बीसीसी/बीआर/103/16 12 जनवरी, 2011.

भारत ि थत सभी शाखा / कायालय के िलए पिरप

िवषय फाइल
फाइल : डीईपी-1
डीईपी 1
िरटेल बिकग िवभाग ारा जारी

ि य महोदय,

िवषय : बचत बक जमा-

जमा- जीवन बीमा से यु त नए बचत बक उ पाद
पाद "बड़ौदा
बड़ौदा जीवन सुर ा बचत
बक खाता"
खाता का 15.
15.01.
01.2011 से शुभारं भ.

यह सव ात त य है िक अ पलागत जमाएं बक की लाभ दता के संबंध म मह वपूण भूिमका अदा करती ह

तथा हमारा हमेशा से यह यास रहा है िक मू यव क िवशेषता को जोड़ते ए बचत बक उ पाद को
अिधक से अिधक आकषक बनाया जाए. इस िदशा म एक कदम और आगे बढ़ते ए बक ने नाममा के
खच पर जीवन बीमा कवर से यु त एक अनूठे जीवन बीमा बचत बक उ पाद "बड़ौदा जीवन सुर ा बचत
बक खाता" के आरं भ करने िनणय िलया गया है. इसे 15 जनवरी, 2011 को हमारी सभी शाखा ने े
वग करण से असंब रहते ए, म शुभारं भ िकया जाएगा.

इस उ पाद की मह वपूण िवशेषताएं नीचे दी गई ह -

• यह उ पाद हमारी सभी शाखा म, े -वग करण से असंब रहते ए उपल ध होगा.
• िनवासी यि , िजसने 18 वष की आयु पूरी कर ली है तथा 60 वष पूरा नह िकया है, इस योजना के
तहत खाता खोल सकते ह एवं आव यक ीिमयम अदा करने एवं वा य संबंधी सामा य घोषणा प
(डीओजीएच) के तुत िकए जाने पर "इंिडया फ ट लाइफ इं योरस कं पनी" से .5.00 लाख की
रािश तक का जीवन बीमा कवर ा त कर सकते ह.
• इस योजना के तहत खाते योजना कोड एसबी -134 तथा बड़ौदा जीवन सुर ा एफएफडी खाते के
िलए टीडी-154 के अंतगत खोले जाएंगे.
• खाते एक नाम से साथ ही साथ संयु त नाम (अिधकतम दो) से खोले जा सकते ह तथा दोन
खाताधारक आव यक द तावेज एवं दोन खाताधारक के संबंध म ीिमयम अदा करने पर बीमा के
तहत कवर िकए जा सकते ह.
• वतमान बचत खात को उसी खाता सं या के साथ "बड़ौदा जीवन सुर ा बचत बक खाता" म
पिरवितत िकया जा सकता है.
• खाता खोलने के संबंध म िन निलिखत द तावेज की आव यकता रहेगीः
1. फोटो पहचान माण
2. पता माण (पासपोट/ ायिवग लाइसस/वोटर पहचान प अथवा सामा य बचत बक खाता
खोलने हेतु वीकाय कोई अ य द तावेज.
3. आयु माण ( यूिनसप टी ारा जारी ज म माणप /मैि क माणप /पासपोट/ ाइिवग लाइसस/
वोटर पहचान काड इ यािद)
4. इस आशय की सहमित एवं वचन प िक ाहक ारा चुने गए बीमा ीिमयम के भुगतान हेतु
अपेि त यूनतम शेष बनाया रखा जाएगा.
• यूनतम .1000/- मा से खाता खोलना.
• दैिनक जमा शेष के आधार पर यूनतम .1000/- का जमाशेष
• येक अ वष म 20 चेक मु त उपल ध कराए जाएंगे.

2 /....
 -2-

• सामा य बचत बक खाता के अनुसार ितअ वष 100 आहरण की अनुमित होगी. ित अ वष 100
से अिधक डेिबट की अव था म (ऑटो वीप लेनदेन एवं सेवा भार लेनदेन को छोड़कर) ित नामे
लेनदेन .10/- का भार, सेवाकर अितिर त लगाया जाएगा.
• यूनतम शेष न बनाए रखने पर ित ितमाही .100/-, सेवाकर अितिर त का भार लगाया जाएगा.
• "इंिडया फ ट जीवन बीमा िल." से .5.00 लाख ( यूनतम 1 लाख एवं उससे आगे .1.00 लाख के
गुणक म) तक का जीवन बीमा कवर िबना िकसी मेिडकल जांच के तथा के वल अ छे वा य संबंधी
घोषणा (डीओजीएच) की तुित करने पर ाहक के खच पर िन निलिखत ीिमयम दर पर दान
िकया जाएगाः

आयु समूह ीिमयम रािश ितवष ित लाख

18 वष से यादा तथा 35 वष तक 125/- सेवा कर अितिर त
35 वष से यादा तथा 50 वष तक 259/- सेवा कर अितिर त
50 वष से यादा तथा 60 वष तक 697/- सेवा कर अितिर त

बीमा कवर को ीिमयम भुगतान के प चात ितवष नवीकृ त िकया जा सकता है. आयु की गणना
िपछली ज म ितिथ को पूण िकए गए वष के आधार पर की जाएगी.

