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Policy Complete Details
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Policy Entry Form
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👨💼 Assigned Agent:
(Admin can change the agent for this policy)
1. Product
2. Current
3. Insured
4. Vehicle
5. Insp
6. Prev
7. Premium
8. Admin
9. KYC
Product Type
Select
Motor
Health
Vehicle Type
Select
2 Wheeler
4 Wheeler
Commercial
Sub Product
Select
Company Name
Select
Policy Name
Start Date
End Date
PDF Upload
RC Front
RC Back
Customer Name
Contact Number
Email ID
Address
Reg No
Engine No
Chassis No
Make
Select
Tata Motors
Mahindra & Mahindra
Maruti Suzuki
Ashok Leyland
Bajaj Auto
Hero MotoCorp
TVS Motor Company
Force Motors
Eicher Motors
Ola Electric
Ather Energy
Royal Enfield
Hyundai Motor India
Honda
Toyota Kirloskar Motor
Kia India
MG Motor India
Skoda Auto India
Volkswagen India
Renault India
Nissan Motor India
BMW India
Mercedes-Benz India
Audi India
Model
Variant
Fuel Type
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Petrol
Petrol/CNG
CNG
Diesel
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Battery
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NCB
0
20
25
35
45
50
GVW
RTO
District
State
Zone
Cubic Capacity
Seating Capacity
Mfg Year
CPA
Policy Mode
Policy No (Unique)
Inspection Required?
Yes
No
Inspection ID
Report PDF
Previous Insurance?
Yes
No
Prev Company
Select
Prev Policy No
Start Date
Expiry Date
Prev PDF
OD Premium
TP Premium
Addon Premium
Added By (Agent Name)
Net Premium
GST Percentage (%)
GST Amount
Final Premium
Remarks
Commissionable Net
Agent Payout %
Agent Payout Amount
Incoming Payout %
Incoming Payout Amt
Profit
Payout Pay
Yes
No
Payout Received
Yes
No
Aadhar Front
Aadhar Back
PAN Card
Extra Doc
🏥 Add Health Policy
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👨💼 Assigned Agent:
(Admin can change the agent for this Health policy)
1. Client
2. Policy
3. Date
4. Payment
5. Nominee
6. Bank
7. Ref
8. Admin
9. Policy
10. Family
Client Name
Mobile Number
Policy Holder
Agent Name
Insurance Company
Select Company
Star Health
Care Health
Niva Bupa
Aditya Birla
HDFC ERGO
ICICI Lombard
Agency Code
Broker Code
Policy Type
New
Renewal
Portability
Insurance Type
Single
Floater
Multi Individuals
Policy Number
Booking Date
Policy Start Date
Policy End Date
Payment Mode
Policy Term (Years)
Plan Name
Net Premium
Total Premium
Sum Insured
Claim Process
Select Process
INHOUSE
TPA
Bonus
Deductible
Name
Relationship
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Husband
Wife
Daughter
Brother
Sister
Son
Mother
Father
Mother in law
Father in law
Sister in law
Daughter in law
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Grand daughter
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Owner
Other
Age
Bank Name
Amount Type
Account Number
IFSC Code
Account Holder Name
Reference Name
Broker Name
Extra Note
Incoming Payout %
Incoming Payout Amt
Agency Profit (₹)
Agent Comm %
Agent Comm Amt
TDS %
TDS Amount
After TDS Value
Upload Policy
Upload Document (Type)
Select Document
Adhaar Card
PAN Card
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RC Book
Add New Document
👨👩👧👦 Family Coverage
This section will be added later for family details.
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Health Insurance
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ASSIGN LEAD
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Lead Status:
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Next Follow-up Date:
UPDATE STATUS
CANCEL
Add Life Insurance Policy
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👨💼 Assigned Agent:
(Admin can change the agent for this Life policy)
1. Client
2. Plan Details
3. Premium & PPT
4. Maturity
5. Nominee
6. Admin Only
7. KYC Docs
Client Name
Mobile No.
Agent Name
Company Name
Plan Name/No.
Policy Number
Sum Assured ()
Premium Mode
Yearly
Half-Yearly
Quarterly
Monthly (NACH)
Single Premium
Policy Term (Yrs)
Premium Paying Term (PPT)
Installment Premium ()
DOC (Commencement Date)
Next Due Date
Maturity Date
Estimated Maturity Amt ()
Nominee Name
Relationship
Commissionable Prem ()
Agent Payout %
Agent Payout Amount
Agency Profit ()
Aadhar Front
PAN Card
Policy Document / First Premium Receipt