{"id":2807,"title":"NEON (GLOW) SIGN AND HOARDING 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/neon-glow-sign-and-hoarding-insurance/proposal-forms/neon-sign-retail-proposal-form.pdf","sha256":"c37624a4c850174f2a47aa60c757d41785ecd44ae2aad3f23febdd6fc510dc47","pages":7,"collected":"2026-10-17","instructions":{"about":"This form is used by a proposer to apply for Neon (Glow) Sign and/or Hoarding Insurance with Generali Central Insurance Co. Ltd.","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 referencing question numbers.","Cover commences only after acceptance and receipt of premium.","Use original documents and provide accurate details.","The insurer reserves the right to reject proposal or terminate contract if proposer is on any blacklist.","For premium above Rs 10000, fill authorization form for NEFT payments.","The form includes a section for intermediary use only which is not to be filled by proposer.","No rebate of commission or premium is allowed as per Section 41 of Insurance Act, 1938."],"title":"NEON (GLOW) SIGN AND HOARDING INSURANCE PROPOSAL FORM","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Proposer's Details","fields":[{"help":"Enter start and end date of insurance period in DD/MM/YYYY format","type":"date","label":"1. Period of Insurance","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"2. Name of the Proposer","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"3. Proposer’s Trade or Business","options":[],"required":null,"pdf_field":""},{"help":"Include full address with state and pin code","type":"text","label":"4. Present Address of the Proposer","options":[],"required":null,"pdf_field":""},{"help":"Include full address with state and pin code","type":"text","label":"5. Permanent Address of the Proposer (if left blank, will be construed as being same as Present Address)","options":[],"required":false,"pdf_field":""},{"help":"Central KYC Registry number if available","type":"text","label":"6. CKYC (if available)","options":[],"required":false,"pdf_field":""},{"help":"Tick all applicable categories; if NGO/NPO, provide Niti Ayog – Darpan Portal Registration Number","type":"checkbox","label":"7. 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 if you are an NGO or NPO","type":"text","label":"Niti Ayog – Darpan Portal Registration Number","options":[],"required":false,"pdf_field":""},{"help":"Tick Yes or No","type":"choice","label":"8. If you are Differently Abled, please tick on the checkbox to provide confirmation.","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide type of impairment if Yes above","type":"text","label":"i. Type of Impairment","options":[],"required":false,"pdf_field":""},{"help":"Provide percentage if Yes above","type":"number","label":"ii. Percentage of Impairment","options":[],"required":false,"pdf_field":""},{"help":"Provide UDID number if Yes above","type":"text","label":"iii. UDID Number","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Business Details","fields":[{"help":"Provide details of your business","type":"text","label":"9. BUSINESS DETAILS","options":[],"required":null,"pdf_field":""},{"help":"Provide PAN number of the business","type":"text","label":"10. BUSINESS PAN","options":[],"required":null,"pdf_field":""},{"help":"Provide address of the property to be insured","type":"text","label":"11. Location of Operation (site of property to be insured)","options":[],"required":null,"pdf_field":""},{"help":"Provide nearest railway station and distance from insured property","type":"text","label":"12. Nearest Railway station and Distance","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Particulars of the Sign Board","fields":[{"help":"Describe foundation/supporting structure with measurements and materials","type":"text","label":"14. Particulars of the Foundation and/or supporting structure on which Sign and/or Hoarding is erected. Provide the measurements of and the materials from which such foundation and/or supporting structure is constructed","options":[],"required":null,"pdf_field":""},{"help":"Confirm if inspections are done regularly and provide details","type":"yes-no","label":"15. Please confirm whether Sign board and its foundation, supporting structure, fastening attachments and similar items are regularly inspected by a duly qualified Electrician and Engineer if so, by whom and at what intervals.","options":[],"required":null,"pdf_field":""},{"help":"Confirm if repairs are done immediately","type":"yes-no","label":"16. Please confirm whether the repairs or defects found by these inspections are immediately carried out or set rights","options":[],"required":null,"pdf_field":""},{"help":"Describe preventive measures","type":"text","label":"17. What are the measures adopted for the prevention of loss or damage occurring as a result of the falling down of the Neon Sign/Hoardings.","options":[],"required":null,"pdf_field":""},{"help":"Answer the sub-questions (a) to (j) about the property and surroundings","type":"text","label":"18. Particulars of the property on which the sign is erected and / or attached to","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Claims and Previous Insurance Details","fields":[{"help":"Provide details of any claims in last 5 years","type":"text","label":"19. Have any claims been made against you in the last five years in respect of accidents caused directly or