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related to various policy servicing.

Rider Claim Form

Claim Form A

To be filled in completely and signed by the nominee/claimant and witness.

Claim Form B

To be filled in completely by Medical Attendant who treated the Life assured till his death and witness.

Claim Form C

Identity Certificate to be completed by any person other than a relative who attends burial/cremation and witness.

Claim Form E

Employers Certificate if the deceased was employed, furnishing details of leave availed by the policy holder on sick grounds during last 3 years prior to policy to the date of death and witnesses. All the claim forms should clearly contain the policy no or nos.

Note: If there are multiple policies and the Claimant / Nominee is only one for all the policies only one set of claim forms will suffice. If there are multiple policies and the Claimants / Nominees are different each Claimant / Nominee should send the claim forms separately duly filling the details.