Previous Policy Zero Dep

For Selected Add-on Does the previous policy have nil dep?

PA cover is mandatory. you can opt out If the following one you do not have

1. The owner does not have driving license or
2. Owner already has PA cover of atleast 15 lacs.
(Including Death , Total disability, partial disability)

Confirmation (Previous Policy Addons)

Does the previous policy have nil dep?

Confirmation (Previous Policy Addons)

Does the previous policy have ?

3 CKYC Detail Back to Quotation

CKYC Type One*

CKYC Type One required

Document Type *

Document Type required

Document No.*

Document No. required Please enter valid Document No.

Company Name *

Company Name required

Date of Birth *

Date of Birth is required Please enter valid Date of Birth

Date of Corporation *

Date of Corporation is required Please enter valid Date of Corporation

Profile Photo *

5 Preview & Payment Change Proposal Detail

Proposer Detail

Company Name
Proposer Name
Date of Birth
Mobile No.
Email Id
State
City
Contact Address
Pincode
Nominee Name
Nominee Relationship
Nominee Age
Nominee Gender
GSTN
PANNo
Appointee Name
Appointee Relationship

Vehicle Details

Registration No.
Chassis No.
Engine No.
Model & Variant
Date of Registration
Previous Insurance Company
Previous Policy No.
Previous TP Insurance Company
Previous TP Policy No.
Agreement Type
Finanancer
Finanancer City

I hereby confirm that I have mandated Millennials Insurance Brokers Private Limited. to place my insurance cover and have read and agreed on the Terms and Conditions. Please select Terms & Conditions

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+91-9910324956,
+91-9212624569
care@milbinsure.com
Principal Officer:
Jitendra Girdhar, +91-9910324956
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Millennials Insurance Brokers Private Limited 570, Tower B, Spaze IT Park, Sohna Road, Sector-49, Gurugram – 122001. Haryana

Licence Number – 638 , IRDA Direct Broker Code: IRDA/DB719/17 , Valid till: 04/03/2027, CIN: U66000HR2017PTC070301, Principal Officer: Jitendra Girdhar (Contact Number: +91-9910324956)

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