खाता खोलने के समय बीमा कवर की रािश के चुनने का के वल एक िवक प उपल ध होगा और बीिमत
रािश को बदलने के िलए भिव य म िकसी िवक प का इ तेमाल नह िकया जा सके गा.

कवर को नवीकृ त करने के िलए कोई ेस अविध नह दान की जाएगी और ाहक से यह अपे ा की
जाएगी िक वह अपने खाते म कवर के नवीकरण के संबध
ं म बीमा ीिमयम के भुगतान हेतु पया त
जमाशेष बनाया रखे.

बीमा ीमीयम हेतु ाहक ारा भुगतान की गई रािश आयकर अिधिनयम के 80(सी) के तहत कटौती
हेतु वीकाय है.

ित यि के वल एक बीमा कवर वीकाय होगा.

संयु त खात के संबंध म संयु त खाता धारक के िलए अलग-अलग ीिमयम रािश का भुगतान िकया
जाएगा.

तािवत बीमा कवर 1 जनवरी से 31 िदस बर तक उपल ध होगा.

बक योजना के िलए समूह शासक का काय करे गा.

• जीवन बीमा कवर वािषक तौर पर नवीकृ त िकया जाएगा. उन खात के संबंध म जो िक वष के म य
म खोले गए ह, ीमीयम ो-रे टा आधार पर िन नानुसार देय ह गेः

3 /....
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महीने िजनके दौरान ीिमयम अदा िकए कॉलम 2 म िनिद ट अविध के िलए िविभ न आयु
खाता खोला गया है जानेवाले महीन की वग हेतु ित लाख ितवष ोरे टा ीिमयम
सं या (सेवाकर छोड़कर)
छोड़कर)
18-
18-35 35-
35-50 51-
51-60
(1) (2) (3) (4) (5)
जनवरी 12 125 259 697
माच 10 105 216 581
जून 7 73 152 407
अ तूबर 3 32 65 175
िदस बर 1 11 22 59

• बीमा कवर बचत खाता के चालू रहने तक ही उपल ध होगा एवं एक बार सं हीत ीिमयम को खाते
के बंद कर िदए जाने पर भी लौटाया नह जाएगा.
• समूह शासक के प म अपनी सेवाएं उपल ध कराने के िलए इंिडया फ ट लाइसस इं योरे स कं पनी
िल. ारा हमारे बक को सं हीत ीिमयम रािश का 10% 10 (सेवा कर छोड़कर) शासिनक भार के
प म अदा िकया जाएगा.
• योजना के तहत दावे का िनपटारा बीमा कं पनी ारा िकया जाएगा.

अ य िवशेषताएं

• .5000/- की िनधािरत सीमा से ऊपर की रािश ऑटो वीप आउट के आधार .5000/- के गुणक म
180 िदन की अ पाविध जमा एवं बचत खाते म आव यक होने पर .1000/- के गुणक म िलफो
आधार पर (अंितम वाला पहले बाहर) िरवस वीप.
• मु त डेिबट काड, बड़ौदा कने ट /इंटरनेट बिकग तथा पहले वष के िलए (बॉबकाड िल. ारा े िडट
काड योजना के तहत द ) .1 लाख के दुघटना बीमा कवर के साथ बॉबकाड िस वर ( े िडट काड).
• शाखा के अंदर साथ ही साथ हमारे बक की शाखा म थायी अनुदश े का मु त िन पादन.
• बक के मानदंड के अनुसार .15,000/- तक के बाहरी चेक के संबंध म त काल े िडट
• इस योजना के तहत बक ऑफ़ बड़ौदा के टाफ सद य भी खाता खोलने के पा है.
• बचत बक खाते पर याज का भुगतान हमारे सामा य बचत बक खाते के अनुसार होगा.
• सामा य जमा खात की तरह नामांकन सुिवधा उपल ध होगी.

खाता खोलने एवं बीमा कवर उपल ध कराने के संबध

ं म शाखा तर
तर पर अपनाई जानेवाली ि या

ऐसे ाहक िज ह ने 18 वष एवं अिधक की आयु ा त कर ली है परं तु 60 वष की आयु पूरी नह की है

एवं इस योजना के तहत खाता खोलने के इ छु क ह, को .1.00 लाख या उससे अिधक का बीमा कवर
.1.00 के गुणक म, अिधकतम .5.00 लाख चुनना होगा.

ऐसे ाहक को आयु माण प जैसे मैि क माणप , पासपोट, ाइिवग लाइसस, पैनकाड, कू ल
छोडने का माण प , वोटर पहचान प अथवा यूिनसपल िनगम अथवा अ य सरकारी िनकाय ारा
ज म माण प तुत करना होगा.

उ ह अनुल नक (पिरिश ट-क) के अनुसार सहमित सह ािधकार प के साथ वतमान म यवहार म
लाए जानेवाले सामा य खाता खोलने के फाम पर ह ता र करने ह गे. साथ म, फोटो, पिरचय एवं
अ य के वाईसी िदशािनदश के अनुपालन की औपचािरकता पालन करना होगा.

