration if applicable","type":"yes-no","label":"NGO/NPO - Provide DARPAN Portal Registration, if applicable","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Company","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Trust","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Society","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Section 8 Company","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Proprietorship Firm","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Specify if other constitution","type":"text","label":"Others (Please specify)","options":[],"required":null,"pdf_field":""},{"help":"Provide details of constitution","type":"text","label":"Constitution Details","options":[],"required":null,"pdf_field":""},{"help":"Provide DARPAN details if applicable","type":"text","label":"DARPAN DETAILS","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Awareness of Circumstances","fields":[{"help":"","type":"yes-no","label":"Are you aware of any circumstances, which could give rise to a claim? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details if aware of any claim circumstances","type":"text","label":"If ‘Yes’ please give details:","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Cover Details","fields":[{"help":"Select required covers","type":"checkbox","label":"Please tick the relevant sections you require","options":["Part 1: Event Insurance","Cover 1A: Event Cancellation Cover for Physical Events","Cover 1B: Event Cancellation Cover for Virtual Events","Part 2: Exhibition Insurance"],"required":null,"pdf_field":""},{"help":"","type":"choice","label":"Type of Event: Physical Event / Virtual / Hybrid","options":["Physical Event","Virtual","Hybrid"],"required":null,"pdf_field":""},{"help":"Answer separately for a) and b)","type":"yes-no","label":"Are any parts of the event to be held: a) Outdoors? b) Under Canvas?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide location details if outdoors or under canvas","type":"text","label":"If ‘Yes’, to either a) or b), please provide details, including exact location:","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Will adverse weather conditions prevent the fulfillment of the event? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Describe adverse weather conditions","type":"text","label":"If ‘Yes’, please provide details of the type of weather:","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"In the event of damage to the venue, are alternative venues available? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide alternative venue details","type":"text","label":"If ‘Yes’, please provide details:","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Have all arrangements been made in order to carry out this event? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Have you had any previous experience in staging this kind of event? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Describe previous event experience","type":"text","label":"If ‘Yes’, please provide some details of previous events:","options":[],"required":null,"pdf_field":""},{"help":"Provide deductible details","type":"text","label":"Deductibles","options":[],"required":null,"pdf_field":""},{"help":"Provide contract date and parties for virtual/hybrid events","type":"text","label":"Date of contract and names / parties subject to contract (for Virtual or Hybrid Event)","options":[],"required":null,"pdf_field":""},{"help":"Select one","type":"choice","label":"What is your organization’s function or interest in the virtual event transmission?","options":["Sponsor","Trader or business using transmission services to process transactions","Virtual event transmission originator & event organizer","Others"],"required":null,"pdf_field":""},{"help":"Name the hosting vendor","type":"text","label":"Which vendor will be required to host and produce the online event? (Zoom/Microsoft Teams/Google Etc)","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Have you worked with the vendor responsible for hosting the online event before? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Describe vendor selection process if new","type":"text","label":"If no, describe the vetting process for selecting the vendor.","options":[],"required":null,"pdf_field":""},{"help":"Describe refund obligations","type":"text","label":"Please confirm the contractual refund obligations to those who have registered to attend in the event of non-delivery of the virtual event","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Is the Insured Virtual event transmission being recorded, so that in the event of failure to deliver or interruption can it still be provided to registered attendees","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Can the virtual event be postponed or delayed in the event of failure or malfunction of necessary facilities?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Do written signed contracts exist between you and all those responsible for providing signal transmission or receiving services? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Confirm SLA details","type":"yes-no","label":"Do these contracts contain SLA’s (Service Level Agreements) and if so please confirm: a) Minimum response time in the event of an interruption b) If the virtual event can still proceed without loss if response is provided within specified time Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Please confirm that all equipment critical to the transmission is within buildings, undercover or in purpose designed vehicles at the location where the Virtual Event Transmission originates Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Does all critical equipment have back up power? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Have satisfactory test transmissions been completed? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Describe backup facilities","type":"text","label":"What back up of Necessary Facilities is there? Necessary Facilities include internet services, computer equipment, communication links, power supply and equipment necessary for the proper fulfilment of the Virtual Event Transmission.","options":[],"required":null,"pdf_field":""},{"help":"If yes, provide details","type":"yes-no","label":"Will any or experimental technology be used If yes please provide the full details Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"List signal transmission methods","type":"text","label":"Please confirm which methods of signal transmittance are to be used Landline/Internet/Satellite/ground Based Radio Transmission, Others----","options":[],"required":null,"pdf_field":""},{"help":"Provide deductible details","type":"text","label":"Deductibles","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Sum Insured Breakdown","fields":[{"help":"Fill amounts and percentages for each category","type":"table","label":"Breakdown of the Sum to be insured: Apportionment of Expenses and Gross Revenue for Virtual and Physical (table with columns: Expenses Amount, % for Virtual, % for Physical, Gross Revenue Amount, % for Virtual, % for