{"id":2829,"title":"PUBLIC LIABILITY POLICY- NON INDUSTRIAL RISKS PROPOSAL FORM","purpose":"proposal","insurer":{"slug":"generali-central-insurance","name":"Generali Central Insurance Company Limited"},"source_pdf":"https://www.generalicentralinsurance.com/downloads/commercial-insurance/public-liability-policy---non-industrial-risks/proposal-forms/public-liability-policy-non-industrial%20risks-commercial-proposal-form.pdf","sha256":"eb9e18d018a5d7a74f74af916dd1326e2876c8f40d9d734d89e92daad354cb57","pages":9,"collected":"2026-10-17","instructions":{"about":"This form is used by a proposer to apply for a Public Liability insurance policy covering non-industrial risks. The proposer fills it to provide details about their business, premises, and insurance requirements.","notes":["Read the prospectus/key features document/policy wordings before completing the form.","Insurance is a contract of utmost good faith; disclose all material facts and do not withhold information.","Answer all questions; if more space is needed, attach a signed and dated sheet referencing the question number.","Cover commences only after acceptance and receipt of premium.","Use original bills and documents where applicable.","Section 41 of Insurance Act, 1938 prohibits rebates on commission or premium.","Go Green initiative: policy document will be sent electronically unless physical copy is requested."],"title":"PUBLIC LIABILITY POLICY- NON INDUSTRIAL RISKS PROPOSAL FORM","submit":{"to":"","how":"","address":""},"purpose":"proposal","sections":[{"title":"Proposer Details and Premises Information","fields":[{"help":"","type":"text","label":"Name of the Proposer (in full):","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Present address of the proposer (Registered Address)","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Registered Address of the Subsidiaries & Associate Companies","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Permanent address of the proposer (if left blank, will be construed as being same as Present Address)","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Business Address of the Proposer","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Location and address of all premises proposed for Insurance","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Full description of each of the premises","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Type of construction","options":[],"required":null,"pdf_field":""},{"help":"Enter age in years","type":"number","label":"Age of the building","options":[],"required":null,"pdf_field":""},{"help":"Specify number of floors, height, and floor occupied","type":"text","label":"No. of floors and height of the building which floor is occupied by you?","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Details of other occupants","options":[],"required":null,"pdf_field":""},{"help":"Include make and capacity details","type":"text","label":"Details of the lifts, elevators, escalators etc., please specify make and capacity.","options":[],"required":null,"pdf_field":""},{"help":"Describe business activities","type":"text","label":"Activities being carried on in the premises","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Are the premises/equipment(s)/machineries in sound condition of repair","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Describe maintenance schedule","type":"text","label":"Please give maintenance schedule","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Have you complied with all statutory rules/ regulations pertaining to the premises and your business activities","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Describe boundary, fencing, security and safety arrangements","type":"text","label":"Does the premises have boundary/fencing: Security/safety arrangements?","options":[],"required":null,"pdf_field":""},{"help":"Describe fire and explosion prevention systems","type":"text","label":"Details of systems provided for prevention of fire, explosion etc.","options":[],"required":null,"pdf_field":""},{"help":"Describe emergency plan if available","type":"text","label":"Details of ‘emergency plan’ if any","options":[],"required":false,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"Do you handle or use or store gases/hazardous/toxic/radioactive materials and/or equipments in the premises. If yes, please give details of max. capacity stored/used/handled at a time.","options":[],"required":null,"pdf_field":""},{"help":"Fill claims history for last 3 years with amounts in ₹","type":"table","label":"Please give the claims history for the last three years in the following format: Year, No. of claims, Total amount paid (Bodily injury, Property damage, Cost of Defence action), Total amount of pending claims (Bodily injury, Property damage, Cost of Defence action)","options":[],"required":null,"pdf_field":""},{"help":"Tick YES or NO and provide details if YES","type":"text","label":"Has your proposal or renewal been declined, or premium been increased or special terms has been imposed by any insurer in the past? If so, please give particulars.","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Specify indemnity limits for one accident and one year","type":"amount","label":"Please indicate the limits of indemnity required Any one accident _______ Any one year _________","options":[],"required":null,"pdf_field":""},{"help":"Enter start and end dates","type":"date","label":"Policy Period required From ________ (date) To ________ (date)","options":[],"required":null,"pdf_field":""},{"help":"Enter CKYC number if available","type":"text","label":"CKYC Number (If available)","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Payment Details","fields":[{"help":"Specify payment mode","type":"text","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 amount paid","type":"amount","label":"Amount in (₹)","options":[],"required":null,"pdf_field":""},{"help":"Enter payment date","type":"date","label":"Date of Payment (DD/MM/YY)","options":[],"required":null,"pdf_field":""},{"help":"Provide PAN if premium is 1 Lac or above","type":"text","label":"PAN (If premium is 1 Lac and Above.)","options":[],"required":false,"pdf_field":""},{"help":"Provide GSTIN(s) or attach annexure","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":null,"pdf_field":""},{"help":"","type":"text","label":"Bank Name & Branch:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Bank Account Number:","options":[],"required":null,"pdf_field":""},{"help":"Enter IFSC code","type":"text","label":"IFS Code:","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Nominee Details","fields":[{"help":"","type":"text","label":"Name:","options":[],"required":null,"pdf_field":""},{"help":"Enter nominee's date of birth","type":"date","label":"Date of Birth:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Relationship with the proposer:","options":[],"required":null,"pdf_field":""},{"help":"Enter nominee's mobile number","type":"phone","label":"Mobile Number:","options":[],"required":null,"pdf_field":""},{"help":"Enter nominee's email address","type":"email","label":"E-Mail ID:","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Address of Nominee: Present address:","options":[],"required":null,"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":null,"pdf_field":""},{"help":"","type":"text","label":"Bank Name & Branch:","options":[],"required":null,"pdf_field":""},{"help":"","type":"text","label":"Bank