Get Family Floater Health Guard - Proposal Form

Completing the FAMILY FLOATER HEALTH GUARD - PROPOSAL FORM online is an essential step towards securing health insurance coverage for you and your family. This guide provides clear, detailed instructions to help users filling out the form accurately and efficiently.

Follow the steps to successfully complete the proposal form.

1. Click the ‘Get Form’ button to access the proposal form and open it in your preferred document editor.
2. Begin with the Proposer Details section. Fill in your full name, including title, first name, middle name, and surname. Use block letters to ensure clarity.
3. Indicate whether you are an existing Bajaj Allianz customer by selecting 'Yes' or 'No.' If you answer 'Yes,' please provide your existing policy number.
4. Select your gender from the options provided: Male, Female, or Other.
5. Enter your date of birth using the format specified (DD/MM/YYYY).
6. Provide your PAN number and UID/Unique ID in the respective fields.
7. If applicable, enter your Bajaj Allianz employee code.
8. Select your marital status—options include Married, Single, Divorced, or Widowed.
9. Indicate the number of children you have by filling in the appropriate fields.
10. Complete your occupation information by selecting the relevant option.
11. Fill in your permanent and correspondence addresses, including house number, locality, city, state, and pin code, taking care to provide accurate contact details.
12. Indicate your educational qualifications by selecting one from the listed options.
13. Provide information on your family monthly income from the available ranges.
14. Select your preferred method of contact for any offers—either Phone or Email.
15. Choose your opted sum insured amount from the options provided.
16. For the ‘Details of the persons to be insured’ section, list each insured person's name, date of birth, gender, height, weight, occupation, and their relationship to you.
17. Specify if you require co-payment for non-network hospitals by selecting 'Yes' or 'No.'
18. Answer questions regarding tobacco or alcohol consumption and provide details if applicable.
19. Respond to health condition inquiries regarding any past illnesses or treatments. List relevant details as requested in the table provided.
20. Include details about any relevant proposals for previous insurance and any health-related issues documented.
21. Fill out the family doctor details, including their name, qualification, mobile number, and address.
22. Select your opted voluntary deductible amount and discount percentage from the given choices.
23. Review the declaration section carefully, confirming the accuracy of all provided information. Signature and date are required.
24. Finally, save your changes, download the completed form, print it out if necessary, or share it as needed.

Complete the FAMILY FLOATER HEALTH GUARD - PROPOSAL FORM online to secure your family's health insurance coverage today.