{"id":5541,"title":"Maxima Product Liability Insurance - Product Recall","purpose":"proposal","insurer":{"slug":"zurich-kotak-general-insurance","name":"Zurich Kotak General Insurance Company (India) Limited"},"source_pdf":"https://cms.zurichkotak.com/uploads/MAXIMA_3_a24d123576.PDF","sha256":"51bbb820adece4372dfbbd4929461b79d87425bbc39fe2200a994e34d4372353","pages":4,"collected":"2026-10-17","instructions":{"about":"This form is a proposal for product recall insurance to be completed by the proposer representing all insureds, typically a manufacturer, distributor, or retailer.","notes":["Answer all questions; if not applicable, state 'N/A'.","Provide supplementary information by addendum if material.","Non-manufacturing risks must complete Appendix 1.","If more than 50% manufacturing is contracted out, complete Appendix 1.","If products have been recalled in the last 10 years, complete Appendix 2.","Use samples of testing documentation/certification as applicable.","This form is to be completed by the proposer on behalf of all insureds."],"title":"Maxima Product Liability Insurance - Product Recall","submit":{"to":"Zurich Kotak General Insurance Company (India) Limited","how":"","address":"401, 4th Floor, Silver Metropolis, Jai Coach Compound, Off Western Express Highway, Goregaon (East), Mumbai - 400063. Maharashtra, India"},"purpose":"proposal","sections":[{"title":"Proposer Details","fields":[{"help":"","type":"text","label":"Name of Proposer:","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Principal Address:","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Main contact name for pre-incident consultancy and response:","options":[],"required":true,"pdf_field":""},{"help":"Provide a valid email address","type":"email","label":"Main contact email:","options":[],"required":true,"pdf_field":""},{"help":"Include country and area code if applicable","type":"phone","label":"Main contact telephone:","options":[],"required":true,"pdf_field":""},{"help":"Provide website URL if available","type":"text","label":"Website:","options":[],"required":false,"pdf_field":""},{"help":"Select one","type":"choice","label":"Primary operation:","options":["Manufacturer","Distributor","Retailer"],"required":true,"pdf_field":""},{"help":"Describe the business activities","type":"text","label":"Description of Proposer’s business activities:","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Insurance Limits and Turnover","fields":[{"help":"Specify the requested insurance limit","type":"amount","label":"Limit of Liability requested","options":[],"required":true,"pdf_field":""},{"help":"Specify the deductible amount","type":"amount","label":"Deductible","options":[],"required":true,"pdf_field":""},{"help":"Provide last year's turnover","type":"amount","label":"Estimated annual turnover prior year","options":[],"required":true,"pdf_field":""},{"help":"Provide next year's projected turnover","type":"amount","label":"Projected annual turnover next year","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Premises and Employees","fields":[{"help":"Enter total manufacturing locations","type":"number","label":"Number of manufacturing premises","options":[],"required":true,"pdf_field":""},{"help":"Enter total storage or distribution locations","type":"number","label":"Number of storage/distribution premises","options":[],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"Are any of the above premises overseas?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"List countries if premises are overseas","type":"text","label":"If so, in which countries?","options":[],"required":false,"pdf_field":""},{"help":"Enter total employee count","type":"number","label":"Total number of employees","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Product Details","fields":[{"help":"Provide sales data by country for actual and projected years","type":"table","label":"Are products exported? If so, please provide breakdown of sales by country/region below:","options":[],"required":true,"pdf_field":""},{"help":"Include columns: Product Type, Product (brand) Name, Annual Turnover of Product, Finished product or component, Daily Production (sales and units), If component: finished product and values, Production Location, Number of production lines, Largest and average traceable batch size or value","type":"table","label":"Please complete the following table for your top 3 products:","options":[],"required":true,"pdf_field":""},{"help":"List new product types","type":"text","label":"Please indicate any new product types that have commenced production or have entered the public stream of commerce within the last 12 months:","options":[],"required":false,"pdf_field":""},{"help":"If yes, provide details","type":"yes-no","label":"Does the Company agree to indemnify or hold harmless any suppliers of components or raw materials?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Enter percentage value","type":"number","label":"What percentage (if any) of your manufacturing is contracted out to third parties?","options":[],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"Do any products require an external power source to operate?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, specify average cost of installation per product","type":"yes-no","label":"Do any products require installation?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, specify certification; if no, describe quality management systems in place","type":"yes-no","label":"Do you have a Certified Quality Management System?","options":["Yes","No"],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Quality Control and Assurance","fields":[{"help":"","type":"choice","label":"Are Quality Assurance audits performed in-house or by an independent third party?","options":["In-house","Independent third party"],"required":true,"pdf_field":""},{"help":"Specify frequency","type":"text","label":"How often are these audits performed?","options":[],"required":true,"pdf_field":""},{"help":"If no, provide details","type":"yes-no","label":"Do all of the products which are the subject of this proposal conform in all respects with requirements of law or regulation, including applicable industry guidelines or any other jurisdiction thereof?