{"id":2754,"title":"LONG TERM PRIVATE CAR PACKAGE POLICY - 3 YEARS PROPOSAL FORM","purpose":"proposal","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited"},"source_pdf":"https://www.generalicentralinsurance.com/downloads/motor-insurance/long-term-private-car-package-policy-3-years/proposal-forms/long-term-private-car-package-policy-3-years-proposal-form.pdf","sha256":"a22afc6e64f42988eb89ec8d256c60e3ca4b174ee669bdb5f529a8e993a4dc4c","pages":10,"collected":"2026-10-17","instructions":{"about":"This form is used by the proposer (registered owner of the motor vehicle) to apply for a Long Term Private Car Package Insurance Policy for 3 years.","notes":["Information for fields marked with asterisk [ * ] is mandatory.","If insufficient space to answer any question, attach a separate signed and dated sheet identifying the question number.","Cover shall commence not earlier than the date and time of acceptance of risk or issuance of cover note subsequent to payment of premium.","Copy of RC book needs to be provided.","For granting NCB, appropriate documentary evidence must be submitted.","Personal Accident Cover for owner driver is compulsory for sum insured of Rs 15 Lakhs except where vehicle is owned by company or owner driver does not hold effective driving license.","Wall charger and associated components/accessories, App Protection Cover and Battery Guard add on covers apply only for electric vehicles if fuel type is battery.","Use of the form is subject to anti-money laundering and anti-financial crime compliance.","The proposer may opt to receive a physical copy of the policy document by ticking the box; otherwise, documents will be sent electronically."],"title":"LONG TERM PRIVATE CAR PACKAGE POLICY - 3 YEARS PROPOSAL FORM","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Cover and Proposal Details","fields":[{"help":"Select the desired cover type","type":"choice","label":"*Cover Desired","options":["Package","Fire Only","Fire with Liability","Theft only","Theft with Liability","Fire & Theft Only","Fire & Theft with Liability"],"required":true,"pdf_field":""},{"help":"Select the type of proposal","type":"choice","label":"Proposal For-","options":["New Policy","Renewal","Rollover","Endorsement"],"required":true,"pdf_field":""},{"help":"Enter start date and time (hours and minutes)","type":"date","label":"Period of Insurance – From","options":[],"required":true,"pdf_field":""},{"help":"Enter end date","type":"date","label":"To midnight of","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Proposer’s Details","fields":[{"help":"Enter full name and select appropriate title","type":"text","label":"Name: -       ▢Mr.    ▢ Ms.     ▢Dr      ▢M/s","options":[],"required":true,"pdf_field":""},{"help":"Enter date of birth","type":"date","label":"Date of Birth","options":[],"required":true,"pdf_field":""},{"help":"Enter age in years","type":"number","label":"Age","options":[],"required":true,"pdf_field":""},{"help":"Select gender","type":"choice","label":"Sex","options":["Male","Female","Third Gender"],"required":true,"pdf_field":""},{"help":"Select marital status","type":"choice","label":"Marital Status","options":["Married","Single","Widowed"],"required":true,"pdf_field":""},{"help":"Enter occupation or business details","type":"text","label":"Occupation/Business/Service/Other","options":[],"required":null,"pdf_field":""},{"help":"Enter PAN number","type":"text","label":"PAN No.","options":[],"required":null,"pdf_field":""},{"help":"Enter educational qualification","type":"text","label":"Educational Qualification","options":[],"required":null,"pdf_field":""},{"help":"Specify if professional and details","type":"text","label":"Are you a professional? Yes/No, if yes please specify","options":[],"required":null,"pdf_field":""},{"help":"Select preferred format for policy documents","type":"choice","label":"I want Private Car Insurance Policy and related information in:","options":["Physical Format","e-Format (electronic)"],"required":null,"pdf_field":""},{"help":"Enter e-Insurance Account number if e-format selected","type":"text","label":"e-IA number (e-Insurance Account number)","options":[],"required":null,"pdf_field":""},{"help":"Select insurance repository","type":"choice","label":"Choose Insurance Repository (for those selecting e-format)","options":["NSDL Data Management Ltd","CDSL Insurance Repository Ltd","Karvy Insurance Repository Ltd","CAMS Repository Services Ltd."],"required":null,"pdf_field":""},{"help":"Enter CKYC number if available","type":"text","label":"CKYC No (Central Know Your Customer Registry No)","options":[],"required":null,"pdf_field":""},{"help":"Enter GSTIN if applicable; attach annexure if more than one","type":"text","label":"GSTIN: If applicable","options":[],"required":null,"pdf_field":""},{"help":"Select 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":null,"pdf_field":""},{"help":"Enter registration number if applicable","type":"text","label":"If you are an NGO/NPO, please provide Niti Ayog – Darpan Portal Registration Number","options":[],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"If you are Differently Abled, please tick on the checkbox to provide confirmation.