Add Endorsement
Back
Client Details
Client Type
Select Client type
Group
Individual
Client
*
Select Client
Branch
Select Branch
Policy
*
Select Policy
Endorsement
TPA
Select TPA
Policy No
D.O.C
D.O.E
Policy Issue Month
*
Endorsement Type
*
Select Endorsement Type
$value) { echo "
" . $value . "
"; } } ?>
Endorsement No
Data Received Date
*
Date of Issue
*
Endorsement Effective Date
No of Insured
No of Dependents
Status
*
Select Status
$value) { if($key == 'pending'){ echo "
" . $value . "
"; }else{ echo "
" . $value . "
"; } } } ?>
Latest Action Date
Installment due Date
Endorsement
TPA
Select TPA
Policy No
D.O.C
D.O.E
Policy Issue Month
*
Endorsement Type
*
Select Endorsement Type
$value) { echo "
" . $value . "
"; } } ?>
Endorsement No
Data Received Date
*
Date of Issue
*
Endorsement Effective Date
No of Insured
No of Dependents
Status
*
Select Status
$value) { if($key == 'pending'){ echo "
" . $value . "
"; }else{ echo "
" . $value . "
"; } } } ?>
Latest Action Date
Installment due Date
Premium Details
Premium Details
Insurer
Is Leader?
CD Acc No
CD Amount
Follower Policy No
Co-Share %
Non Commitional
Premium Amount
Base Premium
TP Premium
TEP Premium
Co-Premium
Co-TP Premium
Co-TEP Premium
CGST
SGST
IGST
GST Amount
Stamp Duty
Total
Agreed BP %
Agreed TP %
Agreed TEP %
>
Agreed Amount
Standard BP %
Standard TP %
Standard TEP %
Actual BP Amount
Actual TP Amount
Actual TEP Amount
Actual BP %
Actual TP %
Actual TEP %
Actual BP
Remuneration Amount
Actual TP
Remuneration Amount
Actual TEP
Remuneration Amount
Expected Amount
Submit