{"id":2750,"title":"HOME SECURE POLICY PROPOSAL FORM","purpose":"proposal","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited"},"source_pdf":"https://www.generalicentralinsurance.com/downloads/home-insurance/home-secure-policy/proposal-forms/home-secure-policy-proposal-form.pdf","sha256":"2dafe7f24306b4faf4b92b1990fd14ff58e8e909bf7182d5c338c3912c7f1e54","pages":14,"collected":"2026-10-17","instructions":{"about":"This form is used by individuals or entities proposing to purchase the Home Secure insurance policy to provide details about themselves, their property, and the coverage they desire.","notes":["Read prospectus/key features/policy wordings before completing the form.","Fill all questions in full; attach separate signed sheet if space is insufficient.","Cover commences only after acceptance and receipt of premium.","Use original documents and provide accurate details for valuation certificates where required.","Policy liability starts only after proposal acceptance and full premium payment.","The company reserves the right to reject or terminate the policy or freeze funds if the customer is on any blacklist.","Use block letters where applicable.","For premium above Rs. 10,000, fill authorization form for NEFT payments.","The form includes a Go Green initiative for electronic policy documents; tick box if physical copy is desired."],"title":"HOME SECURE POLICY PROPOSAL FORM","submit":{"to":"Generali Central Insurance Company Limited","how":"","address":"Registered Office: Unit No. 801 & 802, 8th Floor, Tower C, Embassy 247 Park, LBS Marg, Vikhroli (West), Mumbai – 400083"},"purpose":"proposal","sections":[{"title":"Details about Proposer and Policy Period","fields":[{"help":"","type":"text","label":"Name of Proposer","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Address of Proposer","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Permanent Address of Proposer (if left blank, will be construed as being same as Present Address)","options":[],"required":false,"pdf_field":""},{"help":"","type":"phone","label":"Phone No. a. Mobile","options":[],"required":false,"pdf_field":""},{"help":"","type":"email","label":"Email","options":[],"required":false,"pdf_field":""},{"help":"Central KYC Registry number if available","type":"text","label":"CKYC Number (if available)","options":[],"required":false,"pdf_field":""},{"help":"Tick all applicable categories","type":"checkbox","label":"I am (please tick all that are applicable)","options":["High Net Worth Individual/s","Non-Residential Indian/s","Politically Exposed Person","Non-Governmental Organisation","Non-Profit Organisation"],"required":false,"pdf_field":""},{"help":"Provide registration number if applicable","type":"text","label":"If you are an NGO/NPO, please provide Niti Ayog – Darpan Portal Registration Number","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"choice","label":"If you are Differently Abled, please tick on the checkbox to provide confirmation.","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"If Yes to differently abled, specify impairment type","type":"text","label":"Type of Impairment","options":[],"required":false,"pdf_field":""},{"help":"If Yes to differently abled, specify percentage","type":"number","label":"Percentage of Impairment","options":[],"required":false,"pdf_field":""},{"help":"Unique Disability ID if applicable","type":"text","label":"UDID Number","options":[],"required":false,"pdf_field":""},{"help":"List all insured parties","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":true,"pdf_field":""},{"help":"Start date of policy","type":"date","label":"Period of Insurance From","options":[],"required":true,"pdf_field":""},{"help":"Name of nominee","type":"text","label":"Nomination: Nominee Name","options":[],"required":false,"pdf_field":""},{"help":"Relationship of nominee to insured","type":"text","label":"Relationship with the insured","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section I: Protection of Your Assets Against Fire & Allied Perils","fields":[{"help":"Indicate if existing policy exists","type":"yes-no","label":"Is there any policy in place for the same property? Yes/No","options":[],"required":true,"pdf_field":""},{"help":"Provide details of existing policy","type":"text","label":"If Yes, please provide the details","options":[],"required":false,"pdf_field":""},{"help":"Provide full address including pin code","type":"text","label":"Location of