{"id":5591,"title":"HEALTH MAXIMISE R - PROPOSAL FORM","purpose":"proposal","insurer":{"slug":"zurich-kotak-general-insurance","name":"Zurich Kotak General Insurance Company (India) Limited"},"source_pdf":"https://cms.zurichkotak.com/uploads/Health_Maximiser_Proposal_Form_ZK_v1_25_26_11082025_6d3c0f0024.pdf","sha256":"b829258b7eb60d8035a8ea75badcebeb1e0eb56eece50634f48ecb082c60167d","pages":9,"collected":"2026-10-17","instructions":{"about":"This form is for individuals (proposers) applying for the Health Maximiser insurance product, a combined health and life insurance plan offered jointly by Zurich Kotak General Insurance Company and Kotak Mahindra Life Insurance Company. The proposer fills this form to provide personal, health, and nominee details for insurance coverage.","notes":["Use block letters to fill the form.","Attach original or valid proofs as specified.","Photograph must have signature across it.","Cheque/demand draft should be crossed and drawn in favour of 'KOTAK LIFE INSURANCE' or 'KOTAK MAHINDRA LIFE INSURANCE COMPANY LTD.'","This form is to be filled by the proposer himself/herself.","Policyholder can pay premium via cheque, cash, demand draft, net banking, credit/debit card or other online modes.","Family Health Insurance Plan (TPA) Ltd is the TPA for health insurance claims.","Policyholder may continue either life cover or health cover separately during policy term but will lose combi discount.","Policyholder should familiarize with policy benefits and service structure before purchase.","Withdrawal of tie-up between insurers requires 90 days notice to policyholder.","Grievances can be lodged at branches of either insurer and will be addressed by respective insurer.","The form includes sections for agent and office use only which are not to be filled by proposer."],"title":"HEALTH MAXIMISE R - PROPOSAL FORM","submit":{"to":"Zurich Kotak General Insurance Company (India) Limited or Kotak Mahindra Life Insurance Company Limited","how":"post / in person / online payment modes","address":""},"purpose":"proposal","sections":[{"title":"Details of Proposer","fields":[{"help":"","type":"text","label":"Existing Client ID","options":[],"required":null,"pdf_field":""},{"help":"Enter your Aadhaar number","type":"text","label":"AADHAAR No.","options":[],"required":null,"pdf_field":""},{"help":"Central KYC number if available","type":"text","label":"C-KYC No","options":[],"required":null,"pdf_field":""},{"help":"Enter mobile phone number","type":"phone","label":"Mobile No","options":[],"required":null,"pdf_field":""},{"help":"Enter landline number if any","type":"phone","label":"Landline","options":[],"required":false,"pdf_field":""},{"help":"Select title and enter full name","type":"text","label":"Full Name","options":["Mr.","Ms.","Master"],"required":true,"pdf_field":""},{"help":"Enter mother's full name","type":"text","label":"Mother's Name","options":[],"required":null,"pdf_field":""},{"help":"Enter full current address including landmark, city/district, state, country, and pincode","type":"text","label":"Current Address","options":[],"required":true,"pdf_field":""},{"help":"Enter permanent address if different from current","type":"text","label":"Permanent Address (if different from the above address)","options":[],"required":false,"pdf_field":""},{"help":"Select preferred address for communication","type":"choice","label":"Preferred Communication Address","options":["Current Address","Permanent Address"],"required":false,"pdf_field":""},{"help":"Enter GSTIN if applicable","type":"text","label":"GSTIN","options":[],"required":false,"pdf_field":""},{"help":"Enter email address","type":"email","label":"Email ID","options":[],"required":null,"pdf_field":""},{"help":"Enter date of birth in DD/MM/YYYY format","type":"date","label":"Date of Birth","options":[],"required":true,"pdf_field":""},{"help":"Select gender","type":"choice","label":"Gender","options":["Male","Female","Transgender"],"required":true,"pdf_field":""},{"help":"Select marital status","type":"choice","label":"Marital Status","options":["Unmarried","Married","Widow (er)","Divorced"],"required":null,"pdf_field":""},{"help":"Select residential status","type":"choice","label":"Residential Status","options":["Resident Individual","NRI","PIO","Foreign National"],"required":null,"pdf_field":""},{"help":"Select citizenship or specify country code","type":"choice","label":"Citizenship","options":["IN-Indian","Others (ISO 3166 Country Code)"],"required":null,"pdf_field":""},{"help":"Select occupation and specify if Others","type":"choice","label":"Occupation","options":["Business","Professional","Self Employed","Student","Housewife","Retired","Salaried (Private, Public, Govt.)","Others"],"required":null,"pdf_field":""},{"help":"Enter name and