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Liability Insurance
Coverage Details

Type of cover *    
Previous policy issued by *
Expiry date of current policy* 
Vehicle Details
No of paid drivers
Vehicle registered in the name of :
Make *   Model * City of registration *
Year of manufactureDate of first registration *   Car Registration number * Registration Date *
. .
Is your car CNG / LPG fitted
Effective Driving License
Business Type
UnNamed Pillion
No of Pillion
Paid Driver
For Unnamed Passengers
No of Unnamed Passengers
SumInserd for each passinger
For Employees
No of Employees
Car Holder Details
Name *
E-mail *
Mobile number *
Location *
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*This is based on the difference between the highest and lowest premium's for a single person, age 25, looking for an individual health policy with the sum insured of Rs. 5 lakhs.
**This is based on the difference between the highest and lowest premium's for a single person, age 25, looking for a term plan, with the sum insured of Rs. 30 lakhs, and the premium paying term of 30 years.
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