4 /....
 -4-

संल नक (पिरिश ट-ख) के अनुसार ाहक ारा अ छे वा य की घोषणा पर ह ता र करने ह गे.

खाता खोलने पर चयिनत िकए गए बीमा कवर के अनुसार ाहक के खाते से बीमा ीिमयम नामे कर
िलया जाएगा एवं इसे मैसस इंिडया फ ट लाइफ इं योरस कं पनी िल. – बॉबजीवन सुर ा नाम के
चालू खाता .12470200000980 म जमा कर िदया जाएगा.

िफर आपको संल न फॉमट (पिरिश ट-ग) म खाता धारक के िववरण एमआईएस के मा यम से बीमा
कवर ोसेस िकए जाने हेतु इंिडया फ ट लाइफ इं योरस कं पनी को
distribution.support@indiafirstlife.com या dev.verma@indiafirstlife.com भेजने
ह गे.

बीमाकता ारा महीने के दौरान कवर दान िकए गए खात के बीमा माणप की सा टकॉपी अगले
महीने म शाखा को तथा हाडकापी सीधे ाहक को भेजी जाएगी.

योजना के तहत बीमा कवर को ितवष 01 जनवरी को वािषक प से नवीकृ त िकया जाएगा तथा
यिद पॉिलसी वष के म य म ली जाती है तो बीमा ीिमयम ो-रे टा आधार पर पूरे िकए गए महीन के
िलए अदा िकया जाएगा तािक नवीकरण तारीख सभी पॉिलसीधारक के िलए 01 जनवरी को हो
जाए. इस संबंध म िव तृत िववरण मह वपूण िवशेषता के अंतगत िदए गए ह.

इंिडया फ ट लाइफ इं योरस कं पनी ारा पॉिलिसय हेतु नवीकरण सूचना नवीकरण तारीख से 45
िदन पूव सभी ाहक को भेजी जाएगी तथा ाहक के िलए यह बा यकर होगा िक वे अपने बचत बक
खाते म पॉिलसी के नवीकरण की तारीख से कम से कम 10 िदन पूव से पॉिलसी के नवीकरण हेतु
आव यक यूनतम जमा शेष बनाकर रख. यिद खाते म अपया त रािश होने के कारण पॉिलसी नवीकृ त
नह हो पाती है तो बक ऑफ़ बड़ौदा पॉिलसी के नवीकृ त न होने के िलए उ रदायी नह होगा.

शाखा से यह अपेि त होगा िक पॉिलिसय के नवीकरण हेतु खात म ितवष 30/31 िदस बर को
बीमा ीिमयम काटने एवं उसे चालू खाता इंिडया फ ट लाइफ इं योरस कं पनी – बॉब जीवन सुर ा म
जमा करने का थायी अनुदशे दज कर द.

नवीकृ त खात से संबंिधत एमआईएस नवीकरण के समय इंिडया फ ट लाइफ इं योरस कं पनी को
भेजना आव यक होगा.

योजना के तहत अपवादः

पॉिलसी के अंतगत शािमल िकसी सद य ारा कवर के आरं भ होने के 1 वष के अंदर की गई आ मह या के

पिरणाम व प िकए गए दावे को वीकार नह िकया जाएगा. योजना के तहत अ य कोई अपवाद नह है.

दावा दज करने की ि याः

खातेदार / बीमाकृ त यि की दुभा यपूण मृ यु के संबंध म बीमा कवर के नािमती ारा संब शाखा को
सूिचत िकया जाएगा तदुपरांत शाखा ारा ईमेल के मा यम से claims.support@indiafirstlife.com
पर आईएफएलआईसी, मुंबई के धान कायालय को बीिमत यि की मृ यु के 3 महीने के अंदर सभी
अनुसमथ द तावेज के साथ दावे की ोसेिसग के िलए जैसा िक नीचे उ लेख िकया गया है, सूिचत करना
होगा.

1. दावा सूचना फाम (पिरिश ट-घ के अनुसार) बक ऑफ़ बड़ौदा के कविरग प एवं नािमती की घोषणा
के साथ.
2. नािमित से संबंध का माण एवं फोटो पहचान प .

5 /....
 -5-

3. िपछली बार इलाज करनेवाले डॉ टर से मृ यु के मूल कारण प ट करनेवाले माण प के साथ नगर
िनगम अथवा अ य स म ािधकारी ारा जारी मृ यु माण प की मािणत ितिलिप (शाखा
बंधक ारा स यािपत)
4. अ छे वा य से संबंधी घोषणा की मूल ित (डीओजीएच)
5. आयु माण की वयं स यािपत ितिलिप
6. बीमा का मूल माण प
7. वाभािवक मृ यु के हॉ पीटलाइजेशन/िचिक सा संबंधी द तावेज
8. एफआईआर की ित के साथ हॉ पीटलाइजेशन/ िचिक सा संबंधी पेपर, दुघटना मृ यु के संबंध म
पो टमॉटम /ऑटो सी िरपोट तथा यिद ाइिवग करते ए मृ यु ई है तो ाइिवग लाइसस की ित.
9. बक के पासबुक एवं खाता खोलने संबंधी फाम की ित.