Home Building - full postal address with Pin Code","options":[],"required":true,"pdf_field":""},{"help":"Postal code","type":"number","label":"Pin Code","options":[],"required":true,"pdf_field":""},{"help":"Specify building type","type":"text","label":"Is it in a multi-storey building or is it a standalone house?","options":[],"required":true,"pdf_field":""},{"help":"Floor number if applicable","type":"number","label":"In case of multi-storey building, please provide the floor number of Your house","options":[],"required":false,"pdf_field":""},{"help":"Indicate presence of basement","type":"yes-no","label":"Is there a basement to Your house?","options":[],"required":false,"pdf_field":""},{"help":"Area in square meters","type":"number","label":"Carpet area of structure of Home in square metres","options":[],"required":true,"pdf_field":""},{"help":"Cost rate per square meter","type":"amount","label":"Rate of Cost of Construction per square metre at the policy Commencement Date","options":[],"required":true,"pdf_field":""},{"help":"Select age category","type":"choice","label":"Age of Home Building","options":["Less than 5 Years","5-10 Years","10-20 Years","Above 20 Years"],"required":true,"pdf_field":""},{"help":"Provide item wise sum insured for furniture, electrical/electronic, others","type":"table","label":"If You want to opt out of in-built cover for General Contents and want to have higher Sum Insured or If You have opted for Home Contents Only cover, please provide item wise Sum Insured for General Contents","options":[],"required":false,"pdf_field":""},{"help":"Sum insured for basement contents","type":"amount","label":"In case of Basement, If there are contents in it, please provide the Sum Insured","options":[],"required":false,"pdf_field":""},{"help":"Tick if opting for Loss of Rent cover","type":"checkbox","label":"Cover for (Please Tick) Loss of Rent","options":["Loss of Rent"],"required":false,"pdf_field":""},{"help":"Sum insured for loss of rent","type":"amount","label":"Loss of Rent: I. Sum Insured","options":[],"required":false,"pdf_field":""},{"help":"Sum insured for rent alternative accommodation","type":"amount","label":"Rent for Alternative Accommodation: I. Sum Insured","options":[],"required":false,"pdf_field":""},{"help":"Indicate if personal accident cover is required","type":"yes-no","label":"Do You require ‘Personal Accident Cover’ for Yourself and Your spouse? Yes/No","options":[],"required":false,"pdf_field":""},{"help":"Provide spouse name and age if cover opted","type":"text","label":"Name & age of Your spouse","options":[],"required":false,"pdf_field":""},{"help":"Your age if personal accident cover opted","type":"number","label":"Your age","options":[],"required":false,"pdf_field":""},{"help":"Indicate if cover for valuable contents is required","type":"yes-no","label":"Do You require ‘Cover for Valuable Contents on Agreed Value Basis (under Home Contents cover)’: Yes/No","options":[],"required":false,"pdf_field":""},{"help":"Attach list of valuable items and sum insured","type":"text","label":"If Yes, please attach list of items and Sum Insured","options":[],"required":false,"pdf_field":""},{"help":"Indicate if valuation certificate is attached","type":"yes-no","label":"Valuation certificate attached? (Yes/No)","options":[],"required":false,"pdf_field":""},{"help":"Tick if opting for purchase protection","type":"checkbox","label":"Other Covers: H-A Purchase Protection (10% of Content Sum Insured, coverage upto 90 days from date of purchase)","options":["H-A Purchase Protection"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section II: Burglary and Theft","fields":[{"help":"Select first loss basis percentage if desired","type":"choice","label":"Do you want on % First loss basis, if yes please strike the option □ 25% □ 40%","options":["25%","40%"],"required":false,"pdf_field":""},{"help":"Reinstatement value of furniture, fixtures, fittings","type":"amount","label":"Furniture, Fixture, Fittings (Please take the reinstatement value) Rs.","options":[],"required":true,"pdf_field":""},{"help":"Describe security arrangements","type":"text","label":"Whether 24hrs security provided for","options":[],"required":false,"pdf_field":""},{"help":"Indicate presence of burglar alarm and specify","type":"yes-no","label":"Whether any burglar alarm or similar security devices are provided. If Yes, please specify Yes/No","options":[],"required":false,"pdf_field":""},{"help":"Sum