address of organization or business","type":"text","label":"Name & Address of Org./Business","options":[],"required":false,"pdf_field":""},{"help":"Describe nature of organization or business","type":"text","label":"Nature of Org./Business","options":[],"required":false,"pdf_field":""},{"help":"Describe nature of work","type":"text","label":"Nature of Work","options":[],"required":false,"pdf_field":""},{"help":"Enter total years in service or business","type":"number","label":"Total Years in Service or Business","options":[],"required":false,"pdf_field":""},{"help":"Enter annual income","type":"amount","label":"Annual Income","options":[],"required":false,"pdf_field":""},{"help":"Enter PAN number","type":"text","label":"PAN","options":[],"required":false,"pdf_field":""},{"help":"Specify income proof document","type":"text","label":"Income Proof","options":[],"required":false,"pdf_field":""},{"help":"Specify age proof document","type":"text","label":"Age Proof","options":[],"required":false,"pdf_field":""},{"help":"Specify address proof document","type":"text","label":"Address Proof","options":[],"required":false,"pdf_field":""},{"help":"Specify identity proof document","type":"text","label":"Identity (ID) Proof","options":[],"required":false,"pdf_field":""},{"help":"Enter ID proof number","type":"text","label":"ID Proof No.","options":[],"required":false,"pdf_field":""},{"help":"Enter expiry date of ID proof if applicable","type":"date","label":"ID Proof Expiry Date*","options":[],"required":false,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Are you an existing Kotak Group Employee","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Enter employee ID if applicable","type":"text","label":"If yes, please mention the Employee ID","options":[],"required":false,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Do you have any existing policy from Zurich Kotak General Insurance Company (India) Limited","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Enter policy number if applicable","type":"text","label":"If 'Yes', please provide the Policy No.","options":[],"required":false,"pdf_field":""},{"help":"Enter place and country of birth","type":"text","label":"Additional Details - Indicator for Residence / Tax status: Place and Country of Birth","options":[],"required":false,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Are you a citizen of any other country (dual / multiple)","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Are you a resident (for tax purposes) of any other country other than India","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide FATCA declaration details","type":"text","label":"FATCA Declaration","options":[],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Additional Information of Proposer","fields":[{"help":"Select yes or no","type":"yes-no","label":"Do you have any history of conviction under any criminal proceedings in India or abroad","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Are you a Politically Exposed Person","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Are you currently engaged in or intend to take part in any hazardous hobbies / activities","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide details if answered yes","type":"text","label":"If your answer is 'Yes' to any of the above questions kindly give details","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Previous Policy Details","fields":[{"help":"Select yes or no","type":"yes-no","label":"Do you have any existing insurance policy (ies) or have you applied for any insurance policy (ies) at any time?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Has any of your policy/ proposal (including riders) ever been rated-up/ postponed/ declined on application or revival?","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Details of Proposer and Life Insured","fields":[{"help":"Enter full names of proposer and all life insured persons","type":"text","label":"Name of Proposer and Life Insured in Full","options":[],"required":true,"pdf_field":""},{"help":"Select marital status for each life insured","type":"choice","label":"Unmarried / Married / Widow(er) / Divorced","options":["Unmarried","Married","Widow(er)","Divorced"],"required":true,"pdf_field":""},{"help":"Specify relation for each life insured","type":"text","label":"Relation with the Proposer","options":[],"required":true,"pdf_field":""},{"help":"Enter date of birth for each life insured","type":"date","label":"Date of Birth","options":[],"required":true,"pdf_field":""},{"help":"Select gender for each life insured","type":"choice","label":"Gender","options":["Male","Female","Transgender"],"required":true,"pdf_field":""},{"help":"Enter occupation for each life