Get India Max Life Insurance Attending Physicians Statement for Death Claim- Form C 2012
YSICIANS STATEMENT FOR DEATH CLAIM- FORM C (A qualified and registered medical practitioner should complete this form. Spouse, or Lineal Relative of the Policy Holder/Life Insured who are medical practitioners cannot complete it) I. General Information 1 a) Name of the Life Assured………………………………………….. b) Age……………………………………… 2. Were you the Life Assured’s usual doctor? If “yes”, please give details. How long have you known the dece.
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