Apply for Maternity Cover at Bajaj Finserv

Pregnancy Complications Cover Application Form

Premium: Rs. 499 | Sum Insured: Rs. 50,000 | Duration: 1 year

*This product is for existing customers only

Full Name

Date Of Birth

Mobile Number

I authorize Bajaj Finserv representative to call /SMS towards this application and other products/services. This consent overrides my registration for DNC/NDNC. T&C

Enter the image characters below

Personal Details

Full Name

Date of Birth

Contact Details

Flat / House Number

Street Name

Area

Pin Code

City

Personal email id

Mobile Number

Nominee Details

Nominee Name

Payment Option

Debit from my bank account (INR Rs. will be automatically deducted within 7 working days)

Pregnancy Complications Cover Application Form

Payment Option

Thank you for your interest, unfortunately legal restrictions prevent us from allowing you access to this part of the website.