The Insurance Declaration Form is a crucial document in the Indian insurance industry, required by the Insurance Regulatory and Development Authority of India (IRDAI) for all insurance applications. This form serves as the primary basis for the insurance contract, where the proposer discloses all material facts that could influence the insurer's decision to provide coverage. The form must comply with various Indian regulations, including the Insurance Act 1938, IRDAI guidelines, and the Insurance Laws (Amendment) Act 2015. It is designed to protect both the insurer's and policyholder's interests by ensuring full disclosure of relevant information and maintaining transparency in the insurance application process. The Insurance Declaration Form can be used for various types of insurance including life, health, property, and general insurance, with specific sections tailored to each insurance type.
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1. Personal Information: Basic details of the proposer including name, address, contact information, and identification documents as per KYC requirements
2. Insurance Coverage Details: Specific information about the type of insurance being applied for, coverage amount, and policy term
3. Risk Declaration: Detailed disclosure of all risks and material facts that could affect the insurance contract
4. Medical History: Declaration of current health status and medical history relevant to the insurance application
5. Financial Information: Details of income, occupation, and other financial information required for underwriting
6. Existing Insurance: Declaration of any existing insurance policies held by the proposer
7. General Declarations: Standard declarations about the truthfulness of information provided and understanding of terms
8. Payment Details: Information about premium payment method and frequency
9. Authorization: Consent for verification of information and processing of application
10. Signature Section: Space for signatures, dates, and witness details
1. Nominee Details: For life insurance policies, details of nominees and their relationship to the insured
2. Property Details: For property insurance, detailed description of property to be insured
3. Vehicle Details: For motor insurance, specific information about the vehicle being insured
4. Family Medical History: For health/life insurance, detailed family medical history if required
5. Lifestyle Declaration: For life/health insurance, information about smoking, alcohol consumption, and other lifestyle factors
6. Business Details: For commercial insurance, specific information about business operations and risks
7. Travel Details: For travel insurance, information about travel destinations and duration
1. Schedule A - Medical Examination Report: Detailed medical examination results and doctor's observations (if required)
2. Schedule B - Property Valuation Report: Detailed valuation of property for property insurance
3. Schedule C - Risk Assessment Report: Detailed analysis of risks specific to the insurance type
4. Appendix 1 - Supporting Documents Checklist: List of required documents to be submitted with the form
5. Appendix 2 - Terms and Conditions: Detailed terms and conditions applicable to the insurance policy
6. Appendix 3 - Premium Calculation Sheet: Detailed breakdown of premium calculation and applicable taxes
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