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    4 (A) Declaration (In Case of Assignment)

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    sajeer n FORWARD
    This document details an application for assignment or re-assignment of an insurance policy taken out with India Post. It provides information about the policy being assigned/re-assigned including the policy number, name of insured, sum assured, date of maturity. It also provides details about the bank or financial institution the loan is being taken from/was taken from, including their name, address, regulatory body. There are terms and conditions for assignment that require the insured to continue paying premiums and not exercise policy rights without bank consent. Declarations are also included for the insured and bank to sign acknowledging the assignment or re-assignment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    4 (A) Declaration (In Case of Assignment)

    Uploaded by

    sajeer n FORWARD
    44 views1 page
    This document details an application for assignment or re-assignment of an insurance policy taken out with India Post. It provides information about the policy being assigned/re-assigned including the policy number, name of insured, sum assured, date of maturity. It also provides details about the bank or financial institution the loan is being taken from/was taken from, including their name, address, regulatory body. There are terms and conditions for assignment that require the insured to continue paying premiums and not exercise policy rights without bank consent. Declarations are also included for the insured and bank to sign acknowledging the assignment or re-assignment.

    Original Description:

    Pli rpli

    Original Title

    Assignment_and_re-assignment_form_Loan_other_than_DOP

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    This document details an application for assignment or re-assignment of an insurance policy taken out with India Post. It provides information about the policy being assigned/re-assigned including the policy number, name of insured, sum assured, date of maturity. It also provides details about the bank or financial institution the loan is being taken from/was taken from, including their name, address, regulatory body. There are terms and conditions for assignment that require the insured to continue paying premiums and not exercise policy rights without bank consent. Declarations are also included for the insured and bank to sign acknowledging the assignment or re-assignment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    44 views1 page

    4 (A) Declaration (In Case of Assignment)

    Uploaded by

    sajeer n FORWARD
    This document details an application for assignment or re-assignment of an insurance policy taken out with India Post. It provides information about the policy being assigned/re-assigned including the policy number, name of insured, sum assured, date of maturity. It also provides details about the bank or financial institution the loan is being taken from/was taken from, including their name, address, regulatory body. There are terms and conditions for assignment that require the insured to continue paying premiums and not exercise policy rights without bank consent. Declarations are also included for the insured and bank to sign acknowledging the assignment or re-assignment.

    Copyright:

    © All Rights Reserved
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    Annex - III

    (Assignment/Re-assignment Details (if Loan taken from organization other than India Post):
    Application for Assignment or Re-assignment (Tick whichever is applicable)

    1 Policy Details (particular of policy against which the loan is taken):


    i Policy No. : ii Name of Insurant :

    Date of Acceptance :
    iii Sum Assured : iv
    (dd/mm/yyyy)

    Date of Maturity:
    v vi Amount of Loan required :
    (dd/mm/yyyy)

    vii Purpose for which Loan is required Or was taken :

    2 Details of Bank/Financial Institution etc. (from which loan is being taken Or was taken):
    Name of Bank/Financial Institution etc.: Industry Type : Bank/Financial Institution/Capital Market
    i ii
    Intermediary/Other

    Official Address of Bank/Financial Institution etc:


    iii Regulated By: IRDA/RBI/SEBI/Other iv

    v Contact No.: vi e-Mail ID :

    vi Loan Amount : xv Loan Sanction letter No. (Copy attached):

    Loan Sanction Letter No. & date (copy attached in case of assignment of the policy) :
    3 Or
    Loan Repayment letter No. & date (copy attached in case of Re-assignment of the policy) :

    Terms & Conditions (in case of Assignment)


     All future premiums shall be paid by the Assignor (Insurant) of the Insurance policy.
     The assignor (Insurant) shall not exercise or hold any rights pertaining to services of the insurance policy including partial
    withdrawal/surrender without specific consent of the assignee (Bank/financial institution etc).
     The Assignor (Insurant) with suitable concurrence from the Assignee (Bank/financial institution etc) shall intimate India Post about
    its loan closure for suitable reassignment of the insurance policy to the Assignor (Insurant).
    4(A) Declaration (in case of assignment)
    This is to put on record that Shri/Smt./Ms ………………………………………….. (Name of insurant) is taking loan of
    Rs…..………………………………from …………………………………..…………………. (Bank/Financial Institution etc name)
    for ………………………………………….. (purpose) in terms of the Loan agreement dated …………………..
    I/We hereby declare that receipt of benefits arising under the policy by the Assignee (Bank/financial institution etc), shall be
    valid for sufficient discharge of the said loan. Policy servicing requests, as applied to the Policy prior to this Assignment, would
    continue unless specific instructions are provided to the Bank/Financial Institution etc by both the Assignor and the Assignee. I had
    by recognized the assignee (Bank/Financial Institution etc) as the only person entitled to the benefit under the policy until the policy
    is re-assigned.
    I/We do hereby declare that I/we have read and understood the Terms & Conditions mentioned herein above and agree to abide
    by the same.
    Date:
    Place:
    Signature of Assignor (Insurant) Signature of Assignee with stamp
    4 (B) Declaration (in case of re-assignment)
    This is to put on record that Shri/Smt./Ms ………………………………………….. (Name of insurant) to whom
    …………………………………………. (Bank/Financial Institution etc name) had been granted a Loan of
    Rs.…………………………………… for …………………………………………..(purpose) in terms of the Loan agreement dated
    ………………… and has/have since repaid the same in full with all dues and that no amount is now due from him/her towards or in
    respect of the said loan.
    In view of the above ……………………………………….. (Bank/Financial Institution etc name) has no claim right, title or
    interest in respect of PLI/RPLI Policy.
    I/We do hereby declare that I/we have read and understood the Terms & Conditions mentioned herein above and agree to abide
    by the same.
    Date:
    Place: Signature of Assignor with stamp Signature of Assignee (Insurant)

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