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Form No.HI/DGH/1 (Principal Insureds)Life Insurance Corporation of India, (Personal Statement regarding health for Principal Insured under Health Plus policies)Divisional Office Branch Office Policy.

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How to fill out the HI/DGH/1 online

The HI/DGH/1 form is an essential document for individuals seeking health coverage under Health Plus policies with the Life Insurance Corporation of India. This guide provides a clear, step-by-step approach to filling out the form online, ensuring that all necessary information is accurately captured.

Follow the steps to complete the HI/DGH/1 form effectively.

  1. Click ‘Get Form’ button to obtain the form and open it in your browser.
  2. Fill in the full name of the principal insured as required. Make sure to provide the complete address accurately.
  3. Indicate the date since the commencement of the health cover on the policy and answer the question regarding any existing ailment with 'Yes' or 'No'. If 'Yes', provide further details such as ailment description, date, duration, and the name of the doctor consulted.
  4. Answer the subsequent questions regarding current medications, past medical issues, and any health assessments like ECG, X-rays, or screenings.
  5. Respond to questions concerning any life, medical, or health insurance proposals that have been postponed or accepted under special terms.
  6. Confirm your current health status. For non-medical revivals, state your height in cm and weight in kgs.
  7. For female applicants, provide information related to menstrual cycles, miscarriages, and pregnancy, along with the dates of the last menstruation and delivery.
  8. Review the declaration statement. Ensure that it is signed and dated properly, confirming the truthfulness of the information provided.
  9. If the form was filled in a language other than that of the health declaration form, include the declaration of the person assisting in completing the form.
  10. Finally, once all sections are completed, save changes, download, print, or share the HI/DGH/1 form as needed.

Take the step towards securing your health coverage by completing the HI/DGH/1 form online today.

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Declaration of Good Health - DGH Form.

Kindly note that you can check the status of your Service request any time at https://customer reliancenipponlife.com/customer/ or call our toll free number 1800-102-1010 between 9 am to 6 pm, Monday to Saturday We acknowledge the receipt of Declaration of Good Health for your Reliance Nippon Life Insurance Policy No.

Declaration of Good Health” or “DOGH . Means declaration provided by the Member regarding his medical condition at the time inception of the cover in the format prescribed by the Insurer commonly known as Membership Form- cum-Declaration of Good Health.

The Directorate General of Hydrocarbons (DGH) was established in 1993 under the administrative control of Ministry of Petroleum & Natural Gas through Government of India Resolution.

I further declare that I perform all my routine activities independently, that I do not have any history of, have never suffered from, am not currently suffering from, nor have I received, nor am I currently receiving, nor do I expect to receive any treatment, nor been hospitalized, nor do I expect to be hospitalized ...

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