Follow the steps to complete the form with ease

1. Press the ‘Get Form’ button to download the proposal form and open it to begin the process.
2. Provide the name of the proposer, selecting the appropriate title such as Mr., Mrs., or Miss. This identifies the primary individual applying for the insurance.
3. Enter the address, telephone number, mobile number, and email address of the proposer. Ensure that these details are current and accurate to facilitate communication.
4. Fill in your Permanent Account Number (issued by income tax authorities) as it helps in identifying your financial records.
5. Provide the name, address, and telephone number of your family physician. This information is essential for any necessary health confirmations.
6. Indicate your monthly income, which assists the insurance provider in assessing your financial profile.
7. List the names of people proposed to be insured, their relation to you, gender, their dependency status, date of birth, age in completed years, occupation, and the desired sum insured. Ensure to include all required individuals for coverage.
8. If applicable, indicate any optional co-payment percentage you wish to opt for, either 10% or 20%. This affects your out-of-pocket costs in the event of a claim.
9. Detail any past hospitalizations, illnesses, or injuries for each proposed insured individual, including insurer details and policy numbers if applicable.
10. Answer whether you have been refused insurance previously or had policies canceled. Provide details as required.
11. Decide whether to opt out of Third Party Administrator (TPA) services and indicate your preference.
12. Fill in the proposed date and period of insurance coverage, ensuring it reflects your intended start and end dates.
13. Review the declarations section carefully, ensuring you understand your commitments and the truthfulness of the information provided.
14. Finalize the form by signing it and adding the date. This acknowledges your agreement and understanding of the proposal terms.
15. Upon completion, save any changes made to the form. You can then download, print, or share it as needed.

Start completing your Oriental Insurance Individual Mediclaim Proposal Form online today for a smooth insurance experience.