{"id":2598,"title":"CARE PLUS-ADD ON COVER UNDER CATTLE AND LIVESTOCK 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/Care-Plus-Add-On/CARE-PLUS-ADD-ON-COVER-Proposal-Form.pdf","sha256":"b2ae79a6d5d8e891b6f5f684ea2edc8f6d4e87ce4f0286cfc5a6138bac8f7e22","pages":5,"collected":"2026-10-17","instructions":{"about":"This form is used by the proposer (policyholder) to apply for the Care Plus add-on cover under the Cattle and Livestock Insurance policy with Bajaj General Insurance Limited.","notes":["Please answer all questions in BLOCK letters.","The liability of the company starts only after acceptance of the proposal and receipt of premium.","Use original and accurate information; non-disclosure or misrepresentation may void the policy.","Keep policy contact details and bank account updated for faster service.","The proposal form contents must be explained in vernacular to the proposer if required.","The Insurance Act 1938 Section 41 prohibits rebates and provides penalties for violations."],"title":"CARE PLUS-ADD ON COVER UNDER CATTLE AND LIVESTOCK INSURANCE PROPOSAL FORM","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Proposer and Policy Details","fields":[{"help":"Enter the base policy number under which add-on cover is sought","type":"text","label":"Policy Number of Base Policy","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Are you an Employee of Bajaj General/ Group Companies of Bajaj General","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"If employee, provide employee code","type":"text","label":"Emp. Code","options":[],"required":null,"pdf_field":""},{"help":"List other active policies if any","type":"text","label":"Kindly provide details of any other active policy of Bajaj General Insurance Limited held by you","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Bank Details","fields":[{"help":"Enter bank name","type":"text","label":"Name Of Bank","options":[],"required":null,"pdf_field":""},{"help":"Enter bank account number","type":"text","label":"Bank Account No.","options":[],"required":null,"pdf_field":""},{"help":"Enter IFSC code of the bank branch","type":"text","label":"IFSCCode","options":[],"required":null,"pdf_field":""},{"help":"Tick to accept payment through this bank account","type":"checkbox","label":"* I accept to pay & receive claim amount (if any) in the above given Bank a/c","options":["accept"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Electronic-Insurance Account","fields":[{"help":"Enter electronic insurance account number if available","type":"text","label":"Please provide e-lA No. to deposite your insurance policy.","options":[],"required":null,"pdf_field":""},{"help":"Select if you want to open an electronic insurance account","type":"yes-no","label":"Do you want to open e-lA account","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Customer Status","fields":[{"help":"Select if you are an existing customer","type":"yes-no","label":"Are you an exisiting customer of BajajGeneral?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide PID or policy number if existing customer","type":"text","label":"If Yes. Please provide PID No /Policy No.","options":[],"required":null,"pdf_field":""},{"help":"Tick to confirm no change in KYC details","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":["confirm"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Care Plus Add-On Cover Selection","fields":[{"help":"Select one plan from the available sum insured options","type":"choice","label":"If Yes, Please choose any one plan","options":["Plan 1 (Sum Insured 1000)","Plan 2 (Sum Insured 1200)","Plan 3 (Sum Insured 2000)","Plan 4 (Sum Insured 3500)","Plan 5 (Sum Insured 5000)"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Constitution Details","fields":[{"help":"Provide DARPAN portal registration details if applicable","type":"text","label":"DARPAN DETAILS","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declarations and Signatures","fields":[{"help":"Date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of Proposer","options":[],"required":true,"pdf_field":""},{"help":"Print your name","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"Required only if proposal not filled by proposer","type":"signature","label":"*Signature (on behalf of the Proposer)","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Physical Proposal Form Declarations","fields":[{"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":null,"pdf_field":""},{"help":"Signature of person explaining the form","type":"signature","label":"Declaration: The content of this form and its particulars have been explained by me in vernacular to the proposer","options":[],"required":null,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of Proposer","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Print name of witness","type":"text","label":"Name of Witness","options":[],"required":null,"pdf_field":""},{"help":"Witness signature","type":"signature","label":"Signature of Witness","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Disability Declaration","fields":[{"help":"Declare if any physical disability","type":"yes-no","label":"Any Physical deformity or handicap","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details and attach Disability Certificate issued by Government Medical Board","type":"text","label":"If Yes. Please provide details","options":[],"required":null,"pdf_field":""},{"help":"If proposer is disabled, name of authorised representative","type":"text","label":"Name of Authorised Representative","options":[],"required":null,"pdf_field":""},{"help":"Signature of authorised representative","type":"signature","label":"Signature of Authorised representative","options":[],"required":null,"pdf_field":""},{"help":"Date of signature","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Place of signature","type":"text","label":"Place","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Claim Documents Declaration","fields":[{"help":"Confirm submission of all required documents","type":"checkbox","label":"I/we hereby confirm that I/we have provided all relevant and supporting documents sought by the company, required for the issuance of the policy.","options":["confirm"],"required":null,"pdf_field":""},{"help":"Agree to submit documents on demand for claims","type":"checkbox","label":"Any document(s) as may be required, for claims processing, shall be submitted by me on demand by the company.","options":["agree"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Agent/Intermediary Declaration","fields":[{"help":"Enter agent license number","type":"text","label":"IRDAI COR No./ License No.(Advisor/Corporate Agent/Broker/Relationship Officer)","options":[],"required":null,"pdf_field":""},{"help":"Agent signature","type":"signature","label":"Signature of Agent","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Agent or IMD signature and code","type":"signature","label":"Agent / IMD (SP/DP/ BQP) signature and their code","options":[],"required":null,"pdf_field":""},{"help":"Name of SP/BQP/DP/PoS","type":"text","label":"SP/ BQP /DP/ PoS Name","options":[],"required":null,"pdf_field":""},{"help":"Code of SP/BQP/DP/PoS","type":"text","label":"SP/ BQP /DP/ PoS CoR No.","options":[],"required":null,"pdf_field":""},{"help":"Signature of SP/BQP/DP/PoS","type":"signature","label":"SP/ BQP /DP/ PoS Signature","options":[],"required":null,"pdf_field":""}],"filled_by":"agent"}],"deadlines":[],"applies_to":"Care Plus add-on cover under Cattle and Livestock Insurance policies","attachments":["Disability Certificate issued by the Medical Board appointed by the Government for certifying Disability"],"declarations":["The statements made in the proposal are true, accurate and complete and form the basis of the contract.","The policy shall be void if any untrue or incorrect statement or non-disclosure is made.","Policy issuance is subject to realization of premium cheque.","Consent is given to share personal information with group companies for services and products.","Premiums are paid from legally acquired sources and will continue to be so.","Consent is given to verify identity/address proof through official registries.","The proposer confirms submission of all required documents and agrees to submit further documents on demand.","Agent declares that the proposal form contents have been explained to the proposer in vernacular and that untrue statements may void the policy."],"dropped_labels":19},"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/2598-care-plus-add-on-cover-under-cattle-and-livestock-insurance-proposal-form"}