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"Do all labels, user instructions, manuals and packaging meet applicable industry standards?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, who is responsible for overseeing and implementing QA procedures?","type":"yes-no","label":"Is there a Quality Control Department?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, describe steps taken to monitor and assess quality standards","type":"yes-no","label":"Do you require your suppliers of components or raw materials to abide by specified quality standards?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Describe complaint collection and monitoring process","type":"text","label":"How do you collect and monitor customer complaints?","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Product Testing","fields":[{"help":"Select all that apply","type":"checkbox","label":"Please specify what type of testing is carried out:","options":["in-line","end of line","raw materials","other"],"required":true,"pdf_field":""},{"help":"Provide samples of testing documentation/certification as applicable","type":"choice","label":"Is this testing carried out:","options":["in-house","by a third party"],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Recall Management","fields":[{"help":"If yes, specify when last reviewed or updated","type":"yes-no","label":"Do you have a current recall plan?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, specify type of batch coding used","type":"yes-no","label":"Is a batch coding system utilized?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"Does your batch coding system allow 100% traceability?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, specify when last tests were carried out","type":"yes-no","label":"Do you carry out mock recalls and traceability tests?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Include recall costs, lost sales/profit, re-marketing costs etc.","type":"amount","label":"Please estimate the cost to recall your leading brand:","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Loss Information","fields":[{"help":"If yes, provide details (agency, date, nature, outcome, date resolved)","type":"yes-no","label":"Has the company’s products or any of its premises ever been the subject of review, comment or complaint by any governmental agency or department or local authority agency or department?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, complete Appendix 2","type":"yes-no","label":"Have any products been recalled in the last ten (10) years?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, provide details","type":"yes-no","label":"Are you aware of any specific or material fact which may reasonably give rise to a claim under the proposed policy?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"","type":"yes-no","label":"Has the Company had any strikes, riots, work-stoppages, or plant closings in the last three (3) years?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, provide details","type":"yes-no","label":"Has the Company ever been a direct target of political, racial, environmental, or other extremist or special interest groups?","options":["Yes","No"],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declaration and Signature","fields":[{"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":""},{"help":"Signature of authorised person","type":"signature","label":"Authorised Signatory","options":[],"required":true,"pdf_field":""},{"help":"Position of signatory","type":"text","label":"Position in Your Company:","options":[],"required":true,"pdf_field":""},{"help":"Affix company stamp","type":"signature","label":"Company Stamp","options":[],"required":false,"pdf_field":""}],"filled_by":"authorised signatory"},{"title":"Appendix 2 – Claims Information","fields":[{"help":"","type":"text","label":"What product was recalled?","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"What was the cause of the recall?","options":[],"required":true,"pdf_field":""},{"help":"","type":"date","label":"Date of recall:","options":[],"required":true,"pdf_field":""},{"help":"","type":"number","label":"How many product lines were affected?","options":[],"required":true,"pdf_field":""},{"help":"","type":"number","label":"How many batches/units of product were recalled?","options":[],"required":true,"pdf_field":""},{"help":"","type":"amount","label":"What was the total cost of the recall? Please include recall costs, lost sales, remarketing and any other related costs.","options":[],"required":true,"pdf_field":""},{"help":"If yes, provide details","type":"yes-no","label":"Were any contracts lost as a result of the recall?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Please provide details below of any measures taken since the recall to prevent a Recurrence?","options":[],"required":false,"pdf_field":""},{"help":"If not, have your procedures since been updated?","type":"yes-no","label":"Were your recall and traceability procedures successful during the recall?","options":["Yes","No"],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Appendix 1 – Suppliers Information","fields":[{"help":"","type":"number","label":"Number of suppliers","options":[],"required":true,"pdf_field":""},{"help":"Specify duration","type":"text","label":"Average length of relationship with suppliers","options":[],"required":true,"pdf_field":""},{"help":"If yes, specify countries","type":"yes-no","label":"Are any suppliers located overseas?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, provide details","type":"yes-no","label":"Does the Company agree by contract to indemnify or hold harmless?