वैकि पक तौर पर दावे, को िन निलिखत पते पर उपरो त समय सीमा के अंदर आइएफएलआईसी'एस
कायालय पर तुत िकया जा सकता है.

प
ु ऑपरे शन
इंिडया फ ट लाइफ इं योरस
योरस कं पनी िल.
िल.
301,
301, बी-
बी-िवग,
िवग, द यूब
इि फिनटी पाक
िदडोशी – िफ मिसटी
मिसटी रोड,
रोड,
मालाड-
मालाड-पूव, मुब
ं ई 400 097

उ पाद के संबंध म िकसी भी पूछताछ के िलए शाखाएं िन निलिखत आईएफएलआईसी कायालय को संपक
कर सकती ह.
ी देव वमा – 09920797391
ी नीरज वंजानी – 09322041312

हम पूरा िव वास है िक हमारी पिरचालन इकाइयां बचत बक जमा, जो िक अ पलागत संसाधन सं हण

का सवािधक मह वपूण उपकरण ह एवं हमारे पास िव मान बचत बक ाहक के यापक आधार का
मह व समझती ह. इंिडया फ ट लाइफ इं योरस के साथ वािषक तौर पर नवीकृ त होनेवाले अिधकतम
.5.00 लाख एवं यूनतम .1.00 लाख तथा उससे आगे .1.00 लाख के गुणक म बीमा कवर जैसी
अनूठी िवशेषता उपल ध कराने हेतु बचत बक सेगमट के तहत यह नया उ पाद आरं भ िकया जा रहा है.
यह उ पाद नाममा के ीिमयम पर (जैसा िक ऊपर िदया गया है), जोिक ाहक ारा वहन िकया जाना
है, कवर दान करने के िलए तैयार िकया गया है िजसके साथ बचत बक की अ य सभी सुिवधाएं अिधक
आय सुिनि त करने हेतु ऑटो वीप सुिवधा के साथ उपल ध रहगी. हम पूरा िव वास है िक बचत बक
खाते के साथ जीवन बीमा कवर की इस अनूठी सुिवधा से हमारी पिरचालन इकाइय को आ ामक ढंग से
बचत बक उ पाद की िब ी म मदद िमलेगी एवं वे बड़ी मा ा म अ पलागत जमा का सं हण कर
पाएंगी.

हम आपसे इस उ पाद को सफल बनाने हेतु समिपत यास करने का अनुरोध करते ह.

भवदीय,
भवदीय

ह0/-
न दन
(न दन ीवा तव
तव)
महा बंधक
िरटेल बिकग,
(िरटे बिकग, सीएसओ एवं राजभाषा)
राजभाषा
s/circular.
BCC: BR: 103:16 January 12, 2011

CIRCULAR TO ALL BRANCHES / OFFICES IN INDIA

File: Dep. – 1

ISSUED BY RETAIL BANKING DEPARTMENT

Dear Sir,

Re: Savings Bank Deposit- Launch of new Life Insurance Linked Savings Bank
Product styled as “Baroda Jeevan Suraksha Savings Bank A/c” w.e.f
15.01.2011

It is a well known fact that Low Cost deposits play an important role in profitability of
the Bank and it has always been our endeavour to add value propositions for making
the Savings Bank product more and more attractive. To take our move one step
ahead, it has been decided by the Bank to introduce a unique Savings Bank
product linked with life insurance cover facility at a very nominal cost styled
as “Baroda Jeevan Suraksha Savings Bank A/c” to be launched on 15th
January 2011 at all our branches irrespective of area classification.

Salient features of the product are as under:

• The product shall be available at all our branches irrespective of area

classification.
• Any resident individual who has attained the age of 18 years and has not
completed the age of 60 yrs can open his account under this scheme and
avail the facility of Life Insurance Cover from “IndiaFirst Life Insurance Co.
Ltd” (IFLIC) upto an amount of Rs.5.00 lac after payment of required
premium and submission of simple Health Declaration Form (DOGH).
• Accounts under this scheme shall be opened under Scheme Code- SB-
134 and TD -154 for Baroda Jeevan Suraksha FFD A/c
• Accounts can be opened in single name as well as in joint names (maximum
two) and both the account holders can also be covered under insurance
subject to submission of requisite papers and payment of premium in respect
of both the account holders.
• Existing Savings bank accounts can also be converted into “Baroda Jeevan
Suraksha Savings Bank A/c“retaining the same account number.
• Following Documents will be required for opening of account:
1. Photo Identity Proof.
2. Address Proof ( Passport/ Driving Licence / Voter Identity Card or any
other document admissible to open a normal Savings bank Account)
3. Age Proof (Birth Certificate issued by municipality / Matric Certificate/
Passport / Driving Licence / Voter Identity Card etc.)
4. Consent cum Letter of undertaking to maintain a minimum required
balance for payment of insurance premium opted by the customer.
• Opening of account by minimum Rs. 1000/- only
• Minimum Balance Rs. 1000/- on daily balance basis.
• 20 Cheques Leaves shall be provided per half year free of cost.
• 100 withdrawal per half year shall be allowed as per General Savings bank
A/c.. In case of debits more than 100 per half year (excluding Auto Sweep
transactions and Service Charges transactions) a charge of ` 10/ plus
service tax per debit transaction shall be levied.
• Charges for non maintenance of minimum Balance is Rs. 100/- plus service
tax, per quarter.
• Facility of getting Life Insurance Cover from “IndiaFirst Life Insurance
Co. Ltd” upto an amount of ` 5.00 lac ( minimum ` 1.00 lac and
thereafter in multiples of Rs. one lac) without any medical examination
and only against submission of Declaration of Good Health (DOGH)”, at
the cost of customer at following premium rates:

