{"id":2592,"title":"PROPOSAL FORM FOR CATTLE AND LIVESTOCK INSURANCE","purpose":"proposal","insurer":{"slug":"bajaj-general-insurance","name":"Bajaj General Insurance Limited"},"source_pdf":"https://www.bajajgeneralinsurance.com/download-documents/commercial-insurance/cattle-and-livestock-insurance-product/Cattle-and-Livestock-Insurance-Policy-pf.pdf","sha256":"4561b622bf5e9f019da1e190d292fec31adc8f49dcf7b33e6e34cfe908e634f7","pages":6,"collected":"2026-10-17","instructions":{"about":"This form is used by individuals or entities proposing to insure their cattle and livestock against death and other risks. The proposer fills this form to provide details about themselves, their animals, and the insurance coverage required.","notes":["Use original certificates and documents as required.","Keep policy updated with mobile number, email ID, PAN card, and bank account details.","Attach all relevant and supporting documents required for policy issuance.","The form content and particulars must be explained in vernacular to the proposer.","The form includes a prohibition on rebates under Insurance Act 1938 Section 41.","The proposer must sign and date the form and provide place of signing."],"title":"PROPOSAL FORM FOR CATTLE AND LIVESTOCK INSURANCE","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Proposer Details and Constitution","fields":[{"help":"","type":"text","label":"Name of the proposer·S","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Residential Address","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Farm Address: (If Different)","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Occupation:","options":[],"required":false,"pdf_field":""},{"help":"Select the constitution type of the proposer","type":"choice","label":"Constitution Details","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 DARPAN registration number if applicable","type":"text","label":"Provide DARPAN Portal Registration, if applicable","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Bank Details","fields":[{"help":"Name as per bank records","type":"text","label":"Name as pr Bank","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Name Of Bank","options":[],"required":true,"pdf_field":""},{"help":"Provide bank account number for claim payments","type":"text","label":"Bank Account No.","options":[],"required":true,"pdf_field":""},{"help":"Provide IFSC code of the bank branch","type":"text","label":"IFSCCode","options":[],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"* I accept to pay & receive claim amount (if any) in the above given Bank a/c","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide e-lA number if available","type":"text","label":"Electronic-Insurance Account: Please provide e-lA No. to deposite your insurance policy.","options":[],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Do you want to open e-lA account:","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Are you an exisiting customer of BajajGeneral?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide existing customer PID or policy number","type":"text","label":"If Yes. Please provide PID No: /Policy No.","options":[],"required":false,"pdf_field":""},{"help":"","type":"checkbox","label":"I hereby confirm that, there is no change in my existing KYC details that are available from my previous/existing policy.","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Animal Details","fields":[{"help":"Provide details if animals are hypothecated","type":"text","label":"Hypothecation:","options":[],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Is cover required for Permanent Disability?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide Type of Animal, Sex (M/F), Age (Years), Breed, Colour, Horns, Tail Switch, Distinguishing Features, Tag No., Market Value/S.I., Rt/Lt Ear","type":"table","label":"Give the following particulars in full, of each of the animals proposed for insurance","options":[],"required":true,"pdf_field":""},{"help":"Describe the intended use of the animals","type":"text","label":"State for what purpose the animals will be used.","options":[],"required":true,"pdf_field":""},{"help":"Provide location of animal stabling","type":"text","label":"Where is / are animals stabled?","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Whether own Veterinary Services Available or dependant on Government Veterinary Services?","options":["Own Veterinary Services","Government Veterinary Services"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Loss and Insurance History","fields":[{"help":"Provide Year, Cause of Loss, Number of animals lost","type":"table","label":"Have you lost any animal/s during the last three years? If so state particulars","options":[],"required":false,"pdf_field":""},{"help":"Provide Year, Policy No., Name of Insurer, Claim Amount, Whether claim settled in full or in part or outstanding or repudiated","type":"table","label":"Previous Cattle Insurance and Claims experience (for the last three years)","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"How many other animals do you own and of what type?","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Are they insured and if so with which insurer?","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"If not why are they not proposed for insurance now?","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Were they insured previously and if so where?","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Are any of the animals now proposed for insurance or have any other animals belonging to you been previously insured? If so, state name of Company or Underwriter.","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Insurance Period and Ownership","fields":[{"help":"Specify number of months and start date","type":"text","label":"For What period is insurance required?","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Are you the owner of the animal? If not state name and address of owner and also nature of your interest in the animal","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Is any bank or other financing institution interested In the animal, If so, state (i) name and address of the bank (ii) Amount of loan outstanding.","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Is / are the animal/s proposed for insurance covered by SFDA / MFAL project? If so, state address of SFDA/MFAL agency and amount of subsidy obtained.","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Any other information material to the risk or the terms upon which cover might be offered.","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Payment Details","fields":[{"help":"Select mode of payment","type":"choice","label":"Mode of Payment","options":["Cheque","DD","Cash","Other"],"required":true,"pdf_field":""},{"help":"Select who gave the cheque if applicable","type":"choice","label":"Cheque - Given by","options":["Spouse","Father","Mother","Son/Daughter","Employer / Employee","Financier"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declarations and Signatures","fields":[{"help":"Date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Sign the form","type":"signature","label":"Signature of proposer","options":[],"required":true,"pdf_field":""},{"help":"Politically Exposed Persons declaration","type":"yes-no","label":"Are you or any of the proposal applicants a PEP or a close relative of PEP?","options":["Yes","No"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Disability Declaration","fields":[{"help":"","type":"yes-no","label":"Any Physical deformity or handicap","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Attach Disability Certificate issued by Medical Board appointed by Government","type":"text","label":"If Yes. Please provide details","options":[],"required":false,"pdf_field":""},{"help":"If proposer is disabled, authorised representative details","type":"text","label":"Name of Authorised Representative","options":[],"required":false,"pdf_field":""},{"help":"","type":"signature","label":"Signature of Authorised representative","options":[],"required":false,"pdf_field":""},{"help":"","type":"date","label":"Date","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Place","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer or authorised representative"},{"title":"Agent/Intermediary Declaration","fields":[{"help":"","type":"signature","label":"Signature of Agent","options":[],"required":true,"pdf_field":""},{"help":"","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Agent/IMD name, code and signature","type":"text","label":"Agent / IMD ( SP/DP/ BQP) signature and their code","options":[],"required":false,"pdf_field":""}],"filled_by":"agent"}],"deadlines":[],"applies_to":"Cattle and Livestock Insurance","attachments":["A Certificate given by a qualified Veterinary Surgeon must accompany this proposal","Certificate of good health issued by a qualified veterinary practitioner for each animal proposed for insurance","Disability Certificate issued by the Medical Board appointed by the Government for certifying Disability (if applicable)"],"declarations":["The answers given in this proposal form are true and animals are correctly described and healthy.","No material information has been withheld and this proposal forms the basis of the contract.","No person shall offer or accept rebates on premiums except as allowed by the insurer's published prospectus.","Premiums are paid from legally acquired sources of income.","Consent is given to verify identity/address through official portals for KYC purposes.","Consent is given to share personal information with group companies for insurance and related services.","Policyholder agrees to keep contact and bank details updated for faster service.","Agent declares that the proposal form contents have been explained to the proposer in their vernacular language.","If any untrue statement or non-disclosure is found, the insurer may vary benefits or treat the policy as void."],"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/2592-proposal-form-for-cattle-and-livestock-insurance"}