Physical; rows: Costs, Commitments, Guarantees, Fees, Commissions, Sponsorship, Advertising, Promotional, Broadcasting, Other items not included above)","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Does the above sum represent the full value at risk? Yes / No","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Set Protection Cover","fields":[{"help":"","type":"yes-no","label":"Is the cover required? Yes/ No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Attach separate sheet if needed","type":"table","label":"If ‘Yes’, please provide the following information: Property Description, Value (in Rs.), Ownership Details (for multiple items)","options":[],"required":null,"pdf_field":""},{"help":"","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":"Provide distance","type":"text","label":"Distance between the risk to be covered and nearest Fire Brigade","options":[],"required":null,"pdf_field":""},{"help":"Select required covers","type":"checkbox","label":"Cover Required: 2A. Named Perils Cover, 2B. Burglary and Robbery Cover, 2C. All Risk Cover","options":["2A. Named Perils Cover","2B. Burglary and Robbery Cover","2C. All Risk Cover"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"If you have opted for 2C. All Risk Basis, do you also want to opt for Electrical & Mechanical Breakdown Cover : Yes/No","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Exhibition Insurance","fields":[{"help":"Provide duration","type":"text","label":"Expected duration of Exhibition including transit and storage","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Location of Exhibition","options":[],"required":null,"pdf_field":""},{"help":"Provide policy period","type":"text","label":"Policy Period","options":[],"required":null,"pdf_field":""},{"help":"","type":"choice","label":"Is the transit by Professional Security & Logistic Company or your own vehicle?","options":["Professional Security & Logistic Company","Own vehicle"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Optional Covers for Event Insurance Cover 1: Event Cancellation Cover","fields":[{"help":"","type":"yes-no","label":"Event Cancellation – Electrical/ Mechanical Breakdown Or Accidental Damage Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Named Artist/Named Person Cover Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details of named artist/person","type":"text","label":"If Yes please following Details: Name, Age, Occupation, Travel Arrangement","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"RSMD Cover Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Adverse Weather Conditions And Unseasonal Rain Cover Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Terrorism Damage Inclusion Warranty Cover Yes/No","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Optional Covers for Event Insurance Cover 2: Set Protection Cover","fields":[{"help":"","type":"yes-no","label":"Jewellery and Valuable Cover ( Applicable to Cover 2 (B)) Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide sum insured for jewellery and valuables","type":"amount","label":"Sum Insured","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Accidental Damage Cover ( Applicable to Cover 2(a) & 2 (B)) Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Additional Hire Charges Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide sum insured for additional hire charges","type":"amount","label":"Sum Insured","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Terrorism Cover(Applicable to Part 1 Cover 2(A) & Part 2","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Public Liability","fields":[{"help":"","type":"yes-no","label":"Is the cover required? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide limit amount","type":"amount","label":"Limit of Indemnity","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Have you assumed any liability by agreement, which would not have attached in the absence of such agreement? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details of assumed liability","type":"text","label":"If ‘Yes’, please provide details:","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Are pyrotechnics, lasers or explosives to be used during the event? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details about pyrotechnics/lasers/explosives","type":"text","label":"If ‘Yes’, please provide details regarding: How and when these will be used? Who will be responsible for this part of the event? Do they have their own Public Liability Insurance?","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Will security personnel be present? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide responsible party for security personnel","type":"text","label":"If ‘Yes’, who is responsible for their actions?","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Do they carry their own Public Liability Insurance? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Personal Accident","fields":[{"help":"","type":"yes-no","label":"Is the cover required? Yes/ No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Select applicable covers","type":"checkbox","label":"Please select the covers under Personal Accident: Permanent Total Disability- Yes/No, Permanent Partial Disability- Yes/No, Temporary Total Disability- Yes/No, Medical Expenses Reimbursement- Yes/No","options":["Permanent Total Disability","Permanent Partial Disability","Temporary Total Disability","Medical Expenses Reimbursement"],"required":null,"pdf_field":""},{"help":"Provide number of people if unnamed basis","type":"number","label":"If opted on Unnamed Persons Basis then, Number of People","options":[],"required":null,"pdf_field":""},{"help":"Provide details for each named person","type":"table","label":"If opted on Named Person Basis please provide the details in following format (table): Sr No, Name of the Person, Date of Birth, Profession, Relationship with the Proposer, Any existing disability/infirmity, Nominee, Relationship of the Nominee with the Person to be Insured, Total Monthly Income (in Rs.), Sum to be Insured (in Rs.), Any other policy? If yes, give the following details: Name of the Company, Policy No., Sum Insured","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Money Insurance","fields":[{"help":"","type":"yes-no","label":"Is the cover required? