BIJOCAP FINVEST

:
June 16, 2024

THE BIJO COMPANY

:
June 16, 2024

LIFE INSURANCE FORM

    Associate ID

    Master ID

    LIFE INSURANCE
    TERM POLICYSUPER TERM POLICYMONEY BACK POLICYINCOME POLICYPENSION POLICYCHILD POLICYWHOLE LIFE POLICY

    HEALTH INSURANCE
    INDIVIDUALFAMILY FLOTERMULTI INDIVIDUALTOP-UP / SUPER TOP-UPTRAVEL POLICYCRITICAL ILLNESS POLICYOVERSEAS MEDI-CLAIMGROUP POLICY

    GENERAL INSURANCE
    TWO WHEELER POLICYTAXI / RIKSHAPRIVATE CARPCCVGCCVSCHOOL BUSMISCELLANEOUS POLICYMARINE POLICYPERSONAL ACCIDENTWORKMAN COMPENSATIONGROUP INSURANCE

    Name of Proposer

    Gender

    Proposer Date of Birth

    Name of Life to be Insured

    Gender of Life Insured

    Education of Life Insured

    Life Insured Date of Birth

    Address

    City

    City Code

    Contact Number

    Email ID

    Name of Nominee

    Nominee Date of Birth

    Relationship with nominee

    Contact Number of nominee

    Name of Appointee

    Appointee Date of Birth

    Relationship with Appointee

    Contact Number of Appointee

    Current Occupation

    Firm Name

    Designation

    Monthly Take Home

    Pan Number

    Upload Pan

    Aadhar card

    Upload Adhar card

    Upload Photo

    Other Documents

    Purpose of Proposal

    Proposed Sum Assured

    Premium Payment Type

    Premium Payment Mode

    Premium Payment Way

    Need Health Policy

    Need Motor Policy

    Dear subscriber, this is the system generated service application form for collecting basic and initial information of proposer and service information use for internal record of BIJOCAP FIVEST, there will be more other process if proposal accepted.

    Dear subscriber, you are choosing and applying for services through
    BIJOCAP FINVEST and for discussion of concern service, we are appointing an advisor by BIJOCAP FINVEST for you. It is our assurance that you will be satisfied meeting with our associate for your all requirement-related concerned service, we will not take the final step for closing the deal, till you understand the process and system-related service. Our associate will clear you the whole pattern, system, terms & conditions of the base company and mediator company, also our associate will understand the product features, supportive plan and related policies, properly.