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"If differently abled, specify type of impairment","type":"text","label":"Type of Impairment","options":[],"required":null,"pdf_field":""},{"help":"If differently abled, specify percentage","type":"number","label":"Percentage of Impairment","options":[],"required":null,"pdf_field":""},{"help":"If differently abled, provide UDID number","type":"text","label":"UDID Number","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Vehicle Registration and Communication Address","fields":[{"help":"Enter full registration address of the vehicle","type":"text","label":"2. REGISTRATION ADDRESS OF VEHICLE TO BE INSURED*","options":[],"required":true,"pdf_field":""},{"help":"Enter city of registration","type":"text","label":"City","options":[],"required":true,"pdf_field":""},{"help":"Enter state of registration","type":"text","label":"State","options":[],"required":true,"pdf_field":""},{"help":"Enter postal pin code","type":"number","label":"Pin code","options":[],"required":true,"pdf_field":""},{"help":"Enter full communication address","type":"text","label":"3. ADDRESS FOR COMMUNICATION (DISPATCH ADDRESS*)","options":[],"required":true,"pdf_field":""},{"help":"Enter building or block number","type":"text","label":"Building Name / Block No","options":[],"required":true,"pdf_field":""},{"help":"Enter street name","type":"text","label":"Street Name","options":[],"required":true,"pdf_field":""},{"help":"Enter city","type":"text","label":"City","options":[],"required":true,"pdf_field":""},{"help":"Enter state","type":"text","label":"State","options":[],"required":true,"pdf_field":""},{"help":"Enter postal pin code","type":"number","label":"Pin code","options":[],"required":true,"pdf_field":""},{"help":"Enter office telephone number","type":"phone","label":"Telephone (O)","options":[],"required":null,"pdf_field":""},{"help":"Enter fax number if any","type":"text","label":"Fax No","options":[],"required":null,"pdf_field":""},{"help":"Enter email address","type":"email","label":"Email","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Vehicle Details","fields":[{"help":"Enter vehicle make and model","type":"text","label":"Make and model","options":[],"required":true,"pdf_field":""},{"help":"Enter vehicle registration number","type":"text","label":"Registration No.","options":[],"required":true,"pdf_field":""},{"help":"Enter engine number","type":"text","label":"Engine No.","options":[],"required":true,"pdf_field":""},{"help":"Enter chassis number","type":"text","label":"Chassis No.","options":[],"required":true,"pdf_field":""},{"help":"Enter engine cubic capacity","type":"number","label":"Cubic capacity","options":[],"required":true,"pdf_field":""},{"help":"Enter year of manufacture","type":"number","label":"Year of manufacturer","options":[],"required":true,"pdf_field":""},{"help":"Enter vehicle color","type":"text","label":"Colour","options":[],"required":true,"pdf_field":""},{"help":"Enter RTO location","type":"text","label":"RTO where vehicle is/will be registered","options":[],"required":true,"pdf_field":""},{"help":"Enter date of registration or purchase","type":"date","label":"Date of Registration/purchase","options":[],"required":true,"pdf_field":""},{"help":"Enter seating capacity","type":"number","label":"Seating capacity (including driver)","options":[],"required":true,"pdf_field":""},{"help":"Select vehicle usage","type":"choice","label":"What is the usage of the vehicle","options":["Private Purposes only","Commercial Purpose"],"required":true,"pdf_field":""},{"help":"Select vehicle make origin","type":"choice","label":"Vehicle make","options":["Indigenous/Domestic","Imported"],"required":true,"pdf_field":""},{"help":"Select vehicle condition","type":"choice","label":"Vehicle Insured is","options":["Brand New","Used"],"required":true,"pdf_field":""},{"help":"Select applicable road types; specify if Others","type":"checkbox","label":"Type of Road where vehicle would normally ply","options":["Hilly","National Highways","State Highways","City","Town Roads","District Roads","Others"],"required":true,"pdf_field":""},{"help":"Select parking type","type":"checkbox","label":"Parking","options":["Open Parking","Roadside public Parking","Roadside Outside Parking","Parking lot open or covered","Closed Parking","Within Compound of Residence open","Within compound of residence covered"],"required":null,"pdf_field":""},{"help":"Select fuel type; specify if Others","type":"choice","label":"Fuel type","options":["Petrol","Diesel","Bi fuel","CNG","LPG","Battery","Others"],"required":true,"pdf_field":""},{"help":"Select preferred repair option","type":"choice","label":"Repair","options":["Preferred