{"id":2782,"title":"BUSINESS SURAKSHA-SOOKSHMA PROPOSAL FORM","purpose":"proposal","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited"},"source_pdf":"https://www.generalicentralinsurance.com/downloads/other-insurance/business-suraksha-sookshma/proposal-forms/business-suraksha-sookshma-retail-proposal-form.pdf","sha256":"8cfc1431e8040b6b0706b1ba52e1fc1882fe0d75bec2c563eb326237fc7fd9ba","pages":14,"collected":"2026-10-17","instructions":{"about":"This form is used by proposers to apply for the Business Suraksha Sookshma insurance policy. The proposer fills it to provide details about their business, coverage requirements, and other relevant information for underwriting.","notes":["Read the prospectus/key features document/policy wordings before completing the form.","Answer all questions fully; attach separate signed and dated sheets if needed.","Cover commences only after acceptance and receipt of premium.","If Permanent Address is left blank, it will be considered same as Present Address.","Use original bills and documents where applicable.","For premium above Rs 10,000, fill request for authorization form for NEFT payments.","Policyholder must comply with anti-money laundering and anti-financial crime regulations.","Physical copy of policy document available on request; otherwise digital copy will be sent.","No rebates or inducements allowed as per Section 41 of Insurance Act, 1938."],"title":"BUSINESS SURAKSHA-SOOKSHMA 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; Email ID: GCIcare@generalicentral.com"},"purpose":"proposal","sections":[{"title":"Proposer and Policy Details","fields":[{"help":"","type":"text","label":"Policy Issuing Office Address & Code","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Intermediary/Agent Name & Code (if any)","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"POSP PAN (if applicable)","options":[],"required":false,"pdf_field":""},{"help":"Start date of insurance coverage","type":"date","label":"Period of Insurance: From","options":[],"required":true,"pdf_field":""},{"help":"Full legal name of the proposer","type":"text","label":"Name of Proposer (in full)","options":[],"required":true,"pdf_field":""},{"help":"Full present postal address","type":"text","label":"Present Address of the proposer","options":[],"required":true,"pdf_field":""},{"help":"State of present address","type":"text","label":"State","options":[],"required":true,"pdf_field":""},{"help":"Postal code of present address","type":"number","label":"Pin code","options":[],"required":true,"pdf_field":""},{"help":"Landline number if any","type":"phone","label":"Telephone no.","options":[],"required":false,"pdf_field":""},{"help":"Mobile phone number","type":"phone","label":"Mobile no.","options":[],"required":true,"pdf_field":""},{"help":"If left blank, same as Present Address","type":"text","label":"Permanent Address of the proposer","options":[],"required":false,"pdf_field":""},{"help":"State of permanent address","type":"text","label":"State","options":[],"required":false,"pdf_field":""},{"help":"Postal code of permanent address","type":"number","label":"Pin code","options":[],"required":false,"pdf_field":""},{"help":"Landline number if any","type":"phone","label":"Telephone no.","options":[],"required":false,"pdf_field":""},{"help":"Mobile phone number","type":"phone","label":"Mobile no.","options":[],"required":false,"pdf_field":""},{"help":"Email address of proposer","type":"email","label":"Email ID","options":[],"required":false,"pdf_field":""},{"help":"Name of contact person","type":"text","label":"Contact person details (where proposer is not an individual) a. Name","options":[],"required":false,"pdf_field":""},{"help":"Designation of contact person","type":"text","label":"Contact person details (where proposer is not an individual) b. Designation","options":[],"required":false,"pdf_field":""},{"help":"List all parties with insurable interest","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":"Central KYC registry number if available","type":"text","label":"CKYC Number (if available)","options":[],"required":false,"pdf_field":""},{"help":"Select 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 Organization","Non Profit Organisation"],"required":false,"pdf_field":""},{"help":"Registration number for NGO/NPO","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":"yes-no","label":"If you are Differently Abled, please tick on the checkbox to provide confirmation","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Specify type if differently abled","type":"text","label":"Type of Impairment","options":[],"required":false,"pdf_field":""},{"help":"Specify percentage if differently abled","type":"number","label":"Percentage of Impairment","options":[],"required":false,"pdf_field":""},{"help":"Unique Disability ID if differently