Revised NB Forms for LIC with form number
FORM NO. | REVISED NB FORMS / DESCRIPTION |
3166 | POLICY EXTRACT FROM PREVIOUS /PROPOSAL PAPERS |
3179® 2K | CONSENT LETTER |
3302 | MEDICAL EXAMINER'S APPLICATION |
NB-44 | BM's RECOMMENDATATION FOR APPOINTMENT OF MEDICAL EXAMINER |
3302A | APPOINTMENT OF CARDIOLOGIST/ RADIOLOGIST/PATHOLOGIST |
4104A | STATEMENT WHERE NO STD AGE PROOF |
RE-CHECK | RE-CHECK OF MEASUREMENTS |
P-FIN.QUEST. | PERSONAL FINANCIAL QUESTIONNAIRE |
AGRL.INC. | CERTIFICATE OF AGRICULTURAL INCOME |
CA CERT. | CHARTERED ACCOUNTANT'S CERTIFICATE |
FEMALE-III | SPECIAL MHR FOR WIDOWS |
P' SHIP | SUPPLEMENTARY DEED OF PARTNERSHIP |
FORM 14 | EPF - APPLICATION |
FORM 15 | EPF ASSIGNMENT FORM |
294 | ADDENDUM TO MINOR LIVES PROPOSALS |
400 | ADDENDUM FORM FOR JEEVAN SATHI T - 89 |
ADDNDM | ADDENDUM TO (PPL) JEEVAN BHARATI T-160 |
ADDNDM | ADDENDUM TO (PPL) JEEVAN ADHAR T-114 |
ADDNDM | ADDENDUM TO CAESARIAN CASES |
FEMALE-I | ADDENDUM TO PPL-CAT-I FEMALE LIFE |
HUF | ADDENDUM - HUF POLICIES |
3261 | ELDER’S DECLARATION OF AGE |
5096 | SELF DECLARATION OF AGE (UNSTAMPED) |
5220 | SELF DECLARATION (STAMPED) UNDER (C) DECLARATIONS |
DECLN | DECLARATION (PPL) JEEVAN VISWAS T-136 |
DECLN | DECLARATION (PPL) JEEVAN KISHORE / KOMAL JEEVAN T-102,159 |
DECLN | DECLARATION (PPL) - JEEVAN CHAYA T-103 |
3322 | ADDITIONAL FORM FOR ASTHMA/BRONCHITIS |
3324 | ULCER QUESTIONNAIRE- WITH OPERATION |
3325 | ULCER QUESTIONNAIRE - WITHOUT OPERATION |
3326 | KIDNEY DISEASE, COLIC OR STONE ETC |
3327 | GALL-BLADDER DISEASE |
3330 | GOITRE QUESTIONNAIRE (WITH OPERATION) |
3331 | GOITRE QUESTIONNAIRE (W/O OPERATION) |
3332 | FILARIASIS QUESTIONNAIRE |
3333 | CHEST PAIN QUESTIONNAIRE |
3334 | CNS QUESTIONNAIRE |
3336 | TUBERCULOSIS QUESTIONNAIRE |
3337 | PLEURISY QUESTIONNAIRE |
3340 | EPILEPSY QUESTIONNAIRE |
DEFORMITY | DEFORMITY QUESTIONNAIRE |
HERNIA | HERNIA QUESTIONNAIRE |
HEARING/ENT | HEARING/ENT QUESTIONNAIRE |
LIC03-500 | GENERAL OCCUPATION QUESTIONNAIRE |
LIC03-500-01 | ARMY PERSONNEL QUESTIONNAIRE |
LIC03-500-02 | AVIATION (ARMED SERVICES) QUESTIONNAIRE |
LIC03-500-03 | AVIATION (CIVIL) QUESTIONNAIRE |
LIC03-500-04 | CIVIL GLIDING QUESTIONNAIRE |
LIC03-500-05 | NAVY PERSONNEL QUESTIONNAIRE |
LIC03-500-06 | DIVING (ARMED/COMML) QUESTIONNAIRE |
LIC03-500-07 | MERCHANT MARINE QUESTIONNAIRE |
EMPL-EMP | EMPLOYER-EMPLOYEE QUESTIONNAIRE |
KEYMAN | ANX-A-KEYMAN( RESOLUTION) |
KEYMAN | ANX-B - KEYMAN QUESTIONNAIRE |
KEYMAN | ANX-C - KEYMAN(INC-INS) |
NR1-1 | MAIL ORDER BUSINESS - ACR / MHR |
NRI-2 | NRI - ANX - STUDENTS/ EMPLOYEES |
NRI-3 | NRI - QUESTIONNAIRE |
NRI-4 | NRI - CONDITIONS |
3310 | FLUOROSCOPIC EXAMINATION |