garage","Dealership"],"required":null,"pdf_field":""},{"help":"Select estimated daily mileage","type":"choice","label":"Per day mileage","options":["Upto 20 kms","21 to 50 kms","51 to 100 kms","101 kms and above"],"required":null,"pdf_field":""},{"help":"Enter current speedometer reading","type":"number","label":"Speedometer reading as on date*","options":[],"required":true,"pdf_field":""},{"help":"Enter trailer registration number and number of trailers if applicable","type":"text","label":"Trailer Registration No. and No. of trailer*","options":[],"required":true,"pdf_field":""},{"help":"Tick yes if valid PUC certificate is available","type":"yes-no","label":"Pollution Under Control (PUC) Certificate: Vehicle being insured has valid Pollution Under Control (PUC) certificate as on Inception Date of Policy","options":["Yes","No"],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Financier Details","fields":[{"help":"Enter financier bank name","type":"text","label":"Bank Name","options":[],"required":null,"pdf_field":""},{"help":"Enter bank location","type":"text","label":"Location of the Bank","options":[],"required":null,"pdf_field":""},{"help":"Enter loan account number","type":"text","label":"Loan Account no","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Previous Insurance Particulars","fields":[{"help":"Enter previous insurer name","type":"text","label":"Previous Insurer name","options":[],"required":null,"pdf_field":""},{"help":"Select previous cover type","type":"choice","label":"Type of cover","options":["Package","Fire and/or Theft with liability","Fire and/or Theft only","Liability only"],"required":null,"pdf_field":""},{"help":"Enter previous policy period","type":"text","label":"Period of Insurance","options":[],"required":null,"pdf_field":""},{"help":"Enter previous insurer address","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"Enter previous policy or cover note number","type":"text","label":"Policy/Cover note number","options":[],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"Has any Insurance Company ever: 1) Declined the proposal.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"2) Cancelled & refused to renew","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"3) Required an increase in premium.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"4) Imposed special conditions or excess.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Enter percentage of No Claim Bonus","type":"number","label":"# No claim Bonus in the expiring policy %","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Insured Declared Value (IDV)","fields":[{"help":"Enter IDV of the vehicle","type":"amount","label":"Insured Declared Value of the Vehicle* (A)","options":[],"required":true,"pdf_field":""},{"help":"Enter value of non-electrical accessories","type":"amount","label":"Value of Non-Electrical Accessories fitted to the vehicle (B)","options":[],"required":null,"pdf_field":""},{"help":"Enter value of CNG/LPG kit if fitted","type":"amount","label":"Value of CNG/LPG kit (E)","options":[],"required":null,"pdf_field":""},{"help":"Sum of all above values","type":"amount","label":"Total IDV (A+B+C+D+E)","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Coverage Information","fields":[{"help":"Provide nominee details","type":"text","label":"Personal Accident Cover for Owner Driver is compulsory in the Package policies. Please give details of nomination:","options":[],"required":true,"pdf_field":""},{"help":"Enter nominee name","type":"text","label":"(a) Name of Nominee","options":[],"required":true,"pdf_field":""},{"help":"Enter nominee age","type":"number","label":"(b) Age","options":[],"required":true,"pdf_field":""},{"help":"Enter relationship with proposer","type":"text","label":"(c) Relationship","options":[],"required":true,"pdf_field":""},{"help":"Enter appointee name if nominee is minor","type":"text","label":"(d) Name of Appointee (If nominee is minor)","options":[],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"Do you have a Personal Accident cover with a sum insured of Rs 15 Lakhs?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Enter policy number if applicable","type":"text","label":"If yes, then please provide policy number","options":[],"required":null,"pdf_field":""},{"help":"Select add-on personal accident coverages","type":"checkbox","label":"Do you wish to include the following Personal Accident coverage","options":["Unnamed Passenger","Paid Driver"],"required":null,"pdf_field":""},{"help":"Provide name, sum insured, nominee and relationship for named persons","type":"table","label":"In case of named persons, give name and CSI opted for","options":[],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"Do you wish to opt for statutory TPPD liability coverage of `6000/- only?