Age Group Premium amount per annum

per lac
More than 18 Yrs and upto 35 ` 125/- plus Service Tax
Yrs
More than 35 Yrs and upto ` 259/- plus service tax
50Yrs
More than 50 yrs and upto ` 697/- plus service tax.
60Yrs

Insurance cover is annually renewable after payment of premium. Age

will be calculated as completed years on last date of birth.

At the time of opening of account, only one option for choosing the
amount of insurance cover will be available and no other option can be
exercised in future to change the sum insured.

There will not be any grace period for renewal of cover and the customer
will be required to maintain sufficient balance in his account for
payment of insurance premium for renewal of cover.

Amount paid by the customer towards insurance premium is admissible

for deductions under Section 80 C of Income Tax act

Only one insurance cover per person shall be allowed.

In case of Joint Accounts, premium amount will be paid separately for

each of joint account holder

Proposed Insurance Year shall be from 1st January to 31st December.

Bank will act as Group Administrator for the scheme.

• The Life Insurance Cover shall be annually renewable. In case of those

accounts which are opened during the mid of the year, premium shall be
paid on prorata basis as detailed here under
 Month in Number of months Prorata Premium (excl. Service
which for which premium Tax) per lac per annum for
account is is payable different age-groups for the
opened period in column no. 2
18-35 35-50 51-60
(1) (2) (3) (4) (5)
January 12 125 259 697
March 10 105 216 581
June 7 73 152 407
October 3 32 65 175
December 1 11 22 59

• Insurance cover shall be available only till the Savings Account is running and
Premium amount once collected shall not be refunded even if the account is
closed.
• An administrative charges at the rate of 10% of the premium amount
collected (excluding service tax) shall be reimbursed by IndiaFirst Life
Insurance Co. Ltd to our Bank for providing services as Group Administrator.
• Settlement of claim under the scheme rests with the Insurance Company

Other features:
• Auto sweep out beyond threshold limit of Rs. 5000/- to short deposit of 180
days in multiple of Rs. 5000/- and in case of requirement in SB A/c auto
reverse sweep in multiple of Rs. 1000/- on LIFO pattern (last in first out).
• Free Debit Card, Baroda Connect / Internet Banking and “BOBCARD Silver”
(credit card) for 1st year with accidental death insurance cover of Rs. 1 lac
(provided by BOBCARDS Ltd. Under credit card scheme) subject to income
eligibility requirement.
• Free execution of Standing Instructions within branch as well as with in
branches of our Bank.
• Immediate credit of outstation cheques upto Rs. 15000/- as per Bank’s norms.
• Staff members of Bank of Baroda are also eligible to open their accounts
under this scheme.
• Payment of interest on Savings Bank A/c will be as per our normal SB a/c.
• Nomination facility will be available as per general deposit accounts.

Process to be adopted at branch level for opening of account and providing

insurance cover:

Customers who have attained the age of 18 years or above but not completed
the age of 60 years and wish to open their accounts under this scheme, shall
be required to choose an amount of insurance cover of Rs. 1.00 lac or above
in multiple of Rs.1.00 lac with a maximum of Rs.5.00 lac.

Such customers will be required to provide an age proof viz. Copy of Matric
Certificate, Passport, Driving Licence, PANCARD, School Leaving Certificate,
Voter Identity Card or Birth Certificate issued by Municipal Corporation or any
Government body.

They will be required to sign Consent cum Authorization letter as per
enclosure (Annexure –A) alongwith normal account opening form presently
being used for General Savings Bank Account including obtaining of
Photograph, Introduction and other KYC compliance.

Declaration of Good Health will required to be signed by the customer as per
enclosure (Annexure –B)

After opening of Account, Insurance premium of chosen insurance cover shall
be debited to the customer’s account and it will be credited to C/A No
12470200000980 in the name of M/s IndiaFirst Life Insurance Company Ltd.-
BOB Jeevan Suraksha

You will be further required to furnish details of the Account holder through
MIS as per format enclosed (Annexure –C) to India First Life Insurance for
processing of the Cover at distribution.support@indiafirstlife.com
dev.verma@indiafirstlife.com

Certificates of Insurance in respect of accounts covered during any
month shall be received by the branches in the following month in soft
copy and hard copies shall be dispatched directly to the customers by
the Insurer.

All the insurance covers under the scheme shall be annually renewable on
01st January every year and in case a policy is obtained in the mid of the
year, insurance premium shall be paid on prorata basis for completed months
so that renewal date coincides with 01st January for all policy holders.
Details, in this regard, are given under Salient Features.