insured for purchase protection","type":"amount","label":"Purchase Protection: Rs.","options":[],"required":false,"pdf_field":""},{"help":"Sum insured for deeds","type":"amount","label":"Deeds: Rs.","options":[],"required":false,"pdf_field":""},{"help":"Sum insured for enhanced cover during family events","type":"amount","label":"Enhanced Cover during family events: Rs.","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section III: Protection of Your Valuables","fields":[{"help":"Select first loss basis if desired","type":"choice","label":"Do you want on % First loss basis, if yes please strike the option □ 40%","options":["40%"],"required":false,"pdf_field":""},{"help":"List contents and values in safe deposit box","type":"table","label":"III-B Contents of Safe Deposit Box in bank - All Risks: Description and Value (Rs.)","options":[],"required":false,"pdf_field":""},{"help":"Provide details of portable computers","type":"table","label":"III-C Portable Computer – All Risk excluding Breakdown: Description (Laptop), Serial No., Value (Rs.)","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section IV: Protection of Your Electronic Equipments","fields":[{"help":"Provide details of electronic equipment to insure (less than 10 years old)","type":"table","label":"IV-A Audio Visual Equipments (Electronic Equipments) – All Risk and IV-B Computers (Electronic Equipments) – All Risk: Description, Type of the items along with serial number, Date of manufacturer, Name of manufacturer, Reinstatement value (Rs.)","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section VI: Protection for You and Your Family","fields":[{"help":"Sum insured for each person","type":"amount","label":"Sum Insured","options":["5 Lakh","10 Lakhs","20 Lakhs","25 Lakhs"],"required":true,"pdf_field":""},{"help":"DOB of insured person","type":"date","label":"Date of Birth","options":[],"required":true,"pdf_field":""},{"help":"Occupation of insured person","type":"text","label":"Occupation","options":[],"required":false,"pdf_field":""},{"help":"Relationship to proposer","type":"text","label":"Relationship with proposer","options":[],"required":false,"pdf_field":""},{"help":"Provide details if any","type":"text","label":"Details of preexisting infirmity or disability","options":[],"required":false,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"Have you / and or your spouse taken personal accident cover from any other insurance company and sum insured details","options":[],"required":false,"pdf_field":""},{"help":"Nominee name","type":"text","label":"Name of the nominee","options":[],"required":false,"pdf_field":""},{"help":"Relationship of nominee","type":"text","label":"Nominee Relationship to the Insured","options":[],"required":false,"pdf_field":""},{"help":"DOB of nominee","type":"date","label":"Nominee date of birth","options":[],"required":false,"pdf_field":""},{"help":"Appointee name if nominee minor","type":"text","label":"Name of appointee (If Nominee is a minor)","options":[],"required":false,"pdf_field":""},{"help":"Indicate if opting for hospital confinement allowance","type":"yes-no","label":"Do you wish to opt for the following additional covers: Hospital Confinement Allowance: Yes/No","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section VII: Protection Against Your Liability","fields":[{"help":"Indicate if tenant's legal liability cover is required","type":"yes-no","label":"Do you wish to opt for Tenant’s Legal liability (applicable only if you are tenant): Yes/No","options":[],"required":false,"pdf_field":""},{"help":"Nature of work of domestic workers","type":"text","label":"Nature of work","options":[],"required":false,"pdf_field":""},{"help":"Annual salary of each worker","type":"amount","label":"Salary of each worker (annual)","options":[],"required":false,"pdf_field":""},{"help":"Limit of indemnity for public liability","type":"amount","label":"Public Liability: Please provide the Limit of Indemnity required (maximum Rs. 25 lacs)","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section VIII: Enhanced Protection covers (Other Covers)","fields":[{"help":"Provide card details and sum insured","type":"text","label":"ATM Cash Withdrawal – All Risk: Type of Card (Debit/Credit), Card No., Sum Insured","options":["INR 5000","INR 10000","INR 20000","INR 25000","INR 50000"],"required":false,"pdf_field":""},{"help":"Provide card details and sum insured","type":"text","label":"Credit