{"id":2785,"title":"CAMEL INSURANCE PROPOSAL FORM","purpose":"proposal","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited"},"source_pdf":"https://www.generalicentralinsurance.com/downloads/other-insurance/camel-insurance/proposal-forms/camel-insurance-proposal-form.pdf","sha256":"1e9bcbe36b0505eccbd8728579c9cf098b2c996c9590445cfbac8897f8d1ecf0","pages":7,"collected":"2026-10-17","instructions":{"about":"This form is used by individuals or entities proposing to insure camels under Camel Insurance. The proposer fills it to provide details about themselves, the animals, and other relevant information for underwriting the insurance policy.","notes":["Use a separate signed and dated sheet if additional space is needed, referencing the question number.","Cover commences only after acceptance and receipt of premium.","Provide a certificate of good health from a qualified veterinary practitioner for each animal proposed for insurance.","If permanent address is left blank, it will be considered same as present address.","To receive claim/refund payments directly via NEFT for premium above Rs 25000, fill the attached authorization form.","The insurer follows anti-money laundering and anti-financial crime practices.","The form is part of a contract of utmost good faith requiring full disclosure.","Physical copy of policy document can be requested by ticking the box; otherwise, a digital copy link will be sent."],"title":"CAMEL INSURANCE PROPOSAL FORM","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Proposer Details and Insurance Period","fields":[{"help":"Enter start and end dates of the insurance coverage","type":"date","label":"Period of Insurance","options":[],"required":true,"pdf_field":""},{"help":"Full name of the person or entity proposing insurance","type":"text","label":"Name of the Proposer","options":[],"required":true,"pdf_field":""},{"help":"Complete current address","type":"text","label":"a. Present Address of the Proposer","options":[],"required":true,"pdf_field":""},{"help":"Permanent address if different from present address","type":"text","label":"b. Permanent address of the proposer (if left blank, will be construed as being same as Present Address)","options":[],"required":false,"pdf_field":""},{"help":"State of the address","type":"text","label":"State","options":[],"required":true,"pdf_field":""},{"help":"Postal code","type":"number","label":"Pin code","options":[],"required":true,"pdf_field":""},{"help":"Landline number including area code","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":"Address where animals are stabled if different from proposer address","type":"text","label":"Animal Stabling Address (If Different)","options":[],"required":false,"pdf_field":""},{"help":"State of stabling address","type":"text","label":"State","options":[],"required":false,"pdf_field":""},{"help":"Postal code of stabling address","type":"number","label":"Pin code","options":[],"required":false,"pdf_field":""},{"help":"Telephone number at stabling address","type":"phone","label":"Telephone No","options":[],"required":false,"pdf_field":""},{"help":"Mobile number at stabling address","type":"phone","label":"Mobile No","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Proposer Occupation and Cover Options","fields":[{"help":"Occupation of the proposer","type":"text","label":"Occupation","options":[],"required":true,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Is cover required for Permanent Total Disability?  YES   NO","options":["YES","NO"],"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 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":"yes-no","label":"If you are Differently Abled, please tick on the checkbox to provide confirmation. ☐Yes  ☐No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Describe type of impairment if applicable","type":"text","label":"Type of Impairment:","options":[],"required":false,"pdf_field":""},{"help":"Enter percentage if applicable","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":""}],"filled_by":"proposer"},{"title":"Animal Details and Usage","fields":[{"help":"Details of any hypothecation on the animals","type":"text","label":"Hypothecation, if any","options":[],"required":false,"pdf_field":""},{"help":"Fill columns: Type of Animal, Sex M/F, Age Yrs., Breed, Description of the Animal (Color, All other Distinguishing Features, marks), Tag No., Rt/Lt Ear, Market Value Rs.","type":"table","label":"Give the following particulars in full, of each of the animals proposed for insurance.","options":[],"required":true,"pdf_field":""},{"help":"Describe the intended use of the animals","type":"text","label":"State for what purpose the animals will be used.","options":[],"required":true,"pdf_field":""},{"help":"Provide health status and attach veterinary certificate","type":"text","label":"Is/are the animals in the stable sound and healthy and free from vice? If not give full particulars of defects and ailments if any. Please provide a certificate of good health issued by a qualified veterinary practitioner for each animal proposed for insurance.","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Veterinary Services and Loss History","fields":[{"help":"Specify veterinary service availability","type":"text","label":"Whether own Veterinary Services available or are you dependent on Government Veterinary Services?","options":[],"required":false,"pdf_field":""},{"help":"Select yes or no and provide details if yes","type":"yes-no","label":"a) Have you lost any animal/s during the last three years?  