{"id":2609,"title":"MARINE CARGO PROPOSAL","purpose":"proposal","insurer":{"slug":"bajaj-general-insurance","name":"Bajaj General Insurance Limited"},"source_pdf":"https://www.bajajgeneralinsurance.com/download-documents/commercial-insurance/Marine-Cargo-Digital-proposal-forms.pdf","sha256":"20a00e30bbc215d988b292f4835e16962b1a83980d4b408a839c9e0565c6561a","pages":6,"collected":"2026-10-17","instructions":{"about":"This form is a proposal for marine cargo insurance to be filled by the proposer seeking insurance coverage for cargo shipments.","notes":["Liability of the company starts only after proposal acceptance and premium payment.","If insufficient space, attach separate sheet with additional information.","Use original and complete information to avoid claim rejection or policy avoidance.","Keep policy contact and bank details updated for faster service.","Agent/intermediary declarations and signatures are required.","Section 41 of Insurance Act 1938 prohibits rebates on commission or premium.","The form must be signed and dated by proposer and witness.","Disability declaration requires government-issued certificate if applicable."],"title":"MARINE CARGO PROPOSAL","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Proposer Details","fields":[{"help":"","type":"text","label":"Name of the Proposer ( in full )","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Address for Communication","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"State","options":[],"required":true,"pdf_field":""},{"help":"Enter a valid email address","type":"email","label":"E mail ID","options":[],"required":true,"pdf_field":""},{"help":"Enter a valid mobile number","type":"phone","label":"Mobile Number","options":[],"required":true,"pdf_field":""},{"help":"Enter postal pin code","type":"number","label":"Pin Code","options":[],"required":true,"pdf_field":""},{"help":"Provide bank details for claim payments","type":"text","label":"Bank Details","options":[],"required":true,"pdf_field":""},{"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","type":"text","label":"Bank Account No.","options":[],"required":true,"pdf_field":""},{"help":"Provide IFSC code of the bank branch","type":"text","label":"IFSC Code","options":[],"required":true,"pdf_field":""},{"help":"Confirm acceptance for claim payments to this bank account","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":"","type":"yes-no","label":"Existing Customer Are you an exisiting customer of BGIL?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide previous policy or PID number if existing customer","type":"text","label":"If Yes. Please provide PID No: / Policy No.","options":[],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"I hereby confirm that, there is no change in my existing KYC details that are available from my previous/existing policy.","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide e-IA number if available","type":"text","label":"Electronic-Insurance Account: Please provide e-IA No. to deposite your insurance policy.","options":[],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Do you want to open e-IA account:","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Bajaj General Employee code, if Proposer is an Employee","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Constitution Details","fields":[{"help":"Tick Yes or No","type":"checkbox","label":"Partnership Firm","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"checkbox","label":"Limited Liability/Partnership Firm","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Tick Yes or No and provide DARPAN details if applicable","type":"checkbox","label":"NGO/NPO- Provide DARPAN Portal Registration, if applicable","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"checkbox","label":"Company","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"checkbox","label":"Trust","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"checkbox","label":"Society","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"checkbox","label":"Section 8 Company","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"checkbox","label":"Proprietorship Firm","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Specify other constitution if applicable","type":"text","label":"Others (Please specify)","options":[],"required":false,"pdf_field":""},{"help":"Provide details of constitution","type":"text","label":"Constitution Details","options":[],"required":false,"pdf_field":""},{"help":"Provide DARPAN registration details if applicable","type":"text","label":"DARPAN DETAILS","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Cargo Details","fields":[{"help":"Describe the goods to be insured","type":"text","label":"Goods proposed for insurance","options":[],"required":true,"pdf_field":""},{"help":"Select if goods are new or secondhand","type":"choice","label":"Specify whether New or Secondhand","options":["New","Secondhand"],"required":true,"pdf_field":""},{"help":"Describe the packing type","type":"text","label":"Nature of Packing used","options":[],"required":true,"pdf_field":""},{"help":"Specify mode of conveyance or