Standard Fire & Special Perils policy

Name of Insured/Principal/Correspondence*
Address of Insured/Principal/Correspondence*
Location of work*
Email*
Mobile*
Bussiness of the insured(specify exact nature of work)*
Risk Location Address*
Financial Interest - Hypothication ( Name of Bank)*
Type of Construction*
Basement Occupany*
Age of buildings*
Risk Categary*
Fire protection system installed?(Extinguishers, Hydrants, Sprinkler, Hose Reel, etc.)*
Nearest Fire Brigade Station (Kms) from Premises*
Sum Insured Details - Market Value Basis*
Perils & Add on Covers*
Is Reinstatement Value Clause required ?*
Is Local Authority Clause Required*
s Designation of Property Clause Required*
Is Agreed Bank Clause Required*
Is Voluntary Deductible Required(Amount)*
Is Escalation required and percentage amount(Percentage)*
Existing Insurance company*
Claims Details for Past 3 years*
Would you like to delete these(Strom,Cyclone,group of perils(STFI)) perils from the basic cover?*
Would you like to cover the Plinth & Foundation along with your buildings?*
Whether Insurance cover was declined by any othe company or imposed any special conditions(Give Detail)*
Please download file, input data and upload for premium*
Attachment*