3311(a) | GLUCOSE TOLERENCE TEST (GTT) OF URINE |
3313 | X-RAY OF GENITO URINARY TRACT (G U T) KUB AREA |
3314 | STOMACH & DUODENUM (BARIUM MEAL) |
3315 | X-RAY - CAECUM AND COLON (BARIUM ENEMA) |
3316 | INTRAVENOUS PYELOGRAPHY |
3317 | CHOLECYSTOGRAPHY |
3321 | SPUTUM EXAMINATION |
3335 | STOOL EXAMINATION |
3338® | SPECIAL BLOOD SUGAR TEST (BST) |
3341 | GYNAECOLOGIST REPORT |
LIC03-002 | ELECTROCARDIOGRAM |
LIC03-003 | TREADMILL TEST |
LIC03-004 | HAEMOGRAM |
LIC03-005 | LIPIDOGRAM |
LIC03-006 | BLOOD SUGAR TEST (BST) |
LIC03-007 | SPECIAL BIO-CHEMICAL TESTS (SBT-12) |
LIC03-008 | SPECIAL BIO-CHEMICAL TESTS (SBT-18) |
LIC03-009 | ROUTINE URINE ANALYSIS (RUA) |
LIC03-010 | CHEST X-RAY |
LIC03-011 | ELISA FOR HIV |
LIC03-012 | PHYSICIAN’S REPORT |
OPHTHALMIC | OPHTHALMIC REPORT |
JUVENILE | JUVENILE FMR |
3124B | CLAUSE 4(B) |
3130A | CLAUSE 10(a) |
3140 | CLAUSE 20 - WAIVER OF PREMIUM CLAUSE |
3140A | CLAUSE 20A - WAIVER OF PREMIUM CLAUSE - PLAN 113 ETC |
3140B | CLAUSE 20B - FAMILY BENEFIT CLAUSE - PLAN 113 ETC |
SSS | SSS INTRODUCTION - ANNEXURE I(A) |
3142 | CLAUSE-22 - ANNEXURE II (A) |
3151 | CLAUSE 31 |
3152 | CLAUSE 32 |
CLAUSES | CL 45, 46, 53, 54, 55, 56 |
3198 | CLAUSE 61(SPL DISABILITY CL.) |
3198(N) | CLAUSE 61(N) |
3198(I)(N) | CLAUSE 61(I) (N) |
3198(a) | CLAUSE 61(a) |
3198 AI N | CLAUSE 61(a)(I)(N)(WITH AB) |
3198(a)(N) | CLAUSE 61(a)(N)(W/O AB) |
3214 | CLAUSE 65 |
3215 | CLAUSE 66 |
3216 | CLAUSE 67 |
3218 | CLAUSE 69 |
3228 | CLAUSE 74 |
3230 | CLAUSE 76 |
CLAUSE | CLAUSE 85 |
CLAUSE | CLAUSE 86 |
FORM-A | SSS INTRODUCTION - EMPLOYER'S LETTER |
FORM-B | SSS INTRODUCTION - QUESTIONNAIRE BY EMPLOYER |
FORM-C | SSS INTRODUCTION - REPORT BY SBM/ABM(S) |
460(R-87) PERSONAL | STATEMENT REGARDING HEALTH |
FORM NO.680 | PERSONAL STATEMENT REGARDING HEALTH |
FORM NO.700 | PERSONAL STATEMENT REGARDING HEALTH |
NORM NO.720 | PERSONAL STATEMENT REGARDING HEALTH |
ECS | PREMIUM PAYMENT THROUGH ECS - EXISTING POLICIES |
ECS | PREMIUM PAYMENT THROUGH ECS - NEW PROPOSALS |
ECS - ANNUITY | ANNUITY PAYMENT THROUGH ECS |
FORM NO.3260 | STANDARD AGE PROOF |
SPLITTING. POLS | SPLITTING OF LARGE SUM ASSURED CASES LESS THAN 5 LACS |
3237-A | NOMINATION UNDER JEEVAN SATHI POLICY |
3251 | SPL MHR - ANNEXURE A |
3251 | SPL MHR - ANNEXURE B |
7554 | SPECIMEN OF AUTHORISATION LETTER TO RECEIVE POLICY BOND |
Bima Bachat Plan No 175 Summary
LIC Bima Bachat (Table No.175) is a single premium money-back policy. Bima Bachat offers financial security and assurance to the policy holder and his family.
Benefits:
Death Benefits:
During the Term of the policy if the Life Assured is dead, apart from survival benefits if any, paid earlier, an amount equal to SA will be paid.
