INSURANCE FORMAppalicant nameNominee namePhoneDate of insuranceEmail AddressStreet AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweConsent *SPRAJ Insurance Policy and AgreementThis document outlines the policy and agreement for SPRAJ Insurance, applicable to all customers who opt for this coverage. By accepting this policy, customers agree to the terms and conditions set forth herein.1. Scope of CoverageUnder the SPRAJ Insurance policy, any qualifying incidents or claims will be handled according to the terms specified in this document. Customers are required to ensure the accuracy of all provided details to avoid any claim-related issues.2. Nominee DetailsCustomers must designate a nominee at the time of opting for the insurance policy. The nominee will act as the primary recipient of all credentials, rights, and benefits in case of the customer's inability to manage their account due to unforeseen circumstances.. Updating Nominee Information:The customer may update the nominee's details at any time by notifying SPRAJ Customer Care via email at sprajcustomercare@gmail.com. Verification may be required to process the update.3. Transfer of CredentialsIn the event of a claim, all credentials, rights, and entitlements under the SPRAJ Insurance policy will be transferred to the designated nominee. This includes:Insurance benefits.Refunds or reimbursements, if applicable.Any other entitlements under the policy.a. Conditions for Transfer:The claim must meet all eligibility criteria.Supporting documents, including proof of the customer’s inability to manage their account, must be provided.SPRAJ reserves the right to verify the authenticity of the documents before processing the transfer.4. ExclusionsSPRAJ Insurance does not cover claims arising from:Fraudulent activities.Breach of terms and conditions of the policy.Misrepresentation or submission of false information.5. Dispute ResolutionIn case of any disputes regarding the transfer of credentials or benefits, customers or their nominees must notify SPRAJ in writing at sprajcustomercare@gmail.com. SPRAJ will aim to resolve disputes amicably within 30 business days.6. Acceptance of TermsBy opting for SPRAJ Insurance, customers agree to the terms outlined in this document. It is the customer’s responsibility to ensure compliance with all stated conditions.For any queries or support, please contact us at: SPRAJ Customer Care Email: sprajcustomercare@gmail.com Confirm insurance