Account Number:","options":[],"required":null,"pdf_field":""},{"help":"Enter IFSC code","type":"text","label":"IFS Code:","options":[],"required":null,"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":"Declarations","fields":[{"help":"Sign here","type":"signature","label":"Proposer’s Signature","options":[],"required":true,"pdf_field":""},{"help":"Enter place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Enter date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"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":null,"pdf_field":""},{"help":"","type":"text","label":"Intermediary’s Code","options":[],"required":null,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Intermediary’s Signature","options":[],"required":null,"pdf_field":""}],"filled_by":"intermediary"},{"title":"Additional Information for Specific Business Types","fields":[{"help":"Enter average occupancy","type":"number","label":"Average occupancy per year","options":[],"required":null,"pdf_field":""},{"help":"Provide seating capacity and floor details","type":"text","label":"Max. seating capacity of conference halls/rooms, night clubs, discotheques if any, and floor on which they are located","options":[],"required":null,"pdf_field":""},{"help":"Provide number and seating capacity","type":"text","label":"No. of restaurants and seating capacity in each restaurant","options":[],"required":null,"pdf_field":""},{"help":"Specify availability","type":"text","label":"Whether the above facilities are available to residents only and their guests or also available to club members and their guests?","options":[],"required":null,"pdf_field":""},{"help":"Describe other facilities and security","type":"text","label":"Other facilities (e.g. car parking) please specify and give details of security measures where applicable","options":[],"required":false,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"Do you have a separate strong room/ cloakroom to store items deposited by bonafide residents/guests for safekeeping. Please specify records maintained and special security arrangements","options":[],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Do you need cover against risks associated with foods, beverages served in/by your establishment?","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Include all revenue sources and taxes","type":"amount","label":"State the Estimated Annual Turnover revenue receipts","options":[],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Do you require extension of cover for goods in your care/custody/control (extension limited to 10% of the overall limit of indemnity as per question 11.)","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Enter percentage of limit of indemnity per accident","type":"number","label":"Please indicate the voluntary excess (this excess will apply to each and every claim)","options":[],"required":null,"pdf_field":""},{"help":"List facilities","type":"text","label":"What are the other facilities provided. Please specify whether they are operated and controlled by you.","options":[],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Do you need cover against risks associated with food & beverage served in your establishment","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Include all income sources and taxes","type":"amount","label":"Specify Estimated Annual Turnover","options":[],"required":null,"pdf_field":""},{"help":"List other facilities","type":"text","label":"For Offices/Residential Premises/Adm. Premises: Specify whether other facilities like Canteen, Sports etc., provided (list out facilities)","options":[],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Do you need cover against risks associated with food and beverages served in your establishment","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"Provide number and age group","type":"text","label":"For Schools/Educational Institutions/Libraries etc.: No. of students and their age group","options":[],"required":null,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"Whether hostel facility is provided; if yes, No. of rooms; No. of inmates","options":[],"required":false,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"Are canteen facilities provided in institution/hostel. If yes, state whether they are hygienically maintained.","options":[],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Do you need cover against risks associated with food and beverages served in your institutions","options":["YES","NO"],"required":null,"pdf_field":""},{"help":"List facilities and supervision details","type":"text","label":"Specify other facilities provided: a. Indoor games; b. Outdoor games (like Mountain Climbing, Hang Gliding, Horse Riding, Swimming etc.), and whether such games are taught under the supervision of trainers and/or bodyguards.","options":[],"required":false,"pdf_field":""},{"help":"Enter number of laboratories","type":"number","label":"No. of laboratories","options":[],"required":false,"pdf_field":""},{"help":"Describe safety measures","type":"text","label":"Measures taken to prevent accident in laboratories","options":[],"required":false,"pdf_field":""},{"help":"Provide details of outings and procedures","type":"text","label":"Whether outgoings are arranged by the school/college; If so, how often; Procedure for taking the students for such outings (educational tours may also be included here).","options":[],"required":false,"pdf_field":""},{"help":"Provide ratio","type":"text","label":"Teacher/ Student Ratio","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"}],"deadlines":[],"applies_to":"Public Liability Policy - Non Industrial Risks","attachments":["If additional space is needed, attach a separate signed and dated sheet referencing the relevant question number","If more than one GSTIN, kindly attach an annexure with details","Request for authorization form to receive Claim/Refund payments directly into bank account through NEFT if premium paid is more than Rs 10000/-"],"declarations":["The proposer declares all statutory provisions relating to the business are complied with and all statements are true without omission or misrepresentation.","If any information is found untrue, the policy shall be void ab initio and premium forfeited.","The premium is paid from legally declared income and not from proceeds of crime; GCICL may verify source of funds and reject proposal or terminate contract if violations are found.","The proposer confirms if premium payment is made by another person with insurable interest, refund will be processed to proposer’s bank account.","The proposer declares if they are High Net Worth Individual, Non-Residential Indian, Politically Exposed Person, or Non-Governmental Organization by ticking applicable boxes.","The proposer agrees to receive service-related information electronically and understands no unsolicited information will be sent.","The proposer consents to storage and use of provided data by GCICL for insurance and servicing purposes and agrees not to hold GCICL liable for legitimate use.","The proposer consents to CKYC record verification and receiving related information from Central KYC Registry.","The proposer agrees that information in the proposal will be processed as per GCICL Privacy Policy."],"dropped_labels":4},"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/2829-public-liability-policy-non-industrial-risks-proposal-form"}