abled","type":"text","label":"UDID Number","options":[],"required":false,"pdf_field":""},{"help":"Provide full address, pin code, occupancy, age of unit, floor (GF/MF/H)","type":"table","label":"Location of Risk/business to be covered - full–postal address with Pin code","options":[],"required":true,"pdf_field":""},{"help":"Describe the business activity","type":"text","label":"Business of Proposer","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Coverage Proposed - Section I: Fire and Allied Perils","fields":[{"help":"Tick Yes or No for each property type; specify others if any","type":"checkbox","label":"Details of insured property - Please tick in the space below","options":["Offices, Shops, Hotels, etc","Industrial / Manufacturing risks","Storage outside Industrial/ Manufacturing risks","Tanks / Gas holders outside Industrial/ Manufacturing risks","Utilities located outside Industrial/Manufacturing risks","Boundary wall","Basement storage","Others (please specify)"],"required":true,"pdf_field":""},{"help":"Sum insured value for stored items","type":"amount","label":"If yes value stored SI: ₹","options":[],"required":false,"pdf_field":""},{"help":"List goods stored if applicable","type":"text","label":"If used as warehouse / go down (not located in a manufacturing unit), please give the list of goods stored","options":[],"required":false,"pdf_field":""},{"help":"Describe products manufactured; attach block plan if applicable","type":"text","label":"If used as an Industrial Manufacturing unit give products manufactured at the location proposed","options":[],"required":false,"pdf_field":""},{"help":"Select factory status","type":"choice","label":"If used as an Industrial Manufacturing unit, please state whether the factory is working or silent","options":["Working","Silent"],"required":false,"pdf_field":""},{"help":"Tick all applicable fire protection devices","type":"checkbox","label":"Fire Protection devices installed - Please tick the correct answer","options":["Portable Extinguishers","Small bore hose reels","Trailer Pumps/Fire engines","Hydrant System","Sprinkler System","Fixed Water Spray System","Foam System","Fire Alarm System","Gas Flooding System","Others (please specify)"],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"yes-no","label":"Indicate whether AMC(Annual Maintenance contract) for the Fire Protection Appliances is in force","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Select construction type for walls","type":"choice","label":"Walls - Kutcha / Pucca","options":["Kutcha","Pucca"],"required":false,"pdf_field":""},{"help":"Select construction type for floor","type":"choice","label":"Floor - Kutcha / Pucca","options":["Kutcha","Pucca"],"required":false,"pdf_field":""},{"help":"Select construction type for roof","type":"choice","label":"Roof - Kutcha / Pucca","options":["Kutcha","Pucca"],"required":false,"pdf_field":""},{"help":"Total floors in building","type":"number","label":"Number of Floors","options":[],"required":false,"pdf_field":""},{"help":"Select age category","type":"choice","label":"Age of the Building","options":["Less than 5 Years","5-10 Years","10-20 Years","Above 20 Years"],"required":false,"pdf_field":""},{"help":"Specify distance","type":"text","label":"Distance between the risk to be covered and nearest Fire Brigade","options":[],"required":false,"pdf_field":""},{"help":"Provide yearly premium and claim amounts for last 36 months","type":"table","label":"Premium / Claim details for the past 36 Months for Fire and Allied perils Section excluding the expiring policy period - Year, Premium (Rs.), Claim (Rs.)","options":[],"required":false,"pdf_field":""},{"help":"Provide sum insured for Building, Plant & Machinery, Furniture & Fixtures, Raw Material, Stock in Process, Finished Stock, Other Contents","type":"table","label":"Sum Insured and Other details of Insured Property","options":[],"required":true,"pdf_field":""},{"help":"List locations and sum insured for stocks at each","type":"table","label":"Floater Cover (for stocks at various locations) - Location (Postal Address with Pin code), Sum Insured(in ₹)","options":[],"required":false,"pdf_field":""},{"help":"Maximum stock value at a single location","type":"amount","label":"Maximum value at any one location: ₹","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"yes-no","label":"Whether stocks stored in open: Yes/No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Strike off what is not applicable","type":"yes-no","label":"Do You want to opt for Declaration Policy? -- Yes/No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Specify amount if opting for declaration policy","type":"amount","label":"Stocks which fluctuate in value to be covered on (monthly) declaration basis: Amount (₹)","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No