{"id":5592,"title":"Freight Forwarders Liability Insurance Policy Proposal Form & Questionnaire","purpose":"proposal","insurer":{"slug":"zurich-kotak-general-insurance","name":"Zurich Kotak General Insurance Company (India) Limited"},"source_pdf":"https://cms.zurichkotak.com/uploads/Proposal_form_FFL_03aeb3b434.pdf","sha256":"2c18d19a515140c3ac72bce5e840016a46cf7b7c99c1e5dcb464ed197bc67718","pages":5,"collected":"2026-10-17","instructions":{"about":"This form is a proposal for Freight Forwarders Liability Insurance to be filled by the proposer (the freight forwarder or related business) seeking insurance coverage.","notes":["Fill the proposal form in BLOCK LETTERS.","All details marked with * are mandatory.","The liability of the company starts only after acceptance of the proposal and receipt of premium.","Provide full, accurate and correct information; withholding material information may void the policy.","Attach additional sheets if more space is needed and indicate the question number.","Use original documents where applicable.","Policy and service related communication will be sent in soft copy to the email provided unless physical copy is requested."],"title":"Freight Forwarders Liability Insurance Policy Proposal Form & Questionnaire","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’s Details","fields":[{"help":"","type":"text","label":"Proposer’s Name*","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Proposer's Trade or Business*","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Country of Incorporation","options":[],"required":false,"pdf_field":""},{"help":"","type":"number","label":"Year of Establishment","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"City / District","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Nearest Landmark","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"State","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Country","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Pin Code","options":[],"required":false,"pdf_field":""},{"help":"","type":"choice","label":"Is the Postal address same as permanent address?","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"If yes, provide details","type":"text","label":"Any Overseas Branch Office","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Proposer’s Permanent Address* - Address (Line 1)","options":[],"required":true,"pdf_field":""},{"help":"If postal address differs from permanent","type":"text","label":"Proposer’s Postal Address - Address (Line 1)","options":[],"required":false,"pdf_field":""},{"help":"","type":"choice","label":"Any existing policy from Us","options":["Yes","No"],"required":false,"pdf_field":""},{"help":"Provide existing policy number if applicable","type":"text","label":"If ‘Yes’, Policy No.","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"CKYC Identifier / Number (Generated by CERSAI)","options":[],"required":false,"pdf_field":""},{"help":"Permanent Account Number","type":"text","label":"PAN*","options":[],"required":true,"pdf_field":""},{"help":"Goods and Services Tax Identification Number","type":"text","label":"GSTIN","options":[],"required":false,"pdf_field":""},{"help":"","type":"phone","label":"Telephone No. (Landline No.)","options":[],"required":false,"pdf_field":""},{"help":"","type":"email","label":"Email ID","options":[],"required":false,"pdf_field":""},{"help":"","type":"phone","label":"Mobile No.","options":[],"required":false,"pdf_field":""},{"help":"List all parties with insurable interest","type":"text","label":"Policy to be issued in favour of (list out all the parties who have insurable interest) including the financial institutions","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Risk Details","fields":[{"help":"","type":"choice","label":"Do you employ any subcontractors?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Details of subcontractors","type":"text","label":"If Yes, please specify","options":[],"required":false,"pdf_field":""},{"help":"Provide details of current and previous insurance","type":"text","label":"Please provide details of current freight forwarders liability cover and Previous Insurance Particulars if any","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Claims / Loss History","fields":[{"help":"Year of claim or loss","type":"number","label":"Year","options":[],"required":false,"pdf_field":""},{"help":"Amount of claim or loss","type":"amount","label":"Claim / Loss Amount","options":[],"required":false,"pdf_field":""},{"help":"Amount paid in HKD","type":"amount","label":"HKD Paid","options":[],"required":false,"pdf_field":""},{"help":"Outstanding amount","type":"amount","label":"Outstanding","options":[],"required":false,"pdf_field":""},{"help":"Description of claim or loss event","type":"text","label":"Nature of Event","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Business Activities","fields":[{"help":"Tick all that apply","type":"checkbox","label":"Which of the following business activities are you engaged in?","options":["Freight forwarder as