{"id":2818,"title":"STANDARD FIRE & SPECIAL PERILS POLICY PROPOSAL FORM","purpose":"proposal","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited"},"source_pdf":"https://www.generalicentralinsurance.com/downloads/other-insurance/standard-fire-special-perils-policy/proposal-forms/standard-fire-and-special-perils-policy-proposal-form-retail.pdf","sha256":"63876f8ed3e5c2c3c632b857663ee28b04ddfff2e77d82bb4018df4e20eb611e","pages":8,"collected":"2026-10-17","instructions":{"about":"This form is used by a proposer or insured person to apply for a Standard Fire & Special Perils insurance policy with Generali Central Insurance Company Limited.","notes":["Read the prospectus/key features document/policy wordings before completing the form.","Insurance contract requires utmost good faith; disclose all material facts and do not suppress any.","Fill all questions in full; attach separate signed and dated sheet if space is insufficient.","Cover commences only after acceptance and receipt of premium.","Use original documents and provide accurate bank details for refunds or claims.","If premium paid is more than Rs 10,000, fill request for authorization form for NEFT payments.","The form includes a prohibition of rebates under Section 41 of Insurance Act, 1938.","The proposer may receive the policy document electronically unless a physical copy is requested."],"title":"STANDARD FIRE & SPECIAL PERILS POLICY 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\nEmail ID: GCIcare@generalicentral.com\nToll-free Phone: 1800 220 233 / 1860 500 3333 / 022 6783 7800"},"purpose":"proposal","sections":[{"title":"Proposer/Insured Details","fields":[{"help":"","type":"text","label":"Name of the Proposer/ Insured","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Nature of Business","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Type of Occupancy","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Address of Proposer","fields":[{"help":"Include full address with postal code","type":"text","label":"Correspondence Address with Pin code","options":[],"required":null,"pdf_field":""},{"help":"Address where the insured risk is located","type":"text","label":"Risk Location Address with Pin code","options":[],"required":null,"pdf_field":""},{"help":"Central KYC Registry number if available","type":"text","label":"CKYC Number (if available)","options":[],"required":false,"pdf_field":""},{"help":"Permanent address if different from correspondence address","type":"text","label":"Permanent Address of Proposer (If left blank, will be construed as being same as Present Address)","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Proposer Status and Details","fields":[{"help":"Tick 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.","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"If differently abled, specify type","type":"text","label":"Type 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":"Interest of Financial Institutions/Bank","fields":[{"help":"Provide details if applicable","type":"text","label":"Interest of Financial Institutions/Bank","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Period of Insurance","fields":[{"help":"Start date of insurance coverage","type":"date","label":"From","options":[],"required":true,"pdf_field":""},{"help":"End date of insurance coverage","type":"date","label":"To","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Add-on Covers Required","fields":[{"help":"Select if add-on cover is required","type":"yes-no","label":"Earthquake (Fire & Shock) - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Terrorism - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Omission to Insure additions, alterations, or extensions clause - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Removal of Debris (in excess of 1% of claim amount) - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Architect, Surveyors & Consulting engineer’s fees excess of 3 % of claim amount - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Impact Damage due to insured’s own Rail/Road Vehicles, Fork lifts, Cranes, Stackers and the like and articles dropped therefrom - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Deterioration of Stocks in cold Storage premises due to accidental power failure consequent to damage at the premises of power station due to an insured peril - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Spontaneous Combustion - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Spoilage Material Damage Cover - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Temporary Removal of Stocks - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Loss of Rent - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Rent for an Alternate Accommodation - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Forest fire - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Premium/Claim Details for the Past 3 Years","fields":[{"help":"Provide premium amounts for past 3 years","type":"amount","label":"Premium","options":[],"required":false,"pdf_field":""},{"help":"Provide claim amounts for past 3 years","type":"amount","label":"Claims","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Fire Protection Devices Installed","fields":[{"help":"Tick if installed","type":"checkbox","label":"Fire Extinguishers","options":["Yes"],"required":false,"pdf_field":""},{"help":"Tick if installed","type":"checkbox","label":"Trailer Pumps","options":["Yes"],"required":false,"pdf_field":""},{"help":"Tick if installed","type":"checkbox","label":"Hydrant Systems","options":["Yes"],"required":false,"pdf_field":""},{"help":"Tick if installed","type":"checkbox","label":"Sprinkler","options":["Yes"],"required":false,"pdf_field":""},{"help":"Tick if installed","type":"checkbox","label":"Foam System","options":["Yes"],"required":false,"pdf_field":""},{"help":"Tick if installed","type":"checkbox","label":"Fire Alarm","options":["Yes"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Options to Delete","fields":[{"help":"Select if you want to delete this cover","type":"yes-no","label":"RSMD - Yes / No","options":["Yes","No"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Voluntary Deductible","fields":[{"help":"Specify amount if opting for voluntary deductible","type":"amount","label":"Voluntary Deductible, if opted","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Basis of