indirectly by the Sign Board. If so, give full particulars.","options":[],"required":null,"pdf_field":""},{"help":"Provide details of previous insurance policies","type":"text","label":"20. Please provide previous policy details","options":[],"required":null,"pdf_field":""},{"help":"Answer all parts with details if applicable","type":"text","label":"21. Has any Company: (a) declined your proposal? (b) refused to renew your policy? (c) demanded an increased rate on renewal? (d) cancelled any of your insurances?","options":[],"required":null,"pdf_field":""},{"help":"Provide sum insured amount required","type":"amount","label":"22. Amount of Indemnity/ Sum Insured required for:","options":[],"required":null,"pdf_field":""},{"help":"Provide details if any notice received","type":"text","label":"23. Have you received any notice from any person or authority regarding any defect in the Sign Board ?","options":[],"required":null,"pdf_field":""},{"help":"Provide details of existing policies covering the property","type":"text","label":"24. Provide details of any existing Policies cover the same property","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Premium Details","fields":[{"help":"Specify mode of payment","type":"choice","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 premium amount","type":"amount","label":"Amount in (₹)","options":[],"required":null,"pdf_field":""},{"help":"Enter date of payment","type":"date","label":"Date of Payment (DD/MM/YY)","options":[],"required":null,"pdf_field":""},{"help":"Provide PAN if premium is 1 lakh or above","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 for Refund or Claim Purpose","fields":[{"help":"Provide 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":"Provide bank name and branch","type":"text","label":"Bank Name & Branch","options":[],"required":null,"pdf_field":""},{"help":"Provide bank account number","type":"text","label":"Bank Account Number","options":[],"required":null,"pdf_field":""},{"help":"Provide IFSC code","type":"text","label":"IFS Code","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Nominee Details","fields":[{"help":"Nominee's full name","type":"text","label":"Name","options":[],"required":null,"pdf_field":""},{"help":"Nominee's date of birth","type":"date","label":"Date of Birth","options":[],"required":null,"pdf_field":""},{"help":"Relationship to proposer","type":"text","label":"Relationship with the proposer","options":[],"required":null,"pdf_field":""},{"help":"Nominee's mobile number","type":"phone","label":"Mobile Number","options":[],"required":null,"pdf_field":""},{"help":"Nominee's email address","type":"email","label":"E-Mail ID","options":[],"required":null,"pdf_field":""},{"help":"Nominee's present address","type":"text","label":"Address of Nominee: Present address","options":[],"required":null,"pdf_field":""},{"help":"Nominee's permanent address","type":"text","label":"Permanent address: ((if left blank, will be construed as being same as Present Address))","options":[],"required":false,"pdf_field":""},{"help":"Nominee's bank account holder name","type":"text","label":"Bank Account Details of Nominee: Name of Account holder","options":[],"required":null,"pdf_field":""},{"help":"Nominee's bank name and branch","type":"text","label":"Bank Name & Branch","options":[],"required":null,"pdf_field":""},{"help":"Nominee's bank account number","type":"text","label":"Bank Account Number","options":[],"required":null,"pdf_field":""},{"help":"Nominee's IFSC code","type":"text","label":"IFS Code","options":[],"required":null,"pdf_field":""},{"help":"Provide authorized person details 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":"Declaration by Proposer","fields":[{"help":"Date of signing the declaration","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Place of signing the declaration","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Sign the form; affix stamp if proposer is a juridical person","type":"signature","label":"Signature of the Proposer(s) (Affix stamp, where proposer is a juridical person)","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"}],"deadlines":[],"applies_to":"Neon Sign or Glow Sign and/or Hoarding Insurance","attachments":["Separate signed and dated sheet if additional space is needed","Annexure for more than one location or more than one sign board","Annexure with GSTIN details if more than one GSTIN","Request for authorization form to receive Claim/Refund payments if premium paid is more than Rs 10000/-"],"declarations":["All statements and information provided are complete and accurate with no relevant information withheld.","If misrepresentation or suppression of material facts is found, the policy may be void and premium forfeited.","The proposer 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 or terminate policy if otherwise.","Consent to receive policy and service communications electronically and for processing of personal data as per privacy policy.","Consent for insurer to access CKYC records for verification and communication.","Policy may be rejected or terminated if proposer or associated persons are named in any recognized sanctions list.","KYC records are current and proposer will inform insurer of any changes."],"dropped_labels":17},"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/2807-neon-glow-sign-and-hoarding-insurance-proposal-form"}