principal","Freight forwarder as agent","Distribution/Packing/Consolidating","Road haulage Operator","Warehouse operator","NVOCC (Non Vessel Owning Common Carrier)","Courier","Customs Broker/Agent"],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"If you are a freight forwarder / NVOCC / courier, what percentage of the cargo handled is: (a) export?","options":[],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"If you are a freight forwarder / NVOCC / courier, what percentage of the cargo handled is: (b) import?","options":[],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"What percentage of your import/export cargo involves dealings with each of the following areas? Australia / New Zealand","options":[],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"Russia","options":[],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"Japan / Taiwan / Korea","options":[],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"Europe","options":[],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"China / Hong Kong","options":[],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"USA/Canada","options":[],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"South East Asia","options":[],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"Mexico / Central America","options":[],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"India","options":[],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"South America","options":[],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"Middle East","options":[],"required":true,"pdf_field":""},{"help":"Percentage value","type":"number","label":"Africa","options":[],"required":true,"pdf_field":""},{"help":"Twenty-foot Equivalent Units","type":"number","label":"Cargo Volume and Gross Freight Receipt (GFR) - Past 12 months - TEUs","options":[],"required":false,"pdf_field":""},{"help":"Weight in tons","type":"number","label":"Tons","options":[],"required":false,"pdf_field":""},{"help":"Cubic meters","type":"number","label":"CBM","options":[],"required":false,"pdf_field":""},{"help":"Gross Freight Receipt in USD","type":"amount","label":"GFR in USD","options":[],"required":false,"pdf_field":""},{"help":"Estimated TEUs","type":"number","label":"Cargo Volume and Gross Freight Receipt (GFR) - Estimated for coming 12 months - TEUs","options":[],"required":false,"pdf_field":""},{"help":"Estimated tons","type":"number","label":"Tons","options":[],"required":false,"pdf_field":""},{"help":"Estimated cubic meters","type":"number","label":"CBM","options":[],"required":false,"pdf_field":""},{"help":"Estimated Gross Freight Receipt in USD","type":"amount","label":"GFR in USD","options":[],"required":false,"pdf_field":""},{"help":"Columns: Cargo type and percentage; types include Dangerous Goods, Wines / Spirit, Cigarettes, Mobile Phones, I.C. / Electronic Parts, Computer / Related Equipment, Audio / Video Product, Pharmaceutical Goods, Temperature Controlled Goods, Skin / Related Product, Other High Value Cargo, Construction Material, Chemical Product, General Cargoes","type":"table","label":"Please state the percentage of the type of cargo carried by your company:","options":[],"required":true,"pdf_field":""},{"help":"Tick all that apply","type":"checkbox","label":"Are you engaged in special carriage like: Bulk, Flat Rack, Open top container","options":["Bulk","Flat Rack","Open top container"],"required":false,"pdf_field":""},{"help":"","type":"choice","label":"Do you own, operate or lease a warehouse?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Provide warehouse location details","type":"text","label":"If Yes, please specify location(s) details","options":[],"required":false,"pdf_field":""},{"help":"Name or address of warehouse location","type":"text","label":"Warehouse Location","options":[],"required":false,"pdf_field":""},{"help":"Type of construction: Concrete wall & roof / metal roof / open area / etc.","type":"text","label":"Construction*","options":[],"required":false,"pdf_field":""},{"help":"Warehouse area in square feet","type":"number","label":"Area (square feet)","options":[],"required":false,"pdf_field":""},{"help":"Number of vehicles owned or operated","type":"number","label":"Do you operate your own vehicles? If Yes, how many of: Vans, Light Trucks, Heavy Trucks, Refrigerated Trucks, Tankers, Trailers","options":[],"required":false,"pdf_field":""},{"help":"","type":"choice","label":"Do you subcontract any of your services?