COVID-19 Insurance

Submit your insurance proposal form on-line

A. 1 Lakh Insurance – Personal (Rs. 1000 per person) or Family (Rs. 600 per person)
B. 50 Thousand Insurance – Personal (Rs. 500 per person) or Family (Rs. 300) per person)


Name of Insured (required)
Date of Proposal
Age:
Address
Your Email (required)
Phone (required)
Insurance Type  Individual Family
Sum Insured Amount  100,000 50,000
Pan No
Occupation
CitizenShip Number
Family Members of the insured
SN Name Age Occupation Relation CitizenShip Number Nominee
1
2
3
4
5
6
7
8

Total Number of Members Including Insured

Premium

Stamp Duty

Total Premium


Click on the link below to download the proposal form of COVID-19 Insurance:

  1. PDF File Format
  2. DOC File Format

 

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