Health Insure - Client Family Profile

Read the below instructions to get all the supporting documents ready, before starting KYC Data Entry and Document Upload
The data and documents are to be filled and uploaded for the family members (in case of Individual or Family Floater).
Create a ZIP file with all the below mentioned applicable documents and then upload via Choose File button in form below

Documents to be zipped into an single ZIP file (all documents should be of original color)

PAN Card
Address Proof (India - Aadhaar / Passport / Utility Bill / Voter ID / Property Tax / Tenancy Agreement)
Address Proof (Intn'l - NRIs only) - Driving License / Utility Bill / Tenancy Agreement / Notarized Address Proof)
Passport (NRIs only) - Front & Back inside with latest Visa page
Resident ID / Social Security ID / National ID (NRIs only)
Existing Medical Insurance Policy (Last 2 year Electronic Policy document - if seeking to take additional Medical Insurance cover (or) one wishes to port existing policy to another insurer)

Client Family Profile Form

Proposer Name (as in PAN) *

Permanent Account Number (PAN) *

Email *

Mobile # (India) *

Mobile # (Intn'l - NRI)

City of Birth *

Country of Residence *

Full Address with PIN (India) *

Full Address with PIN (Intn'l - NRIs)

Nominee(s) *

Person 1 Name *

Person 1 Date of Birth *

Person 1 Height (cms) *

Person 1 Weight (Kgs) *

Person 1 - PED *

Person 2 Name

Person 2 Date of Birth

Person 2 Height (cms)

Person 2 Weight (Kgs)

Person 2 - PED

Person 3 Name

Person 3 Date of Birth

Person 3 Height (cms)

Person 3 Weight (Kgs)

Person 3 - PED

Person 4 Name

Person 4 Date of Birth

Person 4 Height (cms)

Person 4 Weight (Kgs)

Person 4 - PED

Do you have Net Banking Facility to make online payment? *

Do you have debit card facility to make online payment? *

Do you have UPI ID linked to your bank a/c to make online payment? *

Document Upload (Single Zip file) *

Submit