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Tuesday, June 15, 2010

Lic Forms

A. Claims Under Regular Life Insurance Policies

Death Claims:

The person legally entitled to receive the policy monies should give intimation of death of the policyholder to the servicing Branch. The requirement for the claim are as given below:

  1. Claim Form 'A' in Form No.3783.
    If policy has run for 3 years or more from date or risk, claim form no.3783A may be used.
  2. Certified extract from death register.
  3. The original policy document with Deed/s of assignment/s, if any.
    (Additional requirement may be required under a policy according to the status of the policy. Please contact our servicing Branch for details).

Click here for Claim Form 'A' in Form No.3783.(PDF Format)

Click here for Claim From no.3783(A)(PDF Format



Maturity Claims:
  1. It is our endeavour to settle your maturity claim on or before the due date. The servicing Branch usually sends maturity claim intimations two months in advance.
  2. Please submit your Discharged Receipt in Form No.3825 with original policy document atleast one month before the due date so that the payment is received before the due date of maturity claim.
  3. If you have not received any intimation for your claim due in the next two months, please contact the servicing Branch immediately.

Click here to download Form No. 3825 (PDF Format)



Survival Benefit Claims forms:

Click here to download Form No.5180 (PDF Format)


B. Proposal Forms

Proposal for Insurance under Jeevan Akshay-II (pdf format)

Proposal for Insurance under Bima Nivesh (PDF Format)

Instructions for filling up above form.



C. Mandate Form For Payment Of LICI Premium By ECS

Click here to download Mandate form for LICI premium by ECS



D. Revival Forms

Revival of Lapsed Policy- Form no. 680

Click here to download (PDF format)

Revival of Lapsed policy - Form no. 700
Click here to download (PDF format)

Revival of lapsed Policy- Form no. 720
Click here to download (PDF format)


E. Application Form For Annuity Card

For annuitants of Mumbai P & GS UNIT
Click here to download (Page 1)
Click here to download (Page 2)

Claim forms are in PDF format. Adobe® Acrobat® Reader® is a free software that lets you view and print Adobe Portable Document Format(PDF) files.
Click here to download Adobe® Acrobat® Reader®

F. IPP-ECS Mandate Form

Click here to download

G. Certificate of Existence

Click here to download

H. IPP-Letter of Indemnity

Click here to download

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