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Office Umbrella Policy
Section 1 - Building Details *
Building SMI
Building SMI
Yes
No
Land lords Fixture and Fittings SMI
Yes
No
Boundary Wall, gates and fences SMI
Yes
No
Other property (to be detailed) SMI
Yes
No
Sr. No.
Location No. *
Location Address *
Desc. of Premises *
Pemises Occupied as *
Ownership of the Premises *
Occupancy *
EQ Zone *
Action
No records found.
Add Row
Section 2 - Office Contents *
Office Content SMI
Business Furniture, Furnishings, safes, Office Machineries, Unused Office Stationeries and Fixtures and Fittings
Yes
No
Documents/ Telephone, gas and electric meters
Yes
No
Tenants and improvements and decorations
Yes
No
Pedal cycle/s
Yes
No
Electronic equipments
Yes
No
All other contents
Yes
No
Professional instruments and equipments for medical purposes
Yes
No
Clothing and personal effects
Yes
No
Temporary removal of documents
Yes
No
Sr. No.
Location No. *
Location Address *
Risk Description *
Sum insured *
Occupancy *
EQ Zone *
Action
No records found.
Add Row
Section 3 - Tenants Legal Liability *
Section 4 - All Risks *
Section 5 - Money Insurance *
Section 6 - Fixed Glass and Sanitary Fittings *
Section 7 - Fidelity Guarantee *
Section 8 - Damage To Equipment *
Section 9 - Personal Accident *
Section 10 - Breakdown Of Office Appliances *
Section 11 - X Baggage *
Section 12 - Workmens Compensation *
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OICL Office State*
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ANDHRA PRADESH
ARUNACHAL PRADESH
ASSAM
BIHAR
CHANDIGARH
CHATTISGARH
DELHI
GOA
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU AND KASHMIR
JHARKHAND
KARNATAKA
KERALA
LADAKH
MADHYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
MIZORAM
NAGALAND
ODISHA
PONDICHERRY
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Declaration
I/ we declare that the statements made by me/ us in this proposal form are true and to the best of my/ our knowledge and belief and I/ we hereby agree that this declaration shall form the basis of the contract between me/ us and The Oriental Insurance Company Ltd.. I/ we also declare that if any additions or alterations are carried out after the submission of this proposal form and/ or issuance of policy document, the same would be conveyed to The Oriental Insurance Company immediately. I/ we hereby agree to and authorize the disclosure to the insurer or the TPA or any other person nominated by the insurer any and all Medical records and information held by any Institution/ Hospital or person from whom the insured person has obtained any medical or other treatment to the extent reasonably required by either the insurer or the TPA in connection with any claim made under this policy or the insurer’s liability there under. I/ we further declare that I/ we have read the prospectus and have understood the same. I accept the policy, subject to terms, exceptions and conditions prescribed therein and further disclose that on the event of finding anything contrary to what has been declared by me, I/ we shall be held responsible for all consequences thereof and insurance company shall incur no liability under this insurance. I/ we further declare that the Insurance Company shall not be liable to make any payment under this policy in respect of any claim if such claim be in any manner intentionally or recklessly or otherwise misrepresented or concealed or non-disclosure of material facts or making false statements or submitting false bills whether by the insured person or Institution/ Organization on his behalf. Such action shall render this policy null and void and all benefits hereunder shall be forfeited. Company may take suitable legal action against the insured Person/ Institution/ Organization as per Law.
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Office Umbrella - Terms and Conditions (Please read carefully)
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Telephone
Date of birth *
GST Number (if any)
Occupation *
Select occupation
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OTHERS
RETIRED
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Select address type
Residence Address
Office Address
Address for communication *
State *
Select State
ANDHRA PRADESH
ARUNACHAL PRADESH
ASSAM
BIHAR
CHANDIGARH
CHATTISGARH
DELHI
GOA
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU AND KASHMIR
JHARKHAND
KARNATAKA
KERALA
LADAKH
MADHYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
MIZORAM
NAGALAND
ODISHA
PONDICHERRY
PUNJAB
RAJASTHAN
SIKKIM
TAMIL NADU
TELANGANA
TRIPURA
UTTAR PRADESH
UTTARAKHAND
WEST BENGAL
City *
Select City
Pin code *
Select Pincode
Declaration *
I/we hereby agree that Oriental insurance company Ltd. can store the personal information/contact details given by me /us in this Basic information form and register me on the portal.