YES   NO If so state particulars","options":["YES","NO"],"required":true,"pdf_field":""},{"help":"Year of loss","type":"number","label":"Year","options":[],"required":false,"pdf_field":""},{"help":"Reason for animal loss","type":"text","label":"Cause of Loss","options":[],"required":false,"pdf_field":""},{"help":"Count of animals lost","type":"number","label":"Number of animals lost","options":[],"required":false,"pdf_field":""},{"help":"Fill columns: Year, Policy No., Name of Insurer, Claim Amount, Whether claim settled in full or in part or outstanding or repudiated","type":"table","label":"b) Previous Insurance and Claims experience (for the last three years)","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Other Animals and Insurance History","fields":[{"help":"List other animals owned","type":"text","label":"a) How many other animals do you own and of what type?","options":[],"required":false,"pdf_field":""},{"help":"Provide insurer details if insured","type":"text","label":"b) Are they insured and if so with which insurer?","options":[],"required":false,"pdf_field":""},{"help":"Explain reason for new insurance","type":"text","label":"c) If not why are they proposed for insurance now?","options":[],"required":false,"pdf_field":""},{"help":"Provide previous insurer names if applicable","type":"text","label":"Are any of the animals now proposed for insurance or have any other animals belonging to you been previously insured? If YES, state name of Company.","options":[],"required":false,"pdf_field":""},{"help":"Provide details if any such actions occurred","type":"text","label":"Has any Company a) Declined insurance of any of your animals or b) Declined to renew the insurance c) Increased your premium or imposed special conditions on renewal?","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Ownership and Financial Interest","fields":[{"help":"Provide ownership details or interest","type":"text","label":"a) Are you the owner of the animal? If not state name and address of owner and also nature of your interest in the animal","options":[],"required":true,"pdf_field":""},{"help":"Bank name and address if financing exists","type":"text","label":"b) Is any bank or other financing institution interested in the animal, If so, state i. Name and address of the bank","options":[],"required":false,"pdf_field":""},{"help":"Outstanding loan amount","type":"amount","label":"ii. Amount of loan outstanding.","options":[],"required":false,"pdf_field":""},{"help":"Government agency address if applicable","type":"text","label":"c) Is/ are the animal/s proposed for insurance covered by any Govt. scheme? If so, state i. Address of Govt. Agency Implementing the scheme","options":[],"required":false,"pdf_field":""},{"help":"Subsidy amount if any","type":"amount","label":"ii. Amount of subsidy obtained from Implementing Govt. agency.","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Other Information","fields":[{"help":"Provide any additional relevant information","type":"text","label":"Any other information material to the risk or the terms upon which cover might be offered.","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declarations and Signature","fields":[{"help":"Sign the form","type":"signature","label":"Proposer’s Signature","options":[],"required":true,"pdf_field":""},{"help":"Location where form is signed","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Payment Details","fields":[{"help":"Payment mode and cheque number if applicable","type":"text","label":"Premium paid by Cash/ Cheque No","options":[],"required":true,"pdf_field":""},{"help":"Date of payment","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Name of bank","type":"text","label":"Bank","options":[],"required":true,"pdf_field":""},{"help":"Amount paid in rupees","type":"amount","label":"Amount (Rs.)","options":[],"required":true,"pdf_field":""},{"help":"Permanent Account Number if premium > Rs 1 lakh","type":"text","label":"PAN (if premium payable is above Rs.1 lac (Please attach proof))","options":[],"required":false,"pdf_field":""},{"help":"Place of