Card/ Debit Card (Loss or Theft) – Fraudulent Use: Type of Card (Debit/Credit), Card No., Sum Insured","options":["INR 5000","INR 10000","INR 20000","INR 25000","INR 50000"],"required":false,"pdf_field":""},{"help":"Provide details of dog; max sum insured INR 10,000","type":"text","label":"Veterinary Cost – Road Accident: Age of Dog, Colour, Any Other Information","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Other Information and Premium Details","fields":[{"help":"Indicate if property insured elsewhere","type":"yes-no","label":"Whether you have insured the same property with any other Insurance Company with the same type of coverage. Yes/No","options":[],"required":true,"pdf_field":""},{"help":"Indicate if insurance declined or special conditions imposed","type":"yes-no","label":"Whether Insurance was declined by any other Company or imposed any special conditions Yes/No","options":[],"required":true,"pdf_field":""},{"help":"Provide flood loss details if any","type":"text","label":"Is the premises has suffered any flood losses in last 5 years. if yes please provide loss/ claim details","options":[],"required":false,"pdf_field":""},{"help":"Provide date of loss, cause, claimed amount, settled amount or outstanding claims","type":"table","label":"Please provide the section wise claim /Loss details if any under any of the opted section of last 3 years. Please mention “NIL” if there are no claims/losses.","options":[],"required":true,"pdf_field":""},{"help":"Specify payment mode","type":"text","label":"Mode of Payment","options":[],"required":true,"pdf_field":""},{"help":"Provide payment details","type":"text","label":"Payment Details","options":[],"required":true,"pdf_field":""},{"help":"Premium amount paid","type":"amount","label":"Amount (in ₹)","options":[],"required":true,"pdf_field":""},{"help":"Date of premium payment","type":"date","label":"Date of Payment (DD/MM/YY)","options":[],"required":true,"pdf_field":""},{"help":"Provide PAN if premium above 1 lakh","type":"text","label":"PAN (If premium is 1 Lac and Above.)","options":[],"required":false,"pdf_field":""},{"help":"Provide GSTIN(s)","type":"text","label":"GSTIN (If more than one GSTIN, kindly attach an annexure with details)","options":[],"required":false,"pdf_field":""},{"help":"Name of bank account holder","type":"text","label":"Bank details of proposer for refund or claim purpose: Name of bank account holder","options":[],"required":true,"pdf_field":""},{"help":"Bank name and branch","type":"text","label":"Bank Name & Branch","options":[],"required":true,"pdf_field":""},{"help":"Bank account number","type":"text","label":"Bank Account Number","options":[],"required":true,"pdf_field":""},{"help":"Bank IFSC code","type":"text","label":"IFS Code","options":[],"required":true,"pdf_field":""},{"help":"Nominee name","type":"text","label":"Nominee Details: Name","options":[],"required":false,"pdf_field":""},{"help":"Nominee bank account holder name","type":"text","label":"Bank Account Details of Nominee: Name of Account holder","options":[],"required":false,"pdf_field":""},{"help":"Authorized person details if nominee minor","type":"text","label":"Authorized person details (in case nominee is a minor)","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declaration by Insured","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":"Signature of proposer","type":"signature","label":"Signature of the Proposer(s) (Affix stamp, where proposer is a juridical person)","options":[],"required":true,"pdf_field":""},{"help":"Provide PAN and attach proof if premium above 1 lac","type":"text","label":"PAN (if premium payable is above Rs.1 lac) (Please attach proof)","options":[],"required":false,"pdf_field":""},{"help":"Provide GSTIN(s)","type":"text","label":"GSTIN (If more than one GSTIN, kindly attach an annexure with details)","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"For Intermediary Use Only","fields":[{"help":"Name of intermediary","type":"text","label":"Name of Insurance Agent/POSP/Specified Person of the Corporate Agent/Authorized Person of the Broker/IMF","options":[],"required":true,"pdf_field":""},{"help":"Code of intermediary","type":"text","label":"Intermediary’s Code","options":[],"required":true,"pdf_field":""},{"help":"Signature of intermediary","type":"signature","label":"Intermediary’s Signature","options":[],"required":true,"pdf_field":""}],"filled_by":"intermediary"}],"deadlines":[],"applies_to":"Home