Scribd Logo
Upload

Welcome to Scribd!

  • LIC Form 311

    Uploaded by

    Policywala
    2K views3 pages
    The document is a form completed by a life assured whose matured insurance policy document has been misplaced or lost. It requests details about: [1] how the policy was misplaced or lost, [2] efforts made to trace the policy, [3] if the policy was assigned or dealt with in another way, [4] if any prior claims or loans were made on the policy, and [5] biographical information like name, DOB, occupation, address. The life assured signs and provides witness details to support claiming the maturity proceeds without the original policy document.

    Original Description:

    LIC Form 311 Lost Policy Questionnaire

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    The document is a form completed by a life assured whose matured insurance policy document has been misplaced or lost. It requests details about: [1] how the policy was misplaced or lost, [2] efforts made to trace the policy, [3] if the policy was assigned or dealt with in another way, [4] if any prior claims or loans were made on the policy, and [5] biographical information like name, DOB, occupation, address. The life assured signs and provides witness details to support claiming the maturity proceeds without the original policy document.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    2K views3 pages

    LIC Form 311

    Uploaded by

    Policywala
    The document is a form completed by a life assured whose matured insurance policy document has been misplaced or lost. It requests details about: [1] how the policy was misplaced or lost, [2] efforts made to trace the policy, [3] if the policy was assigned or dealt with in another way, [4] if any prior claims or loans were made on the policy, and [5] biographical information like name, DOB, occupation, address. The life assured signs and provides witness details to support claiming the maturity proceeds without the original policy document.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 3

    Ref.

    : PS/Claim/Maturity

    Date_______________

    To,
    _____________________________
    _____________________________
    _____________________________
    _____________________________

    (To be completed by the Life Assured/Proposer under a policy which has matured for payment
    and policy document has been misplaced or lost by him)

    Matured Policy No.


    _____________________
    Deferred Maturity Date _____________________

    Full Name of the Life Assured __________________________________________________

    Under what circumstances the Policy


    was misplaced or lost ?

    What efforts have been made to


    trace out the policy ?

    Have you assigned the policy to any


    Person, Bank etc or dealt with the
    Policy in any other way ?
    If so, give particulars thereof.

    Did you/proposer claim Cash option


    Surrender value or loan under this
    Policy earlier ?

    Give the following information :


    (a) Full Name of your Father
    (b) Place & Date of your Birth
    (c) Your occupation in the year of
    Inception of the Policy
    (d) Your address in the year of
    Inception of the policy.
    (e) Name of the Agent through
    Whom policy was effected

    I enclose last / receipt, dated_______________ received by me from the Life Insurance


    Corporation of India, prior to date or maturity.
    Dated at ________________________this_____________________day
    of___________

    Signature of the Life Assured/Proposer.

    Witness

    Signature _____________________________________________________________

    Full Name ____________________________________________________________

    Occupation____________________________________________________________

    Address _____________________________________________________________

    F. No. Claims 311


    Udhaya 100 x 100 Pads 4-96

    You might also like