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LIC Proposal Addendum for Students

This document is an addendum to a life insurance proposal for major students or non-earning major lives, requiring information about the life to be assured and their educational status. It includes sections for submitting educational qualifications, progress reports, and details of existing insurance policies for family members. The applicant must declare the truthfulness of the information provided and agree to pay premiums until the life assured begins earning.

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2K views1 page

LIC Proposal Addendum for Students

This document is an addendum to a life insurance proposal for major students or non-earning major lives, requiring information about the life to be assured and their educational status. It includes sections for submitting educational qualifications, progress reports, and details of existing insurance policies for family members. The applicant must declare the truthfulness of the information provided and agree to pay premiums until the life assured begins earning.

Uploaded by

sachinkalaburagi6
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

LIFE INSURANCE CORPORATION OF INDIA

ADDENDUM TO PROPOSAL FOR ASSURANCE ON THE LIFE OF MAJOR STUDENTS/ NON-EARNING MAJOR LIVES

Division __________________ Branch __________________ Proposal No. ____________

Name of the Life to be Proposal No.


assured
Name & PAN of the person Relationship to the Life
funding the proposal to be assured
Name and Place of If studying, mention the
School/College/Institute of standard in which
the Life to be assured studying

If the life to be assured is studying, please submit the self-attested copy of the recent college progress report or the passing
certificate of the just completed academic year.

1) If the life to be assured is well qualified but, has not started earning, state the reasons for the same ____________________
______________________________________________________________________________________________________
(Please submit the self-attested copy of proof of educational qualification)

2) If applied for Term plan, then submit the copies of educational loan documents.
(Term plan is allowed to major students only as collateral security against educational loan)

3) Full particulars of existing in force and proposed insurance on the date of Proposal, on the lives of other family members :
(If space is not sufficient for all existing policies/proposals, please use separate sheet in the same forma .It must be duly signed
by the father / mother / legal guardian .)

Members of Name of the Policy Plan of Sum Annualized Funded by


family Insurer and no./proposal Assurance Assured premium
Branch code no. under
consideration
Father

Mother

Brother

Sister

I hereby declare that the above statements are true in every particular and agree that they shall form the basis of the contract
of Assurance between me / the life proposed and the Life Insurance Corporation of India.
I also declare that the life to be assured is regularly attending School/College. (Strike out if the life to be assured has completed
education)

I also agree to pay the premia under the policy, if and when issued, till the life to be assured starts earning himself/ herself.

Place :

Date : Signature of Father / Mother / Legal Guardian

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