In-Dependent Kavach

Kavach Segment
MasterSenior

Plan Holder

Date of Birth of Plan Holder

Proposer Name

Date of Birth of Proposer

Relationship with Proposer

Date of Birth

Relationship with Nominee

Relationship with Apointee

Existing Term Policy Number of Proposer

Existing Overseas Mediclaim Policy Number of Plan Holder

Point to be noted
- A BIJO Consultancy Services is the private mutual subsidiary vertical of BIJO Group.
- The membership of BIJO Consultancy Services is private and non-transferable.
- The Kavach Card is not usable as debit, credit or any type of cash-less card.
- There will be no refundable for any kind of pre-paid listed service.
- ₹100 charge for re issuance of loss of the Kavach card.
- The membership and annual membership renewal fees is ₹100 non-refundable.
- Once membership gets terminated or exit kindly submit the card to concerned center.
- The set membership charge is applicable in case re activation of dormant membership account.
- It is mandatory to provide existing insurance cover details.

A BIJO Consultancy Services is the private mutual subsidiary vertical of BIJO Group.

The membership of BIJO Consultancy Services is private and non-transferable.

The Kavach Card is not usable as debit, credit or any type of cash-less card.

There will be no refundable for any kind of pre-paid listed service

₹100 charge for re issuance of loss of the Kavach card.

The membership and annual membership renewal fees is ₹100 non-refundable

Once membership gets terminated or exit kindly submit the card to concerned center.

The set membership charge is applicable in case re activation of dormant membership account.

It is mandatory to provide existing insurance cover details.

Payment Recipt/Refrence Number