IndiaFirst Life Insurance Co. will send the renewal notice for the policies 45
days before the renewal date to all the customers and customers will be under
obligation to maintain a minimum balance in Savings Bank A/c required for
renewal of policy (in addition to minimum balance required for maintenance of
account) at least 10 days before the due date of renewal of policy i.e. 21st
December. In case the policy is not renewed due to insufficient balance
in the account, Bank of Baroda shall not be responsible for such non
renewal of policy.

Branch will be required to feed a standing instruction in the accounts to debit
the insurance premium on 30/31st December every year and to credit the
same to CA 12470200000980 of IndiaFirst Life Insurance Co. – BOB Jeevan
Suraksha for the purpose of renewal of policy.

MIS in respect of renewed accounts will be required to be sent at the time of
renewal to IndiaFirst Life Insurance Co.

Exclusion under the scheme:

Any claim arising as a result of the said member under the policy committing suicide
(whether being a sane or insane at such time ) within one year of commencement
of his/her cover will be disallowed. There is no other exclusion in the scheme.

Procedure for lodgment of Claim:

In case of unfortunate death of the account holder /insured, his/her nominee under
the insurance cover shall be required to inform the concerned branch and in turn the
branch must intimate IFLIC, Mumbai, HO through e-mail at
claims.support@indiafirstlife.com about the death of the insured within 3 months of
the death having occurred for processing the claim with all supporting documents as
stated below :-
1. Claim Intimation Forms ( As per Annexure –D) alongwith covering letter from
Bank of Baroda and declaration from nominee.
2. Nominee relation proof and photo ID proof.
 3. Certified copy of Death Certificate (Attested by Branch Manager) issued by
Municipality or other competent authority alongwith last attending Doctor’s
certificate stating exact cause of Death.
4. Original Declaration of Good Health (DOGH)
5. Copy of Self attested Age Proof
6. Original Certificate of Insurance
7. Copy of Hospitalization / Treatment Papers in case of natural Death
8. Copy of Hospitalization /Treatment papers alongwith Copy of FIR, Post
Mortem/Autopsy Report in case of accidental death and also copy of Driving
Licence , if death occurred while driving
9. Copy of Bank’s Passbook and Account Opening Form.

Alternatively, the claim can also be lodged with IFLIC’s office at the following
address, within the above mentioned time limits:

Group Operations
IndiaFirst Life Insurance Company Ltd.
301, B wing, The Qube,
Infinity Park,
Dindoshi – Film City Road,
Malad East, Mumbai 400097

For any queries regarding the product, branches may contact at the following
numbers of IFLIC Officials :-
Mr. Dev Verma – 09920797391
Mr. Neeraj Vanjani - 09322041312

We trust that our operating units understand the importance of Savings bank Deposit
which is the most important tool for low cost resource mobilization and we have a
very large base of our Savings Bank customers. With a view to provide an unique
feature of annually renewable Insurance Cover under tie-up arrangement with India
First Life Insurance upto a maximum of Rs.5.00 lac with a minimum of Rs.1.00 lac
and thereafter in multiples of Rs. one lac. This new product under Savings Bank
segment is being launched for tapping new Savings bank customers as well as
existing customers. The product has been designed to provide the cover at a
nominal premium (as detailed above) to be borne by the customer in addition to all
other features already available with general Savings Bank accounts with Auto
Sweep facility to earn high yield with liquidity. We are confident that this unique
feature of Life Insurance Cover with Savings Account will enable our operating units
to sell this Savings bank product very aggressively and mobilize substantial low cost
resources.

We request you to put all out efforts for making the product a grand success.

Yours faithfully

(Nandan Srivastava)
General Manager
(Retail Banking, CSOs & OL)

Enclosures – As above.
 Annexure – A

Consent - cum - Authorization Form for “Baroda Jeevan Suraksha Savings Bank Account
Scheme

The Chief / Sr./ Branch Manager

Dear Sir,

Re: Application for membership of Baroda Jeevan Suraksha Savings Bank Account Holders
Scheme

1. I, Mr/Mrs. ______________________________________________________
hereby give my consent to become a member of the IndiaFirst Life Group Term Life Insurance
Scheme, which will be administered by Bank of Baroda as Group Manager.

My details are as below:

Name (in capitals): Shri / Smt. / Kum ___________________________________

Date of Birth : __________________(DD/MM/YYYY) (Proof enclosed)

Age (as on last Birthday) as on date ___________ years

Insurance cover obtained for Rs. _____________________

Premium Amount :Rs.______________________

2. I hereby authorize you to debit my Savings Bank Account No. _____________________

a sum of Rs. _____________ (Rupees____________________________ only) with
your branch towards premium for Baroda Jeevan Suraksha Savings Bank Account Holders Scheme. I
further agree to maintain a minimum balance required for renewal of policy (in addition to minimum
balance required for maintenance of account) at least 10 days before the due date of renewal of
policy. In case the policy is not renewed due to insufficient balance in my account, Bank of Baroda
shall not be responsible for such non renewal of policy.

