Card & Personal Details
ICICI Bank Credit Card or ICICI Bank Debit Card number*
Name*(As on card)
Date of birth*
Type of Policy*
  Annual Fee for Classic Single policy is Rs.1699/-

Communication Details
PIN code*
Residential Number
Office Number
Mobile Number*
Email ID
Please proceed to pay through ICICI Bank Net Banking
 Please note that this is auto renewal plan and will be renewed  automatically every year from the same mode of payment
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* This is a mandatory field