for each add-on cover","type":"checkbox","label":"Details of additional covers (add-ons) offered with the policy - Add On Covers Name, Yes / No","options":["Additional Custom Duty","Claim Preparation Costs","Escalation","Involuntary Betterment","Deterioration Of Stocks In Cold Storage Premises","Insurance Of Additional Expenses Of Rent For An Alternative Accommodation","Loss Of Rent Clause"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section II: Fire Loss of Profit","fields":[{"help":"Tick all applicable covers","type":"checkbox","label":"Tick Description Sum Insured in Rs.","options":["Net Profit","Standing Charges or Fixed Charges","Wages- if required separately"],"required":false,"pdf_field":""},{"help":"Total gross profit sum insured","type":"amount","label":"Gross Profit (TOTAL)","options":[],"required":false,"pdf_field":""},{"help":"List critical equipment and lead times","type":"text","label":"Critical Equipment’s & their Lead time","options":[],"required":false,"pdf_field":""},{"help":"Select process type","type":"choice","label":"Please mention the type of Process","options":["Continuous","Non-Continuous"],"required":false,"pdf_field":""},{"help":"Tick all applicable extensions; provide numbers and percentages where requested","type":"checkbox","label":"Please select Extension/s that you wish to opt","options":["Auditor Fees","Customers Premises","Dependence","Suppliers Premises","Loss due to accidental failure of public electricity/gas/water supply"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section III: Burglary","fields":[{"help":"Describe valuables; attach separate sheet if needed","type":"text","label":"Description of all valuables in the insured premises (excluding jewellery, electronic equipment, TV, domestic appliances)","options":[],"required":false,"pdf_field":""},{"help":"Sum insured for valuables","type":"amount","label":"Sum Insured","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"yes-no","label":"Please specify if Watch & ward facility is available for 24 hours","options":["YES","NO"],"required":false,"pdf_field":""},{"help":"Describe other security measures","type":"text","label":"Please provide details of any other security facilities available at the premises","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"yes-no","label":"Do you wish to avail cover on first loss basis?","options":["YES","NO"],"required":false,"pdf_field":""},{"help":"Specify percentage if opting for first loss basis","type":"number","label":"If YES, please specify the % of First Loss basis (Min 25%)","options":[],"required":false,"pdf_field":""},{"help":"Sum insured for first loss","type":"amount","label":"Please mention the First Loss Sum insured","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section V: Electronic Equipment","fields":[{"help":"Tick Yes or No; if Yes, enclose copy","type":"yes-no","label":"Is a valid maintenance contract in force for the items insured above?","options":["YES","NO"],"required":false,"pdf_field":""},{"help":"Tick Yes or No; if Yes, fill separate EEI proposal form","type":"yes-no","label":"Do you wish to include External Data Media and/or Increased Cost of working covers?","options":["YES","NO"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section VI: All Risks","fields":[{"help":"Provide details of items to insure","type":"table","label":"Description, Make, Sr. No., Year of manufacture, Sum insured Rs.","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section VII: Accident Suraksha","fields":[{"help":"Provide details of insured items","type":"table","label":"Description Type of item along with serial number, Year of manufacture, Reinstatement Value (Rs)","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section XI: Money Insurance","fields":[{"help":"Specify location","type":"text","label":"Location for Money in safe","options":[],"required":false,"pdf_field":""},{"help":"Specify transit route","type":"text","label":"From where to where","options":[],"required":false,"pdf_field":""},{"help":"Specify transport mode","type":"text","label":"Mode of Transport","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Section XII: Fidelity Guarantee","fields":[{"help":"Specify limit","type":"amount","label":"Any One Person Limit","options":[],"required":false,"pdf_field":""},{"help":"Provide description and value of items","type":"table","label":"Description of item, Value (Rs.)","options":[],"required":false,"pdf_field":""},{"help":"Total value","type":"amount","label":"Total","options":[],"required":false,"pdf_field":""},{"help":"Specify limit","type":"amount","label":"Any one-Accident Limit","options":[],"required":false,"pdf_field":""},{"help":"Specify limit","type":"amount","label":"Any one Year Limit","options":[],"required":false,"pdf_field":""},{"help":"Provide