* The same can be recovered from my Savings Account No. ___________

3. I agree that in the event of my unfortunate demise, IndiaFirst Life Insurance may settle the claim
amount in favour of

Sh./Smt./Kum_____________________________________________________
who is my____________________ (relationship) as the nominee to receive such amount.

4. I agree to pay the full premium at inception

5. I agree to abide by the terms and condition of the above scheme.
6. I agree to your conveying the above particulars regarding my admission into the Baroda Jeevan
Suraksha Savings Bank Account Holders Scheme

_________________________
Signature of the Member
Account No………
 ANNEXURE - B

BOB logo

Member form - Group Term Life Plan

.
For Branch Use only
Instructions for filling the proposal form Master policy number:___________________________________
1. All questions in the form have to be answered Branch ID
2. Use BLOCK CAPITALS and tick boxes where appropriate. SB A/c NO
3. Separate form to be collected for Joint Borrowers Branch Name
Note: Cover starts from the time we accept this proposal
1. Details of the Member.

.
Name ( Mr. Ms. Dr. Others specify) : _____________________________________________________________________

DATE OF BIRTH: ________________________ Gender: Male Female

DD / MM / YYYY
Age (last Birth Day) :_______________ Marital Status: Single Married

Occupation:________________________________ Employer:___________________________________________
Nature of Duties:____________________________ Annual Income:______________________________________
Address:_________________________________________________________________________________________________________
Yes No
Are you a Non- Resident Indian ?
Nominee Name_______________________________________ Age :__________ Relation Ship ______________________

2. Plan Details.

.
SUM Assured : Please tick (√) any one option.
1,00,000/- 2,00,000/- 3,00,000/- 4,00,000/- 5,00,000/-

3. Health Declaration for Member.

.
I never had any of the following disorders:
1. Chest pain, high blood pressure, stroke, heart attack, heart murmur or other disorder.
2. Asthma, chronic cough, pneumonia, shortness of breath, T.B. or any other respiratory or lung disorder.
3. Sugar in urine, diabetes mellitus, protein (albumin), blood or pus in the urine, sexually transmitted disease or venereal disease.
4. Ulcerative colitis, chronic diarrhea, hepatitis or jaundice or other chronic liver disorder.
5. Cancer, tumor, thyroid disorder, enlarged glands or enlarged lymph nodes.
6. Anemia, bleeding or blood disorders, dizzy/fainting spells, epilepsy, paralysis, nervous or mental /emotional disorder.
7. Disorder of Urine, kidney, bladder, reproductive organ or prostrate.
8. Rheumatic
9. Acquired immune deficiency syndrome (AIDS) or AIDS related complex or a test indicating the presence of HIV (AIDS virus)

I do not have any bodily deformities and in the recent five years, I have not consulted any doctor except for minor ailments such as common cold,
influenza, fever lasting more than five consecutive days or undergo any tests or investigations such as X-ray, scanning (ultrasound,CT,MRI,PET),
biopsy, Pap smear, mammogram, angiogram,electrocardiogram (ECG), blood or urine test or been hospitalized for observation, treatment or
surgery other than routine checkups/employment/foreign travel.

In the last 5 years I have never smoked more than 30 cigarettes/week , consumed more than 2000 ml of beer/week or habituated to narcotics / habit forming drugs/drug misuse

I do not nor intend to participate in dangerous sports or avocations such as motor sport racing, flying except as fare paying passenger on a commercial aircraft , parachuting , gliding, scuba diving
or climbing

I declare that my job profile does not involve any exposure to hazardous conditions like exposure to high temperatures, high voltage, toxic substances/ fumes, working on heights etc.

Any proposal for insurance on my life has never been declined, postponed, withdrawn , or accepted at an increased premium rates or with reduced cover

Only in case of Female Lives

I declare that I have never suffered / are suffering from or have ever undergone any investigation or treatment or received medical advice or consulted a physician for any gynecological
complications such as miscarriage, disorder of cervix, uterus, ovary(is), breast(s), breast lump / cyst, fibrocystic disease etc...

(If you do not agree to any of the above questions, please provide us complete details including dates, duration and treatment , names and address
of physicians on the back of this form and include your signature and date.)

4. Declaration by the Member.

.

I understand and agree that the answers and statements made on this Health Declaration are full, complete and true and will form the basis of the
contract, which may arise. All material facts which may influence the assessment of the risk, have been disclosed. I also understand that failure to
make such disclosure renders the contract voidable subject to Sec 45 of the insurance Act, 1938. I understand and agree that the maximum cover
under this insurance scheme shall not exceed Rs.5,00,000 irrespective of any number of Savings bank accounts held by me. I consent to IndiaFirst Life
Insurance Company Limited seeking medical information from any doctor in respect of any matter relating to my physical or mental health and I
authorise him/any hospital giving such information to IndiaFirst Life Insurance Company and/or to the claims administrator or medical advisors.
Further, I also confirm that I have never participated nor intend to participate in any hazardous sports or activities. I agree that in case of any medical
request on my cover the risk will commence only on the date of acceptance of my proposal by the company.

______________________________ Date: _________________

(Member's signature ) Place: _________________

5. Declaration for signing in Vernacular or for illiterate members

.