Agree
Disagree
Primary insured details
Name of insured
Date of birth
Email
Mobile
Telephone
Occupation
Address for communication
State
City
Pin code
GST Number (if any)
Plan details
Section 1 - Building Details
Building SMI
Building SMI
Yes
No
Land lords Fixture and Fittings SMI
Yes
No
Boundary Wall, gates and fences SMI
Yes
No
Other property (to be detailed) SMI
Yes
No
Sr. No.
Location No.
Location Address
Desc. of Premises
Pemises Occupied as
Ownership of the Premises
Occupancy
EQ Zone
No records found.
Section 2 - Office Contents
Office Content SMI
Business Furniture, Furnishings, safes, Office Machineries, Unused Office Stationeries and Fixtures and Fittings
Yes
No
Documents/ Telephone, gas and electric meters
Yes
No
Tenants and improvements and decorations
Yes
No
Pedal cycle/s
Yes
No
Electronic equipments
Yes
No
All other contents
Yes
No
Professional instruments and equipments for medical purposes
Yes
No
Clothing and personal effects
Yes
No
Temporary removal of documents
Yes
No
Sr. No.
Location No.
Location Address
Risk Description
Sum insured
Occupancy
EQ Zone
No records found.
Section 3 - Tenants Legal Liability
Sr. No.
Location No.
Location Address
Risk Description
No records found.
Section 4 - All Risks
Sr. No.
Make
Model
Identification Number
Sum insured
No records found.
Section 5 - Money Insurance
Money Insurance SMI
Wages and salary whilst in transit from or to the office(s) -sec III
Yes
No
Money other than wages and salary whilst in direct transit between any two places-sec III
Yes
No
Money in office during business houses-sec III
Yes
No
Money in office in locked safe outside business hours -sec III
Yes
No
Sr. No.
Location No.
Location Address
Sum insured
PML Amount
No records found.
Section 6 - Fixed Glass and Sanitary Fittings
Office Glass & Sanitary SMI
Fixed glass, frame work sec IV
Yes
No
Sanitary fittings sec IV
Yes
No
Surgery lamps, signs, name plate sec IV
Yes
No
Sr. No.
Item No
Desc. Of Glass / Others
ofc-glass-typ
Item Type
Glass Length-inch/cm
Glass Width-inch/cm
Position of Glass
Sum insured
No records found.
Section 7 - Fidelity Guarantee
Sr. No.
No of Persons
Designation
Salary Per month
Limit any one person
No records found.
Section 8 - Damage To Equipment
Sr. No.
Equipment Type
Machine Serial Number
Make
Quantity
Description Of Item
Year of Make
Sum insured
whether items covered under sec 2A
Maintenance facility available
If yes, Type of facility available
No records found.
Section 9 - Personal Accident
Sr. No.
Designation
Name
Date of birth
Age in Yrs
Months
Nominee Name
Nominee Address
Nominee Relation
Monthly earnings
Pre-Existing Ailments
PML Amount
No records found.
Section 10 - Breakdown Of Office Appliances
Sr. No.
Make
Model
Machine Serial Number
Sum insured
whether items covered under sec 2A
No records found.
Section 11 - X Baggage
Baggage SMI
Baggage SMI Sum Insured *
Yes
No
Sr. No.
Location No.
Location Address
Description of Baggage
No records found.
Section 12 - Workmens Compensation
Sr. No.
Location No.
Location Address
Wage Range
Name
Nature of work
Monthly earnings
Sum insured
Medical Expenses %
No records found.
Select your branch office
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