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Enter number of persons for legal liability","type":"text","label":"Legal Liability to Driver, conductor, cleaner - No of person","options":[],"required":null,"pdf_field":""},{"help":"Enter number of other employees covered","type":"number","label":"Legal Liability to Other Employee – No of Person","options":[],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"Is the vehicle fitted with Anti-Theft Device approved by AARI?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"Whether vehicle is specially designed for use of Handicap Person?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"Whether the use of the vehicle is limited to own premises?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Select countries for geographical extension","type":"checkbox","label":"Whether extension of geographical area to the following countries required?","options":["Bangladesh","Bhutan","Maldives","Nepal","Pakistan","Sri Lanka"],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"Whether Vehicle belongs to Foreign Embassy / consulate?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"Whether the vehicle is fitted with fibre glass tank?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"Are you a Member of Automobile Association of India?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Enter membership name if applicable","type":"text","label":"Membership Name","options":[],"required":null,"pdf_field":""},{"help":"Enter association name","type":"text","label":"Association Name","options":[],"required":null,"pdf_field":""},{"help":"Enter membership expiry date","type":"date","label":"Expiry Date","options":[],"required":null,"pdf_field":""},{"help":"Tick yes or no","type":"yes-no","label":"Whether the vehicle is used for Driving Tuition?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Select deductible amount","type":"choice","label":"Please select the higher deductible if you wish to opt for over and above the compulsory deductible.","options":["2500","5000","7500","15000"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Add On Covers","fields":[{"help":"Select desired add-on covers; note some covers apply only for electric vehicles","type":"checkbox","label":"Do you wish to opt add on cover? if yes then please select","options":["Zero Depreciation Cover","Daily Cash Benefit /Inconvenience Allowance","Hospital Cash Cover","Consumable Cover","Roadside Assistance","Loan Protector Cover","Personal Accident Plan","Tyre Protection","Loss of Driving License/RC","Engine & Gear Box Cover","Protection of NCB","Increased property damage liability benefit","Loss of Personal Belonging","Return to Invoice","Additional Towing Charges","Key & Locks Replacement Cover","Wall Charger and associated components / accessories","App Protection Cover","Battery Guard","Electric Vehicle","Hybrid Vehicle","Emergency Medical Expenses","Rim Protect","Tyre & Rim Protect"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Driver Details","fields":[{"help":"Select who will drive the vehicle and provide experience","type":"choice","label":"The vehicle to be driven by","options":["Self – Driving Experience - years","Any other person/s"],"required":null,"pdf_field":""},{"help":"Enter driver name(s)","type":"text","label":"Name","options":[],"required":null,"pdf_field":""},{"help":"Enter driver age(s)","type":"number","label":"Age","options":[],"required":null,"pdf_field":""},{"help":"Select driver gender","type":"choice","label":"Gender","options":["Male","Female","Third Gender"],"required":null,"pdf_field":""},{"help":"Enter driving experience in years","type":"number","label":"Driving Experience","options":[],"required":null,"pdf_field":""},{"help":"Enter educational qualifications","type":"text","label":"Educational Qualifications","options":[],"required":null,"pdf_field":""},{"help":"Enter number of accidents","type":"number","label":"No. of accidents in previous 5 years","options":[],"required":null,"pdf_field":""},{"help":"Indicate if paid drivers","type":"checkbox","label":"Paid drivers","options":[],"required":null,"pdf_field":""},{"help":"Provide details of other drivers if any","type":"text","label":"Others","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Other Details","fields":[{"help":"Tick yes or no","type":"yes-no","label":"Do you have another vehicle insured with Generali Central Insurance Company Limited?