insured","type":"text","label":"Occupation","options":[],"required":false,"pdf_field":""},{"help":"Select marital status for each life insured","type":"choice","label":"Marital Status","options":["Unmarried","Married","Widow(er)","Divorced"],"required":false,"pdf_field":""},{"help":"Enter ABHA Number or create one at https://healthid.ndhm.gov.in/","type":"text","label":"ABHA Number","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Personal Health Details of Proposer and Life Insured","fields":[{"help":"Select yes or no for each life insured","type":"yes-no","label":"Have you Gained or Lost Weight (more than 10 kgs) in the last 1 year?","options":["Yes","No","NA"],"required":null,"pdf_field":""},{"help":"Provide reason if weight changed","type":"text","label":"If yes, please specify reason for gain or loss","options":[],"required":false,"pdf_field":""},{"help":"Select yes or no for each life insured","type":"yes-no","label":"Do you or have you ever smoked more than 5 cigarettes per day or consumed Tobacco in any other form?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Specify tobacco form","type":"text","label":"If yes, then consumed as (Cigarette / Beedi / Chewing Tobacco / Tobacco Toothpaste / other form)","options":[],"required":false,"pdf_field":""},{"help":"Specify duration","type":"text","label":"Since when have you been smoking or consuming Tobacco","options":[],"required":false,"pdf_field":""},{"help":"Specify average daily usage","type":"text","label":"Average Usage per day*","options":[],"required":false,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Do you drink/or had a history of drinking more than 7 pints of Beer or 210 ml of alcohol on an average in a week","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Specify duration","type":"text","label":"Since when have you been consuming Alcohol","options":[],"required":false,"pdf_field":""},{"help":"Specify average weekly usage","type":"text","label":"Average Usage per week","options":[],"required":false,"pdf_field":""},{"help":"Select yes or no","type":"yes-no","label":"Do you or have you in the past taken or injected any Non-Prescribed / Illegal Drugs","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Specify drug type","type":"text","label":"If yes, then consumed as","options":[],"required":false,"pdf_field":""},{"help":"Specify duration","type":"text","label":"Since when have you been taking these Drugs","options":[],"required":false,"pdf_field":""},{"help":"Specify average daily usage","type":"text","label":"Average Usage per day*","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Personal Health Details of Life Insured (Medical Conditions)","fields":[{"help":"Select yes or no for each life insured","type":"yes-no","label":"Have you ever suffered from, received/receiving treatment or advice for any of the following conditions, diseases or impairments? (a) Any cancer, tumour, cyst or unusual growth?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"High blood pressure (hypertension), low blood pressure (hypotension), diabetes, raised cholesterol, stroke, chest pain?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Any cardiovascular diseases/ disorders, coronary artery disease or any form of heart ailment or rheumatic heart disease etc.?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Any respiratory diseases/ disorders like asthma, bronchitis, pulmonary TB, lung ailment, etc?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Any genitourinary diseases / disorders like calculus of kidney/ ureter, acute chronic kidney diseases etc?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Any digestive system disease/ disorders like ulcers, haemorrhoids, diseases of gall bladder or intestine etc?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Epilepsy, mental or nervous disorder including depression?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"HIV infection, AIDS related or any other sexually transmitted disease?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Disorders of the Eyes / Ears / Nose / throat","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Bones and Joints, Spondylitis / arthritis etc.","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Nutritional / Endocrinal disorders","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Accidents / burn","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Have you ever had persistent fever, unexplained infection or swollen glands in the last one year?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Have you ever been diagnosed with any form of congenital anomalies?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Are you currently receiving or considering receiving medical attention or taking any prescribed drugs?