details","type":"text","label":"Expiring policy details","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Premium Details","fields":[{"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 premium was paid","type":"date","label":"Date of Payment (DD/MM/YY)","options":[],"required":true,"pdf_field":""},{"help":"Provide PAN if premium ≥ ₹100,000","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":""}],"filled_by":"proposer"},{"title":"Bank Details of Proposer for refund or claim purpose","fields":[{"help":"Name on bank account","type":"text","label":"Name of bank account holder (mention specifically, if different from name of policyholder)","options":[],"required":true,"pdf_field":""},{"help":"Bank and branch name","type":"text","label":"Bank Name & Branch","options":[],"required":true,"pdf_field":""},{"help":"Account number","type":"text","label":"Bank Account Number","options":[],"required":true,"pdf_field":""},{"help":"IFSC code","type":"text","label":"IFS Code","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Nominee Details","fields":[{"help":"Nominee full name","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"Nominee date of birth","type":"date","label":"Date of Birth","options":[],"required":true,"pdf_field":""},{"help":"Relationship to proposer","type":"text","label":"Relationship with the proposer","options":[],"required":true,"pdf_field":""},{"help":"Nominee mobile number","type":"phone","label":"Mobile Number","options":[],"required":false,"pdf_field":""},{"help":"Nominee email address","type":"email","label":"E-Mail ID","options":[],"required":false,"pdf_field":""},{"help":"Nominee present address","type":"text","label":"Address of Nominee - Present address","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Bank Account Details of Nominee","fields":[{"help":"Nominee bank account holder name","type":"text","label":"Name of Account holder","options":[],"required":true,"pdf_field":""},{"help":"Bank and branch name","type":"text","label":"Bank Name & Branch","options":[],"required":true,"pdf_field":""},{"help":"Account number","type":"text","label":"Bank Account Number","options":[],"required":true,"pdf_field":""},{"help":"IFSC code","type":"text","label":"IFS Code","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Authorized person details (in case nominee is a minor)","fields":[{"help":"Provide details if nominee is minor","type":"text","label":"Authorized person details","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declaration by Proposer","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 here","type":"signature","label":"Signature of the Proposer(s) (Affix stamp, where proposer is a juridical person)","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Annexure (Addendum) Questionnaire","fields":[{"help":"Tick Yes or No","type":"yes-no","label":"Is Watchmen on Duty (Round the Clock) available at your Storage Facility?","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Tick Yes or No","type":"yes-no","label":"Are you following standard housekeeping practices at premises to be covered?","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Tick Yes or No","type":"yes-no","label":"Please confirm whether your premises has conductive wiring in place?","options":["YES","NO"],"required":true,"pdf_field":""}],"filled_by":"proposer"}],"deadlines":[],"applies_to":"Business Suraksha Sookshma insurance policy proposals","attachments":["Separate signed and dated sheet if additional space is needed","Block plan showing various facilities for Industrial Manufacturing unit (if applicable)","Copy of valid maintenance contract for Electronic Equipment (if applicable)","Separate EEI proposal form (if opting for External Data Media/Increased Cost of working covers)","Separate list of permanent employees for Fidelity Guarantee cover","Annexure (Addendum) questionnaire"],"declarations":["All statements and information provided are complete and accurate with no relevant information withheld.","Misrepresentation or suppression of material facts may render the policy void and premium forfeited.","Policyholder and related persons must assist GCICL with records to address anti-financial crime practices.","Premium must be paid from legitimate sources; GCICL may verify source and reject or terminate policy if otherwise.","Consent to receive policy and service communications electronically and for GCICL to process personal data as per privacy policy.","Consent to GCICL accessing CKYC records for verification and communication.","KYC records are current and valid; proposer will inform GCICL of any changes.","Policy may be rejected or terminated if proposer or associated persons are named in any recognized sanctions list."],"dropped_labels":22},"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/2782-business-suraksha-sookshma-proposal-form"}