{"id":2803,"title":"GOLFER’S 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/golfers-insurance/proposal-forms/golfers-insurance-retail-proposal-form.pdf","sha256":"3e09f1ef352a622f46a59918f0ec5cdcd3f51c13869bb3ee924091e8e6256a21","pages":6,"collected":"2026-10-17","instructions":{"about":"This form is used by individuals applying for Golfer’s Insurance to provide personal, health, and insurance-related information to the insurer.","notes":["Answer all questions fully and tick Yes/No boxes as applicable.","Cover starts only after acceptance and premium payment.","Use original documents for attachments.","If premium paid is more than Rs. 10,000, fill authorization form for NEFT payments.","If nominee is minor, provide authorized person details.","Physical copy of policy will be sent only if requested; otherwise digital copy link will be sent.","Section 41 of Insurance Act prohibits rebates; penalties apply for violations."],"title":"GOLFER’S INSURANCE PROPOSAL FORM","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Proposer Details","fields":[{"help":"","type":"text","label":"Name of the Proposer","options":[],"required":true,"pdf_field":""},{"help":"Include state, pin code, telephone and mobile numbers","type":"text","label":"Present Address of the Proposer","options":[],"required":true,"pdf_field":""},{"help":"DD/MM/YYYY format","type":"date","label":"Date of Birth","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Occupation","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Nominee Details","fields":[{"help":"","type":"text","label":"Nominee Name","options":[],"required":true,"pdf_field":""},{"help":"Include state, pin code, telephone and mobile numbers","type":"text","label":"Nominee Address","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Golf Club Membership","fields":[{"help":"","type":"yes-no","label":"Do you have membership with any Colf Clubs?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Include state, pin code, telephone and mobile numbers","type":"text","label":"Name and Address of the Golf Club","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Golf Kit Details","fields":[{"help":"Provide full description (brand, type, model, grade, shaft), source (name, address, date of purchase), and net cost price","type":"table","label":"Enlist and attach a list of articles in Golf Kit to be insured and values thereof","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Insurance History and Health","fields":[{"help":"","type":"yes-no","label":"Has any insurer ever refused to accept, renew or continue your insurance cover or quoted increased rate or special terms?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If No, provide details","type":"yes-no","label":"Are you in good health and free from physical impairment?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Explain health or impairment details","type":"text","label":"If no, then please provide details","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"CYKC No. (If available)","options":[],"required":false,"pdf_field":""},{"help":"If NGO/NPO, provide Niti Ayog – Darpan Portal Registration Number","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":"If applicable for NGO/NPO","type":"text","label":"Niti Ayog – Darpan Portal Registration Number","options":[],"required":false,"pdf_field":""},{"help":"If Yes, provide type, percentage of impairment and UDID Number","type":"checkbox","label":"If you are Differently Abled, please tick on the checkbox to provide confirmation","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"If differently abled","type":"text","label":"Type of Impairment","options":[],"required":false,"pdf_field":""},{"help":"If differently abled","type":"number","label":"Percentage of Impairment","options":[],"required":false,"pdf_field":""},{"help":"If differently abled","type":"text","label":"UDID Number","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Accident and Claims History","fields":[{"help":"If Yes, provide details","type":"yes-no","label":"Have you sustained any accident necessitating medical attention during the last five years or ever made claim against any insurance company for any such injury?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Details of accident or claim","type":"text","label":"If yes, then please provide details","options":[],"required":false,"pdf_field":""},{"help":"If Yes, provide details","type":"yes-no","label":"Have you sustained any loss or damage to your golf equipment or has any third party claimed against you for loss or damage to their property or for bodily injury?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Details of loss, damage or claim","type":"text","label":"If yes, then please provide details","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Caddy Details","fields":[{"help":"","type":"text","label":"Name","options":[],"required":false,"pdf_field":""},{"help":"DD/MM/YYYY format","type":"date","label":"Date of Birth","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Address","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Nominee Name","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Nominee Address","options":[],"required":false,"pdf_field":""},{"help":"Caddy must confirm health status","type":"checkbox","label":"Declaration: I am in good health and free of any physical impairment.","options":["Yes"],"required":true,"pdf_field":""},{"help":"Caddy's signature","type":"signature","label":"Signature","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Plan Details","fields":[{"help":"If Flexi Plan, fill sum insured as required in the table below","type":"choice","label":"Select the Plan","options":["Birdie Plan","Eagle Plan","Albatross Plan","Flexi Plan"],"required":true,"pdf_field":""},{"help":"","type":"amount","label":"Total Premium","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Period of Insurance and Payment Details","fields":[{"help":"Fill start and end dates","type":"date","label":"Period of Insurance: FROM to","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Mode of Payment","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Payment Details","options":[],"required":true,"pdf_field":""},{"help":"","type":"amount","label":"Amount in (₹)","options":[],"required":true,"pdf_field":""},{"help":"DD/MM/YY format","type":"date","label":"Date of Payment (DD/MM/YY)","options":[],"required":true,"pdf_field":""},{"help":"Provide PAN if premium is 100,000 INR or more","type":"text","label":"PAN (If premium is 1 Lac and Above.)","options":[],"required":false,"pdf_field":""},{"help":"Attach annexure if multiple GSTINs","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":"","type":"text","label":"Name of bank account holder (mention specifically, if different from name of policyholder)","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Bank Name & Branch","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Bank Account Number","options":[],"required":false,"pdf_field":""},{"help":"IFSC code","type":"text","label":"IFS Code","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Nominee Bank Details","fields":[{"help":"Nominee name","type":"text","label":"Name","options":[],"required":false,"pdf_field":""},{"help":"Nominee DOB","type":"date","label":"Date of Birth","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Relationship with the proposer","options":[],"required":false,"pdf_field":""},{"help":"","type":"phone","label":"Mobile Number","options":[],"required":false,"pdf_field":""},{"help":"","type":"email","label":"E-Mail ID","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Address of Nominee: Present address","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Permanent address (if left blank, will be construed as being same as Present Address)","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Bank Account Details of Nominee: Name of Account holder","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Bank Name & Branch","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Bank Account Number","options":[],"required":false,"pdf_field":""},{"help":"IFSC code","type":"text","label":"IFS Code","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Authorized Person Details (if nominee is a minor)","fields":[{"help":"Fill 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 to confirm declaration","type":"signature","label":"Signature of the Proposer(s)","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"For Intermediary Use Only","fields":[{"help":"","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":"","type":"text","label":"Intermediary’s Code","options":[],"required":true,"pdf_field":""},{"help":"","type":"signature","label":"Intermediary’s Signature","options":[],"required":true,"pdf_field":""}],"filled_by":"intermediary"}],"deadlines":[],"applies_to":"Golfer’s Insurance","attachments":["List of articles in Golf Kit to be insured and values thereof","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.","The insurer adheres to anti-financial crime practices and may require assistance to address these.","Premiums are paid from legitimate sources and insurer may verify source of funds and reject policy if otherwise.","Consent is given to receive communications electronically and for processing of personal data as per privacy policy.","KYC records are current and proposer will inform insurer of any changes.","The insurer may reject or terminate the contract if proposer or associated persons are named in sanctions lists."],"dropped_labels":2},"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/2803-golfers-insurance-proposal-form"}