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Have you ever suffered from or are currently suffering from any complication of pregnancy?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Have you ever suffered from or suffering or are currently suffering any diseases of breast/ uterus/ cervix?","options":["Yes","No"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Family Medical History","fields":[{"help":"Select yes or no","type":"yes-no","label":"Have your parents / brothers / sisters / spouse / children ever suffered from or died of heart disease, stroke, high blood pressure, diabetes mellitus, any form of eye disease, cancer, kidney disease or paralysis, or any hereditary / familial disorders, tuberculosis, or any contagious diseases such as hepatitis, AIDS / HIV etc.?","options":["Yes","No"],"required":null,"pdf_field":""}],"filled_by":"proposer"},{"title":"Nominee Details of Proposer and Life Insured","fields":[{"help":"Enter nominee name for each life insured","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"Enter nominee date of birth","type":"date","label":"Date of Birth","options":[],"required":true,"pdf_field":""},{"help":"Select nominee gender","type":"choice","label":"Gender","options":["Male","Female","Transgender"],"required":true,"pdf_field":""},{"help":"Enter percentage share for each nominee","type":"number","label":"Percentage Share","options":[],"required":true,"pdf_field":""},{"help":"Specify relationship of nominee with life insured","type":"text","label":"Relationship with Life Insured","options":[],"required":true,"pdf_field":""},{"help":"Enter nominee email if available","type":"email","label":"Email ID","options":[],"required":false,"pdf_field":""},{"help":"Enter nominee mobile number if available","type":"phone","label":"Mobile No.","options":[],"required":false,"pdf_field":""},{"help":"Enter nominee present address","type":"text","label":"Present Address","options":[],"required":false,"pdf_field":""},{"help":"Enter nominee permanent address","type":"text","label":"Permanent Address","options":[],"required":false,"pdf_field":""},{"help":"Provide nominee bank details","type":"text","label":"Nominee Bank Details","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Appointee Details (If Nominee is less than 18 years)","fields":[{"help":"Enter appointee name for each applicable nominee","type":"text","label":"Name","options":[],"required":true,"pdf_field":""},{"help":"Enter appointee date of birth","type":"date","label":"Date of Birth","options":[],"required":true,"pdf_field":""},{"help":"Select appointee gender","type":"choice","label":"Gender","options":["Male","Female","Transgender"],"required":true,"pdf_field":""},{"help":"Specify relationship of appointee with nominee","type":"text","label":"Relationship with Nominee","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Proposal Deposit Paid Details","fields":[{"help":"Enter amount paid","type":"amount","label":"Amount (in Rs.)","options":[],"required":true,"pdf_field":""},{"help":"Enter bank name and branch","type":"text","label":"Bank Name & Branch","options":[],"required":true,"pdf_field":""},{"help":"Enter cheque, demand draft number or transaction ID","type":"text","label":"Cheque/DD No./Transaction ID","options":[],"required":true,"pdf_field":""},{"help":"Enter date of payment","type":"date","label":"Dated","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Plan and Premium Details","fields":[{"help":"Select plan option","type":"choice","label":"Plan Option (select any one)","options":["Standard","Advantage","Edge","Elite","Absolute","Total","360"],"required":true,"pdf_field":""},{"help":"Specify coverage details","type":"text","label":"Coverage","options":[],"required":true,"pdf_field":""},{"help":"Enter policy term in years","type":"number","label":"Policy Term (in yrs.)","options":[],"required":true,"pdf_field":""},{"help":"Enter term in years","type":"number","label":"Term (in yrs.)","options":[],"required":true,"pdf_field":""},{"help":"Select premium payment frequency","type":"choice","label":"Frequency","options":["Yearly","Half Yearly","Quarterly","Monthly","Single"],"required":true,"pdf_field":""},{"help":"Enter sum assured or insured amount","type":"amount","label":"Sum Assured/Insured (in `)","options":[],"required":true,"pdf_field":""},{"help":"Enter premium amount","type":"amount","label":"Premium (in `)","options":[],"required":true,"pdf_field":""},{"help":"Enter applicable GST and cess","type":"amount","label":"Goods and Service Tax & Cess, as applicable on modal premium","options":[],"required":false,"pdf_field":""},{"help":"Enter total premium amount","type":"amount","label":"Total Premium (rounded off to the nearest rupee)","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Bank Details for Direct Credit of Benefits/Refunds","fields":[{"help":"Enter