shipping","type":"text","label":"Conveyance(s) and/or shipping","options":[],"required":true,"pdf_field":""},{"help":"Provide container details if any","type":"text","label":"Containeriation details","options":[],"required":false,"pdf_field":""},{"help":"Specify terms of sale","type":"text","label":"Terms of Sale, whether FOB or CIF or similar terms","options":[],"required":false,"pdf_field":""},{"help":"Provide relevant transport document number and date","type":"text","label":"RR/GR/BL/AWB No. and date if any.","options":[],"required":false,"pdf_field":""},{"help":"Provide details of vessel or transporter","type":"text","label":"Details of the carrying vessel/vehicle such as name/no. and name of the transporter","options":[],"required":false,"pdf_field":""},{"help":"Specify basis on which value is calculated","type":"text","label":"Basis of valuation","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Cover Details","fields":[{"help":"Select the type of policy required","type":"choice","label":"Type of Policy required (Please tick whichever is applicable)","options":["Inland Transit","Inland Transit plus FOB","Overseas Transit","Specific Policy / Declaration Policy / Open Cover / Open Policy","Others (Please specify)"],"required":true,"pdf_field":""},{"help":"Enter voyage start location","type":"text","label":"Voyage details From","options":[],"required":true,"pdf_field":""},{"help":"Indicate if distance is less than 100 kms","type":"yes-no","label":"Distance less than 100 kms.","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Indicate if multiple transit involved and if intermediate processing cover is needed","type":"yes-no","label":"Multi transit involved (If yes, please state whether cover for intermediate processing is required)","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Indicate if transhipment is involved","type":"yes-no","label":"Transhipment, if any with details","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide place of transhipment if applicable","type":"text","label":"If YES, specify the Place :","options":[],"required":false,"pdf_field":""},{"help":"Specify number of weeks for transhipment storage","type":"number","label":"No. of weeks :","options":[],"required":false,"pdf_field":""},{"help":"Indicate if storage cover is required","type":"yes-no","label":"Is Storage cover required?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Select applicable cover clauses","type":"checkbox","label":"Type of Cover (Please tick whichever is applicable)","options":["Inland Transit (Rail/Road) Clauses A / B / C","Institute Cargo Clauses A / B / C","War and / or Strikes Clause","Institute Cargo Clauses (Air)","Post Parcel Clause","Duty Insurance Clauses","Increased Value Insurance Clauses","Institute Theft, pilferage and Non Delivery Clause.","Others (Please specify)"],"required":false,"pdf_field":""},{"help":"Indicate if you want to bear part of every loss","type":"yes-no","label":"Do you want to take on part of every loss:","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Specify percentage of loss to bear","type":"number","label":"If YES, please specify the % of loss","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Claims Experience","fields":[{"help":"Specify department (Marine or Other than Marine)","type":"text","label":"Department","options":[],"required":false,"pdf_field":""},{"help":"Enter year for claims experience","type":"number","label":"Year","options":[],"required":false,"pdf_field":""},{"help":"Enter premium paid in that year","type":"amount","label":"Premium (Rs.)","options":[],"required":false,"pdf_field":""},{"help":"Enter claims paid in that year","type":"amount","label":"Claims (Rs.) Paid","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Other Information","fields":[{"help":"Indicate if any insurer refused or imposed conditions","type":"yes-no","label":"Has any other insurer refused to accept this insurance or imposed conditions to accept the same.","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide details if insurer refused or imposed conditions","type":"text","label":"If YES, give details.","options":[],"required":false,"pdf_field":""},{"help":"Provide previous premium rate if applicable","type":"text","label":"Rate of premium charged by previous Insurer, if any.","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declarations and Consents","fields":[{"help":"Confirm truthfulness and completeness of information","type":"checkbox","label":"I/We hereby declare and warrant that the above statements are true and complete in all respects and that there is no other information which is relevant to my application for insurance that has not been disclosed to you.","options":["Agree"],"required":true,"pdf_field":""},{"help":"Agree to terms and conditions and premium payment","type":"checkbox","label":"I/We agree that this proposal and the declarations shall be the basis of the contract between me/us and Bajaj General and I/We agree to accept a policy, subject to the conditions prescribed by Bajaj General and to pay premium on the amount estimated above at the end of each policy period.","options":["Agree"],"required":true,"pdf_field":""},{"help":"Agree