payment","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Date of payment","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Sign to confirm payment details","type":"signature","label":"Proposer’s Signature","options":[],"required":true,"pdf_field":""},{"help":"Goods and Services Tax Identification Number","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 and Nominee Details","fields":[{"help":"Name on bank account for refunds or claims","type":"text","label":"Name of bank account holder (mention specifically, if different from name of policyholder)","options":[],"required":false,"pdf_field":""},{"help":"Bank and branch details","type":"text","label":"Bank Name & Branch","options":[],"required":false,"pdf_field":""},{"help":"Account number for refunds or claims","type":"text","label":"Bank Account Number","options":[],"required":false,"pdf_field":""},{"help":"Indian Financial System Code","type":"text","label":"IFS Code","options":[],"required":false,"pdf_field":""},{"help":"Name of nominee","type":"text","label":"Nominee Details: Name","options":[],"required":false,"pdf_field":""},{"help":"Nominee's date of birth","type":"date","label":"Date of Birth","options":[],"required":false,"pdf_field":""},{"help":"Relationship to proposer","type":"text","label":"Relationship with the proposer","options":[],"required":false,"pdf_field":""},{"help":"Nominee's mobile number","type":"phone","label":"Mobile Number","options":[],"required":false,"pdf_field":""},{"help":"Nominee's email address","type":"email","label":"E-Mail ID","options":[],"required":false,"pdf_field":""},{"help":"Nominee's current address","type":"text","label":"Address of Nominee: Present address","options":[],"required":false,"pdf_field":""},{"help":"Nominee's permanent address if different","type":"text","label":"Permanent address: (if left blank, will be construed as being same as Present Address)","options":[],"required":false,"pdf_field":""},{"help":"Name on nominee's bank account","type":"text","label":"Bank Account Details of Nominee: Name of Account holder","options":[],"required":false,"pdf_field":""},{"help":"Nominee's bank and branch","type":"text","label":"Bank Name & Branch","options":[],"required":false,"pdf_field":""},{"help":"Nominee's bank account number","type":"text","label":"Bank Account Number","options":[],"required":false,"pdf_field":""},{"help":"Nominee's bank IFSC code","type":"text","label":"IFS Code","options":[],"required":false,"pdf_field":""},{"help":"Details of authorized person if nominee is minor","type":"text","label":"Authorized person details (in case nominee is a minor)","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Intermediary Use and Declaration","fields":[{"help":"Code of insurance agent or intermediary","type":"text","label":"Intermediary’s Code","options":[],"required":false,"pdf_field":""},{"help":"Name of insurance agent or intermediary","type":"text","label":"Intermediary’s Name","options":[],"required":false,"pdf_field":""},{"help":"PAN of Point of Sale Person if available","type":"text","label":"POSP PAN (if available)","options":[],"required":false,"pdf_field":""},{"help":"Name of intermediary signing declaration","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":"Intermediary code","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":"Camel Insurance policies","attachments":["A Certificate given by a qualified Veterinary Doctor must accompany this proposal","Proof of PAN if premium payable is above Rs.1 lac","Request for authorization form to receive Claim/ Refund payments if premium paid is more than Rs 25000/-"],"declarations":["All statements and information provided in this proposal are complete and accurate with no relevant information withheld.","If misrepresentation or fraud is found, the insurance policy may be voided and premium forfeited.","The proposer agrees to assist the insurer with records and information to address anti-financial crime practices.","Premiums are paid from legitimate sources and the insurer may verify source of funds and reject or terminate policy if otherwise.","Consent is given to receive communications electronically and for processing of personal data as per insurer's privacy policy.","The insurer may reject or terminate the contract if the proposer or associated persons are named in any recognized sanctions list.","KYC records are current and proposer will inform insurer of any changes.","Intermediary declares that product features and proposal contents have been explained to the proposer and that untrue or undisclosed information may void the policy.","The company reserves the right to reject the proposal or terminate the contract if the customer or associated persons are named in any recognized blacklist."],"dropped_labels":0},"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/2785-camel-insurance-proposal-form"}