Extended Warranty Buy Process

Your Product Details

Select Product*

Select Brand*

Other Brand*

Manufacturer Warranty*

Date of Invoice*

Pincode of your current residence*

Invoice Amount*

Your Name*

Mobile Number*

+91

Sum Insured :

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Premium for One Year

Premium for Two Years

Premium for Three Years

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Section	Premium ()
Net Premium
GST (18%)	GST+Kerala Flood cess (18%+1%)
Final Premium

Additional details of the product

Model Number*

Serial Number

Invoice Number*

Upload Invoice

Upload

Your Personal Details

Personal Information

Email Id*

Date of Birth*

Aadhaar Number

Pan Number

Gender*

Male

Female

Transgender

Permanent Address Details

House No./ Building / Flat No.*

Street Locality / Landmark*

Pincode*

State*

City*

Area*

Other Area

My policy mailing address is same as risk location address*

No Yes

Policy Mailing Address

House No./ Building / Flat No.*

Street Locality / Landmark*

Pincode*

State*

City*

Area*

Other Area

Your Policy Summary

Full Name :*

Mobile Number :

Email Address :

Selected Product
Selected Brand
Date of Invoice
Invoice Amount

Manufacturer Warranty	Year
Model Number
Serial Number
Invoice Number

Extended Warranty Period
Extended Warranty Plan

Sum Insured
Premium

House No. / Building / Flat No. :

Please enter house number

Street / Locality / Landmark :

Please enter street

Pincode :

Please enter pincode

State :

City :

Area :

Please enter area

Disclaimer

 I/We, the undersigned hereby declare and warrant that the Extended Warranty Insurance Policy [EW Insurance Policy] is issued by Bajaj Allianz General Insurance Company Ltd [Company] subject to the declarations, warranties, statements and particulars given in this online proposal form during the process of my/our online purchase through web. The statements and particulars given in this proposal form are complete, true and accurate to the best of my/our personal knowledge and belief. I/we have understood the terms and conditions to the contract and agree that the statements and particulars given in this proposal form shall be held to be promissory and shall be the basis of the insurance contract between me/us and the Company and the Company shall have no liability under the insurance contract if it is found that any of the statements or particulars or declarations in this proposal form or other documents are incorrect and or untrue or suppressed any information or provided misleading or false information in any respect on any matter to the grant of a cover. I/we will accept the usual conditions and form of the policy prescribed and issued by Company. I/We hereby agree and undertake that I/we are agreeable to receive EW Insurance Policy documents [without enclosing the terms and conditions of policy] from the company and I hereby authorise Company that all terms and conditions of EW Insurance 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 EW Insurance Policy displayed on website.
  @@I also agree that the various documents required under KYC norms [such as identity proof, residence proof, income proof etc., are submitted in soft copy and I/we shall submit the self-attested hard copies of KYC documents before expiry of 15 days from the date of issuance of EW Insurance Policy [Please click here to view the list of KYC documents required to be submitted].  
  STATUTORY WARNING:
  No person shall allow or offer to allow either directly or indirectly as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate except such rebate as may be allowed in accordance with the published prospectuses or tables of the Insurer. Any person making default in complying with the provisions of this section shall be punishable with a penalty, which may extend to Ten Lakh Rupees.
  @@Note: required to be activated only in case of (i) online proposal form and issuing web sales, and (ii) in cases where premium is Rs.100000/- and above. Further our system has to automatically detect the name of The insurer should not enter into a contract with a customer whose identity matches with any person with known criminal background or with banned entities and those reported to have links with terrorists or terrorist organizations. There has to be suitable inbuilt provisions for compliance of these requirements [this entire para will be in the system and will not be in proposal form, when printed for sending to online web purchasers].
  Disclaimer � This is a computer generated statement and does not require signature.

I Agree

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Coverage

Comprehensive coverage on parts and labor
Peace of mind by protecting your product against unexpected repair work
Unlimited repair during EW period subject to sum assured
Hassle free cashless facility
Quality repair assurance
Genuine Spare Parts
Covers multiple brands
Door step service for large appliances
Nationwide service network

1800-209-1021

Extended Warranty

Your Product Details

Click to choose your plan

Additional details of the product

Your Personal Details

Personal Information

Permanent Address Details

Policy Mailing Address

Your Policy Summary

Personal Information

Product Details

Plan Details

Permanent address

Disclaimer

Coverage