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Policy Details

  • Policy Name

    AC Insurance

  • Policy Duration

  • Sum Insured

  • Premium Amount

    Rs. 399

AC Insurance Application Form

Premium: Rs. 399 | Sum Insured: Rs. 50,000 | Duration: 1 year

*This product is for existing customers only

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AC Insurance Application Form

Product Details

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  • Brand Name

  • Invoice Number

  • Item Identification No

  • Date of Purchase

  • Invoice Value

  • Premium Amount

Product Details

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Please enter Brand Name

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Please enter Item Identification No

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Please select Correct Date of Purchase

Nominee Details

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  • Nominee Name

  • Nominee Relationship

Personal Details

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  • Name

  • Mobile No.

  • Date of Birth

  • E-mail

Personal Details

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Please enter your Full Name

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Please select Correct Date of Birth

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Please enter your Mobile No

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Please enter Correct e-mail ID

Address Details

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  • Address line 1

  • Address line 2

  • Pincode

  • City

Address Details

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Please enter your Address

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Please enter Pin Code

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Please enter your Address

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Please enter City Name

Choose Your Payment Method