bank account number","type":"text","label":"Account No.","options":[],"required":true,"pdf_field":""},{"help":"Enter IFSC or MICR code","type":"text","label":"IFSC/MICR Code","options":[],"required":true,"pdf_field":""},{"help":"Enter bank name","type":"text","label":"Bank Name","options":[],"required":true,"pdf_field":""},{"help":"Enter account holder name","type":"text","label":"Account Holder Name","options":[],"required":true,"pdf_field":""},{"help":"Tick if no existing bank account","type":"checkbox","label":"No existing Bank Account","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Optional Benefits","fields":[{"help":"Opt for hospital daily cash benefit","type":"yes-no","label":"Hospital Daily Cash","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Opt for daily cash for accompanying insured child","type":"yes-no","label":"Daily cash for Accompanying an Insured Child","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Opt for compassionate visit benefit","type":"yes-no","label":"Compassionate Visit (with 3 year waiting period)","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Opt for air ambulance cover","type":"yes-no","label":"Air Ambulance Cover","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Opt for critical illness cover","type":"yes-no","label":"Critical Illness Cover (Available for Age 18 years and above)","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Opt for personal accident cover","type":"yes-no","label":"Personal Accident Cover","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Opt for cap on room rent","type":"yes-no","label":"Cap on Room Rent","options":["Yes","No"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declaration by the Proposer","fields":[{"help":"Sign to declare all information is true and complete","type":"signature","label":"Signature of Proposer","options":[],"required":true,"pdf_field":""},{"help":"Enter date of signing","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Enter place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declaration by the Person Filling in the Form (if applicable)","fields":[{"help":"Signature or thumb impression of proposer","type":"signature","label":"Signature / Left Thumb Impression of the Proposer","options":[],"required":true,"pdf_field":""},{"help":"Date of declaration","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Place of declaration","type":"text","label":"Place","options":[],"required":true,"pdf_field":""}],"filled_by":"scribe or authorized representative"},{"title":"Agent's Confidential Report & Declaration","fields":[{"help":"Enter licence number","type":"text","label":"Licence No.","options":[],"required":true,"pdf_field":""},{"help":"Enter agent ID","type":"text","label":"Agent ID","options":[],"required":true,"pdf_field":""},{"help":"Enter contact number","type":"phone","label":"Contact","options":[],"required":true,"pdf_field":""},{"help":"Enter place","type":"text","label":"Place","options":[],"required":true,"pdf_field":""},{"help":"Enter telephone number","type":"phone","label":"Telephone","options":[],"required":false,"pdf_field":""}],"filled_by":"agent"}],"deadlines":[],"applies_to":"Health plus Life Combi Product","attachments":["Photograph of Proposer with Signature across the photograph","Income Proof","Age Proof","Address Proof","Identity (ID) Proof","Cancelled Cheque for bank details"],"declarations":["The proposer declares all information provided is true, complete and no material facts are withheld.","The proposer consents to the insurer seeking information from doctors, hospitals, employers for underwriting and claims.","The proposer agrees to undergo medical tests as required by the insurer.","The proposer agrees that policy acceptance is subject to underwriting and premium payment in full and on time.","The proposer consents to electronic communication and e-policy delivery unless opting for physical copy.","The proposer consents to KYC verification through various government portals.","The proposer agrees to share medical records via ABHA number if available.","The proposer declares if a High Net Worth Individual (HNI) by ticking the box.","The proposer agrees to comply with Insurance Act provisions and understands policy contract terms.","The proposer consents to linking Aadhaar number with policies and authorizes its use for authentication and KYC.","The proposer authorizes insurer to contact via calls or SMS for policy servicing.","Non-tobacco users declare no tobacco use in past 12 months and no intention to use in future.","If proposer is a person with disability, they authorize a representative to assist in form completion."],"dropped_labels":16},"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/5591-health-maximise-r-proposal-form"}