Get Claimant Statement Form For

Filling out the Claimant Statement Form is an essential step in processing your claim. This guide will provide you with clear and supportive instructions for completing the form online, ensuring you understand each section and its requirements.

Follow the steps to complete your Claimant Statement Form successfully.

1. Click 'Get Form' button to obtain the Claimant Statement Form and open it for editing.
2. Enter the policy details, including the policy number(s), master policy holder's name, loan disbursement date, member identification number, name of the deceased group member, their date of birth, and the cause and place of death.
3. Provide the name and address of the beneficiary along with their state, city, pin code, contact details, and email address.
4. Fill in the financial details, including the sum assured, original amount of the loan, outstanding loan balance, and balance claim amount payable to the nominee.
5. Include the name and contact details of the doctor who certified the death of the life assured.
6. Attach mandatory documents such as the original policy certificate, copy of the death certificate, claimant's photo identity proof, and claimant's current address proof.
7. If applicable, provide additional documents for natural or accidental death, such as medical records or police reports.
8. Complete the electronic payout option section by entering the account holder's name, mobile number, bank name, branch name and address, bank account number, MICR code, and IFSC code. Attach a cancelled cheque for verification.
9. Sign and date the authorization and declaration section, confirming the accuracy of the details provided.
10. Save your changes, download, print, or share the completed form as necessary.

Start completing your Claimant Statement Form online today.