INDIVIDUAL CYBER SAFE INSURANCE POLICY

Your Details

First Name*

Last Name*

Your mobile number*

Date of Birth*

Email ID*

Gender*

Male

Female

PAN No

Pincode of your current residence*

GSTN/UIN

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Your Risk Profile

Do you actively implement the best network security practices recommended by your service provider such as strong passwords, two factor authentications, regularly changing your passwords? *

No Yes

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Is the antivirus software updated as per the recommendations of antivirus software service provider?*

No Yes

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Do you maintain regular backup of data on either cloud/external device for your Computer System including all digital devices?*

No Yes

Please provide details of backup*

Have you been a victim of any of the perils covered under the policy in the past?*

No Yes

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Let us know the events that you were a victim of

Cyber Identity Theft

Cyber Stalking

IT Theft

Malware attack

Phishing or E-Mail Spoofing

Media Wrongful Act

Data Breach or Privacy Breach

Please provide details of events *

Address Details

Permanent Address

House No./Building No.*

Street Locality / Landmark *

Pincode*

State*

City*

Area *

Other Area

To support our Go Green initiative, we will send the policy copy on your email. This is a digitally signed valid document. The hard copy of the policy would be sent on request only.Please confirm if you still want to receive the physical hard copy of your insurance policy.*

No Yes

Declaration

1. I/We hereby declare on behalf of proposer and on behalf of all persons proposed to be insured that the above statements, declaration, warranties and or particulars given by me are true and complete in all respects to the best of my knowledge and belief. I/We am/are authorized to propose on behalf of these other persons.
2. I understand that the information provided by me will form the basis for of the insurance policy and is subject to the Board approved underwriting policy of the Company.
3. I/we have understood that the statements and particulars given in this proposal form and this declaration shall be held to be promissory and shall be the basis of the insurance contract between me/us and the Bajaj Allianz General Insurance Company Ltd [Company] and the Insured Beneficiary/Group Member and that, if it is found that any of the statements or particulars in this proposal form or other documents are incorrect, untrue, suppressed any information or provided misleading/false information in any respect on any material/ immaterial facts/particulars, to the grant of a cover or otherwise, the Company shall have no liability under the insurance contract or the policy document thereunder, apart from Company's right to cancel my/our policy and the premium paid by me/us shall be forfeited by the Company.
4. I/we also do hereby agree and undertake to immediately inform the Company any changes in this proposal form/documents/ risk proposed for insurance after the submission of this proposal form.
5.I/we do hereby agree to accept the Standard Terms and Conditions and form of the policy issued by Company in such cases. I/We hereby authorize company that all Standard Terms & Conditions of policy can be displayed in the website of company that enables access by me/us if I/We want to know the terms and conditions of policy displayed on website.

I Agree

Policy Summary

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Key Features

Covers phishing, cyber stalking, malware attacks and other cyber risks
First Indian insurer to introduce cyber insurance for individuals
Multiple coverage options at affordable premium
Sum insured options ranging from INR 1 lac to INR 1 crore

Disclaimer: I hereby authorize Bajaj Allianz General Insurance Co. Ltd. to call me on the contact number made available by me on the website with a specific request to call back. I further declare that, irrespective of my contact number being registered on National Customer Preference Register (NCPR) under either Fully or Partially Blocked category, any call made or SMS sent in response to my request shall not be construed as an Unsolicited Commercial Communication even though the content of the call may be for the purposes of explaining various insurance products and services or solicitation and procurement of insurance business. Furthermore, I understand that these calls will be recorded & monitored for quality & training purposes, and may be made available to me if required.

This site is best viewed with IE 9+, Firefox 20.0+, Chrome 30.0+, Safari 4.0+ Bajaj Allianz General Insurance Co. Ltd. All Rights Reserved. | IRDA Reg. No. 113 | An ISO 27001:2005 Certified Company | Tollfree: 1800-209-0144 | Bajaj Allianz House, Airport Road, Yerawada, Pune-411006

1800-209-0144

INDIVIDUAL CYBER SAFE INSURANCE POLICY

Your Details

Plan Details

Your Risk Profile

Let us know the events that you were a victim of

Address Details

Declaration

Policy Summary

Already have a Quote?

Key Features