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide maximum amount carried per transit","type":"amount","label":"Money kept at Venue - Maximum estimated amount (in Rs.) that will be carried in any one (1) transit","options":[],"required":null,"pdf_field":""},{"help":"Describe security measures","type":"text","label":"What security precautions will be taken?","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Fidelity Guarantee","fields":[{"help":"Select basis of cover","type":"choice","label":"Fidelity Guarantee Cover is Required on Named Basis/Unnamed Basis","options":["Named Basis","Unnamed Basis"],"required":null,"pdf_field":""},{"help":"Provide employee details","type":"table","label":"If on named basis please provide the following information in respect of all the employees in respect of whom insurance cover is sought: Employee Name, Designation, Monthly Salary, Amount of Cash / Stock held by the Employee, Amount of Guarantee","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Please confirm if the cover is required on floater basis: Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide total employees and guarantee amount","type":"text","label":"If required on floater basis, please provide the following information: Total number of Employees, Amount of Guarantee","options":[],"required":null,"pdf_field":""},{"help":"Provide details for unnamed floater basis","type":"text","label":"If cover is required on floater Unnamed Basis, please provide the following information in respect of all the employees in respect of whom insurance cover is sought: Total number of Employees, Amount of Guarantee","options":[],"required":null,"pdf_field":""},{"help":"Confirm reference system","type":"yes-no","label":"Is there a system to obtain references from previous Employers? If not, specify practice Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details if yes","type":"yes-no","label":"Has there been any occasion to question honesty or conduct of any person proposed for guarantee? If yes, please provide details Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Describe frequency","type":"text","label":"How often are the employees required to account for money?","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Are books of accounts balanced every day? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Describe audit system and frequency","type":"text","label":"What independent system including Audits is there to check that all sums received by employees are accounted for and how often are Audits done.","options":[],"required":null,"pdf_field":""},{"help":"Provide loss details if any","type":"text","label":"Have there been any reported losses (whether insured or not) due to fraud or dishonesty of employees, partners or directors during the last three years? If yes please provide particulars as under: Date of Occurrence, Details of Loss, Amount of Loss, Name of Insurer & Policy No","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Other Insurance Details","fields":[{"help":"","type":"yes-no","label":"Do you have any other current or pending insurance policy covering any of the insured perils? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Whether Insurance was declined by any other Company (Give details) Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details of declined insurance","type":"text","label":"If yes please provide the following details: Name of the Insurance Company, Policy Type, Sum Insured, Policy Period","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Over the preceding five (5) years, have you had any claim under a similar insurance policy declined and/or refused in whole or in part? Yes/No","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide claim refusal details","type":"text","label":"If Yes please provide the details","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declarations and Authorizations","fields":[{"help":"Agree to declaration","type":"checkbox","label":"I/We hereby declare and warrant that the declaration, warranties, statements and particulars given in this proposal form are complete, true and accurate to the best of my/our personal knowledge and belief.","options":["Agree"],"required":true,"pdf_field":""},{"help":"Optional agreement to website display","type":"checkbox","label":"I/We hereby authorize company that all Standard Terms & Conditions of policy can be displayed in the website of company that enables access by me/us if I/We want to know the terms and conditions of policy displayed on website. (Please tick in case same is agreed)","options":["Agree"],"required":false,"pdf_field":""},{"help":"Optional agreement to vernacular explanation","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":false,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of Proposer","options":[],"required":true,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Name of proposer","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"Date of certification","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Signature of certifier","type":"signature","label":"Signature (on behalf of Proposer)","options":[],"required":true,"pdf_field":""},{"help":"Place of certification","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Name of certifier","type":"text","label":"Name","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declaration - Physical Proposal Form for Juridical person/non-individual customer","fields":[{"help":"PEP means Politically Exposed Persons","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":true,"pdf_field":""},{"help":"Provide details if PEP","type":"text","label":"If yes, please share the details","options":[],"required":false,"pdf_field":""},{"help":"Consent for KYC verification","type":"checkbox","label":"I/we hereby give my/our consent to the Company to verify and obtain my/our identity/address proof through Central KYC Registry or Goods and Service Tax Portal or Ministry Of Corporate Affairs Portal or National Securities Depository Limited portal for the purpose of undertaking KYC. (tick in the box)","options":["Agree"],"required":true,"pdf_field":""},{"help":"Confirm legal source of premium","type":"checkbox","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. (tick in the box)","options":["Agree"],"required":true,"pdf_field":""}],"filled_by":"proposer"}],"deadlines":[],"applies_to":"Event Insurance including Event Cancellation Cover, Exhibition Insurance, Set Protection Cover, Public Liability, Personal Accident, Money Insurance, Fidelity Guarantee","attachments":["If there is insufficient space in this proposal for you to provide relevant information, attach a separate sheet","Attach separate sheet for all items to be insured under Set Protection Cover with value and ownership details"],"declarations":["The information provided in this proposal form is complete, true and accurate to the best of the proposer’s knowledge.","The proposer agrees to inform the company immediately of any changes in the proposal or risk after submission.","The proposer agrees to accept the standard terms and conditions of the policy issued by the company.","The proposer authorizes the company to display standard terms and conditions on its website if agreed.","The proposer confirms that the policy contract is effective only upon company acceptance and receipt of full premium.","The proposer confirms that the premium is paid from legally acquired sources and future premiums will be similarly paid.","The contents of the proposal form and documents have been fully explained to the proposer and understood.","The proposer confirms whether they or any applicants are Politically Exposed Persons (PEP) or relatives thereof.","The proposer consents to KYC verification through specified government portals."],"dropped_labels":6},"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/2555-event-insurance-laghu-udyam-suraksha-proposal-form"}