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide policy number and details","type":"text","label":"If Yes, please share policy details","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Payment Details","fields":[{"help":"Specify payment mode","type":"text","label":"Mode of Payment","options":[],"required":null,"pdf_field":""},{"help":"Provide payment details","type":"text","label":"Payment Details","options":[],"required":null,"pdf_field":""},{"help":"Enter payment amount","type":"amount","label":"Amount in (Rs.)","options":[],"required":null,"pdf_field":""},{"help":"Enter payment date","type":"date","label":"Date of Payment (DD/MM/YY)","options":[],"required":null,"pdf_field":""},{"help":"Enter PAN if premium is 1 lakh or above","type":"text","label":"PAN (If premium is 1 Lac and Above.)","options":[],"required":null,"pdf_field":""},{"help":"Enter GSTIN or attach annexure","type":"text","label":"GSTIN (If more than one GSTIN, kindly attach an annexure with details)","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Bank Details for Refund or Claim Purpose","fields":[{"help":"Enter bank account holder name","type":"text","label":"Name of bank account holder (mention specifically, if different from name of policyholder)","options":[],"required":null,"pdf_field":""},{"help":"Enter bank name and branch","type":"text","label":"Bank Name & Branch","options":[],"required":null,"pdf_field":""},{"help":"Enter bank account number","type":"text","label":"Bank Account Number","options":[],"required":null,"pdf_field":""},{"help":"Enter IFSC code","type":"text","label":"IFS Code","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Nominee Details","fields":[{"help":"Enter nominee name","type":"text","label":"Name","options":[],"required":null,"pdf_field":""},{"help":"Enter nominee date of birth","type":"date","label":"Date of Birth","options":[],"required":null,"pdf_field":""},{"help":"Enter relationship","type":"text","label":"Relationship with the proposer","options":[],"required":null,"pdf_field":""},{"help":"Enter mobile number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Enter email address","type":"email","label":"E-Mail ID","options":[],"required":null,"pdf_field":""},{"help":"Enter present address","type":"text","label":"Address of Nominee: Present address","options":[],"required":null,"pdf_field":""},{"help":"Enter permanent address or leave blank","type":"text","label":"Permanent address (if left blank, will be construed as being same as Present Address)","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Bank Account Details of Nominee","fields":[{"help":"Enter nominee bank account holder name","type":"text","label":"Name of Account holder","options":[],"required":null,"pdf_field":""},{"help":"Enter bank name and branch","type":"text","label":"Bank Name & Branch","options":[],"required":null,"pdf_field":""},{"help":"Enter bank account number","type":"text","label":"Bank Account Number","options":[],"required":null,"pdf_field":""},{"help":"Enter IFSC code","type":"text","label":"IFS Code","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Authorized Person Details (in case nominee is a minor)","fields":[{"help":"Provide details of authorized person if nominee is minor","type":"text","label":"Authorized person details","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declaration","fields":[{"help":"Sign the declaration","type":"signature","label":"Signature of the Proposer(s)","options":[],"required":true,"pdf_field":""},{"help":"Enter date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Enter place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declaration for No Claim Bonus (NCB)","fields":[{"help":"Sign to declare correctness of NCB","type":"signature","label":"Proposer’s Signature","options":[],"required":true,"pdf_field":""},{"help":"Enter place","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Enter date","type":"date","label":"Date","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"}],"deadlines":[],"applies_to":"Long Term Private Car Package Policy - 3 Years","attachments":["Copy of RC book","Expiring Policy copy with schedule/Renewal notice or cover note as proof of insurance","Request for authorization form to receive claim/refund payments if premium amount is more than Rs.10,000/-"],"declarations":["All statements and information provided in this proposal are complete and accurate with no material facts withheld.","If misrepresentation or suppression of material facts is found, the policy may be void and premium forfeited.","The policyholder agrees to assist the insurer with records and information to address anti-financial crime practices.","Premiums are paid from legitimate sources and insurer may verify source of funds and reject or terminate policy if otherwise.","Consent is given to receive policy and service communications electronically and for processing of personal data as per privacy policy.","The insurer reserves the right to reject or terminate the policy if the proposer or associated persons are named in any recognized sanctions list.","The proposer confirms KYC records are current and will inform insurer of any changes.","The No Claim Bonus declared is correct and if found incorrect, benefits under the policy will be forfeited.","The intermediary confirms that product features and proposal contents have been explained to the proposer."],"dropped_labels":9},"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/2754-long-term-private-car-package-policy-3-years-proposal-form"}