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Details of subcontracted services","type":"text","label":"If Yes, please provide full details","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Coverage / Indemnity Limit","fields":[{"help":"Provide details or attach separate sheet if insufficient space","type":"text","label":"If you have selected section 3, please provide details of the equipment to be insured","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Documents / Conditions","fields":[{"help":"Tick all applicable and provide copies","type":"checkbox","label":"Please indicate document and conditions of business currently in use (Please provide copy where applicable)","options":["Bill of Lading","Sea waybill","Air waybill","Terms and conditions of trade","Any contracts of domestic carriage","Others"],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Electronic Insurance Account Details of Proposer","fields":[{"help":"Electronic Insurance Account","type":"choice","label":"Do you have an EIA Account?","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"","type":"checkbox","label":"If Yes, please fill up Insurance Repository Application form","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Your address details as mentioned in the EIA account shall override the address provided in this application for Insurance","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Bank Details and Payment Details","fields":[{"help":"Cheque or Demand Draft number","type":"text","label":"Cheque / D.D #","options":[],"required":false,"pdf_field":""},{"help":"Name of bank or payee","type":"text","label":"Drawn To","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Bank and Branch Name","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"For Credit / Debit Card - Transaction Reference No.","options":[],"required":false,"pdf_field":""},{"help":"Bank IFSC or MICR code","type":"text","label":"IFSC/MICR Code","options":[],"required":false,"pdf_field":""},{"help":"Amount drawn on cheque/DD","type":"amount","label":"Drawn Amount","options":[],"required":false,"pdf_field":""},{"help":"Date of transaction","type":"date","label":"Transaction Date","options":[],"required":false,"pdf_field":""},{"help":"Bank account number for electronic fund transfer","type":"text","label":"Account Number","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Bank Name","options":[],"required":false,"pdf_field":""},{"help":"","type":"text","label":"Account Holder name","options":[],"required":false,"pdf_field":""}],"filled_by":"proposer"},{"title":"Declarations and Signatures","fields":[{"help":"","type":"signature","label":"Signature / Thumb impression of Proposer*","options":[],"required":true,"pdf_field":""},{"help":"","type":"signature","label":"Signature of Intermediary / Sales person*","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Place*","options":[],"required":true,"pdf_field":""},{"help":"","type":"date","label":"Date*","options":[],"required":true,"pdf_field":""},{"help":"","type":"signature","label":"Signature & Stamp as applicable of the Insurance Advisor / Specified person of Corporate Agent/Authorised Employee of Broker/ Sales person*","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Place*","options":[],"required":true,"pdf_field":""},{"help":"","type":"date","label":"Date*","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer and intermediary"},{"title":"Additional Declarations","fields":[{"help":"Confirm understanding","type":"checkbox","label":"If any additions or alterations are carried out in the risk proposed after the submission of this proposal form then the same should be conveyed to the insurers immediately","options":[],"required":false,"pdf_field":""},{"help":"","type":"choice","label":"Type of Organisation making the payment","options":["Limited Company","International Organisation","Section 25 Company","Non-Government Organisation (NGO)","Government Organisation","Co-operatives","Trust","Partnership","Society","Others"],"required":false,"pdf_field":""},{"help":"PEP means individuals with prominent public functions","type":"choice","label":"Are You or any of the proposed applicants or close relatives associated to Politically Exposed Person (PEP)?*","options":["Yes","No"],"required":true,"pdf_field":""},{"help":"Non-profit organization as defined under Income-tax Act","type":"choice","label":"Are you a Non-Profit Organization?*(only in case of an entity)","options":["Yes","No"],"required":true,"pdf_field":""}],"filled_by":"proposer"}],"deadlines":[],"applies_to":"Freight Forwarders Liability Insurance Policy","attachments":["Additional sheets if more space is needed for answers","Copies of documents and conditions of business currently in use (Bill of Lading, Sea waybill, Air waybill, Terms and conditions of trade, Any contracts of domestic carriage, Others)"],"declarations":["Statements made in this Proposal Form are true to the best of my knowledge and belief and form the basis of the contract.","Any additions or alterations in the risk after submission must be conveyed immediately.","Consent is given to verify identity/address proof through specified government portals for KYC.","All premiums have been/will be paid from bonafide sources and not from proceeds of crime.","The proposer has understood the contents of the proposal form and terms and conditions before signing.","The insurance company is not obliged to issue a policy until the proposal is accepted and premium is received."],"dropped_labels":29},"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/5592-freight-forwarders-liability-insurance-policy-proposal-form-and-questionnaire"}