Secure insurance policy proposals","attachments":["Separate signed and dated sheet if insufficient space to answer questions","Valuation certificate for valuable contents if sum insured exceeds specified limits","List of items and sum insured for valuable contents if opting for agreed value basis","Proof of PAN if premium payable is above Rs.1 lac","Annexure with GSTIN details if more than one GSTIN"],"declarations":["All statements and information provided are complete and accurate with no material facts withheld.","Misrepresentation or suppression of material facts may render the policy void and premium forfeited.","Policyholder agrees to assist the insurer with records and information to address anti-financial crime practices.","Premium is paid from legitimate sources and insurer may verify source of funds and reject policy if otherwise.","Consent to receive policy communications electronically and for insurer to process personal data as per privacy policy.","Consent to insurer accessing CKYC records for verification and communication.","Agreement to insurer's right to reject proposal or terminate contract if named in any recognized sanctions list.","KYC records are current and valid and proposer will inform insurer of any changes."],"dropped_labels":34},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"grievance","channel":"email","value":"GCIcare@generalicentral.com","label":"HELPLINE Email","level":1,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/customer-service/grievance-redressal","quote":"atrix given below.\nLEVEL 1\nYou Can Call On Our HELPLINE\n1800-220-233 / 1860-500-3333 / 022-67837800\nOR\nSEND US AN EMAIL\nGCIcare@generalicentral.com\nOur senior citizen policyholders can avail priority support by choosing the valid option from the helpline menu or writ","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"phone","value":"1800-220-233 / 1860-500-3333 / 022-67837800","label":"HELPLINE","level":1,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/customer-service/grievance-redressal","quote":"may have. You can escalate your concerns as per the\nescalation matrix given below.\nLEVEL 1\nYou Can Call On Our HELPLINE\n1800-220-233 / 1860-500-3333 / 022-67837800\nOR\nSEND US AN EMAIL\nGCIcare@generalicentral.com\nOur senior citizen policyholders can avail priority support by choosing","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"address","value":"Generali Central Insurance Company Ltd.\nUnit No. 301, 3rd Floor Part, Building No. 8,\nMindspace IT/ITES SEZ, MIDC Industrial Area,\nAiravali, Navi Mumbai,\nThane District – 400 708.","label":"Corporate Grievance Redressal Officer (GRO) Address","level":2,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/customer-service/grievance-redressal","quote":"ON\n+91-79001 97777\nOR\nSend your complaint to our Corporate Grievance Redressal Officer\nMr. Hari Shankar Mishra\nADDRESS\nGenerali Central Insurance Company Ltd.\nUnit No. 301, 3\nrd\nFloor Part, Building No. 8,\nMindspace IT/ITES SEZ, MIDC Industrial Area,\nAiravali, Navi Mumbai,\nThane District – 400 708.\nLEVEL 3\nIf you are still not satisfied with the solution provided, you can email\nour CEO’s office.\nEMAIL OUR CEO’s OFF","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"email","value":"GCIGRO@generalicentral.com","label":"Corporate Grievance Redressal Officer (GRO) Email","level":2,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/customer-service/grievance-redressal","quote":"solution provided to you does not meet your expectations,\nyou can write directly to our Corporate GRO.\nSEND US AN EMAIL\nGCIGRO@generalicentral.com\nOR\nCALL US ON\n+91-79001 97777\nOR\nSend your complaint to our Corporate Grievance Redressal Officer\nMr. Hari Shankar Mish","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"phone","value":"+91-79001 97777","label":"Corporate Grievance Redressal Officer (GRO) Phone","level":2,"hours":null,"applies_to":"all","source_url":"https://www.generalicentralinsurance.com/customer-service/grievance-redressal","quote":"ur expectations,\nyou can write directly to our Corporate GRO.\nSEND US AN EMAIL\nGCIGRO@generalicentral.com\nOR\nCALL US ON\n+91-79001 97777\nOR\nSend your complaint to our Corporate Grievance Redressal Officer\nMr. Hari Shankar Mishra\nADDRESS\nGenerali Central In","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/generali-central-insurance/2750-home-secure-policy-proposal-form"}