If the member can not read or understand English, then this declaration to be completed by bank official
I have explained the contents of this declaration to the Member and endeavored to ensure that the contents have been fully understood.
I have accurately recorded the responses to the information sought in the declaration and have confirmed with the member that they are
correct.

Date :____________________

Name & Signature of the Bank Official Place: ___________________

Bank of Baroda /Ver 1.0 / Dec'2010 IndiaFirst Group Term Plan: UIN
 Annexure - C
MIS FOR ACCOUNTS COVERED UNDER BARODA JEEVAN SURAKSHA SAVINGS BANK ACCOUNT
INFORMATION FOR DATE - dd/mm/yyyy
NAME OF THE BRANCH: REGION:
S.No Name of Gender DOB (DD/MM/YYYY) Savings Bank Address of the Sum Assured Premium Date of Premium SOL ID Transaction ID
Credited
customer account number customer chosen proposal Date
to be e-mailed at : distribution.support@indiafirstlife.com
CC at dev.verma@indiafirstlife.com
 Claim Intimation Form

Please attach this form fully completed with a copy of the death certificate to help us process your claim promptly.

Policy Holder’s details

Name of the group policy holder : Policy Type: IndiaFirst Group Term Plan
I IndiaFirst Credit Life Plan
Loan Number/ Membership Number: Insured Coverage Amount:

Life Assured’s (Member) details

Name: Date of birth:
Gender: Male Female Date & Time of death:
Cause of death: Place of death:
Address:
City and Pin code: State:
Occupation:

Nominee details
Name: Date of birth:
Address: Relationship with Life assured:
City and Pin code: State:

Doctor’s details (In case of death due to medical reason):

Name:
Address:
City and Pin code: State:
When did the deceased first take treatment for the illness, which eventually caused his death?
Duration & Type of Illness:
Contributory Cause of Death (if any):

IndiaFirst Life Insurance Company Ltd

301, ‘B’ Wing, The Qube, Infinity Park,
Dindoshi – Filmcity Road, Malad (E), Mumbai 400 097
T +91 22 3325 9553 F +91 22 3325 9600
www.indiafirstlife.com
Other doctors/specialists/hospitals consulted
Name of the doctor/ Address Phone Reason for consultation/
hospital Number admission

Accident details (in case of death due to accident)

Date & Time of accident: Place:

Cause of death: Road accident Accident at home Accident at work

Shooting incident Other
In case of other, please specify:

How did the accident occur?

Investigation details (please provide copies of FIR, police inquest report, Panchanama, post mortem report etc.)
Police station: Case number:
Findings:

I hereby declare and confirm that I am the rightful claimant of this plan and that the details provided above are
correct and true to the best of my knowledge. I have not withheld any relevant information and believe that the
deceased is the same person as the life assured under the plan issued by IndiaFirst Life Insurance Company Ltd.

Through this statement, I authorize any hospital, institution, nursing home, medical clinic or medical practitioner
who has treated or examined the deceased to provide IndiaFirst/any court of law/ any grievance redressal forum
with any medical information regarding the deceased’s state of health which he/she may have acquired before or
after the issuance of the plan on its request. This authorization is notwithstanding any law, custom or usage for the
time being in force which prohibits any physician or hospital from divulging any knowledge or information, acquired
by him/them in attending upon or examining a person on the ground of secrecy.

Further, I authorize any insurance company, government organization, employer, other organization, institution or
person to release to IndiaFirst or its duly authorized representatives any record or knowledge about deceased.
Such information shall without limitation include information about deceased’s health (including any information

IndiaFirst Life Insurance Company Ltd

301, ‘B’ Wing, The Qube, Infinity Park,
Dindoshi – Filmcity Road, Malad (E), Mumbai 400 097
T +91 22 3325 9553 F +91 22 3325 9600
www.indiafirstlife.com
relating to the use of drugs or alcohol, AIDS, or mental and physical history, condition, advice or treatment),
earnings or other insurance benefits, including any accounting information of the life assured’s account.

Lastly, I declare that I am entitled to make the above authorizations and agree to help IndiaFirst or its duly
authorized representatives to gather any information and use it as may be deemed fit to help process this claim.

Nominee/Appointee:
Signature:
Name:

The above claim is forwarded to you for doing the needful at your end.

Authorised Signatories of the Group Policy Holder

Signature:
Name and designation:
Company seal and address:

Claims process requirements

Mandatory documents (for all claims) Please tick
Original policy document
Claimant’s statement along with copies of photo identity and proof of relationship with the life assured
Death claim
Copy of the death certificate issued by the local authority
Burial/cremation ground certificate
FIR/Panchnama/Inquest report (in case of death due to accident)
Driving license of the life assured (in case of death due to road accident)
Post mortem report (if performed)
Newspaper clippings, if any
Other supporting documents
Last attending doctor’s certificate
Hospital treatment certificate
Medical records (admission notes, discharge summary, test reports etc.)
Reason for delay in claim intimation

IndiaFirst Life Insurance Company Ltd

301, ‘B’ Wing, The Qube, Infinity Park,
Dindoshi – Filmcity Road, Malad (E), Mumbai 400 097
T +91 22 3325 9553 F +91 22 3325 9600
www.indiafirstlife.com