to take reasonable safety precautions","type":"checkbox","label":"I /We undertake to exercise all ordinary and reasonable precautions for safety of the property as if it were uninsured.","options":["Agree"],"required":true,"pdf_field":""},{"help":"Consent to sharing information within group entities","type":"yes-no","label":"I/we hereby unconditionally allow the Company to share all my / our information being collected in this proposal form or through telephone / email / web-inputs means or other means, as updated from time to time within group entities.","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Declare if you or relatives are Politically Exposed Persons","type":"yes-no","label":"Are you or any of the proposal applicants a PEP or a close relative of PEP*?","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":"yes-no","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","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Confirm premium payment from legal sources","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":true,"pdf_field":""},{"help":"Consent to share personal data with group companies","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":false,"pdf_field":""},{"help":"Keep contact and bank details updated","type":"info","label":"It is mandatory to keep your policy with updated contact (Mobile No., Email ID and PAN Card) and bank account details, to process any of your service requests faster and hassle-free in future.","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Signatures and Witness","fields":[{"help":"Sign the form","type":"signature","label":"Signature of the Proposer (WITH OFFICE SEAL, IF ANY)","options":[],"required":true,"pdf_field":""},{"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":"Name of witness","type":"text","label":"Name of Witness","options":[],"required":true,"pdf_field":""},{"help":"Witness signature","type":"signature","label":"Signature of Witness","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer and witness"},{"title":"Disability Declaration","fields":[{"help":"Declare if any physical disability","type":"yes-no","label":"Any Physical deformity or handicap","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide details and attach Disability Certificate issued by Government Medical Board","type":"text","label":"If Yes. Please provide details","options":[],"required":false,"pdf_field":""},{"help":"If proposer is disabled, authorised representative name","type":"text","label":"Name of Authorised Representative","options":[],"required":false,"pdf_field":""},{"help":"Signature of authorised representative","type":"signature","label":"Signature of Authorised representative","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer or authorised representative"},{"title":"Agent / Intermediary Declaration","fields":[{"help":"Agent signature","type":"signature","label":"Signature of Agent","options":[],"required":true,"pdf_field":""},{"help":"Place of agent signature","type":"text","label":"Place (Agent)","options":[],"required":true,"pdf_field":""},{"help":"Name of agent or IMD","type":"text","label":"Agent/IMD Name","options":[],"required":true,"pdf_field":""},{"help":"Agent or IMD code","type":"text","label":"Agent/IMD Code","options":[],"required":true,"pdf_field":""},{"help":"Name of SP/BQP/DP/PoS if applicable","type":"text","label":"SP / BQP / DP / PoS Name","options":[],"required":false,"pdf_field":""},{"help":"Code of SP/BQP/DP/PoS","type":"text","label":"SP / BQP / DP / PoS CoR No.","options":[],"required":false,"pdf_field":""},{"help":"Signature of SP/BQP/DP/PoS","type":"signature","label":"SP / BQP / DP / PoS Signature","options":[],"required":false,"pdf_field":""}],"filled_by":"agent or intermediary"}],"deadlines":[],"applies_to":"marine cargo insurance policies","attachments":["Separate sheet if insufficient space for information","Disability Certificate issued by the Medical Board appointed by the Government for certifying Disability"],"declarations":["The proposer declares all statements are true and complete with no undisclosed relevant information.","The proposal and declarations form the basis of the insurance contract and proposer agrees to pay premium as estimated.","The proposer undertakes to exercise reasonable safety precautions for the insured property.","The proposer consents to sharing information within group entities.","The proposer declares if they or relatives are Politically Exposed Persons (PEPs).","The proposer consents to KYC verification through specified government portals.","The proposer confirms premiums are paid from legally acquired sources.","The proposer consents to sharing personal data with group companies for services and products.","The proposer agrees to keep contact and bank details updated for faster service.","The proposer or authorised representative confirms understanding of the form content in vernacular.","The insurance advisor declares having explained the form contents to the proposer in vernacular."],"dropped_labels":14},"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/2609-marine-cargo-proposal"}