Survival benefits:
Survival benefits (15% of SA) are paid at 3rd, 6th, 9th & 12th policy year respectively depending on the policy term. On maturity the single premium paid alongwith Loyalty addition if any will be paid back.
Maturity Benefit/Survival benefit for 2 lakh SA: (30yrs age)
Policy Term 3rd Year 6th Year 9th Year 12th year
9 years 60,000 60,000 Final Maturity -
12 years 60,000 60,000 60,000 Final Maturity
15 years 60,000 60,000 60,000 60,000
Eligibility Conditions and Restrictions LIC Bima Bachat:
Min. age at entry: 15 years (completed).
Max. age at entry: 66 years (Nearest).
Min. S.A.: Rs. 20,000
Max. SA.: Any Amount.
SA in multiples: Rs. 5000
Max. Maturity age: 75 years (Nearest).
Terms Available: 9, 12 or 15 years.
Modes Allowed: All
Dating Back @ 8%: Allowed
Term Rider Option: Not available
Critical Illness Rider: Not available
Policy Loan: Available
Surrender Values:
The Bima Bachat can be surrendered after 1 year. The Guaranteed Surrender Value is equal to 90% of the single premium paid excluding extra premium paid and the survival Benefits paid earlier.
Bima Bachat Examples:
Let me give you an example to understand this policy. Mr. Dilip aged 30 years takes a Bima Bachat Policy for 15 years term for Rs 2 lakhs SA. He pays single premium of Rs. 1,48,322. He receives Survival Benefit of rs 30,000 each at the end of 3rd, 6th, 9th & 12th year respectively. On Maturity, he will receive Rs 1,48,322 being the single Premium paid by Dilip. Thus total amount received by him will be Rs 2,68,322 (Rs 1,20,000 as Survival Benefits + 1,48,322 as single Premium paid) + LA if any. If Mr. Dilip dies during the 13th policy year, his nominee will get Rs 2 lakh as SA as death benefit (Survival benefit of Rs 30000 each received during 3rd, 6th, 9th & 12th year will not be deducted from the SA). hence the total amount received would be Rs. 3,20,000.
Cooling off period:
If you are not satisfied with the “Terms and Conditions” of the policy, you may return the policy to Life Insurance Corporation Of India within 15 days.
Benefits:
Death Benefits:
During the Term of the policy if the Life Assured is dead, apart from survival benefits if any, paid earlier, an amount equal to SA will be paid.
Survival benefits:
Survival benefits (15% of SA) are paid at 3rd, 6th, 9th & 12th policy year respectively depending on the policy term. On maturity the single premium paid alongwith Loyalty addition if any will be paid back.
Maturity Benefit/Survival benefit for 2 lakh SA: (30yrs age)
Policy Term 3rd Year 6th Year 9th Year 12th year
9 years 60,000 60,000 Final Maturity -
12 years 60,000 60,000 60,000 Final Maturity
15 years 60,000 60,000 60,000 60,000
Eligibility Conditions and Restrictions LIC Bima Bachat:
Min. age at entry: 15 years (completed).
Max. age at entry: 66 years (Nearest).
Min. S.A.: Rs. 20,000
Max. SA.: Any Amount.
SA in multiples: Rs. 5000
Max. Maturity age: 75 years (Nearest).
Terms Available: 9, 12 or 15 years.
Modes Allowed: All
Dating Back @ 8%: Allowed
Term Rider Option: Not available
Critical Illness Rider: Not available
Policy Loan: Available
Surrender Values:
The Bima Bachat can be surrendered after 1 year. The Guaranteed Surrender Value is equal to 90% of the single premium paid excluding extra premium paid and the survival Benefits paid earlier.
Bima Bachat Examples:
Let me give you an example to understand this policy. Mr. Dilip aged 30 years takes a Bima Bachat Policy for 15 years term for Rs 2 lakhs SA. He pays single premium of Rs. 1,48,322. He receives Survival Benefit of rs 30,000 each at the end of 3rd, 6th, 9th & 12th year respectively. On Maturity, he will receive Rs 1,48,322 being the single Premium paid by Dilip. Thus total amount received by him will be Rs 2,68,322 (Rs 1,20,000 as Survival Benefits + 1,48,322 as single Premium paid) + LA if any. If Mr. Dilip dies during the 13th policy year, his nominee will get Rs 2 lakh as SA as death benefit (Survival benefit of Rs 30000 each received during 3rd, 6th, 9th & 12th year will not be deducted from the SA). hence the total amount received would be Rs. 3,20,000.
Cooling off period:
If you are not satisfied with the “Terms and Conditions” of the policy, you may return the policy to Life Insurance Corporation Of India within 15 days.
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