Personal details
Date of birth*
Gender*
PAN number
Period of Insurance
Start date of policy
End date of policy
Select sum insured
Sum insured*
Name of the nominee*help
Click here for details
Relationship with the insured*
Previous diseases (if any) *help
Click here for details
Suffering since
Upload Photo
Upload a photograph of the person to be insured*
Please upload the passport size (preferred) photograph.
Do you wish to insure your spouse?
Do you wish to insure your dependent children?
Have you insured your entire family?
Tip: You get discount if your entire family is insured
Details of family physician
Name of family physician
Address of family physician
TPA/NON-TPA
Do you wish to opt for TPA services?
Tip: You get 5% discount if you opt out of TPA service
Select your branch office
OICL Office State *
City/Town *
Branch/Office *
OTP Validation
Mobile :
Email :
Notification
Medical checkup is mandatory. Kindly contact nearest OICL office.
Notification
The maximum age for Dependent male child is 25 years.
Please select a role to continue
Whether any agent is involved for this proposal?
* If 'NO' is selected, the policy will be issued under code of Development Officer without an Agent.