Insurance Proposed","fields":[{"help":"Specify Markel value","type":"amount","label":"Markel Value","options":[],"required":false,"pdf_field":""},{"help":"Specify reinstatement value","type":"amount","label":"Reinstatement Value","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Details of Sum Insured","fields":[{"help":"Sum insured for building in Indian Rupees","type":"amount","label":"Building","options":[],"required":true,"pdf_field":""},{"help":"Sum insured for plinth and foundation","type":"amount","label":"Plinth and Foundation","options":[],"required":true,"pdf_field":""},{"help":"Sum insured for furniture and fixtures","type":"amount","label":"Furniture and Fixture","options":[],"required":true,"pdf_field":""},{"help":"Sum insured for plant and machinery","type":"amount","label":"Plant machinery","options":[],"required":true,"pdf_field":""},{"help":"Sum insured for stocks and stocks in process","type":"amount","label":"Stocks and Stocks in Process","options":[],"required":true,"pdf_field":""},{"help":"Sum insured for other items if any","type":"amount","label":"Others if any","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Stock Coverage Options","fields":[{"help":"Select if you want declaration basis coverage","type":"yes-no","label":"Do you want to cover the stock (Excluding stock in process) on Declaration Basis: Yes / No","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Select if you want floater basis coverage","type":"yes-no","label":"Do you want to cover the stock (Excluding stock in process) on Floater Basis (floater location list to be provided): Yes / No","options":["Yes","No"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Underwriting Information on Risk Proposed","fields":[{"help":"Select the age category of the building","type":"choice","label":"Age of the Building","options":["Up to 5 Years","More than 5 Years but less than 10 Years","More than 10 Years but less than 15 Years","More than 15 Years but less than 20 Years","More than 20 years"],"required":false,"pdf_field":""},{"help":"Select type of construction for each part","type":"choice","label":"Type of Construction (RCC/Brick RCC/Kutcha/Others) - Wall / Roof / Floor / Others","options":["Wall","Roof","Floor","Others"],"required":false,"pdf_field":""},{"help":"Select surrounding occupancy type","type":"choice","label":"Surrounding Occupancies","options":["Open","Industrial","Residential","Warehouse"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Insurance with Other Companies","fields":[{"help":"Provide details of other insurance if applicable","type":"text","label":"If yes, give details","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Insurance Declined or Special Conditions","fields":[{"help":"Provide details if applicable","type":"text","label":"If yes, give details","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Premium Details","fields":[{"help":"Specify mode of payment","type":"text","label":"Mode of Payment","options":[],"required":false,"pdf_field":""},{"help":"Provide payment details","type":"text","label":"Payment Details","options":[],"required":false,"pdf_field":""},{"help":"Premium amount paid","type":"amount","label":"Amount in (₹)","options":[],"required":false,"pdf_field":""},{"help":"Date when premium was paid","type":"date","label":"Date of Payment (DD/MM/YY)","options":[],"required":false,"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":"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 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 name and branch details","type":"text","label":"Bank Name & Branch","options":[],"required":false,"pdf_field":""},{"help":"Bank account number","type":"text","label":"Bank Account Number","options":[],"required":false,"pdf_field":""},{"help":"Bank IFSC code","type":"text","label":"IFS Code","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Nominee Details","fields":[{"help":"Nominee's full name","type":"text","label":"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 address","type":"text","label":"Address of Nominee","options":[],"required":false,"pdf_field":""},{"help":"Nominee's present address","type":"text","label":"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":"Nominee's bank details for claim payments","type":"text","label":"Bank Account Details of Nominee","options":[],"required":false,"pdf_field":""},{"help":"Bank account holder name for nominee","type":"text","label":"Name of Account holder","options":[],"required":false,"pdf_field":""},{"help":"Bank name and branch for nominee","type":"text","label":"Bank Name & Branch","options":[],"required":false,"pdf_field":""},{"help":"Bank account number for nominee","type":"text","label":"Bank Account Number","options":[],"required":false,"pdf_field":""},{"help":"Bank IFSC code for nominee","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":"Declaration by Insured","fields":[{"help":"Sign and date the form","type":"signature","label":"Signature of the Proposer(s) (Affix stamp, where proposer is a juridical person)","options":[],"required":true,"pdf_field":""},{"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":""}],"filled_by":"proposer"},{"title":"Intermediary Use Only","fields":[{"help":"Name of intermediary","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":"Code of intermediary","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":"Standard Fire & Special Perils insurance policies","attachments":["Separate signed and dated sheet if insufficient space to answer any question","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 10,000"],"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.","Policyholder and related persons will assist the insurer with anti-financial crime compliance.","Premium is paid from legitimate sources and insurer may verify source of funds and reject policy if otherwise.","Consent to receive policy and service communications electronically and for processing of personal data.","Consent to insurer accessing CKYC records for verification and receiving related communications.","Agreement to abide by insurer's Privacy Policy and acceptance that insurer may reject or terminate policy if named in sanctions list.","KYC records are current and proposer will inform insurer of any changes."],"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/2818-standard-fire-and-special-perils-policy-proposal-form"}