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, describe monitoring and assessment steps","type":"yes-no","label":"Do you require your suppliers to abide by specified quality standards?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"If yes, provide details; if no, provide details of testing by suppliers","type":"yes-no","label":"Do you carry out testing on products received from your suppliers?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Please give any further applicable details of your supplier selection and management/evaluation procedures, attaching any relevant documentation.","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"}],"deadlines":[],"applies_to":"product recall insurance for manufacturers, distributors, retailers, and non-manufacturing risks","attachments":["Current Recall Manual or Plan","Current Quality Control Plan","Samples of any documentation or certification referred to in this proposal"],"declarations":["Signing or completing this proposal does not bind the proposer or any represented individual/entity to complete this insurance.","All information given is true to the best of the proposer's knowledge.","If any information is found false or misleading or material facts are not disclosed, the insurance cover shall be null and void.","All written statements and materials furnished to the insurer are incorporated into the proposal form."],"dropped_labels":0},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"customer-care","channel":"email","value":"care@zurichkotak.com","label":"Email Address","level":null,"hours":null,"applies_to":"all","source_url":"https://www.zurichkotak.com/customer-support/grievance-redressal-process","quote":"in\nToll Number (INDIA And Overseas)\n+91-22-69417220\nToll Free Number\n1800 2120\nWhatsApp Number\n7998879988\nEmail Address\ncare@zurichkotak.com\nOur WhatsApp number cannot be used for calls. This is chat only number.\nAccessibility\nZoom in page\nZoom out page\nIncrea","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"1800 2120","label":"Toll Free Number","level":null,"hours":null,"applies_to":"all","source_url":"https://www.zurichkotak.com/customer-support/grievance-redressal-process","quote":"age claims\nCustomer support\nGrievance redressal\nLogin\nToll Number (INDIA And Overseas)\n+91-22-69417220\nToll Free Number\n1800 2120\nWhatsApp Number\n7998879988\nEmail Address\ncare@zurichkotak.com\nOur WhatsApp number cannot be used for calls. This is cha","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"+91-22-69417220","label":"Toll Number (INDIA And Overseas)","level":null,"hours":"IST 8 am to 8 pm","applies_to":"all","source_url":"https://www.zurichkotak.com/customer-support/grievance-redressal-process","quote":"Download policy\nManage policy\nManage claims\nCustomer support\nGrievance redressal\nLogin\nToll Number (INDIA And Overseas)\n+91-22-69417220\nToll Free Number\n1800 2120\nWhatsApp Number\n7998879988\nEmail Address\ncare@zurichkotak.com\nOur WhatsApp number cannot be","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"whatsapp","value":"7998879988","label":"WhatsApp Number","level":null,"hours":null,"applies_to":"all","source_url":"https://www.zurichkotak.com/customer-support/grievance-redressal-process","quote":"t\nGrievance redressal\nLogin\nToll Number (INDIA And Overseas)\n+91-22-69417220\nToll Free Number\n1800 2120\nWhatsApp Number\n7998879988\nEmail Address\ncare@zurichkotak.com\nOur WhatsApp number cannot be used for calls. This is chat only number.\nAccessibilit","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"email","value":"grievanceofficer@zurichkotak.com","label":"Grievance Officer","level":1,"hours":null,"applies_to":"all","source_url":"https://cms.zurichkotak.com/uploads/Policy_Wordings_CPI_dc7b416cf1.pdf","quote":"om .\nIn case the I nsured is not satisfied with the response, I nsured may contact the Grievance Officer of the ZKGI at grievanceofficer@zurichkotak.com . In case if the I nsured is not satisfied with the solution the\nGrievance Officer has provided, | I nsured | can write","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"address","value":"Unit no. 401, 4th Floor, Silver Metropolis, Jai Coach Compound, Off Western Express Highway, Goregaon (East) Mumbai- 400063. Maharashtra, India.","label":"Registered & Corporate Office","level":null,"hours":null,"applies_to":"all","source_url":"https://www.zurichkotak.com/","quote":"ker\nHealth portability\nResearch & Reports\nCorrespondence Address\nZurich Kotak General Insurance Company (India) Limited\nUnit no. 401, 4th Floor, Silver Metropolis,\nJai Coach Compound, Off Western Express Highway,\nGoregaon (East) Mumbai- 400063. Maharashtra, India.\nConnect with us\n: 022 - 69417220 (Toll number)\n: 1800 2120 (Toll free)\n+91-22-69417220 (IST 8 am to 8 pm)\nwww.zurichkot","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"email","value":"care@zurichkotak.com","label":"Customer Care Email","level":null,"hours":null,"applies_to":"all","source_url":"https://cms.zurichkotak.com/uploads/Policy_Wordings_CPI_dc7b416cf1.pdf","quote":"may contact the respective branch office of the ZKGI or may call toll free number 1800 2120 or may write an e - mail at care@zurichkotak.com .\nIn case the I nsured is not satisfied with the response, I nsured may contact the Grievance Officer of the ZKGI at gr","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"url","value":"www.zurichkotak.com","label":"Grievance Redressal Process","level":null,"hours":null,"applies_to":"all","source_url":"https://cms.zurichkotak.com/uploads/Policy_Wordings_CPI_dc7b416cf1.pdf","quote":"nder.\nThe details of the Insurance Ombudsman/ complete Grievance Redressal Process is also available at ZKGI’s website: www.zurichkotak.com\nThe updated details of Insurance Ombudsman offices are also available on the website of | Council for\nInsurance Ombudsm","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/zurich-kotak-general-insurance/5541-maxima-product-liability-insurance-product-recall"}